Tuesday, January 22, 2013

Return of the Monster Migraine

I am allergic to Vegas. Seriously. I am allergic to alcohol, I break out in hideous hives every time I drink anything containing alcohol and, apparently, I cannot abide prolonged exposure to cigarette smoke, dry weather, and salty food without ending up with a hideous migraine. So, this weekend's trip to Vegas was quite a learning experience.

I have mentioned before that, prior to my weight loss, I got regular, severe migraines. Since I have lost weight those have all but completely disappeared. I will start to get one every once in a while, but they are much easier to stop in their tracks than they used to be. So on Saturday night, when I woke up with the worst migraine I've had since I lost weight, I panicked. I thought I had solved the problem. I hadn't prepared for this vacation like I used to, by packing all manner of migraine medication, because I have not needed it in over a year. Thus, at 1 am, I got online and started to look at natural remedies for migraines. In doing this research, I found a lot of information about migraine prevention. It turns out that quite a bit of what I did to lose weight falls within the scope of "natural migraine prevention strategies."  I had heard most of these suggestions before and I was aware that some of the lifestyle changes I made to lose weight may have played a part in my migraine relief, but a couple of the articles I read put into stark relief just how much these lifestyle changes paralleled the changes I needed to make to help reduce and relieve my migraines.

One suggestion was to increase intake of Riboflavin, which is found in found in milk, meat and green vegetables. One major diet change I made to lose weight was to greatly increase my intake of vegetables and two of my favorite vegetables, that I eat all the time - probably 5 or more times a week - are broccoli and spinach. Apparently, these are great sources of riboflavin. Another suggestion is to increase intake of Omega 3. Part of my dietary change was to increase the amount of fish I eat and decrease the amount of red meat I eat. The fist to which I will default is salmon, I eat it at least once or twice a week. Salmon, it turns out, is a great source of Omega 3.  Drinking more water is one way to help to prevent and relieve migraines. As part of my weight loss dietary changes, I had to start drinking more water. I still do not drink enough, to be honest, but I drink a lot more than I used to. In fact, one of the first things that I did on Saturday night / Sunday morning to get rid of the monster migraine was to drink a LOT of water. Increasing exercise is a migraine prevention strategy and another lifestyle change that I made to lose weight and one that I will continue. Finally, there were several prevention strategies related to reducing stress and relaxation. I have found that several of the activities I do to get my exercise are also incredibly relaxing: walking, hiking, and swimming, for example, are all quite relaxing for me. I always feel refreshed and de-stressed after I am done with a good walk or a nice swim.

So what brought on this monster migraine despite all of my great lifestyle changes, after over a year? I'm not a doctor and only time will tell - but my best guess is that I walked around the strip all day on Saturday, hung out in smoke-filled casinos, and - though I was pretty proud of how I balanced my calorie intake / output for the day - the calories I ate were not exactly healthy. I ate a lot of bread, and a lot of salt, and I didn't drink nearly enough water in Las Vegas' dry climate. I think that all worked together to result in a hideous migraine. Happily, after I drank a huge quantity of water (like 5 glasses), took two Advil, and got some sleep, my migraine was completely gone by 8am Sunday morning. A year and a half ago, that may not have been the case. On Sunday, I avoided the smoke-filled casinos, drank more water, spent some time at the end of the day in the spa, and ate a bit more reasonably (still not great, but went out and bought some fruit to eat) - and Sunday ended much better than Saturday did. No migraine. whew! Hopefully this was a one-time thing, and I have learned how to have a great time in Vegas without the resulting migraine.

Thursday, January 17, 2013


This may very well be the first of a series of these WTF  posts...because just when I think I have everything figured out, my body decides to do something unexpected. So, this blog post will not really provide any brilliant insights, this one is just more of a vent.

I have been sick for a few days. Not on death's doorstep sick, but generally miserable, missed-a-couple-of-days-at-work sick. I had a sore throat, ear ache, headache, fatigue, and felt crappy. So all I've been eating for three days is oranges, minestrone soup (with a little cheese on the soup - about 0.5 ounce of Parmesan), veggies, and Robitussin Oh, and I had a bit of stir fry yesterday with about 2 oz. of chicken, veggies and 1/2 a cup of brown rice. I didn't get my usual workout for three days - but I've been tracking my calories, and I've been well within 1200-1400 calories / day. I should not be gaining any weight. I generally know what to expect from the scale and today, I was expecting to maintain or be slightly down. But low and behold, I stepped on the scale this morning and was UP FIVE pounds from Monday. sigh. WTF?! I do not get it and I'm really frustrated at the moment. I'm at another one of my stupid plateaus, I've been back and forth within this five pound range for like a month and a half. Gah!

Okay, that said, I know how to do this and I am going to keep plugging along. This has happened before and it will probably happen again. Generally when I bounce like this, it is right before I lose another couple of pounds. My clothes are not tight, in fact, the skirt I just had altered 6 weeks ago is a bit loose, so that is a good sign. As long as I don't keep on gaining, I'll be fine....breathe.....okay. I feel much better, thanks to lots of rest, and I'm back to the gym and my routine tonight, and I have a really active weekend planned. So, I'll see where I am on Monday and go from there. This can be a frustrating process, but the rewards are worth it. I've been at this for a year and a half now, and I'm still learning.

1/18/2013 Update: I still have no idea why I was up so much yesterday morning, but I'm back down to within a pound of my low weight again today - whew!

Friday, January 11, 2013

The Big BMI Freak Out

This month, the Journal of American Medical Association (JAMA) published a study done by Dr. Katherine Flegal. The study looked at data related to BMI and mortality.  The study looked at data from studies worldwide which examined the link between BMI and any cause of mortality. The Flegal study found that, while people who were considered to be "class 2" (BMI between 35 and 40) or "class 3" (BMI >40) levels of obesity did indeed have higher levels of mortality for any cause, those with a "normal" BMI (between 18.5 and 25) actually had a higher risk of dying (of any cause) than those in the overweight category (BMI between 25 and 30). And in fact, those who weighed in at a "class 1" level of obesity had no higher risk of dying than normal weight individuals.

Okay, I just spent all kinds of time and energy losing weight and now this #%^@$ study is telling me that I'm not increasing my chances of living longer. And this opinion piece in the New York Times seems to agree! Gah! I'm calling Pizza Hut right now!

I am kidding, of course. Actually, I found this article in Forbes that breaks it down nicely. I find that I really agree with the level-headed, analytic approach that the author takes to the Flegal study.

The problem with obsessing about BMI is that it is not the only indicator of health (note that the study looked at ANY CAUSE of death) Frankly, I hate the BMI. It has been the bane of my existence during this weight loss process because, even though I have lost over 125 pounds and even though I look great and I feel great, my numbers are spectacular (my cholesterol, my blood pressure, my triglycerides...), and I am healthier than I've been my entire adult life, the BMI still says that I am "overweight." Blah! And a big middle finger salute to the BMI.

Though the BMI is useful as one tool to determine a healthy weight, I don't think that one should obsess over it. As the author in the Forbes article points out, there are several other factors that are just as, if not more, important. Cardiovascular fitness, losing fat around the midsection, cholesterol, and blood pressure are all important. Being a non-smoker or quitting if you are a smoker is important. Exercising regularly is important. So, we should not ignore the BMI entirely, it is important as one measure of health.

The danger I can see with the Flagel article and in articles like the New York Times opinion piece is that people who really do need to lose weight will look at these things and decide that they are not really unhealthy enough to make the difficult changes they need to make. Why go through the hard work of changing your lifestyle if the payoff is not going to be a longer, healthier life?  That mindset is dangerous. One thing that I have learned on this journey is that weight loss is a complicated and, surprisingly, controversial issue. Oversimplifying data that shows a relationship between obesity and health risks to the point of overemphasizing the importance of BMI in one's health profile is dangerous. So is oversimplifying data showing that mortality risk is lower for people who are "overweight" according to the BMI.

In my experience, losing weight (and lowering my BMI) has improved my health in more ways than I can count. I used to get migraines, I don't anymore. I used to get winded WALKING up stairs or up hills, now I can run up several flights of stairs without getting winded and I can walk 15-20 miles in a day. I used to get tired quickly and had no energy to do anything by sit on the couch at night - now I am active and go out nearly every night. I'm happier. I have more energy. I look better. I'm more confident. I don't get heartburn anymore. My cholesterol (and my risk of heart attack and stroke) is WAY down. My blood pressure is fabulous. My blood glucose levels are normal (no more borderline diabetes)....and on and on..... So, in the end, regardless of what the BMI says, I'm way more healthy. And it was / is totally worth the effort. So, while the experts are arguing about the importance of the BMI, I'll be enjoying my time learning to swing dance with my husband, hiking (Iron Mountain this weekend!), swimming, and kayaking...all thanks to my weight loss and the health benefits that came with it.

Thursday, January 3, 2013

Post-Holiday Debriefing

Well, I have officially maintained through the Holidays. Huzzah!

I stepped on the scale this morning, and I am actually a couple of pounds down from just before Thanksgiving. Yay! Now, to be fair, there were ups and downs. I seemingly gained about 5 pounds over three days surrounding Christmas, but I'm thinking a lot of that was water weight, given all of the salty food I ingested (tasty, but salty), because it dropped right off after a couple of days back on my normal routine of diet and exercise.

I quite enjoyed the Holidays, and I can say honestly that I do not feel like I missed out on anything at all. I got a helping of all of my favorite foods, and I even had some sweets. I balanced the heavier eating with more physical activity (and I only ate "heavier" on a few of the days, most of the time, I stuck to my routine diet ) Instead of filling my time off with lazy days on the couch, I enjoyed San Diego with my husband. We went on several beautiful long walks and hikes along the coast and we went to Disneyland a couple of times. If you can avoid the junk food, Disneyland and the area surrounding it provides a nice place to walk around and get some exercise on a day off. It did rain quite a lot, and I went to the gym on those days and did Zumba or got a workout on the elliptical.

There were days when I went over my calories, but I didn't beat myself up. I think it is important to learn how to weather days when your diet and exercise routine doesn't go like you had planned without feeling horribly guilty. Hey, it happens. Learn from it and move on. My attitude is that tomorrow will be better. I have successfully gotten rid of all of the excess weight from 20+ years of terrible eating and exercise habits, one day is not going to kill me. That said, the second part is important too - learn from it.  I don't beat myself up, but I try to take note of what went wrong, so that I can avoid it happening again.

Example: I went on a really long walk (17 miles) on one of my days off. After the walk, I had some pizza, WAY too much pizza. It was delicious and I enjoyed it. Had I stopped at 1 or 2 pieces, it would have been perfect - but I could not get full, I was absolutely famished and I had 4 pieces (blushing) of pizza. ouch.  Okay, so crud...that was not the most healthy or productive thing I've ever done. I think my problem was that I did not have a proper lunch because I knew I was going to have pizza, so I didn't pack enough food for my little picnic lunch at the half-way point of my walk.  I just had fruit and a half a cup of cheerios. Um, yeah, not enough sustenance, I'm lucky I didn't hurt myself.   Next time (1) I will pack a proper healthy lunch, with appropriate nutrients (2) I will have a few veggies BEFORE consuming my pizza to help alleviate some of my hunger and to start to fill my stomach before I dive face-first into said pizza, and (3) I will drink a good amount of water with my pizza (or with the veggies before my pizza) to help me feel full faster. These things should help in the future, on the rare occasion that I decide to treat myself to hideous junk food after an intense, exhausting day of exercise. In the end, my calories were not so far over the goal I set, but calories are not the only thing on which to focus. I consumed WAY too much salt and the cheese and pepperoni are not great for my cholesterol. So, lesson learned. Am I going to deny myself pizza forever and ever - no. But, I'll be more reasonable next time I decide to treat myself. This weight loss thing is all a big learning process...and I'm still learning and adjusting.

Happy New Year!