Welcome!

If you are new to Total Knee Replacement recovery I suggest that you read from the bottom up (starting July 2011). As I get further into recovery it becomes more about the new ME rather than the new KNEE! I hope you enjoy this blog and I welcome all your comments!

Tuesday, April 15, 2014

LAST day and on to a NEW START

Well I made it ... almost perfectly.  I told the dietician today that the worst day (ending up in a binge) was the day I transitioned from 2 scoops x 3 to 1 scoop x 2.  I told her it was the first time in three weeks that I was hungry and when I walked through the door at night I hit the kitchen and didn't leave until it was bedtime.  She is going to do some research on the available protein shakes and recommend one for me to have as my afternoon snack on the way home from work.  Just getting rid of that afternoon hunger will work wonders.

So we got started on real eating today.  It was only a half-hour meeting so we didn't go into depth (I have a 2 1-hour meetings coming up and we will go into more depth).  The highlight of it is to count carbs for starchy vegetables, fruits, and any non-gluten grains that I might eat.  20g for each meal and 10g for each snack.  Of everything I have ever counted in  my life carbs has not been one of them so it something totally new for me.  Also fruits are limited to two a day, and the carbs are so limited all in an effort to get my glucose lower.  It was 112 at last testing and the doctor said they look for 75 (yikes! I have never seen that number!).  She said it would also be great to have at least 18g protein at each meal.

I am also going to experiment bringing the following into my eating: eggs (YAY!), beef, pork and cashews.  The dairy she wants to put off for at least another 60-90 days.  Surprisingly enough I am not sensitive to ALL cow's milk dairy.  I can handle Swiss cheese of all things.  She said that in addition to the dairy sensitivity that I do have that dairy causes inflammation.  On the way home I shopped for goat cheese, sheep's milk pecorino and organic cheddar.  I am not going to go overboard on any of them but a little bit goes a long way just a small addition to a salad.  Alas, my cappuccinos must wait BUT she told me of a way to make a latte that I am going to try. Oh - I bought an egg replacement powder that I am going to use with my morning muffins.  If it works well I actually won't be in any rush to add bak the eggs.  AND I can use ghee as long as it is casein free - got that too.

I was concerned that I would have to count carbs in green vegetables but I don't so that will make cooking easy and I can get back to my creative Paleo ways.

So all in all, a good experiene.  My goal was to blog throughout the detox and I have and now I am going to take a break while I figure things out.  I will be back periodically to update my experience (maybe) - thank you for thoseo who have followed along up to now and for offering your encouragement.

Thank you!
Miriam

Monday, April 14, 2014

Where did the time go? I am at day 27

Almost finished!  I think I must have miscounted somewhere along the way because I am at day 27 today and tomorrow is THE END.  

I had one near miss, one collision and one fatality this weekend.

The near miss was that yesterday was Sunday morning, I was so desperate for my relaxation "ritual" so I poured a cup of coffee, added my creamer, Splenda and Starbucks flavoring.  I put it to my lips and took a small sip.  I looked at it and said - what would be the point... and poured it down the sink.

The collision was that yesterday was our Passover Seder.  I made a chicken dish that I couldn't eat (because there was sesame and sugar in the sauce).  With all the recipes and cooking I do you would think I would have made something "safe" but all I could think about was how I was going to have my cousin's wonderful brisket.  I don't know how many of you are familiar with the goings-on at a Passover seder but from appetizers to desserts probably no less than two dozen different foods hit the table.  I had NOTHING but the steamed string beans that I brought (I did have a shake on the way there so I was sure to not be hungry!) and two pieces of brisket.  As I raised the fork to my mouth my husband quietly said, "I thought you are not supposed to be eating beef."  I didn't even THINK of that ... all that was on my mind was NOT eating the chicken!  Let's just say I savored every single bite of that brisket - guilt free, knowing that there probably was little damage done since I had eaten NOTHING else from the meal.  (Side note:  I was extremely gassy all night which has not happened since starting the detox... which either means that the beef FINALLY got things going or that my stomach was complaining about having it added back... the two might be one and the same! I will ask the dietitian tomorrow.)

The fatality was those darn cookies after I was already ready for bed.  However, I did not have a huge binge.  Just a few.  But I also had a small amount (I swear) of chocolate covered raisins.  In one of the programs I have worked with this past year, the teacher says "Of course you eat at night.  You are so exhausted from being good all day."  You would think after being good all day I would have stopped myself.  But I just had a little bit (HONEST) and didn't feel bad about myself.  I wonder what the dietitian will say tomorrow - if she follows the 80/20 rule - or even 90/10.  If I had outright allergies I would be stupid to put myself in harms way, but I am curious whether there will be a little leeway once I get started on normal eating.  

The thing of it is, once I am off detox and can go back to my full Paleo cooking I am pretty sure that I won't be having (too many) lapses into sugar and flour because I will be so much more satisfied during the day.  I won't be fighting to stay on a restricted program.  I am actually very proud of myself.  I can count on one hand the number of times I went off the program (three being yesterday and a fourth when I had that horrible binge last week).  Other than that I have been true to the program - even way better than the 90/10 rule would be.  I had someone compliment me today on sticking to the program.  I am happy to say I basked in the compliment of the 90% instead of bringing up the 10% and hanging my head!  That in itself is an accomplishment.  

Tonight I am going to take out some of my favorite Paleo cookbooks and bring them to my appointment.  I am hoping that I can go back to full Paleo eating, with restrictions only on the worse of the offenders (eggs and honey... unfortunately very important...).  I am sure I will have to restrict the full sensitivity food list but I am hoping that we are talking moderation and not total cutting out.  We shall see...

Miriam


Thursday, April 10, 2014

Day 22



I had a FABULOUS visit this morning with my new primary care – she went over all my results and OMG… so much going on.

I think the most important thing is that she is giving my thyroid medication that I will start tomorrow.  Even though the numbers are in the “normal” range and that is why the endocrinologist said everything is fine, in fact, the number is NOT fine.  She will retest that in a couple of months.  Then she definitively diagnosed metabolic syndrome which is why my glucose, insulin, adrenals, etc. are all out of whack.  She did prescribe supplements for that and when I am retested again for the thyroid hopefully she will find that maybe that all sorted itself out.  ALL of this is why I am so weight loss resistant – and even though I won’t be dropping gobs of weight, straightening out all these numbers will have a big effect.

The most worrisome part of the testing was the particle size of my LDL which are small and dense – the kind that burrow into the arteries and are very dangerous.  HOWEVER, she said that this can be changed, but movement is the most important fact to do so.  I am glad I got my Fitbit and starting TODAY I am going to institute a serious and dedicated walking program and go back to using my bike daily.  No fooling around.  All these years I said I needed some sort of wake-up call – I have known these numbers and facts for ages – I think the difference is that she believes in me and believes I CAN turn things around.  (So much for the “oh well” attitude I have had all these years.)  I feel energized and excited to make a change. 

In terms of turning things around she believes that EVERYTHING can be turned around – even my autoimmune issues (Hashimotos).  My autoimmune antibodies which should be under 1 are in the thousands – so lots of room to improve there! 

She is doing two more tests that involve macro-nutrients.  One was a blood test and one is a stool sample (yikes – sending poop through the mail… will wonders never cease??).  One is partially covered by insurance, one is not, but I told her that I want to go all the way with this, so I am not going to argue (at this point at least) about the cost.  Well worth it if I can bring down my blood glucose, reverse my Hashimotos, get off the new thyroid medication, and change the dangerous size of my LDL.. wouldn’t you say? LOL

Anyway – I have to read all the material I have and absorb it some more, but I am very excited.

I have the appointment with the dietitian on Tuesday.  Turns out that one of the ingredients in the shake is something that turned up on my food sensitivity list, so she said that might be what was causing the constipation problems I was having – everything should have been smooth sailing (so to speak) during the detox and it wasn’t.  I am going to be about 2 days short on the shakes but I did not pick up another container.  If there is something in there I shouldn’t have then I don’t want to be stuck with another big bottle of it.  I will continue to eat the way I am supposed to but won’t do the shakes the last couple of days. 

I am so excited – can you tell?????

M

Wednesday, April 9, 2014

Day 21

Just so you don't think I'm so wonderful and this is all wine and roses... I had a horrible eating experience last night.  I should have just HALTED and had my second shake but instead I went for cookies and then, just for the heck of it, I had a handful of popcorn.  For some reason it was important for me to totally smack this program in the face.  Of course I am the one who fell down on my rump, not the program, but that's okay - I am fine this morning and ready to see through the last week.

What was going on?  I have come so far with emotional eating, but this is a reminder that it is waiting in the wings for me.  As much as I can list what was going on in my mind to drive me to cookies, I cannot fathom why I didn't care enough about myself to stop it.  I think, as with any emotional eating, it was a distraction - if I am busy being mad at myself for straying, then I won't be busy facing what was bothering me:

  1. I was in incredible pain all day - my leg, my back and my shoulder.  I started researching the lumbar facet joint injections again and am just so conflicted about them.  Part of me just wants relief but I think the part of me that drove me to cookies is the part that knows that if I was vigilant about the home exercises and actually did more of those and walking, the problem might be greatly alleviated without the injections.  So I think I was hating myself for not helping myself, more than I was trying to distract myself from the pain.
  2. I was in a sibling email loop which addressed my mother's weight gain.  She had been losing too much weight even with supplements and the nursing home was at a loss as to what to do and did not want to get into feeding-tube territory.  So I had the idea to bring in all her favorite snacks - which I did, and she gained weight.  So yesterday the nursing home said we could withdraw the snacks now, as she had successfully gained 5 pounds (took three months of snaking to do it!).  Two of my siblings (the long-distance ones who know NOTHING about anything and who don't deal with this personally day in and day out) said yes, they thought it was a good idea too because she wasn't eating her regular meals, and what about her health with all the sugar and crap I was allowing her to eat.  OMG - she is 98 years old and not on a single health-related medication.  But no, THEY knew it was unhealthy to give her all those snacks and it was a good thing the nursing home finally put an end to it.  I was angry.  Eating the cookies helped me forget those emails.
  3. I was constipated again.  Some cookies and popcorn surely would upset my stomach enough to get things moving.  But also eating those things got my mind off the fact that my mind is starting to wander into the realm of wondering if this detox is good for anything, really, and if I am on the right path. 
  4. I was mad that I haven't lost weight - so what the hell - I might as well have cookies. Besides, cookies were a way to beat up the program and kick it to the curb.  See?  I can eat cookies and not drop dead.  
  5. I was SO HUNGRY on the way home from work. It reminded me of how I used to be before going on the program. Going to one scoop/two shakes (from 2 scoops/three shakes) really threw me for a loop. I stopped at the supermarket and got two cooked skinless chicken breasts with some sort of bruschetta sauce on them.  I was feeling bad about doing that (not pasture-raised, no control over the ingredients).  I might as well have gone to get a Big Mac with an extra-large fries for the guilt that chicken caused me.  I felt myself spiraling into the diet mentality that I have worked so hard to break free from - guilt over eating something not "on program" and the black and white, all or nothing thinking - well I ate that, I might as well binge on cookies.....
Oh well... there was probably a 6, 7, 8, 9 AND 10... but it is a new day, and I am back on the program.  Just one more week.

I am glad I wrote this all out.  It makes me hate my cookie episode less, and instead I understand it more.  Although I still do not entirely understand why I just did not have my second shake of the day (I landed up skipping it).  I am not even entirely sure I would stop myself if this happened again.  

But I looked at the calendar and realized that I almost made it through 21 full days without touching a morsel that was not on the program.  I can do it one more week!

Miriam

Monday, April 7, 2014

Days 18, 19, and 20 (weekend + today)

HOORAY!!!!!!!!!!!!!

Starting tomorrow I am back to normal (well as far as normal goes for this program) and I can reintroduce chicken, lamb, nuts and seeds.  Never thought I would be so grateful to eat a piece of chicken! 

I weathered the weekend very well - including dinner at my daughter's house.  I brought cod and made a wonderful warm tapinade (olives, capers, shallots and cherry tomatoes), with rice pilaf (white rice made in vegetable broth, with sauteed onions, peppers, celery and black beans) and steamed vegetables (broccoli and carrots).  The only thing I forgot was my Bengal Spice tea, so while everyone was finishing the meal with coffee I cleaned the kitchen! 

On Sunday I actually only had one meal.  I woke up famished and had a plate of rice pilaf ((I wanted FOOD not a shake!) then later through the day I had a shake at lunch, then one midday so was not hungry for dinner; in the evening I had another shake.  In between I had some of the roasted veggies I had made that afternoon for the week.  I couldn't face another piece of fish, although I sure did enjoy it today for lunch!  I don't know yet what I will have for dinner.  I miscounted and thought tonight could be lamb chops but I need one more night of the fish/legume options.  Sigh.. maybe I won't have dinner...  Maybe I will stop by Whole Foods and pick up a mixed-melon salad - that would be a wonderful treat to celebrate the last night of the most difficult phase.  Oh... maybe some almond nut butter in celery for the side!  LOL - tonight's dinner is looking better and better!

That is another change coming up:  As of today I need only two shakes and starting tomorrow I need only two shakes using one scoop each (instead of 2).  I made it to the final stretch - I am so proud of myself! 

I am contact with the dietitian over the log jam (yes, again) and she suggested adding flaxmeal - something I had every day when I was making my breakfast muffins.  I will add a TBS to each shake from here on - extra berries to balance the flavor. The other things she suggested are already being done: magnesium, probiotic, lots of liquids.  I also told her that lemon juice instead of vinegar just doesn't do it for me so I haven't been eating ANY salads at all during this phase.  I am eating a ton of cooked and raw vegetables and there is no law that I have to eat salad, but I bet that might have something to do with it.

Anyway - I am happy as a clam to be almost done with this, and as Babs pointed out - no need to worry about a future that isn't here yet.  And in the spirit of Elaine's advice I am embracing the moment (hence that wonderful dinner at my daughter's house).

Putting lamb shanks in the crock pot tonight :)

Miriam


Friday, April 4, 2014

Days 16 and 17 (today)

Well, it killed me to do it because I have been eating Paleo for so many months now, but I made a wonderful white rice and black bean pilaf to have last night.  I had my fish soup (absolutely wonderful) with a little rice for dinner but about 8 I was looking for something else and didn't want my shake just yet.  So I went ahead and made the pilaf. 

I have three concerns at this point:

1)  This is throwing me into a diet mentality which I tried so hard to break out of.  Even though the point of the detox is not weight loss (and this was quite freeing at the beginning) I have started to think about things - like "Should I really be having this rice?"  "How many extra calories is it when I could have just done without it?"  "The nutritional information on the shakes says it is only 145 calories... but is it?"

2)  I am starting to covet things that I have learned to walk away from...  the chips, the bagels, the candy, the bread.  The deprivation mindset is seeping in. 

3) My friend last night said I am doing so well because I have my eye on the prize.  But right now I am thinking, "What prize?"  For all this limited eating I have NOT lost weight, I do not feel miraculous changes like boundless energy or no aches and pains.  I know that the healing is internal and I might not be feeling anything on the outside.  I understand that. 

I am not getting discouraged (I had nothing to look forward to in a concrete way so there is nothing to be disappointed about).  And, since I have come this far it would be just plain stupid not to see it through.  I am not even blue about it as I was in the earlier phase.  I don't know how I feel about it, actually.  If I had dropped 10 pounds then I would tell anyone to go for it!  But because the benefits are not yet showing themselves it is hard for me to answer anything but "Okay" when someone asks "How's it going?". 

I am constipated again.  Sort of begs the question of how this is supposed to cleanse you if everything is jammed up?  I am eating a lot of fruits and vegetables, but probably still not as many as I would eat if I were not doing this.  I had already cut out grains but at least I was having seeds and nuts and nut flours and flax seed meal before.  So I know there has been a dip in fiber. 

Anyway - just to honestly report:  The gun-ho exhilaration has passed but I am no where giving up on it.  Sort of like the exhilaration of  falling in love and making a wedding... then the drudgery of marriage sets in.  Not bad, but not the falling-in-love phase either! LOL  No reason to give up on that... or this!

Miriam


Wednesday, April 2, 2014

Days 14 (continued) and 15

First of all, I am so hungry.  I can eat as often as I want and as much as I want from the list of approved foods, but I am just hungry... I just finished a box of blackberries and am going to move on to melon.  My husband is making me boiled white rice (which I can add back) but that isn't until I get home.  Maybe for lunch I will hit a Chinese restaurant and get an order of rice.  I am starting to have food on the brain.  I have to admit... I am getting tired of the shakes, as yummy as they are....

So why I have a continuation of yesterday is that I wanted to report back on dinner.  I spoke to the waitress and told her my concerns - that if at all possible I did not want butter, although I could have oil if the cook didn't want to dry cook things and I did order the seasoned salmon that came with steamed broccoli, roasted asparagus and grilled tomato.  I have to say it was one of the nicest restaurant dinners (for that level of restaurant) that I have had and enjoyed every single morsel.  The victory for me was that I did not look at the menu.  Often I decide in advance, from an on-line menu, what I am having then once I get there I look at everything else and get distracted by fries, burgers and the like.  I was glad to have what I ordered and was very happy and satisfied with it.

I got home, had my third shake for the day, and called it a night.  I don't think I am getting tired of the limited list so much as I am tired of the shakes.  Or maybe it's not that I am tired of the shakes but that I am tired of the limited list.  Oh... whatever....

This morning I was already saying to myself that the FIRST thing I am going to do when this is over with is to have my morning cup of coffee.  Then have a REAL breakfast.  But, alas, I am sure my dietitian has plans for me with regard to how to reintroduce foods... at what pace, in what quantity and choices.  Unfortunately right now my follow-up appointment is over two weeks after I finish this program so at the end of next week I will call to be put on a cancellation list to go sooner.

I liked Babs' comment yesterday though, about how if I am taking this one day at a time, why worry about the future?  So true.  I just have to shake the thoughts of coffee, cappuccino and eggs out of my head.

However, to put this all in perspective, it is with a heavy heart that I say prayers today for my friend's daughter-in-law who has gone into premature labor.  She is due just a week later than my own daughter, in June, so it is very early and very worrisome.  Sort of makes shakes and limited food lists pale in comparison compared to real life and death issues.  Prayers are with her and her family.

Miriam

ADDENDUM: I couldn't wait till getting home and got a small white rice for lunch and ate only that (and some melon) for lunch.  A bit nauseous - but I don't think it was the rice - I think it was that I ate quickly and ate it ALL.

Also - heard from my friend - her daughter-in-law delivered a three pound baby girl by C-section and so far they are both doing well, although the baby is in the NICU.  I told her that three pounds is a GOOD thing, and wish them all well.

Tuesday, April 1, 2014

Days 13 and 14

Well yesterday was my last day (13)of the REALLY strict phase - I made it!!!  Not a morsel passed my lips that was not on the list, and I am now on Day 14, the start of the reintroduction.  Now before I get too excited I have to remind myself that this only means that now I can have all fruits and vegetables (not just what is on the "core" list) and I can add white rice if I want.  This reintroduction phase goes in several steps so I am here for three days.

This is a good thing because:

I had to set out a seminar luncheon today and there was a Greek salad to die for.  Before the participants came in I took a paper cup and took off (carefully rearranging so no one would notice) peppers, tomatoes and red onions.  I was not so careful about taking off the flecks of feta cheese, which I think probably, in total, amounted to about 1/2 tsp.  I got out of there, though, before I was tempted to snitch a sandwich!

Tonight I am meeting with my daughter's mother-in-law to go shopping for shower invitations and to discuss the menu.  We are meeting at the 99 Restaurant.  I checked the menu before suggesting that - they have a grilled salmon with side vegetables (all of which I can eat as of today).  However, I know these chain restaurants get their food already prepared (no matter HOW healthy it looks with their fancy marketing) so I am going to go early as not to embarrass the other woman, and ask them to rinse off the salmon and all the vegetables before cooking them for me.  If this is not possible, I will just do my best and call it a day.  I am not outright eating anything I shouldn't be, and the worst will be if there is some butter on the various items. (Even if you ask for "no butter" that stuff comes frozen like drop-in boil bags already seasoned and buttered, just FYI.)   I am not going to stress about it.  I will just order what looks to be the healthiest meal on the menu. 

I cannot believe I am so far into the program.  Hmm... let me rephrase - I cannot believe I am already into the reintroduction phase, yet it seems like I have been doing this forever, yet only started yesterday. LOL...

I am already starting to stress over what/how I will eat when this program is over.  Like today at the luncheon - I could have inhaled the entire salad and eaten four sandwiches (well I think I could... maybe not...).  And this isn't just because I am on a restricted program - I could eat like this ALL the time. I think what has been easy about following this program is that there are such strict boundaries.  Eat this. Don't eat that.  Eat this.  Don't eat that.  I hate micromanaging - meaning I don't like things with strict meal plans directing every morsel.  But I do like macromanaging - meaning I am okay with general larger boundaries (no gluten, no dairy, etc.).  So my stress is arising from worrying that I will be given TOO much freedom.  I am meeting with the dietitian within a few days of finishing the program so I am sure she will work with me to slowly reintroduce things so I won't be overhwhelmed.  I am also hoping that I will have enough of a jump start with a little bit of weight loss and that I will be motivated to keep on keepin' on.

Well I won't worry now what might be at the end of April.  Let me get through tonight's dinner first!

Miriam

ADDENDUM TO POST:  About an hour after lunch I got such bloating and discomfort in my upper abdomen.  I don't know whether it was the tomatoes, peppers or the bit of dairy I had (I know it wasn't the onions, I had even less of that than the cheese).  And now I have the burpees.  Oh well... I am pretty sure it is the green pepper, but I will also have tomatoes on day that I don't have the pepper and see if those could be the culprit too.  Interesting development ....