Last week I lost a couple of pounds and this week I seem to have put them back on – despite eating and exercising to plan.

So what am I going to do?

I’m going to keep pushing through until something happens.

I’m going to keep running and walking and journalling and being positive that my health is being improved even if the scale isn’t doing anything positive.

I’ve said it before but I certainly need to remind myself that this isn’t really the “last 10 pounds”.  Mentally, I’m at the end of something but, physically, my body could lose another 25 pounds and still be healthy.   So I just need to keep doing this – and do my best to ignore my projected weight loss figures for March. That kind of counting unhatched chickens only leads to discouragement.

I’m keeping this positive mindset because I’ve been reading up on the subject of visceral fat – the fat that sits inside your body and around your organs.  Here’s what I’ve learned:

• There’s no doubt that I have an “at risk” shape. Even though I have a healthy BMI, I should lose another inch or two off my waist to be really healthy in the body fat department.

• Exercise will work on this kind of fat – even in the absence of weight loss – so I will keep moving whether the scales move down or not.

If you want to read more, look at these Obesity Panacea posts:

• This one talks about how exercise reduces visceral fat even if it doesn’t have a large effect on weight.
• This one talks more in depth about the relationship between exercise and weight loss.

After a full year of waiting and worrying and scanning and waiting and worrying some more, I have a letter stating that there doesn’t appear to be anything sinister about the complicated thing on my liver. I’m not sure I will ever be very happy that it’s sitting there but I know the decision has been made by some top docs.  I could choose to lose 3-6 months of my life and about a 5th of my liver to major surgery but chances of dying during that are about the same as just living with the “thing”.  So for now the “thing” stays.

And my weight?  Well – it seems that I managed to hit that level of stress where I lose my appetite so I still weigh around 145 pounds.  That’s a good thing.  And I’ve decided NOT to test my “ability to gain weight just in case I’m dying” because that always ends badly.

Instead, I’m going to enjoy the feasting ahead and look forward to a happy and healthy 2011.

Merry Christmas.

ps I might just start blogging a little more too.

Well I’m three for three on Decembers being marred by the medical community.  Of course, I’m hugely grateful they exist to screw up every Advent season but I’m tired of having my Christmas plans tinged with anxiety.

This year?  I’ve had yet another liver scan and now an appointment with the liver surgeon.  I know that doesn’t necessarily mean that I’ll be having half my liver removed, yet.

I know it doesn’t really mean anything other than I’m bloody lucky to live near a world class liver unit.

It might even mean that the guessing and shoulder shrugging and puzzled looks about what’s growing on my liver will come to an end.

In the meantime, I would like to eat a loaf of bread a day and drink myself to sleep at night.  (I don’t do that – but that’s the kind of stress it is.)  I’m certainly not feeling like counting points and getting hungry (for ProPoints leaves me VERY hungry indeed) so I’m not losing any weight.

Which, as mentioned before, is a wonderful thing according to all gastroenterologists, for whom weight loss is a sure sign of malignancy.  So my head is a mess and probably will be till Thursday when I go through the stress of finding a new clinic, meeting a new doc and, hopefully, hearing new news.

Until then, I will move when the pavements thaw and I will try to stick to eating small portions of good food and drinking no more than 2 units of alcohol per night. Here we go again………..

Just when the motivation is waning to the point of invisibility, we step over the threshold of our friends’ home and are greeted with a vision of two svelte men who, at our last meeting, were both on the chubby side.  They look great!

The husband and I were both, 1) jealous and 2) inspired to do something about our own chubby situations.

When I got home, I was doing a little wandering through the internet and came across some research on waist circumference and mortality.  It’s summarised in this CBC web article.

The words that grabbed me by the throat were:

Oddly, the strongest link — 25 per cent — was in women with normal BMI. People with bigger waists had a higher risk of death from causes including respiratory illnesses, heart disease and cancer.

I have fussed and fumed in previous posts about where exactly this measurement should be taken but this research seems to have encouraged a definitive answer.  This is the best description I’ve found yet – from that same CBC report.

Waist circumference is measured at a point halfway between the hip bone and lowest rib — about five centimetres above the belly button.

Many people think the hip bone they feel toward the front of the body is the top of their hips but it’s not. By following this spot upward and back toward the sides of your body you should be able to find the true top of the hip bones.

Wrap the tape measure around you in a circle, making sure it is level all the way around. The tape shouldn’t push in or indent the skin. Relax, take two normal breaths, exhale, and then take the measurement. It’s best to take the measurement on bare skin. If you wear clothes, measure it the same way each time.

A waist circumference of more than 102 centimetres (40 inches) for men and more than 88 centimetres (35 inches) for women is associated with increased risk of Type 2 diabetes, coronary artery disease and hypertension.

A healthy waistline is 94 centimetres (37 inches) for most men and 80 centimetres (31.5 inches) for women. Health Canada recommends measuring waist circumferences for adults with a BMI between 18.5 and 34.9 to prevent and manage obesity.

So – at a “healthy” BMI of 24.6, I still have a 35.5 inch abdomen – 4 inches larger than ideal.  I’m not sure I’d be able to get that low but I’d settle for half way there – say around 33 inches.

The main point is that vanity size 8 Gap jeans with their Lycra forgiveability may still fit beautifully but I have blubber inside my body that is wrapping itself around my organs and increasing my risk of an early death.

Guess it’s not yet time to give up the fight.

I’m in my usual countdown panic as I try to tie up things in the UK and think ahead to what I’m going to need for the next 6 weeks in Canada.

And I’m still reflecting on this past week of “stepping back”.

All in all it’s been a good thing.  I’ve been chilled out about food and have lost the weight I gained due to stupid eating.  I’ve done a bit of running and a bit of walking and have enjoyed not writing it all down.

In my “counting unhatched chickens” way, I was thinking that I would have a relaxed week, get a final diagnosis from the senior consultant and then get on with life in whatever direction it was going to go.

But instead, as is normal in these “pre-hatched chicken counting” situations, I didn’t get any news at all from the appointment. Instead,and I quote the consultant, “we are back at square one”, which means that I know nothing more than I knew 6 months ago. I feel knocked back and maybe not quite as reslilant as I thought I was feeling.

But one good thing came out of a not very good appointment.  Firstly, I decided to take the husband into the room just so he could witness what I’ve been up against.  The senior doc was NOT pleased that I was seeing him rather than the other guy but – and this is the new thing for me – I just didn’t care. I think maybe I’m getting to the point where I’m not feeling awkward about being a pain.

Anyway, after telling me that there was no news, he leaned back in his chair and said, “Would you like me to refer you to the specialist liver unit for a second opinion even if it is a bit early for that?”

Old me might have given the decision back to him, asked him if I should wait until his team had had another chance.   New me just said, “Yes, I would.”

New me was also still too polite to ask how I could possibly get a second opinion when I hadn’t had a first one yet. But never mind.  I figure, God willing, I can be rude when I’m an old lady.

The slightly humourous thing about hospital appointments is that, when you step on the scales, everyone is hoping that you haven’t lost any weight. The nurse who weighs you smiles and commends you for not being much lighter than you were 3 months ago, and the doctor comments on how well you’re not losing.  I didn’t dare tell them how bloody hard I’d been working to lose it.  And I was truly glad to know that I could sit there and not worry that the pounds were falling off for the worst possible reason.

Funny old world.

I get frequent emails from RealAge – you know, health news for people with no attention span, which suits me just fine most days.  Usually I read and delete but yesterday I got fed up with the words “a new study” or “recent research” that they throw out there all the time.

One of yesterday’s tidbits interested/annoyed me enough to go looking for the original research.

According to the abstract, the researchers’ hypotheses were:

that dieting, or the restriction of caloric intake, is ineffective because it increases chronic psychological stress and cortisol production—two factors that are known to cause weight gain; and to examine the respective roles of the two main behaviors that comprise dieting—monitoring one’s caloric intake and restricting one’s caloric intake—on psychological and biological stress indicators.

Basically they wanted to prove that dieting fails because both reducing calories and tracking calories increase stress levels.

121 women were split into four groups:

• monitoring & restricting – ate 1200 calories/day and tracked their caloric intake
• monitoring only – tracked their calories but ate normally
• restricting only – were given 1200 calories per day in prepared food so not tracking was needed
• control – ate normally and did not track calories

The results?

Restricting calories increased the total output of cortisol, and monitoring calories increased perceived stress.

The RealAge advice based on this one study?

So while it’s good to think about what you’re putting in your mouth, don’t obsess about it. Watch portion sizes, choose healthy foods, be aware of how many times you visit the snack cupboard, but don’t make things too difficult.

I do get the point about stress and obsessing and fully accept that starvation is bad, but I think the overall advice is pretty poor. And I’m especially pissed off that they make it sound like “eating more” and “winging it” are going to help you reduce belly fat!  BELLY FAT: every woman’s enemy.  I can’t believe that an editor didn’t stand back from both the headline and the advice and think, “Oh no – that could do more harm than good to overweight people who are completely out of touch with how much food they really need.  And using the belly fat thing is probably a little too emotive.”  You’d think. You really would.

Pamela Peeke has come up with a much more reasoned response. And yes, I think it’s reasoned because I’ve had similar thoughts myself.

I hadn’t realised quite how angry that one little email made me.  Maybe we should do some research into the effect of poorly thought out health advice on cortisol levels then we could follow it up with a really helpful headline and a “tip of the week”.

Flatten your belly with this reading habit.

If you want to lose belly fat, don’t read snippets of health advice on the internet.

After four months of appointments, blood tests and scans of the expensive kind, I’m no closer to understanding what I’ve got than when my GP sent me my ultrasound report.  So on Tuesday I decided to take more control of my situation.   I wrote a letter with all my unanswered questions to the consultant and took a copy to my GP.

The GP thing was the best move ever as she was appalled that I didn’t have any answers to fairly straightforward questions.

Then the specialist phoned me at home to ask about the letter and STILL didn’t answer any of the questions. He really doesn’t get it and I think I’ve run into a huge cultural wall.  I’m just not sure which one.

Is it just that he’s a medical specialist and I’m a medical nothing?

Is it that he’s a man who doesn’t like to be questioned by women?

Is it more that he’s a man from a very male dominated Asian culture and I’m a woman?

At first I was blaming the “Canadian in Britain” thing but I’ve worked with a few specialists over the years and not one has been anything other than polite, respectful of my questions and informative.  Maybe it’s the fact that I’ve had such a positive experience of all things NHS (National Health Service) that this has really stunned me.

Anyway, after having told me that my case would go to a committee of other specialists, it now seems that he’s going to have a chat with the radiologist.  Not good enough.

I’m off to Canada for a month but will be in touch with my GP and insist on seeing a real liver specialist when I get back.  I was almost ready to collapse into a depressed heap over this until the husband reminded me that I need to fight for my own health and peace of mind.

So that’s what I’m going to do.

I’m also going to hold steady on the weight thing.  I’m still around 144lbs – pretty much where I wanted to be.  I don’t want weight loss confusing health issues right now.   I am, however, going to get as much fresh air as possible and just walk all I can in daily life until I’m back.

In the mean time, there’s SO MUCH to do before I go.

My very best Lent was back in the early 90s when I gave up guilt.  I decided to be conscious about how many times a day/week/month I felt bad because I was letting down my kids/husband/friends/neighbours/community/the world in general and it was a lot.  So I quit for Lent and have never been that guilt-ridden again.

This Lent is going to take me right up to my next appointment with the specialist.  Tests will have been done, MRI results in.  This is a big ask, but I’m going to stop worrying about it for 40 days and spend that normal worry time working on my spiritual life. If any of my symptoms change I’ll just go to my gp.

Simple?  No.  But that’s why it’s a good thing to do for Lent.  It will require a little faith, a little hope and a lot of discipline.  I will have to interrupt my own thoughts regularly.  I will practice deep breathing and pray as best I can.

What does this have to do with food/body sanity? Everything insofar as stress leads to out of control eating and fear of illness leads to a “who cares” attitude about caring for my body.

I’ll let you know how it goes.

By the way, if the best Lent was when I gave up guilt, the toughest was the one when I gave up coffee.  I don’t think it made me a better human being or drew me any closer to God.

My long awaited specialist appointment can be summed up in the following conversation:

Me: Can you explain the ultrasound results?  My gp said they were unusual.

Doc – with many many years of training:  No. We can explain the usual but not the unusual.  That’s why it’s unusual.

Ok, thanks.  He was actually a good, non-patronising human being but he also wasn’t going to tell me there was nothing to worry about.  Instead, and I quote again, he said, “There is both worry and no worry”, which I’m pretty sure translates to, “It could be something; it could be nothing”.

SO. ……my big challenge is to live as though it is nothing,  even though that not-so-little-voice is BOOMING in my ear that it bloody well could be fatal.  You see my challenge.

So now I’ve said it, I’m going to write as though everything is fine and I will keep doing that until I know something to the contrary.  That’s called “Faking It” and it’s not one of my born talents.  I prefer blabbing out the truth of the matter even if it’s not warranted in that situation.  But this time I’m going to hold it in – or at least express it sparingly and in the right arena.

In the process, I’ve got to get over the feeling that I’m an idiot to concentrate on losing weight if I’ve actually got something seriously wrong.  I actually had a conversation with myself at the gym yesterday and came to the conclusion that I should lose weight and get fit ESPECIALLY if I’ve got some physical thing to fight.

Well, another “duh” moment on this journey.

Tomorrow – WW weight loss cards: the story of my life.

A mildly depressive personality is the flip side of some great blessings in life. I don’t want to stop being creative or visionary. Therefore, I have to put up with the fact that sometimes my mood will dip below “fed up” and into a place that I’d rather not be.

I’m also very very lucky that the dips rarely last more than a few days and I can wake up one morning feeling absolutely fine. Today I feel almost absolutely fine. Don’t know why and I don’t want to put too much energy into figuring it out. Generally, life is exactly as it was yesterday and the day before so I’ll accept the brighter day as a gift and get on with it.

The one thing I do want to talk about is weight and depression. Many people (ie doctors) feel that weight loss is a “normal” sign of depression. Well let me tell you (and them), sometimes it’s the opposite.

As soon as I start sleeping nine hours a night and finding that simply I must feel full all the time, I know it’s time to pay attention, pull back, draw in and take the pressure off – whatever that pressure is at the time.

There was a time when I’d have said that weight gain is a symptom of depression but now I realise that it’s a result of not paying attention when things are sliding. Usually, when I start feeling low, I don’t go near a scale or give a thought to what or how much I’m eating. The result is that I am thrown way off the healthy and sane path and right onto the crazyiness of the gaining and losing pendulum. hmmmmm.

Of course, depression is only one of many many life situations that have caused that in my life. So what’s going to be different this time, now that I refuse to get on the pendulum? I guess, no matter how I’m feeling, I’ve got to figure out how to get of the house, walk to do errands, eat to full but not crazy full. I may not be able to lose weight during a darker time but I can do everything in my power not to make weight gain a “symptom of depression”.

This is different. Thinking new thoughts is like trying on a style of clothes that you’ve seen in the shops but thought could never work for you. I’ve just tired on something and I think it fits.

I’ll walk around in it for a while and see how it goes.

PS/Edit

I realised I felt brighter even before I stepped on the scale and saw the loss. So maybe there’s a connection between water retention and depression?