Monday, April 30, 2012

The struggle with weight

I should definitely talk about my weight issues here, because they are related to my fertility issues.

I was always overweight. Always. Until I was about 26 years old. Throughout childhood, people made gun of my weight and I just grew so used to it because that was the way things had always been. So it didn't bother me. I had no sense of portion control. I thought that if you wanted to eat Oreo's, you opened a sleeve and ate the whole sleeve. It was much later that I realized that the sleeve (about 5 oz) has approximately as many calories as I need in a whole day. I had very little idea of what was healthy and what was not. I never knew that most salad dressings contained a lot of fat. I thought that pasta was good for you. Well, it's not entirely unhealthy when eaten in moderation, but regular pasta that is not whole grain is not the best choice you can make. Plus, I didn't realize that the white sauces were made with so much cheese. I thought they were mostly mushrooms and milk. Not that I ate a lot of white pasta sauces. I always preferred the flavor of the tomato based ones which usually came with little or no cheese.

In February 2007, a friend of mine who was also a coworker asked if I wanted to go to the gym with her. We had a gym right there, in our office building. It was free for employees to use. I had some time to spare. And I still didn't go.

A few days later, a few more girls in the office got together and decided that they should all go to the gym together. This time I went with them. Just to check things out. I don't think I had ever actually been to a gym in my whole life before that.

That first day at the gym was not easy. Being there made it even more obvious that I was the only one of all my friends who was overweight. They just wanted to get some exercise and stay fit, but I really needed to get moving. It also became very obvious that I had very little stamina, especially compared to the others. Obviously, since I hadn't exercised since I was a little kid and had spent most of my life being a couch potato and hating and dreading the mandatory physical education classes in school.

But then, for at least a few days, most of the girls wanted to go every morning and I liked their company so I started going every morning too. Almost every day, there would be one or two people who did not want to go, but the rest of us still went. And then, one morning, less than two weeks into this routine, I went around asking each of my buddies and nobody had the time or inclination to work out. I do not know what happened inside my brain that morning, but I decided to go by myself anyway. A couple of my friends were surprised, a couple of them were much too busy to notice. But that was not important. What was important was that I went and power walked on the treadmill by myself.

I was just beginning to enjoy my morning routine when one fine day, I lost my footing on a staircase and slipped a couple of steps. I hurt my left ankle. No big deal, I initially thought. I had slipped and twisted my ankle a number of times while I was in college.I had twisted both of them, actually, but thankfully never both at the same time. So I figured it would just heal on its own in two or three days with a little extra rest. I would prop it up on an extra chair in my cubicle and avoid walking around unless it was absolutely necessary.

It took me about three days to acknowledge that the pain in the ankle was increasing instead of decreasing. And that I needed to see a doctor for it. Until then, I had been using spray-on pain relievers and crepe bandages. No pain killers or anything else. I had a strong tendency to not ingest any medication or go to a doctor unless something was definitely, seriously wrong with me.

I finally went to see an orthopedic doctor near where I was working at the time. They did an X-ray and told me to take it to the doctor so he could analyze it. He told me I had a hairline fracture in my left ankle. He said it would need to be in a cast for about four weeks. He would put it in a cast for me and give me strong pain killers for three days, and also recommended that I would have to be on bed rest for the next three days. After those three days, I could go about my usual every day activities but I was not supposed to get the inside of the cast wet or do anything extreme that would run the risk of breaking the cast. But I was still supposed to take it easy and rest the ankle as much as possible.

He asked if I had any questions before he put the cast on. My friend, who had accompanied me to see him, wanted me to get a second opinion before getting a cast. But I was in an especially excruciating amount of pain that day and wanted to get the healing process underway as quickly as possible. The only thing I wanted to ask him at that point was if I could go to the gym after the three days of bed rest. Of course, it must have sounded completely crazy to him and to my friend at the time, just as it does to me now, but at that time, I had just found a strong passion to be healthier and look better and that passion was getting its way with me. The doctor did not laugh at me or anything but very calmly stated that I should hold off until my ankle was healed.

The process of getting the cast was a huge relief. The plaster that they used to set the cast in place was warm, and it reduced the pain greatly. Very soon, it was set and in place and I immediately saw what a huge difference it made. Since the pieces of the broken bone did not move against each other any more, the root cause of the pain was now gone. I could walk around without pain. Of course, it was a whole different ordeal to carry around the weight of the cast, which seemed quite heavy at first. And it was also not easy to walk without moving the ankle joint. That put a lot of pressure on my knee because the knee joint had to do the work of both the knee and ankle joints single handedly. My friend filled my prescription for the pain killers for me while I sat in the hospital lobby. I am so thankful to her, she took so much time out of her work day to be with me the whole time.

So I resigned myself to four weeks of waiting for the cast to work its magic on my ankle before it was taken off. The first few days, I was very uncomfortable walking around and even drank a little less water than usual so I wouldn't have to go to the bathroom quite as often. I learnt to cover the cast with plastic bags so I could take a shower without getting it wet. It was the month of May, and I lived in a sub-tropical climate, so my foot would get quite hot and sweaty inside the cast. Just another reason to stay inside the air conditioned office instead of joining my friends on their post lunch stroll.

But after a few days, I got used to the cast and could walk at a reasonable pace with it. I found an old pair of my brother's athletic sandals that I could fit on the injured foot over the cast. I did look funny wearing his sandal (which was two or three sizes too big for me) on my left foot and wearing my own sandal on my right. But I am sure I already looked funny enough with the cast and the crooked walk. Not too many people noticed the mismatched footwear. A coworker who saw me on a daily basis noticed it after about a week.

Two weeks later, I went in for another X-ray and saw the doctor after that. This time I felt well enough and normal enough to go by myself. The doctor said it was all healing well, and I could have the cast off in another week if I wanted to. But I had to promise not to do any heavy exercise, climb stairs or drive for the fourth week. In spite of the fact that I could walk at a reasonable pace and do everything else that was important, I was more than ready to get rid of the cast at that point. It was getting hotter every day and the layers of padding inside the cast did not help. I wanted to be able to take showers more freely. And the top edge of the cast hurt the lower part of my leg if I moved in certain ways. Because of that problem, I found it very uncomfortable to go up and down flights of stairs. I told the doctor that I did not climb stairs even with the cast on, even though I was allowed to, because of the edge of the cast bothering me. I did not drive because I could not feel the clutch or the brake when I needed to press them, and I did not know how hard I was pressing them. So, basically, since I couldn't do those things for the fourth week even with the cast, and I'd be much happier without it, I could certainly avoid doing any of them if he took it off a week early. And so he did. The first thing that I could feel after it came off was a sense of relief at the fact that the skin on my foot could breathe now. I could scratch it without using a plastic foot ruler. I could wipe the sweat off if I wanted to.

It took a few hours to realize that I would need a little more time to go back to walking normally. See, after three weeks of learning to walk without bending my ankle joint, I was just so used to walking that way that I had to learn how to walk normally again, now that I had the use of the ankle joint again. The foot still hurt if I walked around too much for the next few days, but the pain was nowhere near what I had before I first saw the doctor. It was about a month before I was comfortable going to the gym again.

Since the time I first started working out, I made a few changes to my diet. No sweets and nothing fried on weekdays. Fewer carbohydrates and more protein. But I let myself eat whatever I wanted on weekends. With just these changes, I did begin losing weight in spite of the forced break from exercise. I didn't really notice it at that point, but people whom I saw only occasionally began to notice. At that point, I learnt that taking charge of my diet was more significant than exercising for my weight loss journey. Think about it. It takes a few minutes of leisurely sipping to finish a can of soda, which has about 150 calories or more. But it takes half an hour of really fast running to burn those calories. And I have never been able to run that fast for that long. It usually takes me about 45 minutes of moderately fast jogging interspersed with slower walking to burn off 150 calories. When you think of it this way, you realize that it is so much easier to pass up the can of soda than to do all that running.

For about two years after that, I kept up my routine. No sweets or fried food on weekdays. Jogging on the treadmill every weekday morning. I allowed myself to indulge in special occasion foods, like a friend's birthday cake. But I also made sure that I made exceptions only when the occasion was truly special, and did not let every other day become a special occasion.

It was a moment of exhilaration for me when I went shopping and realized that I no longer needed to buy plus sized clothes and had transitioned from XL sizes to L. But I did not buy too many of those because I knew that I was not at my final goal. I did not really have a clear sense of my final goal at the time, but I knew this was not it.

When the size L clothes began to hang a little loose on me, I decided it was time to get some new clothes for myself. In the dressing rooms that day, I saw how nicely the size M shirts and pants were fitting me now. I saw what I had been missing all those years and never knew that I was missing it because I had never had it in the first place. I tried on a top with a raspberry colored paisley pattern on a white background and I just felt so pretty in it that I did a little dance just for myself in front of the dressing room mirror. The other great thing I realized that day was that I could now find my size in just about any style of garment in just about any store. I know some of this may sound shallow, but for me it was bigger than just the pretty clothes. It was about feeling good about myself and my body, about knowing that I had the willpower to lose all that weight, about feeling healthy and having a strong sense of well-being. All those years, I never knew or thought I had the willpower needed to pass up a decadent brownie or an ice cream sundae.

There were a lot of things that were great about my weight loss strategy that worked for me, but there were some things missing. I was still afraid of stepping on a weighing scale. I had never weighed myself during all this time. Never. Not ever. Some of my friends estimated that I lost about 35 pounds during this time, and I think it may be pretty close to the truth, based on how much I lost later when I started weighing myself and how that loss felt to me. Also, I gave myself a free run on weekends. That wasn't always the best idea. And so, a little over a year into my routine, I noticed I wasn't losing any more. I wasn't gaining any of the lost weight back as far as I could tell, based on the way my clothes fit, either. But I was still working out and feeling healthy. Now when I say working out, I mean a light jog for about half an hour, maybe 40 minutes on some days. I had been doing this for quite some time and it never occurred to me to pump up my routine. To increase the intensity or duration. Or to simply change the kind of activity I was doing.

At this time, fitness temporarily took a back seat because I was getting married and moving to a different country on a different continent. There was so much to do and the first thing to think about was not usually related to what I was going to eat or when I was going to go to the gym.

Once I was married and somewhat settled into the new place with my husband, I started visiting the gym in our apartment complex somewhat regularly. I was working out, I was eating mostly right, but I didn't seem to be losing any more weight. I must mention again that I had still never weighed myself, but I had always been able to tell that I was losing weight based on how my clothes fit me.

Around the same time, I came across some articles and other tidbits on the Internet that talked about how women's weight and fertility were linked. I read about how the excess fat releases extra estrogen, which can prevent ovulation. At this point I still did not have extremely regular cycles and came to think that the weight definitely had something to do with it.

We were definitely not yet thinking about having kids but I had been trying to lose the weight on my own for a while and I thought that losing excess weight couldn't be a bad thing and I wanted and needed to lose it. I knew it was time to look for a different approach. That's when I joined Weight Watchers.

Weight Watchers is an organization that has helped lots and lots of people attain and maintain their weight loss goals. They have helped me in more ways than one, in more ways than they probably know about. First off, I was not working for a while after I got married because of work visa time lines and going to Weight Watchers meetings gave me something productive that I could go outside the home and do. I made a few friends there who would ask me how I was doing with my weight loss and cheer me on. My original meetings leader was a very encouraging and supportive woman. I should mention that I attended a few meetings with other leaders from time to time and did not find another leader who was quite as engaging and encouraging as she was. She was definitely part of the reason why I stuck around and went to meetings just about every week.

Going to weekly meetings also means getting weighed in every week. The weigh in is confidential and no one else in the meeting room has to know about it unless you want to share. But just seeing that number for yourself makes you a little more accountable. Plus, since you see your progress on a week by week basis, you can go back and see what you ate that week and how much you exercised so you know right away about what works and what doesn't. They give you a daily points target (based on your height, age, current weight and so on) and recommend that you track everything that you eat and drink and all the exercise you do. It can sometimes be surprising when you see it all in black and white. You may discover some gaps, large or small, between how healthy you think you're eating and how healthy you actually are eating. I discovered a few things about my eating patterns that way. I had read earlier that breakfast should be the biggest meal of the day, lunch should be moderate and dinner light. That is sound advice and I do still try to follow it as far as I can, but I saw that I had basically been giving myself a free hand and eating whatever I wanted at breakfast. I would usually eat a healthy breakfast but I was usually eating too much of whatever I was eating. Eating too much of even the healthiest foods is not necessarily healthy. The calories do add up. The other important thing I discovered was that I wasn't getting enough protein in my diet. That was a side effect of eating mostly vegetarian food and not always eating beans or lentils.

With Weight Watchers, I learnt that getting steady feedback was important. The weekly weigh in was a source of constant feedback and it told me what I was doing right and what I wasn't. I did not often share my weight loss for the week with other meeting members, but I did share when I reached a significant milestone like losing 5% of my original weight, or losing 10 lbs since I first joined. They split the whole thing up into mini milestones or mini goals which seemed more achievable than the ultimate goal. That was something I had been doing for myself before and I knew it was helpful. When I started out, I did not even know my ultimate goal and they did not ask me to set one. They wanted me to lose 1 lb at a time, and, whenever I was comfortable, I could pick a target weight that was a healthy weight for my height and that I thought I could comfortably maintain and write that down as my goal weight.

I also learnt that, on the Weight Watchers plan, no foods were struck off the list of foods that you could eat. They encourage members to eat all kinds of food items in moderation. They want you to make sure that you get a certain number of servings of fruits and vegetables, dairy, lean protein and so on every day, in order to make sure you're getting all the nutrition you need, but, beyond that, if there are points remaining in your tracker, you can go ahead and indulge in chocolate, or cake, or whatever strikes your fancy. Each food is assigned a points value depending on things like its fat and fiber content. Naturally, that means that if you change the portion size of the food item, the points value changes. So you can play around with your day's eating regime and see how much of what you can fit into it.

I learnt that getting into a monotonous rut in terms of either eating or exercise or both stalls your weight loss. You need to change both of these every so often. It is okay to eat fatty food once in a while because that works to change the eating routine. It surprises your metabolism and wakes it up from its dormancy. With exercise, I saw that changing the intensity or the type of activity I was doing was essential. I did not always increase the intensity, sometimes I would decrease the intensity for a week and go back to the original intensity level the next week and that worked too.

When I lost about 18 lb on the Weight Watchers program, I was, according to their charts, in the healthy weight range. This happened a year after I got married and about three years after I first started trying to lose. This was the very first time in my life that I was not overweight. And right about then, I started to get regular cycles. Not like clockwork, not predictable to the day, but more or less every 30 days. That was unusual for me, and hadn't happened to me in a long time. That was the beginning of how Weight Watchers was helping me. More on that later.

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