SUGAR INDUCED COMA!!!!!

Well, not really a coma but a sudden onset of a need to nap.  Let me explain.  


Today I went back to the gym.  I felt confident enough in my knee's recovery to get back on the bike.  If there was a problem at least I don't have to work tomorrow so I have some time to recover. No need though, I'm fine.  Anyway afterwards I went to rehearsal for our latest opera and did a quick dash to the mall.  Then, at home, we had a birthday celebration for my daughter, Katie.  Amanda, my other daughter made a beautiful rainbow birthday cake. 






It looked so wonderful and yummy that I decided to have a small piece.  It did taste delicious but after not having that amount of sugar in over 18 months it had a surprising effect on me.  I was extremely thirsty and drank a glass of milk.  Then I started yawning uncontrollably.  I had no reason to be very tired at 6 pm but I could barely hold my head up.  I went up to my bed and took a little nap.  For about two hours!  


Dr. Jarrett likes to remind me that even though I have not needed insulin injections since my bariatric surgery I am and always will be a diabetic.  People claim that weight loss surgery is a cure for diabetes but strictly speaking that is not true.  A type II diabetic has a pancreas that produces insulin but not enough.  In addition there is a tendency of insulin resistance which basically means that the insulin doesn't work as well at controlling the glucose level. 


 My gastric bypass limits the amount of food I can ingest and also the amount of nutrients I absorb.  An overdose of sugar-laden foods can cause a reaction called dumping syndrome.  The fear of the dumps made me cautious about eating sugar during the past 18 months.  I've never dumped yet and I don't want to.  I probably should have checked my blood sugar but the battery on my glucose meter is probably dead anyway.  It's been a long time since I tested.  I did not like the way I felt after eating that cake.  The reaction wasn't worth the pleasure of having it.  


I like to say that whenever things go wrong if you learn something from the experience then it isn't a waste.  So today's little reaction to sugar was not the same as a diabetic coma (or any other type of coma for that matter).  It was, however, a little kick in the ass to remind me that I feel better when I eat healthy.  


Love to all, 
Marlena of Mohegan

This Old Man, He Played Three, He Played Knick Knack On My Knee

Back when I was learning to be a nurse we were trained in body mechanics.  This training was to help us safely lift and move patients in a way that minimized trauma to our backs.  "Lift with your knees"  we were told.  I'd known nurses with back injuries incurred at work and have been determined that I would protect mine.  My knees, however, are shot.

I tore a ligament in my knee at a roller disco back in the 1980's.  My orthopedist was pretty impressed that I tore my posterior cruciate ligament because he said it was really hard to do that. Apparently an ACL injury is much more common than a PCL.  Later on another orthopedist asked me if I'd had an MRI at the time of that injury.  I laughed and reminded him that roller disco's did not exist in the same decade as MRI's.

Years of working on my feet, being overweight and "protecting my back" finally resulted in a torn meniscus.  I had arthroscopic surgery on that same knee in the late 1990's.  Since then I've had several episodes when my knee locked up presumably from debris present in the joint capsule.  I've had relief though from injections of synthetic joint fluid.  Before my weight loss surgery this was my best option.  I was so heavy that the orthopedist would not risk knee replacement surgery.  My xrays and MRI's had showed arthritis and worn cartilage.  I really needed weight loss and I was less and less active because of my knees as well as my other, more serious, health issues.

I hadn't needed any of the "Synvisc" injections since before my gastric bypass.  My knees have been much better without the extra baggage.  I have been sticking to the stationary bike rather than more high impact exercises.  I was holding up pretty well until yesterday.  All of a sudden when I went to stand up I had a severe sharp pain in my knee.  It was a spot that never hurt before.  I could barely put weight on the leg and my husband brought me to the ER.

I had hoped for a steroid injection in the knee but, not surprisingly, there was no orthopedist handy on a Sunday night.  Narcotic pain medication was my only option for relief.  I had xrays that showed no acute bony injury but severe osteoarthritis.  No surprise there.  I was sent home and referred to ortho for the next day.

So today I did see Dr. Brand, my orthopedist, and he was able to do the injection.  I'm starting to feel better already.  He was amazed to see how much weight I'd lost.  (I still love showing off).  He had suggested in the past that I get a handicapped parking permit.  I'd avoided it before. I didn't want to admit I was handicapped because I was too fat.  There are so many people who have handicaps that are not self-induced that I felt ashamed to get one.  He still feels that I should get the permit because of the severe osteoarthritis.  I have very little cartilage left in my knees.  We did not talk about surgery today but I expect that subject will arise sooner or later.

This whole episode worries me because I don't want to stop exercising!  I need to stick with my quest for better health.  I can still go to the gym and do my upper body weight training.  Dr. Brand said that with the steroids I may be able to get back on the bike in a couple of days.  I hope so.

Love to all,
Marlena of Mohegan

The Germs are Coming Ha Ha!

I've always felt that there would be less illness if there was no holiday season.  Some of my worst colds and flu in my life have come after the holidays or other interstate travel.  The reason for this is simple.  When something is going around eventually everyone in town is exposed to it and either gets sick or develops an immunity. Then comes Thanksgiving, Christmas, Hanukkah, Kwanzaa, Ramadan and Festivus.  We go visiting, we kiss, hug and slobber germs all over each other.  We cram together in airplanes with recycled pathogen-filled air. We are in crowded, overheated stores handling merchandise that has been inoculated with millions of microbes. Out of town germs mingle with ours and sometimes mutate into new and more exciting creatures.  We dip chips, munch finger foods and cluster at the buffet table.  Not everyone remembers to wash their hands or cover their coughs and sneezes.  The graph below shows increasing numbers of influenza infections in the last weeks of 2011.  

All this becomes painfully obvious in my line of work.  In my 30 years as an ER nurse I've braced myself as the relief from the hectic holiday season settles in and the cold and flu season accelerates with vengeance.  Sometimes I get lucky and I've already had my own exposures early in the season and I sail through this time unscathed.  This year our house got hit with a gastrointestinal affliction which is going around.  It may or may not be a rotavirus but it's hit everyone in my family and delayed my return to my routine at the gym.  


One always hopes when things are passing through our intestines more quickly than usual that the result is unexpected weight loss.  If that happens it never lasts once we're no longer dehydrated so there is no use getting excited about it.  I thought I was well enough to go to the gym last night but I guess all the pedaling on the bike got things to start moving again.  As I was getting off my bike I made a little "fluff" (my sister-in-law's word)  Nobody hears these things at the gym because its noisy and everyone is wearing ear buds anyway.  But by the way the guy on the next bike looked at me I knew that he knew I did it.  Fortunately I got home before anything worse happened.  There is little that is more humiliating than having diarrhea in a public restroom.  


During my time in the bathroom I came up with this little adaptation to a popular holiday tune.  


You'd better not wait
You'd better run now
Before its too late
And the bathroom's not free
Rotavirus is going around.


We're going a lot
Many trips to the pot
Our bellies sure do gurgle a lot
Rotavirus is going around.


There's nasty diarrhea
And really stinky farts
You'd better not come visit us
If you don't want to start...


The run for the pot
Pooping a lot
Tummy cramps and your social life's shot
Rotavirus is going around!


Love to all, 


Marlena of Mohegan

Its Resolution Time Again!

Christmas 2011 has come and gone.  Last year I wanted to reach the goal of 100 lbs lost and I made it.  This year I've lost another 73 lbs.  I did not really have a specific goal in mind for this year but I did want to securely break through the plateau I've been at all through the autumn months.  I'm not so sure its completely behind me yet but I will continue striving to leave it in the dust.

A friend I know from work had a gastric bypass right before Thanksgiving.  She is back to work now and looks great!  She's down 30 pounds.  She said she kept away from people around Thanksgiving and still feels somewhat awkward around holiday foodfests.  I have to say that I no longer feel out of place at the family holiday table or anywhere else.  I can eat most of what everyone else eats with a few exceptions.  I've just adjusted to my plate having tiny portions of everything. I don't touch the desserts and really don't miss them.  I did eat a few Christmas cookies and had about 5 or 6 Hershey Kisses. (I actually claimed to one friend that I did not eat one piece of candy all season but I'd forgotten about those kisses.) I was worried that I might have gained yet I was hearing people tell me I looked thinner.  Well, the scale told me I was down another two pounds!

I went back to the gym this week after taking a hectic Christmas week off.  I enjoyed the relative peace at the gym because very few people were there.  Next week starts the New Year's resolution onslaught.  In January the gyms are crowded to the max.  You can't find a parking space or a vacant machine.  I saw a commercial tonight for Weight Watchers new campaign for male members.  Former NBA All-star Charles Barkley, who has struggled with weight issues, is the spokesperson.  This is a new direction for WW as mostly women show up at the meetings.

One of my friends has vowed to lose 100 lbs this year.  We had an interesting conversation about setting goals.  This friend sets finite goals with specific details about daily, weekly and monthly progress.  I was less than enthusiastic of this method because I feel that once the big goal is reached then behavior reverts to previous bad habits. My friend has a solution for this.  About a month shy of the set goal, a NEW goal is set continuing the reason to keep working.  This, to my friend, is better than perpetual lack of indulgences.  What ever works for you, I'm happy to be supportive.

In my earlier life I've given up smoking, drinking alcohol, tea and coffee.  I've always felt that those were easier to do without than certain foods.  One either is or is not a smoker.  The same applies to alcohol, caffeinated drinks and for that matter, recreational drugs.  While the latter was never a problem for me it certainly is for lots of people. I feel I've made permanent lifestyle changes that I will keep doing and don't plan on stopping anything when I get to a certain point. I really don't need desserts. I can have a sugar-free pudding or popsicle and be fine! (I really like that they've started printing calorie count on restaurant dessert menus. That way I know just how much I'm resisting.)

 I can't forget how miserable I was before my weight loss surgery.  I am back to shopping for clothes in regular stores instead of plus-size shops.  I'm no fashionista but at least I don't need Omar the Tentmaker anymore!

Happy New Year!
Love to all,
Marlena of Mohegan

Merry Christmas to All and to All a Good Night!

Baby Its Cold Outside

As we're halfway through December I'm already ready for spring. One morning as I was scraping ice off my windshield the temperature was 22.  Anyone familiar with the northeast knows that 22 degrees is nowhere near the bottom of the winter weather spectrum.  BRRRRRR!

We've been in our house for 23 years now.  We have a steam boiler heating system and our bedroom is directly over the furnace.  The first time the heat came on we found that our room became extremely hot and stuffy.  I hate to sleep in a room that is too hot and so we turned the radiator off.  Since that time we've never opened it up again and used an electric blanket  coldest weather.  I don't like sleeping with a lot of clothing either and through the years no matter what I weighed I managed to be comfortable.  We've gone through a lot of electric blankets over the years.  In addition when the heat is turned off in our room it distributes to the rest of the house more evenly.

This year I can't take it anymore.  I have been wearing sweats and socks to bed.  Even with the blanket set at nuclear level it has taken me a while to get comfortable.  I've been so cold that one night my husband, not so discreetly, made a little wall with the blankets between us so my cold wouldn't rub off on him.  I finally decided to open up the valve of the radiator.  My husband asked if I thought it was the weight loss that made the difference.  Well, yeah.  170 pounds of insulation makes a huge difference!

I used to think that being cold burned more calories.  It makes sense, right?  You need fuel to make heat.  I read that mountain climbers in the Himalayas or explorers in Antarctica have to eat 5000 calories a day to prevent losing muscle tissue.  Surely that should translate into more calories burned if the thermostat is set at 60 degrees in our house in the winter.  Well through the years I haven't noticed anyone in our home looking too lean in the cold months.  So much for theoretical dieting.

I have given away all my old winter coats because they were too big.  I refuse to buy a new coat before Christmas when I know they'll be on sale the day after.  So in the meantime I'm dressing in layers.  Lots of layers.

My husband couldn't be happier when I gave away my brown microsuede parka.  That coat was a bit of a menace.  It had lots of pockets, drawstrings and flaps. It was soft and very warm but I was always getting caught on things with it.  TWICE I got a flap caught on my turn signal in my Buick snapping the thing off completely.  Now I was much bigger back then and squeezing into the driver's seat was difficult. But this coat just was out of control.  The second time I broke it I didn't even want to go home and face my husband's anger.  The repair was about three hundred dollars each time and I had to rent a car as well.

Another time the coat turned me into a shoplifter!  I went to a pharmacy to pick up a prescription for my mother in law.  When I got out of the car at home I noticed that caught on one of the dangling strings was a pegboard rod with about six Chapsticks hanging from it.  There was a display under the counter at the pharmacy and my coat stole the whole row!  I was way too embarrassed to go back to the store and explain.

When I go to the gym I usually do my weight training first and then the stationary bike.  The week that I went five times I only did the weights three of those days.  I found if I go straight to the bike from the outside my hands are so cold that the sensors on the handlebars don't pick up my pulse.  I have to ride for a while on manual before I can set it to cardio which monitors the pulse and changes the resistance to maintain the target rate.  If I do the weights first I get warmed up sufficiently.

So it looks like it's gonna be a long, long winter. No matter what anyone says I'm not buying the global warming thing until I see palm trees growing in New York.

Love to all,
Marlena of Mohegan

A Little Obsession is Good For You

I've been working very hard this week on breaking through my latest plateau.  I normally go to the gym three days per week for my stationary bike and weight training.  This week I went five days in a row.  I do 23 miles in an hour each time.  So instead of my normal 70 miles a week I did 115.  I continued the weight training every other day.  Previous weeks I tried to keep my pedometer reading over 7000 steps per day by my normal activities supplemented by walking either at the track or around my neighborhood.  When it rained I walked at the mall.  When the weather is stormy my knees tend to protest all that impact.  The cycling is better. Besides 60 minutes of cycling gives me 10,000 steps or more.

 I am determined to continue my weight loss.  I refuse to let go of my momentum.  Am I obsessed?  Maybe. In a good way.  Really.

Several individuals in  my family tend toward obsessiveness.  My husband says he's not truly obsessive he just gets a lot accomplished.  He wishes I'd get obsessed about things like laundry or balancing my checkbook.  It makes him crazy that if I can't find something I don't tear the house apart looking like he does.  My attitude is that it will turn up.  Often if I try to think about something else the location of the lost item will pop into my head.  I feel that frantic searching creates negative energy that blocks the brain.

On the other hand I find it irritating that he insists on rearranging the dish cupboard after I've put dishes away.  When we first got married I tried to make his lunch for him to take to work.  He preferred to make his own sandwiches because mine had too much stuff on them.  He ate a bologna sandwich with only one slice of meat and plain yellow mustard on wheat bread every day for years.  Recently he made the switch to turkey because its healthier.  He's also very particular about the way he mows our lawn or shovels snow.  He gives our kids a hard time if they don't do the yard jobs his way.  (Although I could see his point when one of the kids mowed his name in the grass).  I mentioned these behaviors to my psychiatrist once.  He told me that these things aren't pathological just annoying to live with.

I've tried my whole life to avoid regimented behavior.  I enjoy being spontaneous.  I like that my daily commute goes in the opposite direction of the main flow of traffic.  Of course the fact that I DO commute shows that I'm not really as bohemian as I'd like to be.  Raising a family required some routines.  My husband is an early riser and I'm a night owl.  In spite of that I've worked the day shift for 27 years.  When you love somebody you adjust.

A friend complimented me the other day because he wishes he could sustain the behavior necessary to lose his excess pounds.  He doesn't know how I've kept focused for this long.  I just know that I must continue this attitude for the rest of my life.  I do not plan to reach a goal and the battle is over.  I've made a lifestyle change that must be permanent.  

My voice teacher wrote a book "Singing in Your Sleep" about developing obsessive behaviors that will lead to success as a professional opera singer.  He was telling me at my lesson the other day that when he was learning to sing he was afraid to go to sleep without repeating and perfecting a skill he had learned that day.  He thought he'd forget it during night otherwise.  He tells me that I've never learned to practice this way because I sing for my own enjoyment rather than for a career.  He's right of course.  

Obsessive compulsive disorder has probably been responsible for a lot of scientific and artistic achievements through history.  Overcoming repeated failures or rejections have produced useful technology, literature, music, architecture and discovery.  

Of course, there are limits.  When obsessiveness becomes so time consuming that normal living is impaired then professional help is necessary.  If you insist on washing your hands till they're raw, its a problem. 

 On the other hand, I really do need to start balancing the checkbook.

Love to all, 

Marlena of Mohegan