Health

Binge Gone Crazy

January 28, 2020 by tanya

Things Were Going Well . . . Until They Weren’t

I was on that restrictive diet – a gluten-free, dairy-free pescatarian diet. With it, I was usually able to keep my weight where I wanted it to be – in the 120s (pounds) range. If I got out of hand with alcohol or sweets, I would see a slight uptick in my weight that might put me into the 130s. Upon seeing that I was getting unruly, I’d commit to cutting back to shed the pounds and get back to a weight in the 120s.

I used to be able to shed the weight fairly easily, once I’d committed to pulling things back together. In the later part of last year, I realized that I’ve come to a point in my life (perhaps age, hormones, not exercising as hard), where it’s just not as easy as it once was.

I’ve come to terms with the fact that I’ve got to take a different approach now. The old system no longer works with my current body. It now takes longer to get the same results.

I also don’t have the same willingness or desire to subscribe to a highly restricted diet in which I’m rejecting entire food groups indefinitely. That doesn’t work for me anymore. I want to come up with a system that aligns with the way my body works and that will help me produce the sustainable results that I’d like.

I mentioned several months ago that I was trying the program outlined in the book The Plan. I started the Plan and began to see some results in terms of weight loss. The Plan is basically a guided elimination diet program that aims to help you find those foods that work well with your body and those that do not. The idea is to develop your diet around knowledge about how your body functions and focus on that instead of on calories.

What delighted me about my experience with The Plan is that I was able to test (and pass the test for) 3 of the things I hadn’t eaten in over 3 years, but absolutely LOVE – bread, chicken and cheese. This had me so excited!

A couple of weeks after I started The Plan, my birthday came and I went HAM. HAM! Having recently passed that part of the Plan that tested bread, chicken and cheese, I first started by having some of those foods while out. Oh how elated I was to be able to have the pre-meal bread and to not have to hold the cheese on a salad.

The HAMation that began on my birthday quickly turned into a full on spiral. I swear, I had a 3-week binge. Even though I had only passed the 3 tests (and hadn’t tested anything else yet), I decided to eat AAALLLLLLLL of the stuff that I had missed over the previous 3 years! All of it!

Chicken? Yup. Beef? Yup. Queso dip with beef? Yup. Cheeseburgers? Yup. Dessert (that wasn’t sorbet)? Pancakes? Yup. Pizza?! Yup, yup, yup! I went bananas!

Because it was my birthday, the holidays (remember, I also went to Las Vegas to hang out with The Bulldozer), and I had a strong dating month in December, I was getting treated to a number of restaurant outings. So I had several opportunities to indulge. I went from one end of the diet spectrum all the way to the other.

Getting Back On Track

By the time I started to gain some semblance of sensibility, I had become quite the thickums. As a woman who is only 5 feet tall (and is used to being in the 120s), the addition of weight can feel and look significant pretty quickly. I like being smaller. I like my clothing to fit (much of which aren’t fitting right now). Though I was having a great time eating all of the stuff I wanted to eat, I knew it was not sustainable. I had to reel it in. I just didn’t want to go back to the diet I had been on for the previous 3 years.

Like I said before, I don’t want to struggle with both debt and weight. As I work my way through this debt situation, I can’t, simultaneously, stumble into a weight problem. That’s the reason I included weight loss and maintenance as one of my goals for 2020. Finding a new system – a controlled, but not highly restrictive system – is critical. What was working for me before no longer works. So it’s time to identify a new solution.

For now, I’m going old school. I shook the dust off of the MyFitnessPal app on my phone and have started tracking everything I eat and drink. I’m operating on a 1,200 calorie per day allotment. So far, the calorie counting has been working. When I keep my consumption under 1,200 calories per day, I lose weight. I have been able to enjoy certain foods, while still reducing the pounds.

Additionally, I’m paying attention to not just to my caloric intake, but also how my body is responding to different foods. I think that the premise of The Plan is great; I just don’t think that eating the way that is outlined in the book is sustainable for me. Many of the recipes just don’t resonate with me. I’m looking for sustainability – something that I can subscribe and commit to as a lifestyle.

I’ve also started exercising consistently again. Though I play tennis, I don’t typically play during winter season and my next season won’t be starting up for another month or so. Nonetheless, even when playing tennis, I still need to have a consistent workout habit. I let that fall to the wayside last year, but have now picked it back up.

Was weight loss and/or fitness on your list of goals for 2020? We’re almost a full month into the new year, so how has it gone so far? Which program or approach are you using and how do you like it?

Health Insurance for the Self-Employed

December 6, 2019 by tanya

Over 66% of bankruptcies in the United States are related to medical issues. From a financial perspective, how someone handles their health and medical treatment can significantly impact their money. The decisions that one makes around their health care and health insurance are very important. Since it’s open enrollment time in the U.S., health insurance is a timely topic.

No Compromising On Health Insurance

I’ve worked for myself full-time for 7 years now. Sometimes it has been a tremendous struggle. No matter what kind of challenge I’ve faced from an income perspective, the one thing I haven’t sacrificed is health insurance. It has always been a priority for me. I cannot think of a time I’ve ever seriously considered going without it.

As you may know, I’ve dealt with fibroid tumors for about the last 14 to 15 years of my life. Aside from those and issues related to those, I’m healthy. My blood pressure is great; my cholesterol is great; I’m not diabetic; I don’t have any chronic pain. The only medication I take regularly is Flonase. I say this to say, I wouldn’t consider myself to be one of those people who must, must, must have health insurance due to chronic illness or the need for expensive prescription drugs.

That – one’s general health – is part of the analysis for people who are self-employed and can’t rely on an employer to provide health care (or supplemented health care) for them. For the single and self-employed, especially, not only is there no employer, but there’s no spouse’s employer who can come to the rescue either. As a result, many self-employed folks go without the insurance or get very minimal plans. A couple of months ago, a friend of mine who recently got terminated from his job, stated flat-out that he’ll just “take the tax hit” instead of utilizing COBRA or obtaining a policy on his own.

Self-Employed Plans Suck

Plans for the self-employed aren’t great. Most are high-deductible (if you want to have a lower monthly premium payment). As far as I’m concerned, the premiums are high, too. And there’s not as much flexibility with the coverage as I used to have during the pre-Affordable Care Act (“ACA”) days.

I did have a downright bad policy one year. That was due to me being on the verge of missing the open enrollment deadline and picking some stupid plan in haste. I soon learned that it was some catastrophic health insurance bullshit that didn’t cover a damn thing. I’ve learned to do better and be more diligent about looking into plans.

This year I’m on top of the healthcare process earlier than I’ve ever been in the past. Of course, my premium went up a bit from last year for the same policy. The difference is $51.25 per month.

Before the ACA, I was always on a PPO plan. I like flexibility. I don’t want to have to get approval before seeing any provider that I want to see. In recent years, however, I’ve been on an HMO plan because the PPO plans were more than I was interested in paying.

My Insurance

Below you’ll see what I currently pay.

Premium: $337.03 per month
Deductible: $6,700

Here’s what I’ll be paying in 2020:

Premium: $388.28 per month
Deductible: $6,800

A Health Savings Account (HSA) Plan

I made sure to pick a plan that is HSA eligible. An HSA allows an employee to make savings contributions for their health care on a pre-tax basis (or tax-deductible basis if not done through an employer). The HSA contributions, effectively, reduce one’s tax burden by decreasing the amount on which a person will be taxed.

Another advantage of an HSA is that the funds held in the account can be invested and the earnings will be tax free. Considering where I am in my debt free journey (Baby Step 2 in the Dave Ramsey plan, which is the payoff of all debt besides my mortgage), I’m not concerned much about the investment benefit. My primary concern is the reduction in my tax liability using money that I’m going to spend anyway. As an additional benefit, my accountant told me that I’ll be able to receive reimbursement from my business for the $7,000+ I spent on my uterine fibroid embolization last year.

Before a couple of years ago, I didn’t realize that you couldn’t just tack on an HSA to whatever your existing plan was. You have to have a plan that is eligible for the HSA. That’s going to be a plan that qualifies as a high deductible health insurance plan, according to the guidelines for that established by the IRS.

Since I have a high-deductible plan, and one that is specifically designated as high-deductible, I’m eligible for the HSA. My aim is, obviously, to use the HSA to reduce my tax burden.

On another good note, fortunately, my dental insurance didn’t go up. That’s still $47.38 per month.

Choosing health insurance is so not my favorite thing. How are you handling it? Do you have an HSA? What was your decision-making process in selecting the appropriate plan?

Fibroids, Food and Frustration – Part 2

November 9, 2019 by tanya

Audio version of this post, read by the author.

This is a continuation of Fibroids, Food and Frustration.

The thing about fibroids is that no definitive cause of them has been determined. The Mayo Clinic states plainly, “Doctors don’t know the cause of uterine fibroids,” but certain factors appear to contribute to them. Among those factors are genetics and hormones – particularly estrogen and progesterone.

I definitely had the genetics piece covered. As I mentioned before, my mother had fibroids. My grandmother also had them. My grandmother’s fibroids were so severe that she ended up having a hysterectomy.

In the face of having a hysterectomy myself, I wanted to learn more about these alien tumors. Clearly, something was wrong in my body, which was leading to the aggressiveness of the tumors. My uterus wasn’t normal. I figured there had to be something in my biological ecosystem that was causing the fibroids to come back over and over again.

As I did more research, I discovered the work of doctors who deemed the key cause of fibroids to be the relative levels of estrogen compared to progesterone. They determined that when the presence of estrogen was too pronounced, that led to the growth of fibroids. Estrogen dominance, therefore, was the real issue.

Or, was it? Maybe there were other possibilities contributing to some kind of breakdown in my overall health. I continued to research. Did I have gut flora issues? Did I have a candida overgrowth or something? Did I have a latent allergy that had me living with acute inflammation? Was stress wreaking havoc on my body? I had to see what I could discover.

I committed to getting myself checked from top to bottom to see if there was some underlying or pervasive issue that I just didn’t see – something that was causing the fibroids to grow back.

I found a naturopathic doctor, told him about my history, and said that I really needed him to check everything. I wanted the kinds of tests that traditional doctors won’t usually order on a patient’s behalf because (1) they don’t believe that your medical theories are supported by science and (2) the tests aren’t covered by insurance policies. I took a special stool test to check my gut flora. I took hormone tests. I took blood tests. I also took a food sensitivity test. (These non-traditional tests were very expensive, by the way; the food sensitivity test, by itself, was several hundred dollars.)

I learned that my hormone levels weren’t right; my gut wasn’t right, either. These issues could be remedied with strong probiotics and some progesterone supplements.

Why I Eat the Way I Do

The worst part was the results of my food sensitivity test. I was reactive to almost everything I liked to eat – everything! There were literally 42 items on my list of reactive foods. The results of the test showed me to be mildly reactive to, among other foods, almonds, cashews, pinto beans, cherries, white potatoes, peanuts, black pepper, chocolate, yeast, turkey, vanilla, watermelon, trout, pineapple and peppermint. It showed me being highly reactive to chicken, egg, wheat, cow’s milk, garlic and ginger.

Jesus Christ.

It was ridiculous! I had already stopped eating red meat a couple of years prior, but . . . chicken? . . . . chicken?! Nooooooooooooooooo! And cheese?! Oh, and wheat?! What-in-all-the-fuck?!

The doctor assured me that if I avoided these foods for about 3 months, my body would likely reset and I would then be able to resume eating these foods. Since I had told myself that I wouldn’t get a hysterectomy until I had done all that I could do to try to correct my body, I was willing to eliminate the unfriendly foods and see what the results would be. Though I had previously engaged in some extreme food experiments in the past, this was going to be more than I was thinking I could handle. This wouldn’t be my first time not consuming something I liked, but it would surely be next level deprivation for me.

Deprivation Start Date – October 1, 2016

Before embarking on a major food deprivation project, I always mentally prepare. I pick a date and wrap my mind around the fact that, beginning that day, I’ll be giving up some things that I really like and want. The date I chose for my 3-month no cheese, no wheat, no chicken, no nothing I like diet was October 1, 2016. That would give me about 3 weeks to mentally prepare and eat a slew of cheese, chicken, bread and butter.

When the 3 months were over, and I went for my doctor’s visit, I was looking forward to hearing the doctor tell me that I could get off of my program. Instead, he told me that it would be best that I continue for an additional 3 months, as 3 months really wasn’t an adequate amount of time. Though disappointed, I made the decision to continue on with my special diet. Six months passed, then a year . . . then another year. Overall, I lost weight and felt better, but the fibroids didn’t go away.

About 2 years into the special diet, I woke up one morning to find a huge lump in my lower abdomen – in the exact same place that the two other super large fibroids had been. Over that 2-year period, there were times that I could feel the fibroids – particularly on the lower left side of my abdomen, but I could bear them. I suffered through several rough periods, but they hadn’t bothered me to the point of me feeling that I needed to pull the trigger on an extreme solution.

As I layed in bed and looked toward my stomach, I saw what, to me, was the fibroid version of Mt. Everest. I couldn’t believe it. I had been working so hard to eat properly and was diligently going to the doctor to get my hormones checked and adjusted. But that morning confirmed for me that my solution wasn’t in the food. Frankly, I was fed up and pissed the fuck off. At that point, I concluded that I had tried. I had truly given a solid effort to see if there was more that I could do – naturally – to try to reduce the presence of and effects of the fibroids.

That next month, I had another procedure to help reduce the size of the fibroids. I didn’t want to do another major surgery, so I opted against a hysterectomy. Instead, I had a uterine fibroid embolization. It was much less invasive. After one of these procedures, though a woman can still get pregnant, it isn’t recommended.

Last month made 3 years on this special diet. I was supposed to have taken the food sensitivity test again after the 6 month mark. I couldn’t bring myself to spend the money again. Yet, I wasn’t quite ready to eat a slice of pizza. Or regular, non-gluten-free bread. I figured that I had come so far and done so well over these years. My weight was where I wanted it and, aside from the fibroids, I felt pretty good. So, why stop?

The Frustrating Part

A restricted diet and restricted budget don’t go well together.

While on this debt free journey, my relationship with food has become one with very little love and a whole lot of hate. Once I got serious about finances, my diet of salmon, scallops, crab and shrimp was much too expensive. It wouldn’t work. I wasn’t willing to continue to spend the money that I had been spending. The dining out was cut and the grocery budget (even though there really wasn’t a “budget” because I bought whatever I wanted from the grocery store) was slashed. Super slashed.

A restricted diet and restricted budget don’t go well together.
~ Single Girl

It’s been a challenge for me over the last few months. Seriously. And I’m still trying to figure out how to make my diet work while on this journey. There’s the financial side and the health side to consider. I’ve been incorporating other foods that I hadn’t been eating previously. The only non-red meat protein option that isn’t chicken (highly reactive food for me) or seafood (too expensive) that I’ve been consuming is turkey (mildly reactive for me). But, I’m not so sure that I should be eating as much of that as I do, either. Peanut butter and jelly sandwiches are a staple in a common debt-free diet, but gluten- free bread is much more expensive than regular bread. Ramen noodles (which I actually like) could be a cheap snack or meal, but . . . they are made with wheat. So, that’s not an option for me.

What’s even more frustrating is that the benefits that I got from having such a restricted diet aren’t as apparent as they once were. My body is not responding to the diet like it did before. My weight has gone up gradually over the last few months. I’ve got to figure out what to do to get it back down to where I like it – again, without blowing my budget. It’s one thing to be broke. I really don’t want to be broke and fat (yes, I said it).

I’m also at the point where I’m wondering if I even need to continue on the diet at all. It’s been 3 years now, which is way longer than the 6 months the doctor said I needed to give my body time to reset. I could probably easily get some answers by just taking the food sensitivity test again. But, I don’t want to spend several hundreds of dollars on it right now. Instead, I’ve started to read a book called The Plan: Eliminate the Surprising “Healthy” Foods That Are Making You Fat — and Lose Weight Fast. In the book, author Lyn-Genet Recitas outlines a way to test your reactivity to food on your own. I intend to take the time and steps to do my own testing to see if I can get a grip on what I should be eating to feel as good as possible and keep my weight in check as well. We’ll see what happens.

Fibroids, Food and Frustration – Part 1

November 6, 2019 by tanya

Audio version of this post, read by the author.

I promised in a previous post (see Thou Shalt Cook – A Debt-Free Commandment) that I’d provide more details on the nature of my diet and why I eat the way I do. Let me start by giving some background.

Attack of the Demon Fibroids

When I was about 29 years old, I was told that I had abnormal growths on my internal lady parts. With her finger in my vagina, my gynecologist asked me rather casually, “Anyone ever told you that you have fibroids?”

Ahhhh . . . nooooo.

Uterine fibroids are smooth muscle tumors – usually benign, non-cancerous – that grow in a woman’s uterus. They can grow in the lining of the uterus or be attached to the uterus by way of a stalk or stem. They can be small, like a pebble, or grow to the size of a grapefruit. Depending on their size and location, they can change the size, shape and position of the uterus. In extreme cases – medically described as a “giant” fibroid – a fibroid can be the size of a pumpkin and weigh over 25 pounds.

According to Our Bodies, Ourselves 2011, “about 30 percent of women get fibroids by age 35 and almost 80 percent of women will have fibroids by age 50.” Though most women will eventually have them, they are often non-problematic. To the extent that the fibroids don’t impact one’s menstruation, romantic life or quality of life, they’re pretty much a non-issue. For others, fibroids can cause heavy bleeding, pain during intercourse, and infertility.

I first heard about fibroids when I was 10 years old. I remember my mother telling me that she was diagnosed, while she was pregnant with my little brother. She didn’t do anything about hers. They didn’t give her any trouble.

I opted to not do anything about mine, either. As far as I could tell, they weren’t bothering me. Though I had always had terrible periods, I thought that’s just how my body was. As a teenager, I’d be paralyzed by menstrual cramps (yes, actually paralyzed in my seat, unable to move) every month. I also had a very heavy flow. Again, I assumed that this was just how periods went – or, at least, my period.

In my early 30s, the fibroids became a problem. By this time, intercourse started becoming noticeably more uncomfortable. Sometimes, it was flat out painful. Eventually, I could actually feel the tumors in my lower abdomen. On my left side, just above my bikini line, when I touched my stomach, I could feel a hard bump – a little hill in my belly. When looking at a profile of my body in the mirror, I could also see where my lower stomach protruded. It seemed that I had one particularly out of control fibroid. And it continued to grow.

When I was 32, the fibroids started affecting my bladder. I was waking up often during the night because my bladder simply couldn’t hold much. The fibroids had gotten so big that they were pressing on my bladder, decreasing the amount of space I had in there to contain my urine. At this point, these damned things were not only affecting my sex life, but also just my general quality of life. I couldn’t get a restful night’s sleep and I was spending too much time going to the bathroom. By this time, according to my doctor’s assessment of my ultrasounds results, my biggest fibroid was the size of a grapefruit. I’m not a big woman. I’m only 5 feet tall. At the time, I probably weighed 127 pounds. So a fruit-sized protrusion from my abdomen is noticeable.

In 2010, I opted to have an operation – a myomectomy. It is a major surgery in which the fibroids are cut out of the uterus, while keeping the uterus as intact as possible. A great thing about the surgery is that it removes the growths; a bad thing about the surgery is that it impacts the integrity of your uterus. Once a woman has a myomectomy, in the majority of instances, her gynecologist will warn her that she should not plan on delivering a baby vaginally after the procedure. The concern is that, with the uterus having been compromised through the surgery (and being cut in a number of places), the risk of her uterus rupturing during labor is greater than if the uterus had never been cut.

WARNING: MEDICALLY GRAPHIC IMAGES FOLLOW IN THIS POST

Generally, a woman at my age (32 at the time) who wants to have children should have a myomectomy with the aim of getting pregnant shortly after healing from the procedure. Though I had a boyfriend at the time, he was just a boyfriend – not a husband – so I had no pregnancy plans in mind.

What mattered most to me was my quality of life. I was tired of not being able to sleep through the night. I was tired of the extraordinary bleeding. From a vanity perspective, I was irritated that I had a pooch tummy, even though I was in good shape.

The fibroids that were removed during my 1st surgery in 2009. The measure on the left is in centimeters. The big one is 7×9 centimeters.

These Demon Fibroids Won’t Go Away!

About 4 years after my first myomectomy, I woke up one morning and couldn’t urinate. It was physically impossible for me. I began to panic. I was used to, at some points during the month, having to press a little on my lower abdomen to ensure that my bladder was empty. Eventually, that morning, I was finally able to use the restroom, but I knew that something was amiss.

I went to see a urologist and was told that, indeed, something was impacting my bladder function. The fibroids had returned. Apparently, it’s a very common occurrence. Depending on the woman, the myomectomy can turn out to be a temporary fix, not a permanent one. I didn’t realize that when I opted for the first surgery.

My periods got progressively worse. Over time, a big fibroid, in the same location as the previous mammoth one, was protruding from my stomach, making even the wearing of a seat belt an uncomfortable proposition. I was planning life activities around my period because there was always a risk that I would be bleeding all over the place. I was in constant fear of soiling my clothing or a car seat (which happened more than once; my poor boyfriend at the time was traumatized).

I was also in an extraordinary amount of pain every month. One day, I was working and the pain was so severe, that I literally crawled on the floor in the office to get to the bathroom. Pain medications weren’t working; the blood was excessive, and I was hating my body and my life. A male colleague of mine, who was working with me in the office at the time, was unwilling to let me drive home because I was in no condition to be coherent on the road.

This led to a second myomectomy – even though I had just had one only a handful of years earlier.

So, I have the scars of a woman who has had 2 C-sections, even though I’ve never had a baby.

Fibroids that were removed during my 2nd surgery. I grew several sizeable fibroids in the period of time between my surgeries.

Time for the Big “H”

Things were going well after my 2nd myomectomy . . . until they weren’t. Once again, the fibroids were back – noticeably back. I could see and feel them – again! My gynecologist said that, at this point, we ought to look into a hysterectomy as a next step.

As I sat in his office faced with the suggestion that I, a woman in her late 30s without children, completely eliminate the possibility of ever carrying a child, I wasn’t really open to his suggestion. Before I went to his office, I expected him to encourage a hysterectomy as a next move, but I wasn’t sure that I was ready to embrace it. Obviously, we needed a non-myomectomy solution because I had already had 2 of those surgeries for the same issue in a period of less than 5 years. It would be ridiculous to think that I could just keep having surgeries periodically to remedy the issue. So, here I was again, with a uterus full of these fucking demon fibroids trying to figure out what step to take. “You have a uterus that loves fibroids,” my gynecologist said. Apparently, I do.

I didn’t cry when I heard him mention the “H” word. Though I, intellectually, could fathom the idea that I might eventually have to have a hysterectomy, I wasn’t willing to tear out my uterus quite yet. Before taking that step, I wanted to be sure that I had done everything I could possibly do to fix the problem. Yes, I had already taken extreme measures by having 2 major surgeries, but, was there something else I could do? Anything? In response to my doctor’s recommendation, I was thinking, “Eh, I hear you, but I’m not quite ready to do that.”

[To be continued . . .]