Thursday, March 18, 2010

Not the answers I wanted to hear

As a result of my lovely cancer and other medical adventures, I have gained weight and now weigh more than I have ever in my life. I have tried to eat healthy, blah, blah, blah, and it hasn't worked so I broke down and went to a dietitian yesterday for some help. She looked at my medical history and the list of medications I am on and said it will be very difficult for me to lose weight. Ever. Why?

- Because three of the medications I am on cause weight gain. I asked why they cause weight gain and she said they don't really know - whether they interfere with how food is digested or what.
- Because I don't have a thyroid so they can't really help me increase my metabolism to help lose weight.
- Because of my back, ankle, and arm issues, increasing workouts is not advisable with out help from a physical therapist.
- Because other issues in my medical history make it difficult to lose weight including menopause (thank you chemotherapy for that one).
- And, when/if I have ankle surgery and am in a boot/cast for three months, I can hope to only maintain and not really continue to lose any weight.

Which by the way, if I maintain a strict low fat, low calorie diet, I should hope to lose around 0.5 lb/week. That wasn't in the script - she was supposed to say here's a plan that includes yummy foods and will result in a skinnier you in three months.

In the meantime, she said I should take my food journaling online and use to track what I eat and see what I am eating. I started this yesterday and learned an interesting fact - its not meals that are doing me in but snacks. No more snacks unless they are fruit and vegetables.

Oh, and this is a permanent lifestyle change, not a short term solution. Bummer.


Judie said...

It is so hard to lose weight - I'm sorry you got the answers you did. I haven't heard of but the USDA also has a food and exercise tracking thing that I use everyday. I think I sent you this before?

Anonymous said...

How very clever of you to go to a nutritionist!! How incredibly useful it is to know that you are fighting with some implacable foes--your meds and ankle/arm medical issues. How practical to review all dietary intake and realize that those darling little snacks add up! And 1/2 pound per week is 50% of what the average dieter aims for, so it will take you twice as long, but IT CAN BE DONE. All in all, you should be giving yourself a BIG pat on the back for a job well done yesterday!
This is not bad news; it is just factual news, which must be dealt with, and you can do it. Your practical and caring thoughts on this complex medical situation neer fail to inspire me. /rt

Ann aka ButDoctorIHatePink said...

I've never had a weight problem and certainly don't have all the other physical problems you do. I am in chemopause now though, and wondering if I will start to gain weight. Because of the kind of reconstruction I'm having, with only one breast, it's very important that my weight remain stable for the rest of my life. So, I guess I'll have to buy my first scale ever and start to pay attention.

Good luck to you on your endeavor. Fruits and vegetables are what I crave since I can't eat them due to low whites. I can't wait until I can bite into a juicy peach!

Dee said...

Hi Caroline,
I only just started reading your blog . . . I've known I've had metastatic breast cancer for two years.

Anyway, I am reading a book entitled "Anticancer: A New Way of Life". The author is a big proponent of a diet that is comprised of "anti-inflammatory" foods, such as fresh fruits and veggies, but also other things like soy, tumeric, flaxseed, red grapes (or wine), dark chocolate, blueberries, and "stone fruits", among a few other things. He explains that our modern diets are so full of processed foods (full of corn syrup or oils) - and meat raised on corn and soybean feed - that our balance between Omega-6's and Omega-3's is disrupted so that we have five times as much Omega-6's as Omega 3's. They are supposed to be equal. These Omega-6 foods are implicated in creating inflammation in the "terrain" of our bodies and this inflammation makes it easy for cancer to grow, as well as obesity, diabetes, and heart disease. He cites a study where a group of diabetic and overweight people are given the exact same diet - except that one group is given meats and other foods high in Omega-3s. This group lost 1.6 pounds a month (I think that was the unit of time) even though they ate the exact same foods. I say all of this because maybe by eating foods that are anti-inflammatory, you could lose weight a bit easier. Just my two cents . . . I would recommend the book, though. It's an interesting read.

Lisa said...

I was diagnosed metastatic in 2000 at the age of 35, and one of my first thoughts was "Well, at least I'll lose some weight". Nothing could be further from the truth as you all know if you've been through b.c. treatment with those darn steroids! I ate like a horse and was unhappy with my weight for many years. In 2007 my husband and I decided to lose weight together and we did LA Weight Loss. We each lost 40 pounds and have managed to maintain it - but it's work. You can NOT go back to your old ways :)

You don't have to exercise to lose weight....I'm metastatic with lots of bone involvement and there's not much physically that I can do. I pretty much sat on my arse and ate all day - and lost weight. My problem was that I wasn't eating enough, or the right things. LA WL is good because if you are a b.c. patient/survivor they will NOT let you use the majority of their supplements and bars (because they have soy in them). I didn't use any supplements (except Calcium) of theirs and I did just fine. I started the program in February and had lost 40 pounds by late July.

I have discovered that my weight goes UP in the winter and I think it's because I'm even more of a sofa slug during the winter months. Daytime tv, reality tv, internet....I laze around and am not nearly as active as I am in the summer when I can fiddle around in the garden every day.

Be sure to talk to your doctor if you are considering doing something from a weight loss company/program or a book - they can catch stuff you don't know about. If you can get help from a Registered Dietician or your family doctor you'll know you're on the right track.

With respect to the email from Dee, please be very careful about using soy & flax. They both have natural estrogen in them (phyto-estrogens) which you may want to avoid if you are ER+. The "jury is still out on soy" and it's best to use stuff like this in moderation or avoid it if possible. It's not going to hurt you to have it every once in awhile but you likely shouldn't make it part of your regular diet because of the natural estrogen's that are in soy and flax.

Bottom line: lower your sodium & sugar intake, eat breakfast, a snack, lunch, another snack, supper and then another snack (nutritious snacks!). Try to have protein of some sort with your meals (peanut butter works!)and make SURE YOU DRINK 8 CUPS OF WATER EVERY SINGLE DAY. I swear I just pee'd all the weight out!! I still drink 8 cups of water every day, three years after losing the weight.

I was never concerned about my weight because I was just happy to be ALIVE...but with a partially collapsed vertebra I began to worry that my weight would compromise my spine's stability.

Do the best you can and what you feel is right for you at this point in your journey. It's a long road after chemo physically AND mentally so take the time to get back on your feet before worrying about things like your weight, and just keep kicking cancer's BUTT!

Dee said...

@Lisa, I've read that the juryis still out on the issue of soy. However, the author of Anticancer does discuss the issue of phytoestrogens in soy and flax. He said that these phytoestrogens are only about 1/100th as active as our body's natural estrogen and I *think* he said (but I'd have to double check this) that the phytoestrogens somehow are anti-inflammatory - and work against our own estrogens and xeno-estrogens, which are inflammatory foods. In other words, he felt the phyto-estrogens contribute to an Anti-Cancer diet and are good for you, as compared to our body's and xeno-estrogens. The author is an MD/PhD and did a considerable amount of research - the book is well-referenced so that you can look up the original studies yourself.

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I started this blog when I was diagnosed with breast cancer in 2007. Blogging really helped me cope with my cancer and its treatment. Howe...