Well, stone me! #gallstones

2018-06-29 18.36.36Three months and not a little confusion, falling-through-the-cracks and communication hiccups later, I finally had my gallbladder and its impressive payload of gallstones removed, in the latter days of June, courtesy of the NHS – just a week or so shy of its 70th birthday milestone.

Things went more-or-less as they should, save for the fact that a bigger than usual gallbladder meant a bigger than usual keyhole incision in my bigger than it should be abdomen. Then – as far as I can tell – this was followed by a bigger than usual amount of surgical rummaging about to sew me up. (In the words of my surgeon, it was a bit tricky … and that, I think, is as much detail as I choose to cope with.)  Mea culpa though, at least in part, because for the first time in my life, obesity was cited as a co-morbidity.  That’s a fairly brutal word to see, even though it doesn’t mean quite what you imagine it does. Ironic it was, all things on my healthy lifestyle journey considered, but I have to suck that one up.

But that wasn’t the end of things. A couple of weeks after my operation, with things generally going just fine, I found myself doubled-up in agony and back in hospital again, as some kind of surgery-related kink or blockage knotted my insides. That kind of pain, you really don’t want. It took several days to resolve, as I attempted to rest my protesting intestines, my arms perforated by cannulae, dragging a drip-stand wherever I went, and not get too stressed about it all; all in an overstretched, overheated ward, during one of the most suffocatingly steamy weeks of the decade.

But as the cliché goes, every cloud has a silver lining, and my silver lining has been that with the surgery, followed by the imposed starvation necessary to relax my twisted gut, I have waved farewell to a further 10 pounds.  That leaves just 10 more to go until I’m back where I was at my lowest, in May 2017.  That’s properly within reach now – so I’ll take that win.

Then, at last, I will be able to put the psychological, emotional and physical disruptions of the last 18 months behind me, and continue the onward/downward weight management drive. Hopefully by the next time I need hospital care (ummmm…. hopefully never?) they won’t feel the need to note obesity anywhere on my records.

The Lifecycle of a Yo-Yo Dieter #FullDisclosure

Even when you think you’ve got the healthy eating thing nailed, it can all still go horribly wrong. Again and again. And again.

If you’ve been following my blog for a while, you’ll be familiar with my excited posts (for example, here and here) about the massive benefits and gains I’ve enjoyed as I shed the pounds throughout 2016. And you may have noticed that I’ve gone a bit quiet about the weight-loss situation in the last year.

Well… here’s why.  When it comes to managing my weight, I’m a habitual Yo-Yo.  And what goes down…

Downhill all the way – except when it’s uphill

As far as I can remember, including my lately renewed efforts, there have been ten sustained periods of weight-loss in my life, beginning at the tender age of 21.

1981:  Loss of 2 st / 28 lbs / 12.7 kilo

2018-05-09 17.11.06

Aged 21 and weighing-in at 11 st 5 lbs / 159 lbs / 72.1 kilo at the outset, that 28 lbs qualified as mega. It earned me Lifetime Membership of WeightWatchers. Today I would kill to be the weight I started at back then, again, let alone the slender form I achieved after a few months of modest self-control. It didn’t seem hard – at least, I don’t recall the hardship. I do recall eating a lot of beansprouts in tomato puree on dry toast though. Little did I realise what was to come in the years that followed.

1989:  Loss of 4 st / 56 lbs / 25.4 kilo

This time the work started around 14 st 7 lbs / 203 lbs / 92 kilo. My life disrupted by divorce and then career-change, a swirling cocktail of negative and positive influences served to transform my approach to food in ways I still don’t fully understand; for a while, at least.  I did it all by myself this time; skipping meals, developing a single-track approach to lunches (smoked mackerel and undressed salad, every day – yes, every day), shunning alcohol, and falling for a trainer at my local gym (great motivation to hit the treadmill). For a while, I drew energy from the way I could see both me and my life transforming. For a while.

2002:  Loss of 3 st 8 lbs / 50 lbs / 22.7 kilo

2018-05-09 17.12.28

I kept a lid on my weight for a while but eventually it nudged steadily upward again. In 2002 I’d just been made redundant and come out of a very toxic relationship, so my life was again disrupted and unsettling. I’d decided to go self-employed – which was simultaneously invigorating and downright scary.  I needed to feel stronger, more together, more in-control of myself – not unlike I’d needed to feel back in 1989. Flexing that Lifetime Membership card for the first time, I went back to WeightWatchers, and the stars aligned. My membership card for that period, which I have never discarded, tells me that I started out at 16 st / 224 lbs / 101.6 kilo. I thought that was the worst I would ever let it get. But I was wrong.  When the weight-loss stalled for a few weeks, I lost the plot. Every single pound I’d dropped went back on in the 18 months that followed. It’s hard to describe the sense of helplessness I felt.

But there was more to come:

2004:  From 244 to 219 lbs…

2005:  From 234 to 218 lbs…

2006:  From 246 to 235 lbs…

2007: From 246 to 242 lbs…

By the time of that pathetic attempt in 2007, I had all but given up hope of losing weight permanently.  I could see that every time I lost weight, I put it back on, and more besides.  I became afraid to try again.  So I didn’t, until…

2013:   Loss of 1 st 8 lbs / 22 lbs / 9.9 kilo

By now I was back up again, at an unbearable and lumbering 18 st 13 lbs / 265 lbs / 120.2 kilo.  I kept my food intake under control for around six months and lost weight slowly, before it all fell apart… again.  And at the age of 53, those surplus pounds felt like a permanent fixture, a metaphorical if not literal millstone around my waist. I was resigned to almost always being the largest person in the room; to worrying if picnic chairs would hold me; to getting out-of-breath when faced with more than a single flight of stairs; to seeing good people, with the best of intentions, begin to treat me as if I were… disabled.

And you can see why they did, can’t you?

Screenshot 2016-03-28 11.22.46 copy

Then, it seemed, the universe threw me a lifeline:

2015/16:  Loss of 5 st / 70 lbs / 31.8 kilo

And quite the lifeline it was. At my heaviest ever, I was introduced through business networking, to a healthy lifestyle coach. I weighed 19 st 4 lbs / 270 lbs / 122.5 kilo. The most powerful impact that working with my coach had was to help change my mindset. For the first time I focused on a holistic healthy lifestyle rather than weight-loss for the sake of it.  I locked into powerful visualisations, focused on what I wanted to gain rather than what I wanted to lose – and what sort of a person I wanted to be. And it worked. In 12 months, I lost 70 lbs, and it felt (and I felt) … amazing.

2016-11-23-09-31-45.jpg

Even when the weight-loss stalled, I didn’t actually gain anything, bouncing along in a plateau state for several months. For the first time ever, I believed I had gained some mastery over my capricious fat cells and my chaotic eating habits.

Everything goes well, until it doesn’t

But if the universe had thrown me a lifeline, it seemed it was still possible to drown.

In early 2017 my mother fell ill, dramatically, unexpectedly, and terminally. In the two months during which I cared for her, I lived on healthy snacks, grabbed whenever I could find a moment to myself. I was grateful for the Marks & Spencer Food Shop at the hospital, where I picked up a super-green salad and mini packet of kofte kebabs almost every day. (Yes, there’s a pattern here… when I find a meal that works, I stick to it!) When she came home for her last few weeks, the deli shelves at the M&S store my local filling station became my daily pit-stop.  Whilst everything else seemed to be spinning out-of-kilter, I kept the whole healthy lifestyle business under control (to be fair, sometimes I could barely eat for distress). I even managed a decent walk on days when kind souls offered an hour or two of their time to be with my mother.

Until, that is, she died.

Since that day in May 2017, I’ve managed to undo about half the stellar weight-loss job I did on myself.  In total, between then and March 2018, I regained no less than 37 of those 70 pounds.

Don’t be too hard on yourself,’ everyone has very kindly said. And I was grateful for their empathy and understanding. Emotionally exhausted, weary and sad to my bones, I started out on the process of deconstructing her life and disposing of her things. This has proved to be time-consuming and energy-sapping, and more often than not, very, very hard. I’ve blogged occasionally about it (see here). Whilst it’s been an enormous relief to have my brother working alongside me throughout much of this clear-out, it has been an intensely difficult personal journey too, for many reasons.

I’ve stayed away from sugar though. That was my one consolation as the weight crept back on. I never went back on the sugar. But I let other things back in; if very occasional take-aways weren’t that much of a problem, the 3-for-2 bumper-sized bags of crisps (potato chips) were. Where I didn’t succumb to biscuits and cakes, I did to increasingly more generous and more frequent slabs of cheese and ever larger blobs of butter. My portion sizes grew and my daily walks fell away, always with the excuse that I was ‘too tired’ or that I had ‘too much to do’.  And one by one, the pounds returned – and I returned to my carefully stored bag of big-clothes.

But the universe had one more trick up its sleeve.

In March, I ended up in hospital as a result of what turned out to be an attack of cholecystitis (that’s a big, evil and unbearably painful gallstones problem).  I blogged about it here.

As I wait now to have my gallbladder removed, the guidelines as to what I should and shouldn’t eat, to stave off any potential future attacks, are varied. But whichever way you look at it, they do boil down to an incredibly healthy diet.  From low-fat to no-dairy to small portions; from avoid fatty meat and stay away from fried anything to eat plenty of vegetables – you just can’t argue with it. As spicy foods may have been a trigger for me, I’m avoiding those too.  Add my avoidance of added sugar into the mix and my diet has become, well… a bit dull. However, I’m not complaining, as this dull, healthy diet that has been enforced upon me on pain, literally, of… pain, is helping me to shed those pounds again.  So far, of those 37 lbs I regained, I’ve lost 17 since March. There’s another 20 to go, but that feels within my grasp, now that I’ve recaptured my mojo, and my enthusiasm for health over comfort-eating. And when I’ve re-lost those remaining 20 lbs, I feel positive about staying on-track and chipping away at what remains, which is easily another 30 lbs.

Positive, but not complacent. Not with my track-record.

Onward and upward… or downward

I feel stronger again though. Strangely, with the threat of another crampy gallstones attack hanging over me, it’s not that hard to eat cautiously and modestly. And with the weight-loss – and perhaps too, some distance from my mother’s death – has come a re-gaining of lost energy and the impetus to continue with the exciting process of physical and mental transformation which was taking place two years ago.  I’m taking more care to exercise regularly too.

But I’m under no illusion; I’m a Yo-Yo dieter and that’s my physical and psychological ‘cross-eyed bear’, for life. As soon as my attention goes elsewhere, or I feel the pull of the comfort-food, the weight soars back on. But at my age, I can no longer expect to get away with it. Serious health problems will – for sure – surface, if I don’t keep a lid on my impulses. I must stay the course this time. But to do this, I need to re-connect, vigorously, with the positive healthy lifestyle choices I was making a little over a year ago – and with those massive gains in which I was revelling for those few wonderful months.

I just hope I get a clear run at it now. No more killer blows to the emotional solar-plexus please, for a while at least.

Well now, that was interesting… #NHS

Getting carted off to hospital in an ambulance at 4am, doubled-over with acute abdominal cramps that just won’t go away; not the best start to the week.

I’ve had a stressful year, upturned – the untimely death of a parent does that. So when stomach problems started to surface a few months ago, that’s what I put it down to – stress. I’ve had several instances of crampy discomfort, one or two much worse episodes more recently. And then there was Sunday. Sunday was off-the-scale. I’ll spare you the details, but the upshot, after several increasingly painful and vile hours, was this: A call to NHS111 when I could stand the pain no more and was thinking I might be having an actual heart attack; the despatch of an ambulance; a day in a chaotic and overwhelmed A&E; nil-by-mouth; the extraction of blood – lots of it; X-rays and ultrasound; people prodding and poking (I hope they were doctors); a further day on a ward operating beyond its remit; industrial quantities of antibiotic and painkillers on drip; thence to be packed off home with instructions to avoid overly fatty meals and attend a clinic next Monday to see what comes next.

Unbeknown to me, over recent weeks, I’d developed an inflamed gallbladder and a ‘deranged’ liver, courtesy of some errant gallstones, one of which kicked off the latest, greatest episode of vileness and agony. It wasn’t pretty. It wasn’t pretty at all.

That’s more detail than anyone would want, so I’ll leave the rest of this miserable experience to your imagination. Save to say a word or two about the extraordinary situation in my local hospital (that’s Hillingdon Hospital in West London, but it could just as well have been any hospital, anywhere in the country), and the equally extraordinary professionals who are doing their very, very best in utterly over-stretched conditions.

I have a lot of time for the NHS – it has served my family well over the years and is a good and positive thing,  whatever Donald Trump might think. The UK is a much, much better place for the NHS. But this venerable institution is in trouble, thanks to a decade of austerity (from the financial crisis, which was kicked off by the USA’s sub-prime loans catastrophe).  A decade of under-funding has left the armies of dedicated and committed professionals across the NHS fire-fighting, horse-trading, and doing everything in their power to deliver care in totally and utterly strained circumstances, day after day, night after night.  And do you know what? All except for one sullen nurse, every single person I met in the last few days at Hillingdon Hospital, was doing it with a smile and good cheer. And I imagine it’s much the same in every hospital and clinic across the country – because that’s the kind of people they are.

They raced around, chasing down scarce equipment. They juggled cubicles, tended to people on beds in corridors and chairs all over the place. When they needed more beds they ‘flexed’ a day ward into service, forcing them to cancel who knows how many minor operations in the process. If the odd minor thing fell through the cracks, they stayed on top of what mattered.  And they kept going, through twelve hour shifts and acres of… carnage.

It’s a crime that the NHS has been expected to operate under such conditions.  And now that we’re getting the small hints that ‘austerity’ might be coming to an end, the very, very first priority of the Government must be to pump money into its veins and jump-start its exhausted heart before it expires altogether. The country deserves it, but more than that, those hundreds of thousands of extraordinary professionals – nurses, doctors, consultants, radiologists, anaesthetists, orderlies, porters, paramedics and everyone else, yes, even the administrators and managers – deserve it.