Health update

[lnr]

Doctor confirms I have primary hyperparathyroidism, which is what's causing the raised blood calcium, and will refer me back to the hospital to deal with it, and it's nice that it's been found. Edit: aha, I have the results of these blood tests in the post: serum parathyroid hormone 188 ng/L (14-72 is normal), parathyroid hormone 19.93 mmol/L (1.48-7.63 is normal). I'm not quite sure what the difference between these two is :)

Doctor also notes that my blood sugar *is* slightly raised (6.5, below 6 is normal, over 7 is diabetic), that I have slightly too high cholesterol (7), and that they did some liver function tests which show I may have "fatty liver". Overall together they add up to "metabolic syndrome". I asked about Metformin, which he agreed was a good idea. He also suggested statins. And I also asked if it could be related to PCOS (as I've only had 3 periods since coming off the pill about a year ago and am a bit hairier than I used to be) and he suggested they probably do all tie together, so I'm going back on the pill too (which can reduce the risk of womb cancer as well as because I'm bored of condoms: I only really came off it out of curiosity anyway, since I've been on one form or another of contraceptive pill nearly all my adult life. So I have a paper bag full of drugs.

I'm also encouraged to lose weight, which will help with all of the above (apart from the hyperparathyroidism, which isn't connected to the rest). Interestingly he reckons since my weight is currently pretty stable I'm probably not overeating, but also that I probably don't need to cut back from what I'm eating now once I've lost weight, I just need to make some serious changes to lose it, and then keep my eye on the ball to catch it if I start gaining again. I'm not 100% convinced I won't just regain any weight lost with more on top, which is what I've done before. We'll see.

To round off he took height, weight and blood pressure, which I'll list here to remind myself. 1.70m, 110kg, 135/87.

So I went to the co-op and bought lots of fruit and veg and some fat free yoghurt. I'm now contemplating whether joining Slimming World again is a good plan, even if it's only online until I'm more mobile. And at the same time not sure if this is even sensible or possible, but I really do feel like I ought to try it and see if it does fix the metabolic and cholesterol problems. *sigh*

Comments

[uisgebeatha.livejournal.com]

*hugs*

Sorry to hear you had to come back with a bag o' drugs, but at least it seems all very manageable. And I'm sure I can come up with some low-fat baked goodness to bring round to future parties. ;-)

[lnr]

*grin* well, that's very kind of you. I'm not sure manageable is the word I'd use.

Amusingly I finished a glass of juice I poured earlier and then looked at the instructions on the boxes of pills, and discovered an "avoid grapefruit or grapefruit juice while taking these pills" on the front of the statins. Guess what sort of juice it was? I'll start those tomorrow instead :)

[perdita-fysh.livejournal.com]

Well I'm glad its not cancer anyway! Hopefully the treatment should be fairly straightforward, reading the wikis on it.

If you'd like to lose weight in a shorter-sharper hit than SW, I can recommend (by proxy) Lighter Life. My mum had struggled to lose with both WW and SW even when she was 'good' on them, and my aunt had never tried to lose weight before. They joined LL early last year and both lost all of the weight they wanted to, in the initial 13 week plan for my mum for about 3 stone and about 6 weeks longer for my aunt who lost nearer 5 iirc. They've both regained a little in the year since then, but not a significant amount. The approach is very different to SW, its closed small-numbers sessions which go into your relationship with food and don't discuss your progress within the group, rather than happy clappy 'sarah lost 5lb this week!' and it is total food replacement for the first 13 weeks so your only choice is the method and flavour of your nutritional delivery. I've suggested to G he try it because he's gained lots while we've not been cycling (I have too natch, but I'm hoping for a freebie headstart on the weightloss for me with the breastfeeding *&)

[lnr]

I'm a bit wary of that sort of thing, total meal replacement definitely sounds like a dangerous strategy to me, and I know Karen found the Cambridge Diet made her ill. The counselling may work, but it seems counterintuitive to me to try and fix your relationship with food by replacing one sort of weird eating habits (and I'm not sure I'm even that bad, apart from slightly large portions and a tendency to a few too many convenience foods when we're too tired to cook) with another sort of completely unnatural eating.

[atommickbrane.livejournal.com]

Yeah, I think this too~~

it's not inappropriate to use this icon, is it? (of course replacing all meals w/ a hotdog served to you by a japanese boyband member is perfectly adequate and I would recommend this diet if I could afford it).

[lnr]

Nah. Absolutely not inappropriate to continue to eat nice things around me or talk about them. And I shall try not to bore people with diet talk.

[perdita-fysh.livejournal.com]

The replacement is temporary (and needs to be GP backed and for you to have a BMI over 29 fwiw) and the reintroduction of foods is considered and at a measured pace designed to give an appreciation for portion size and diet balance, from the bits I've seen/read anyway.

It may be though that I find the idea more appealing than many because if I could pop 'food pills' for the normal routine meals and then just take the opportunity to enjoy really good food on the occasion it happens along I'd be quite happy - so the idea of 13 weeks on (essentially) food pills doesn't worry me. My problem with diets so far has been never quite reaching my target so tending to abandon them rather than get there and learn to stay there. So getting there quickly and strictly enough that I don't give up in the meantime also appeals!

As with most things in life though, its whatever works for you, init *&)

[nassus.livejournal.com]

At least it sounds like it's treatable. Funny thing is after reading about your calcium levels I found that my friends mum had tests come back with the same. Turns out she had a benign tumour on her parathyroid which was causing the generation of the extra calcium which has a heap of other rather nasty side effects. She'd have had it for years and now they've removed it they expect huge positive changes (once she gets over the original problem that put her in ICU for a month in the first place).

[lnr]

Yup, that's the badger. I'm expecting the hospital will want to operate and remove the dodgy gland (you have 4, and don't need them all), but we'll see. I'll be interested to see if it does make me less depressed or less fatigued.

[nassus.livejournal.com]

From memory at extremes it could cause depression, headaches, reduced cognitive functioning, grumpyness, quite major personality changes. All of which are reverseable. It'd be great if it helped with the depression!

[naath.livejournal.com]

I dunno about the "stable now so will be able to be stable at lower weight with this diet" thing - my personal experience is that a "diet like this" will lead to a "weight of that" and stabilise there (with changes upwards being rapid and changes downwards slower, but eventually stabilised). Maybe YMMV, it's a big YMMV thing really.

It's nice to have some idea what the issues are, and A Plan and Some Drugs are a useful starting point - here's hoping that they work. Could the doctor not provide weight-loss advice? Given that he suggests weight-loss as a health-gaining strategy it would seem sensible... or is he relying on you picking out your own diet? (I've no idea if slimming world a)works or b)is sane, no comment there).

[lnr]

We'd already had rather a long session by then, and they were a doctor short so had rather more people waiting than usual, so I was lucky to get as long with him as I did. I don't know if the practice has a nutritionist I could talk to. I'll want to go back in a bit and see how the drugs are working too anyway. Having lost 4.5 stone with it before I know I *can* lose weight with SW, and it is a fairly sensible diet which should be pretty healthy.

As doctors go he was pretty good on acknowledging that dieting isn't easy, and that people do naturally come in different shapes and sizes.

I did ask about the idea of being able to eat the same, since nearly everyone suggests you can eat more calories for weight stability when you're heavier, but he seemed to think that the greater energy needed to keep you warm when you're thin would balance out the greater energy needed to move you around when you're fat. All my life I have tended (when not dieting) to be mostly stable then gain a little weight on holiday or something and stay stable at that weight for a while, and repeat, so maybe there's something in it.

[sphyg.livejournal.com]

I'd be interested to know if you get any useful weight loss advice out of your doctor. Mine was useless.

[atommickbrane.livejournal.com]

I just had to look up hyperpara, hyperparathyroidism, and you learn it through a rhyme! "moans, groans, stones, bones, and psychiatric overtones". Cor!

I am glad it doesn't appear to be anything more serious dude.

If you do the online thing, let us know how it works! I am miserably concluding that I need to stick to some proper diet-ism (AND I am rejoining the gym from payday) <-- lol at end of month optimism eh?

[lnr]

Oh wow, I hadn't looked it up on WP so hadn't seen that description. That's brilliant. (Interesting to see if the acid reflux does go away though, that would be brilliant!)

I'm still not sure about the online thing. Part of me just can't quite face the rigmarole of following a proper diet with rules. The class definitely worked for me, first time round anyway, and I made some lovely friends. Good luck anyway, though bear in mind people mostly regain even after successful dieting.

[atommickbrane.livejournal.com]

I'm not sure if I could be bothered either! I'd rather get back to the gym really (EW URGH WOT AM I SAING). Ooh speaking of active, how's the leg getting on?

[lnr]

It's just a pain in the, er, ankle. Not much improvement over the last week, still fine round the house but worse over longer distances and uneven surfaces. I've got an offer of a lift into the office at least some days next week though, which will make a nice change.

[j4.livejournal.com]

*hugs* Sounds rotten, but better to know about it & be able to treat it (as I'm sure you're already sick of people saying!) ...

Can't advise on specific diets but I can recommend getting a fruit-and-veg box delivered, as a way of encouraging oneself to a) eat more fruit and veg (it is particularly nice always to have tasty fruit in for snacking!) and b) cook stuff rather than get ready-meals (cos the veg is sitting there going "eat me" and there's less need to go to the supermarket & be tempted by other stuff).

Unrelatedly, are you in Cambridge over Easter?

[lnr]

Veg box: not a bad idea actually. We do cook real food quite a lot, but usually with no restrictions on eg how much butter is involved (mmm), and often go and eat frozen chips with it because they're easy and tasty. Fresh filled pasta and PIE are probably our main ready meal culprits :)

I will indeed be here over easter. Looking forward to it!

[j4.livejournal.com]

If your oven was as rubbish as ours then frozen chips would never seem easy -- it takes 20 mins for the oven to get up to heat! But "get a more rubbish oven" seems like a silly diet strategy... :-}

[feanelwa.livejournal.com]

I second the veg box idea! And it goes from hmm, carrots, whatever to OMNOMNOM YUMMY ORANGENESS because they are fresher and yummier if it's local.

The obvious advice?

[hairyears.livejournal.com]

Most people have a 'stable weight' in which their appetite and energy expenditure come into equilibrium. It can be difficult to 'reset' it, as more exercise will make you hungrier!

Nevertheless, raising you work rate is a necessary step: dieting alone is never enough for a permanent change. So... Look for opportunities for extra footsteps (ie: always walk to one more bus stop, never take the lift for three floors or less, walk up escalators instead of just standing on the right) and find a regular exercise that you enjoy.

The enjoyment is critical: if you make a 'penance' of it like all those January Joggers and Gym-Joiners, you won't keep it up. I suspect that cycling is the one for you, but you need to include it in an extra half-hour a day of moderate or vigorous exercise.

Have you considered more sex?

Re: The obvious advice?

[lnr]

Do you think advice about walking to the next bus stop is good when talking to someone for whom the nearest bus stop is most of a mile anyway and hence too far to walk when she's recovering from a chipped ankle bone?

I normally cycle 4.5 miles each way for about 50-60 minutes of exercise a day. This is in increase from 10-15 minutes a day before we moved house, and guess what, I don't weigh any less than I did then. And I haven't actually put on any weight in the 3 weeks I've been stuck in the house unable to exercise either. I'll be moving from the first floor to the third at work fairly soon after Easter, but somehow I don't think that's likely to make much difference either.

To be honest I'd hoped that you were right, and the extra exercise of my longer commute would be making a difference, but 6 months later it's clear that exercise alone is not "the answer" any more than you think diet alone is. I can't *keep* adding another half hour of exercise into my day indefinitely.

Less-Obvious Advice...

[hairyears.livejournal.com]

Based on that, you were absolutely right to seek medical advice, and your doctor was right in looking at thyroid function.

I guess the best answer, in terms of your long-term health, is to ignore the conventional advice about 'healthy' weight and the gruesome pictures of fat-clogged arteries that are used as propaganda, and look at getting your cardiovascular fitness (endurance, blood pressure, lung capacity) up to a level that reduces the risk of heart disease etc.

...Which you've probably done perfectly well already. You're certainly exercising more than the majority of the population!

There are other tactics available: one of them is exercising before breakfast, when there's no circulating glucose in your bloodstream, forcing your cells to metabolise fat - but that's something you do very carefully. It's also far, far removed from anything I'd consider 'enjoyable' exercise: the shift from glucose to fatty-acid metabolism is referred to as 'the wall' by endurance athletes. Also: the triglycerides in your bloodstream make you grumpy - this is why small children squabble at breakfast - and you may find that an uncontrollable craving for sugar at the end of the session eats through all the good work. Finally, this avenue of attack might be a complete waste of time if you just don't metabolise fat very well - a very likely explanation for your current difficulties.

Other ideas? Consider the type of exercise: what you're doing is mostly mild-to-moderate, and maybe you'd benefit more from a couple of half-hour sessions of vigorous exercise every week. Anaerobic -sprint-style, red-and-breathless exertion... But it'll be harder to find an enjoyable outlet for that.

And that's most of the useful suggestions I can offer, knee-jerk or otherwise. The guiding pinciple in all of them, dietary as well as 'lifestyle' and exercise, is to seek out pleasurable avenues of 'virtue' - find things to eat and do that you enjoy - because a penitential approach is doomed to failure in all but the small minority of people who are naturally sanctimonious and miserable.

Re: Less-Obvious Advice...

[lnr]

Ah, you must have missed a post or two: the blood tests were actually for *para*thyroid and not thyroid problems, and were done because some routines tests when taking part in a medical study indicated there's too much calcium in my blood. It's hormonal, but it's to do with the balandce between bones breaking down and being rebuilt all the time being off, rather than involving the weight related hormones. The hospital tests had shown normal blood sugar and composition apart from the calcium, which is why this is all a bit of a surprise. (Although not as much as it could be, the missing periods were making me wonder about PCOS which is linked with metabolic syndrome).

Other thoughts: I suspect my cardiovascular fitness may well be rather better than many people my size, but it's probably still not great. I definitely think you're absolutely right that you've got to make your exercise something you enjoy or something that's part of your routine: hence the benefit of the new commute :) I used to quite often cycle to work and then eat breakfast there, which is mainly not recommended due to it being pre-packed sandwiches and hence rather calorific.

But exercise in general is rather out the window until I can walk properly again!

Re: The obvious advice?

[lnr]

Erm, sorry for the slight knee-jerk reaction there!

[gailsedotes.livejournal.com]

welcometothe club...
the metformin will some of the job with weight loss (partially because it will make you feel nausious for most of the day). things to be careful with; fresh fruit, dried fruit, fruit juice - these are all high in sugars and you will be replacing one type of sugar for another and your blood count wont know the difference. "low fat" labels means the fat has been replaced with sugar so watch your labels. ultimately carbohydrates are better than fruit. Me i got a tircycle and now i am one of the biking set. (yes karen you werent halucinating on the way to work - that was me).Don't diet - change your life. just over 1 year ago i was almost 19 stone, today less than 16 and a half. you dont have to do it fast - just forever.

[lnr]

Well, good luck keeping the weight off. I said when I joined SW that I promised myself I wasn't going to be one of those people who lose weight and then go and put it all back on again, but obviously I was wrong. And as someone who already cycles as a primary mode of transport and doesn't binge eat junk food it's kinda hard to overnight become someone who's so fat they need to take two different sorts of drugs. I've always seen myself as fat but reasonably healthy and it's not nice to be proved so completely wrong. I still don't think dieting is good for you, and I'd been promising myself to give it up for the last year or so and my weight has pretty much stabilised, and now that's not good enough.

[gailsedotes.livejournal.com]

what is dieting other than punishing ourselves for not being what society tells us we should be. enough with trying to fit in with vapid chavvy girls we hated anyway and who hate themselves equally!

i found that hypnotist guy helped - very common sense
1. eatwhen you are hungry
2. taste and enjoy every bite
3. stop when you are full
4. dont have to eat everthing on your plate.

nick piles the plates high and i used to feel like i had to eat what was there or it would be a waste. now i dont. he still doesnt get the fact that girls eat half what boys do. but in the last year, i didn't significantly exercise, was careful to cut down on the sugar, took the drugs and the weight came off. the other big significant factor was to remove the stress from my life. the things that weren't working had to go! (like my relationship, got a permanant job rather than contracting...)

enjoy being you!

[lnr]

Um, 2500 calories is not twice as many as 2000!

I personally don't find that trying to lose weight by calling it a lifestyle change rather than a diet doesn't work for me. If it works for other people fair enough. But for the meantime I *do* have to deliberately eat far fewer calories than I actually need in order to lose weight. Changing habits to include more fruit and veg and less saturated fat is something you can try and keep up forever, but for me I need more structure than that to actually lose weight.

But I'm dieting for my health, and not because I want to fit in with thin people, I already fit in with thin people because I don't think weight makes any difference. And I've just bought myself some fab new clothes in the size I am *now*.

[nassus.livejournal.com]

That's one thing I really like about your group is that size, race, sexual preferences and other kinks don't make a sot of difference to anyone - you just take people as you find them. It *is* important to do stuff because you want to because it's healthier rather than being worried about image/fitting in. Got to admit I'd really like to get back down to fitting into some of my old clothes as I have some really nice dresses (as well as the health reasons).

[lnr]

Ah see as much as I like some of the clothes that *don't* fit any more I've mostly got a wardrobe full of things that do fit me right now, some of which are lovely dresses too. If I lose weight they'll stop fitting and I'll have to buy more clothes again. But it will be nice to have a bit more choice, and if I'm honest I do feel less attractive at this size than at even 5-10kg lighter - partly because I really do put weight on round my abdomen and it's just not a very flattering shape.

[1ngi.livejournal.com]

I'm so glad it's not the other! And I'm so sorry that you have to go through all the hospital crap - I hope it is all over really soon and that you feel much better really quickly.

Can I suggest the Food Doctor's Everyday Diet book? It's basically little and often low GI and when I'm doing it properly then I don't get hungry on it. It's an eating plan for the rest of your life thingy and it does an 80/20 thing for treats/eating out stuff.

I kept up with it for a good 12 months and it really helped - slow gradual loss. Sadly I undid a lot of the good work this winter and need to get back on it again. I get lazy about menu planning and food shopping etc etc.

All the best hon xxx

[lnr]

I will definitely be interested to see what sorting the parathyroid out does for how healthy I feel actually. Even if all it changes is to sort out the acid reflux for good that will be a huge positive change, and the literature all seems to suggest that people who do have the overactive one removed feel much better overall afterwards. So despite the idea of surgery and a small scar on my neck being a bit frightening I'm trying to stay positive about that aspect.

I have decided to give the slimming world online option a go for three months: it has the advantage of being mostly familiar, so I don't have to look up *everything* I eat at first, and they've got a new twist to it which actually looks like it will be even easier to follow than it used to be, as well as having a bit of a fresh outlook. They too include a reasonable amount of treats which you can adjust to suit your own lifestyle quite a lot and sell themselves as a way to eat forever. I think I'm still going to find myself really missing bread again!

[k425.livejournal.com]

Not much advice but if you're on enough drugs to make you rattle, get a prescription pre-payment form sorted out - consider how long you're going to be taking numerous drugs and get a certificate to cover. Which reminds me, I need to renew my annual certificate. Er. Last week or the week before...

[lnr]

It's good advice, so I checked the back of the prescription and a) it looks like you can't just buy one immediately, so I'd want to wait until my next lot are immediately due and b) it suggests you'd need more than 4 prescriptions in 3 months to make it worthwhile, and I've just got a 3 month supply with 2 charges, so it looks like at the moment I'm cheaper just paying for them. The contraceptives of course are free.

[gailsedotes.livejournal.com]

on the plus side if you are on levothyroxine - your perscriptions should become permanatly free. low thyriod = excemption

oops sorry wrong way - but still check to see if you are exempt!

[lnr]

I'm pretty sure I'm not, but thanks for thinking of it anyway. They actually checked in the chemists if I was diabetic, since that would also mean I was exempt.

[monkeyhands.livejournal.com]

I would recommend the GI Diet, because it's the only diet I've ever been on and it worked very well for me. I was following the book by Rick Gallop. Although I wasn't trying to lose a lot of weight, I did lose the half-stone or so I wanted to lose and then, more importantly, kept the weight off for a couple of years.

You probably know about it already, but anyway: the point of the diet is to eat things with a low glycaemic index so your body takes longer to digest food and you don't get blood sugar spikes or crashes. There's no real limit on portion sizes, just on the kinds of foods you eat.

I liked it because I was never actually hungry, although I often craved specific things that weren't allowed on the diet. It made me recognise the difference between hunger and cravings. You think you're hungry because you really fancy a chocolate bar, and the diet says "Hungry? No chocolate allowed, but go ahead and gorge on pumpernickel bread and fresh fruit!" Then you think "Hmm, lost my appetite."

[lnr]

The Slimming World diet works on a similar principle: anything that's very filling for the number of calories it has you're pretty much allowed to eat as much of as you like: especially fruit and veg. But yeah, a diet you don't have to feel hungry on is definitely necessary.

I had wilted spinach, lean ham and a fried egg (in a good non-stick pan with no fat) on wholemeal toast for breakfast. Nom. The only trouble is you do have to actually take the effort to plan and prepare much more, because (for example) you can't just grab a cup of soup and a sandwich at work. It would be much easier if I had even a kettle or a microwave I could use.

[glitterboy1.livejournal.com]

That's a lot of stuff to have landed on you. *hugs*

I'm glad that you now know what's going on with your blood calcium - and that it isn't what you were worried about. Between the drugs and dieting (and presumably something more yet to come for the hyperparathyroidism?), it's a lot of things to do, but I hope that they'll help.

[lnr]

Thanks!