Diet Update – Week 7

16 pounds down and 76 more to go.

I’ve come to accept that this is going to take awhile, and that there will be a few bumps in the road (like that little bump up there when I gained a few pounds back on our college road trip).

I remember many times in the past when I could not stay with a food program, asking myself “What is wrong with me? Why can’t I do this?”

After all, I had made it though med school and a grueling residency, doing every 3rd night on call, with every other night during my fellow resident’s vacations. (These were the days before resident work rules). I had been on my feet for 36 hours at a time, then went home, slept and came back the next morning to start all over again. After residency, I made it through two pregnancies working full time till term, on call every other night the week before my first child was born.

If I could do that, why couldn’t I stay on a measly old diet?

I think it was because I had no choice in residency and pregnancy but to keep on going. Stopping was not an option, and I never even considered it. After all, you can’t walk out on a residency or a pregnancy and come back when you feel like it, can you?

But dieting – Dieting is another story. After all, if you go off it today, you can always restart tomorrow. My life, in fact, was an unending series of such tomorrows. Every day was the first day of the diet I had failed the day before. (Sounds like a T-shirt saying..)

Now, no matter what happens, I’m on the diet. I have no choice. The food shows up every morning, and I eat it. No going to the market, no running out of the good food and eating the bad instead. No second guessing what I ate or how much I ate. No having to go to meetings or back to a center to weight in and get more food. No having to supplement anything (although I do have an off-program glass of milk in the evening with my snack.) There is just the food. And for the most part, it’s good.

Most importantly, there is no guilt. I felt no remorse when I gained weight on the college trip – I knew I would. But I planned ahead that I would be back at the cottage after that, biking every day and eating healthy. (Which is rarely hard for me on vacations, because I find time to exercise and am just not that hungry.)

I’m no longer living in a dieting tomorrow. It’s today. Every day.

For some reason, I now feel, like residency and pregnancy, that I am on a path on which I have no choice but to stay. It has a clear end (March or April to reach my goal weight) and a clear plan that works. Stopping no longer feels like an option. Putting it off for tomorrow just isn’t a consideration anymore.

I have lot of thoughts about why this is, and what has changed in me. But those are still percolating and this post is long enough.

And a beautiful day and the West Side Bike Path beckon.

Nice to be back.

I’m Still Here

Just a quick postcard to let y’all know I’m still alive and kicking.

Had a very packed week touring colleges in Pennsylvania, Ohio and Illinois, then to our cottage for some R&R – that’s re-decorating (post and photos coming) and relaxation.

Gained back a few pounds while eating road food on the college trip, but have lost most of it again biking this week (a total of 48 miles, some on the Pine Creek Trail and the rest riding loops around the lake). Very much looking forward to getting back on the delivered food plan when I return this week for a few days so I can knock off some more serious weight.

I’ve started a few posts, but nothing is ready for publication yet. In the meantime, I’ve been catching up on my blog reading. I’m especially looking forward to listening to Dr Ramona Bate’s interview on the Dr A show (sorry I missed it live.). I also found out that Linda has published her book (Congrats! I can’t wait to read it.), Kevin, MD has published a fabulous editorial in USA Today (Thanks, Kevin, for being our voice in the mainstream media), Dinosaur Doc is still ranting (I happen to agree with her on this one…) and Dr Val has been admitted to the National Press Club (Congrats, Dr Val!).

On a more serious note, I learned that Paul Levy has really ugly feet, and not all of his readers are happy he posted a photo. In case any of those commenters also read my blog, here’s what I have to say about that –

Have a great end of summer, and see you in September!

Love,

TBTAM

Pink Patch Ads Pulled on AOL and Facebook

After reading my rant against Pink Patch Ads on Myspace, commenter MNetty contacted AOL and demanded that they pull their Pink Patch Ads.

And guess what? They did! (See the comments section of my pank patch post for her letter and AOL’s reply.)

Pink Patch ads have also been banned on Facebook. The Advertising Standards Agency has called the Pink Patch Ads “irresponsible” and claims they promote “bad medical practice”.

“Irresponsible”. Exactly the word I used in my post.

Let’s hear it for the power of the blog, the power of truth and the power of the people!

Diet Update – Week 3

And I’m 12 1/2 lbs down.

Yesterday, I had the amazing experience of not eating all my food – it seemed to be too much for me. “So”, said Mr TBAM (150 lbs since the day I married him..), “Don’t eat it all.” It hadn’t occurred to me. After all, this was the food they were giving me. I had to eat it all, right? Just shows my screwed up relationship with food.

So I gave the second chop and potatoes to my daughter, who declared them delicious.

Things I am noticing

1. Despite losing 12 lbs, I am still fat. Since I was a good 10 lbs over my previously high weight when I started this thing, this should not be surprising to me. And yet it is. I feel so good, I am shocked to look in the mirror and see that I still have a long way to go.

2. You know how we all complain about how fast time flies? Well, go on a diet and weigh yourself every day. Time will CRAWL, I promise you. This is one of the good things about dieting. Slowing down time.

3. The way I feel at this weight today on the way down is vastly different then how I felt at this weight on the way up. Why is that?

4. My ankles have pretty much stopped swelling. Must be the bike riding. (Bardiac cries “Yes!”)

The challenge

I am heading out tomorrow for a 2 week vacation. (Part of the reason blogging has been so scarce – I’m trying to get things done before we leave. I promise I’ll get back to blogging once I get caught up.)

That means no delivered food, and keeping to the program while on the road for a week looking at colleges, then for a week at the cottage. I decided I am schlepping the scale along with me and weighing myself daily. I am also going to keep a food diary. Any other suggestions for eating on the road would be welcome.

I’ve done fine so far on the two weekends I was away at our cottage and cooking for myself, so I’m not too worried about that part of vacation. I’m actually looking forward to creating and cooking new foods.

But even if I screw up, I know that once I return, I’m back on the food delivery program. And that is so very reassuring to me. It also fits right in with what I’ve been reading about in Beck’s book on cognitive thinking and dieting. That we need to get out of the perfectionist mode with dieting. Going off a diet is not a failure, and doesn’t need to turn into a downward spiral of eating out of control. You just get right back on the wagon.

Ordering In with Seamless Web

You’re offering me $100 in restaurant coupons to blog about Seamless Web? The online restaurant delivery service that Andy turned us on to a few weeks ago? That lets me order in from pretty much any restaurant in my neighborhood by just logging and and placing my order? And the food arrives as predicted within 15-45 mins? And I don’t have to stand there with a menu by the phone getting the lady on the other end to hear me over the banging pans and shouting voices? And I discover restaurants I didn’t know existed? And it’s teamed up with Zagat so I know what I’m getting in to if I order in from a new place? And they offer 10-20% discount like the one we got from our favorite neighborhood Chinese place?

That Seamless Web?

Okay. I”ll do it.

Cancer Stats Deliberately Altered

Someone’s been messing around with the cancer statistics in Maryland. Apparently a private vendor, which had contracted to collect the statistics, was responsible.

Here are specifics from the FHA report itself.

..MCR data (for 2001 and 2002) had been deliberately altered between August
2004 and December 2004. Specifically, over 13 percent of all cases in diagnosis
year 2002 showed some sign of alteration, especially cervical, prostate, and melanoma cancer cases. The investigation disclosed that the changes were made
after the cases were initially entered into the MCR by the laboratory facility or provider (such as, changes to the codes from non-invasive cancer to invasive cancer and changes to the year that the diagnosis was made)…

The vendor concluded that these changes were methodical and were made by one or more persons with broad access to the system, and not a result of a random set of events.

As a result of the aforementioned changes, recipients of the MCR data (such as, federal Centers for Disease Control and Prevention, NAACCR, other states, and researchers) were obtaining and using incorrect data.

It’s unclear as to what the motivation was for over-reporting of cancer statistics.

Given all the politics around cervical cancer vacination at this point in time, this information is sure to cause concern, although I’m not sure to what use, if any, the 2002 data may have been put in this regard. Studies I’ve seen that examined the cost effectiveness of HPV screening and vaccination used much earlier cancer incidence data.

Two Weeks and Nine Pounds Down…

and I’m still going strong on this diet of mine.

I actually lost weight while on my own last weekend at our cottage, but could not wait to get back to my delivered food on Monday. When’s the last time you couldn’t wait to get back ON a diet?

This is not to say it has been entirely easy. I’ve had a few shaky afternoons, and the headaches were no fun. My kids have commented that I’ve had some pretty irritable moments with them, but I have to say that overall, I feel much more calm. I did finally add skim milk in the mornings (decaf cappuccino with a bit of Agave nectar) and before bed with my evening snack. With that, the early morning headaches are better.

Health pluses

1. I’m snoring much less already, according to Mr TBTAM.

2. My reflux is better.

3. Most importantly, I am feeling so good. The biking probably has something to do with this as well – three times a week at this point, though I’d like to increase that over time.

Psyching myself out

Tonight was a bit of a milestone for me. We were set to meet a family from Barcelona, in preparation for our kids doing a student exchange with one another next year. I had originally planned to have them all over for dinner, on a weeknight. Which would have meant my running home early from work, scrambling with Mr TBTAM to make something incredible, then worrying if everyone was happy and fed, then cleaning up after everyone had gone (and blogging it, of course…) In an amazing move (you have NO idea how significant this is) I suggested we meet downtown at their hotel instead and go out to a restaurant. It was a perfectly lovely evening, and I had a great time. And ordered a wonderful grilled shrimp on arugula that fit perfectly with my diet.

I realized that a lot of my cooking is me trying to get others to like me. Which doesn’t mean I don’t love to cook, because I really do. But if cooking becomes mostly about doing something I love more than about trying to impress, it just becomes that much more fun, right?

Oh, the things I am learning about myself…

I have just started reading Judith Beck’s book that offers Cognitive Therapy as an adjunct to dieting. Because if I am successful at getting the weight off with this diet, the last thing I want to do is regain it all. Will let you know what I think as that goes on.

What Diet am I on?

It’s probably not important which Diet Home Delivery Service I am using, but if you want to know, you can check out their web site. If you want to see exactly what they are serving daily, go here.

For me, it’s not whether it’s the Zone or Atkins or South Beach. I lose weight no matter what diet I am on. But what I haven’t been able to do for a very long time is stay on any diet. Having someone else take care of the food is what is making this one work for me right now.

More to come…

Who’s Your Mommy?

Apparently, more and more women are nursing each other’s babies, a practice called Cross-Nursing.

I think that it’s just not been our social norm,” said Morgan McFarland, who has been breast-feeding her friend Sarah Griffith’s son since he was just 3 months old. “In some cultures, it is, and you would think nothing of, you know, nursing your neighbor’s child if something happened, or nursing your sister’s baby if she has to go to work.”

While I can understand this practice in primitive societies where refrigeration and infant formula are not affordable or available, or for the rare woman who cannot breastfeed for medical reasons, I see no reason for such practices in the modern society, especially for the reasons cited in this article, namely “community and convenience”.

Breast feeding is an intimate, bonding act between Mother and Child. Why would anyone want to share that with another woman?

Are there Health Risks?

There is little to no data on long term outcomes for infants fed with breast milk from someone other than their own mother. One should not assume the benefits are the same as for infants fed with mom’s milk.

Breast milk contains antibodies unique to Mom and shared to some extent genetically with her child, not to mention growth factors and other proteins. What are the impacts of exposing a child to these proteins from an unrelated individual? No one knows.

More concerning for me is that infections such as TB, HIV and hepatitis can be transmitted via breast milk. In addition, medications taken by the nursing woman also find their way into breast milk.

So if you are going to share your child with another woman, you better be pretty darned sure she is free of infection and not taking any medications that could harm your child. I for one would not be willing to take that risk with my child.

Bottom Line

I see no reason why, in today’s society, a nursing mother needs to share nursing with anyone. There are potentially serious risks and no proven benefits.

If you want community and convenience, then join your neighborhood food coop.

(Okay, Commenters, let loose…)

Fresh Air Fund Asks Your Help

The Fresh Air Fund is looking for families willing to host a city kid on their farm or at their rural home this summer. The end of July is nearing, and they still have about 200 children who need placement.

Further information at http://freshair.smnr.us

Dr Bubbe

Oy! Such tsuris. All these nice, pretty, young patients of mine dating on the Internet. Such nice girls. Why can’t they find a young man to settle down with? Is it so wrong for me, their doctor, to want them to be happy?

Take my patient Rachel H. Such a shaina maidel!She’s 36 years old, and doesn’t look a day over 25! She comes to see me today for her annual check up, and we schmooze a little after her pap smear. You know, a biseleh girl talk…

Afterwards she sends me an email to tell me the visit has inspired a new chapter in her forthcoming book entitled – “Tequila Has No Carbs; and other things that are important to know when dating in New York City”.

I get a little verklempt just thinking about it! Me – in a Book! But I’m going on. Here, let Rachel tell you all about it…
______________________________________________________

So, worse than the scrutiny by my Jewish grandmother as to why I’m not married is the conversation I have yearly with my gynecologist as she looks at my date of birth on my chart and then immediately says, “So, seeing anyone special?”

I look down at the floor shaking my head in shame, because of course, I have also indeed checked the box that says “YES, I have had new sexual partners since my last visit.”

Have you tried “eHarmony? I have a patient who just got married…”

She actually listens with great interest as I explain to her my friend Jen’s marketing theory surrounding Internet dating – and how few men despite how good the date is, are going to commit easily when 7 blondes have e-mailed him between our last martini and the time he gets home and logs on…

I tell her that most men around 40 – fall into a number of categories. After dismissing the divorced with kids, we get to the classic 40 something guy that and all my friends and I have dated – We all know the type – he’s too independent at this point to easily integrate someone into his life – and if he’s attractive and successful – he can get sex whenever he needs it – so why should he settle down?

I mention an exception, a friend that I had dinner with recently whose wife died several years ago… But he’s still getting over it and while he’ll make some girl really happy someday – he’s just not there yet. She nearly jumps out of her seat and says:

“THAT’S THE [type of] GUY YOU WANT!!!”
(and she’s getting really excited and animated now…)

“OR – THE GUY WHOSE WIFE CHEATED ON HIM!”
(at this point she’s squealing so loud nurses are surely starting to detect the conversation behind the closed door…)

“HE’S CAPABLE OF LOVE!!! THAT’S A GUY YOU WANT TOO!”

So I left the gynecologist this morning, one pap smear down, another few years reprieve from my first mammogram, with the following advice:

Place an ad:
Wanted: Damaged Goods.
Has your wife died or left you? If so, call me…
________________________________________
Tsuris = Serious worry
Shaina Maidel = a pretty girl
Biseleh = just a little
Ken Ayina Hora = lit. = without the evil eye, “not to jinx it”
Verklempt = How you feel knowing you’re meeting Barbra Streisand. A voice like BUTTA!

Food Blogging at it’s Best

This post by Shuna Fish Lydon, a pastry chef in San Francisco with a blog called Eggbeater, is quinessential food blogging. It combines wonderfully enjoyable prose (in Shuna’s inimitable poetic fashion), judiciously placed links and photos to create the perfect blog post about the perfect cup of mocha, at a place called Blue Bottle Coffee.

Read and enjoy.

ps – Shuna also made the NY Times this weekend, in an article by Amanda Hesser.

Someone is Feeding Me

I signed on to one of those diet delivery services, with three fresh meals and 3 snacks delivered right to my door every morning in a little black cooler.

The food ranges anywhere from fabulous to just fine (that’s a particularly delicious lunch in the photo up there), and I’ve lost 5 lbs in four days. I’m giving up caffeine in the process (can’t drink coffee without half and half and sugar, so it had to go), so I can’t say I feel fabulous yet, but I expect that will follow.

What I’m finding is that this diet is NOT about the food. The food is taken care of, and it’s out of my control – except for restrictions I might put on it, such as no vinegar because it gives me headaches. The meals are good enough that I enjoy what I am eating, but can’t over eat. I just eat what they give me, and that’s that, on the schedule they suggest.

Which leaves me to deal with the emotions that come up when I can’t use food to stuff them down. It’s the closest thing to going cold-turkey that I can imagine.

I’ve probably cried more in the past 4 days than I have in months. Not about anything in particular, or anything serious – just raw emotion coming up. Seeing Mama Mia last night, for instance, was a real wellspring. (Fun movie, by the way. A bit silly, but hey, why not? It’s summer, and a chance to see Meryl Streep singing and doing air splits and catch a little Colin Firth eye candy.) Maybe it’s just the caffeine withdrawal, but I really think it’s more than that.

Because in the end, my weight is not about the food. It’s about what I use food for other than sustenance. Now, someone else is dealing with the food. Leaving me to deal with the rest some other way.

So stay tuned. This is going to be interesting…

Week 2 Update

Touched by the Dalai Lama

Okay, I realize I am outing myself here, but it’s only for one post and it’s only because my sister writes such a great newspaper column, and I just have to say that this was one of her best.

Go read it and see if he touches you, too.

Love ya’, sis.