Archive for the ‘health care’ Category

antidepressants

In case you’re wondering how I gained all the weight in the first place… I blame it on antidepressants.

I never really struggled with weight at all (although I thought I was fat at 135 pounds — what was I thinking???) until I started taking antidepressants when I was 19.  I started taking them after a traumatic event happened in my life.  A friend who knew better told me not to take them and to work through the trauma on my own, but it just seemed too hard to face the pain.

The family practice doctor started me on Paxil, but it made my mouth feel incredibly dry.  He switched me to a low dose of Effexor.  It wasn’t doing much good for my anxiety or depression, so he referred me to a psychiatrist.  She gave me a higher dose of Effexor as well as Trazodone for help with my insomnia problem.  For the next year and a half, she kept increasing my doses, because I never felt any better on them.  In fact, I didn’t feel anything at all.  I didn’t even care whether I got out of bed some mornings, unless it was to eat and then go back to bed.

When I was taking these antidepressants, I was a full-time college student, and I was in an aerobics class that met three times per week for my PE credit.  One day, after aerobics, I changed back into my jeans, and they wouldn’t button.  Just like that.  I had to go to my next class, but I couldn’t breathe because the jeans were too tight.  I’ll never forget it.  How could I gain weight if I was doing aerobics three times a week?

So, for the next year and a half, while feeling nothing and caring about very little, I gained over 100 pounds.  While I might have eaten a little more than usual at that time, it was certainly not enough to gain that much weight.  (You’d have to eat a lot of donuts to double your body weight in a year and a half.)  I have since learned that antidepressants can shut down liver/metabolic functions, and I’m convinced that’s what happened to me.   I also craved carbohydrates like crazy.  Many nights, I’d just eat tortillas for dinner (and, occasionally, cookies for dessert)… nothing else.  Since there is little to no nutritional value in these foods, I needed to eat more and more of them, since my body was asking for nutrition.  I would try to satisfy the need for real nutrients, but it never happened.  Since I never had a weight problem until then, I didn’t know anything about nutrition or weight loss.

The psychiatrist never permitted me to come off the antidepressants.  (She said I needed them because I was depressed… of course I was depressed!  I was getting fatter and fatter by the minute!)  So I made the decision to end them on my own.  The withdrawl was terrifying… I could not just stop them “cold turkey”… had to do it a little at a time.  My body had become addicted to these chemicals, and it didn’t know what to do without them.  And, I found out later that at the end of my Effexor run, the psychiatrist had me on a dose normally reserved for somebody in an inpatient mental health facility!

In late 2003/early 2004, right before I started losing weight, I had a personal situation that convinced the doctor I needed Lexapro, another antidepressant.  I told her about what Effexor and Trazodone did to me, but she assured me this one was different.  So I took them.  They made me so tired, I couldn’t get out of bed in the morning.  Afraid of losing my job, I threw them away.  (I would really be depressed if I got fired!)  Perhaps some people have better luck with antidepressants, but they just do me more harm than good.  I will never put them into my body again.

I do have to wonder, though… although there may be some cases where people actually need antidepressants due to an imbalance in the brain, how often do doctors prescribe antidepressants when they are not necessary?  Unfortunate events are a part of life — maybe we should not just automatically take pills when they happen.  On the other hand, my father-in-law took them for a few months as he was grieving my mother-in-law’s death, and he was able to stop them with no problems after he felt better.  So, maybe it is just a matter of individual reactions to these drugs.

The doctor that prescribed the Lexapro had drug ads plastered all over the office (Lexapro clock, Lexapro tissue box, Lexapro pen… anyone who has been to a doctor’s office in recent years has seen this.)  Once, while I was waiting for her, I saw a drug rep approach another physician in the office with a big shopping bag full of antidepressant samples.  The rep said to the doctor, “These will be very helpful to you, especially with the holidays coming up.”  (It was October or November, I think.)  I thought it was one of the most insensitive things I’d ever heard!

Do I think antidepressants made me fat?  Yes.  Do I have proof?  Not scientific proof.  Google antidepressants weight gain and you’ll see that there are many conflicting opinions about this. 

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Step 2

I want to thank everyone who’s visited and/or written such lovely comments on this blog so far.  I’ve only been blogging here for 4 days, and I’ve already had up to 40 views in one day.  And, I’m still elated that southernfriedfatty has named “Gain this!” her first “blog of the week”. 

But, as David Letterman says, “That’s not why you called.”  Step 2, for me, was exercise.  The Atkins book, which was really a bible for me in those early months of my weight loss, plainly stated that if you are not exercising, you are not “doing Atkins.”  I took it seriously.

For me, adding exercise was even more difficult than changing my diet, and I told you yesterday how difficult it was to change my diet!  It wasn’t really so much the discipline as it was the physical act of exercise.  At 300 pounds, I could barely make it up the stairs to my third floor apartment, let alone go to a gym for the explicit purpose of exercising.

I started with two things.  The first was the fitness center at my apartment complex.  At first, I was pushing myself too hard to even walk 2 miles per hour on the treadmill, and using the treadmill hurt my lower back.  A friend suggested that I should try the elliptical machine, because it creates little or no impact on your joints.  It was much more comfortable for me.  In those days, I wasn’t comfortable going to work out without my husband (who has much longer legs and has never had a serious weight problem!), but I got over that soon enough.

The second thing was Leslie Sansone’s “Walk Away the Pounds”.  A friend said she was using it; she told me it was a DVD that you could use to lift weights (toning) and walk (cardio), right there in your own home.  At first, the thought seemed silly — why would marching in place do anything significant toward improving your fitness level and lose weight? — but I borrowed hers, and then I went out and bought my own copy.  I really loved it because I could do it in 20-30 minutes, I didn’t have to go to a gym where people could see how fat and out of shape I was, and I was seeing results from it!  I remember doing it at 6 AM, before my husband got out of bed.  He crawled out to the living room, still attempting to wake up, and I was already awake, energized for the day, and starting breakfast.  I don’t use Leslie’s DVDs anymore, because my fitness level has surpassed what she provides in them, but they sure were wonderful in the beginning.  (hint: in my opinion, the music on the DVDs is a bit cheesy, so I just muted the sound on the TV and listened to my Walkman/iPod/whatever.)

It really is true that exercise gives you energy and makes you feel better… and you don’t have to be in shape already to feel better from it.  Just take it slowly in the beginning, and it will get easier every day.  After you do it for a certain amount of time, you will actually feel worse if you don’t exercise.  Today, I actually get irritated about it if I can’t exercise, such as when my job gets really busy or when I have to travel. 

People have told me, “I don’t have time to exercise”, “I’m too tired to exercise”, and so on,  when I talk to them about the weight I’ve lost.  Believe me, I’ve “been there”, more than you can imagine, and there have been times in the last three years when I really was not able to exercise because of issues in my life.  During these times, however, I felt worse, and my weight loss stopped.  Losing weight simply will not happen if I don’t exercise. 

More on how to exercise in future posts…  just like I didn’t know how to eat a healthy diet, I also didn’t know how to exercise. 

Prehistory

Not long before the ER visit I described yesterday, I visited a doctor who made me feel very angry and hurt.  My husband and I call him Aggie Doctor, because he had Texas A&M paraphernalia tacked all over his examination room.  He was not my usual doctor, but worked in the same office as my primary care doctor at the time.

I had to see him that day because I felt very ill.  My feet were swollen and tingly, my head was rushing, and I felt like fainting (I may have; I don’t remember for sure.)  My husband had to miss work to drive me there because I was not feeling well enough to drive. 

I didn’t like Aggie Doctor.  He was just rude.  He said my problems were likely related to my high blood pressure.  He increased the dosage on my blood pressure medicine, and lectured me about my weight.  He told me to lose weight and said, “This blood pressure incident should be a wake-up call for you.  You really need to lose some weight.”

Wake-up call?  Like I didn’t know I was fat until he pointed it out?  I was a size 28 and was on the verge of being too fat for Lane Bryant clothes!  I had tried losing weight in the past, but nothing was ever terribly successful.  I tried low-fat, but I was hungry all the time.  I tried the Jared Subway thing, but I got bored with it.  Honestly, I didn’t know how to lose weight.  Aggie Doctor didn’t give me any clues, either; he just gave me a lecture, a prescription, and the bill.

I really can’t say whether Aggie Doctor helped me get on the right track.  What I decided shortly after I started losing weight was this:  when I reached my goal weight, I was going to get dressed up in a short, tight, leather mini-skirt, go into his office, lean over his desk, and coo sultrily, “Wake-up call…”  My husband is in completely in favor of the idea, because he knows it would end there, and because he thought Aggie Doctor was a jerk.

I didn’t go back to that office after that, not even to see my usual doctor.  A few days later, my husband and I were at the grocery store, and I was staring blankly at frozen dinners, trying to decide which ones would help me lose weight.  A woman in the aisle struck up a conversation with me, and it turned out she had just lost about 60 pounds.  She gave me the name of her doctor — “this doctor actually listens“, the woman told me, so I switched doctors immediately.  The idea of a doctor actually listening sounded incredibly intriguing.  And she was right — the new doctor did listen, and I never looked back.  (I don’t go to her anymore, because she decided to become a fibromyalgia specialist rather than a general practitioner.  I love my new doctor even more, but she’s a post for another day.)

Prelude

Flashback to the spring of 2004. I was a 29-year-old, 5’4″ woman who weighed 300 pounds. My blood pressure was 145/95, even with medication.

It happened at the hospital. The Moment. I had decided to try traditional Chinese medicine to lower my blood pressure and lose weight. But, an unintended adverse reaction caused by a prescribed herbal tea led me to the emergency room. The emergency room nurse could not get the IV needle in my vein using normal procedures because my arm was too fat for him to find the vein. He led my husband and me to some scary-looking back room, where he used an enormous needle to reach my vein, and I almost fainted when the needle punctured it. I cried from the pain and from the embarrassment.

My husband and I were in the emergency room for over five hours that night. We never saw a doctor; our hopelessly brilliant lack of a civilized health care system causes many people with no health insurance and little money to use the ER as their primary care physician, and hospitals are woefully ill-equipped for this demand. Around 2 am, I started feeling much better, so we just went home.

Sometime in hour 2, I think, the aforementioned Moment hit me. I thought (and said to my husband), “That’s IT. I’m tired of being fat. I’m tired of being sick. I need to do something about this.”

So I did. At the time, I had no idea what the “something” would be. Little did I know there would be many “somethings”, and that none of them would be easy. But, nothing worthwhile is ever easy.

Fast forward to April 2007. I am a 32-year-old, 5’4″ woman who weighs 180 pounds. My blood pressure is 112/70, without medication. I look and feel years younger than I did when I was 29. I am a stronger person, both physically and emotionally. I never imagined I would have a waist again, or that I would ever be told by a clothing salesperson that I should go shop in the juniors’ department.  I stil want to lose about 30 more pounds, so I can reach my goal of 150, but needing to lose 30 pounds sounds much more manageable than needing to lose 150 pounds (half my size, effectively.)

So many people ask me, “That is amazing! How did you lose all that weight?” that I’ve decided to start a blog about it. Now, usually when I start to tell people how I did it, they say things like, “Oh, I could never give up sugar” or “Forget it — I don’t have time to exercise.” I don’t mean to sound like Dr. Phil, but the decision to make yourself healthy is a choice you have to make on your own. I can’t make you do the things I have done to bring myself back to health, nor can I give you the inner emotional strength you need to do this. But what I can offer you is this: “weigh” the choices. If you are overweight and unhealthy, you can continue on your current path (not a desirable option, for sure!) or you can follow a new one and become less overweight and more healthy. Once you see how much better you will feel after you make the changes, you may not want to go back to your old habits. (I know I don’t.)

I plan to share not only my weight loss tips, but also my personal story… you don’t get to be 300 pounds without a story, believe me. Also, I’ll share anything I think might be related to the general topic here. After all, it’s my blog, and my story, but it’s not my weight anymore!