Well, this is good anyway

[annathepiper]

Had the appointment with the nutritionist today, which went about like I expected, only longer--solarbird and I were there for an hour and a half while this woman quizzed me thoroughly about my history with food and weight and such.

The good news is, she was pretty pleased with many of our already established eating habits, and she approved of my ditching the soda and of my strict snack rationing. The bad (albeit expected) news was that I need to bump up my fruit and veg intake, and also definitely resume my free weights exercises. I also need to ditch the efforts I'd started to have juice with lunch, on the grounds that juice is less helpful than having actual fruit. Meanwhile, Dara has been advised to edge the veg up during dinners, and the nutritionist made a good suggestion about putting the veggies on the plate first, so as to have them dominate the territory.

I am to keep up with this food log thing. And I think I'll be resuming the weights on Saturday when I'll have my first window of time free to work 'em in. Till then, I'll keep up with the current food habits; I'm already seeing improvement in my appetite just by ditching the soda and by rationing the snacks. And I've been inspecting the drink shelves at Whole Foods to see what I can purchase to drink with lunch that a) isn't water and b) doesn't have too many calories. The HonestTea brand seems potentially good; I found their "Community Green Tea" flavor today, which had only 34 calories to the bottle and just enough cane sugar and orange flavor to it to make it not too bad. I think this'll be my lunch drink for a while.

I think that in the interests of keeping this in the forefront of my brain, I shall start adding food log data to pertinent posts (like this one). And just to throw in other pertinent numbers, I'll resume more regular tracking of my walking as well. I'll slap this stuff behind a cut, though.

Meanwhile, the Stunt Boob has been acquired, and it's surprisingly comfy and natural-looking. Enough that it boggled both me and Dara. Should it happen that I have to postpone reconstruction surgery for whatever reason, I think I'll be able to put up with wearing this for a while.


Breakfast at 7:15am: 1 cup miso soup, 1 oaty bar, 1 cup green tea
Lunch at 12:30pm: 1/2 herb turkey & havarti sandwich, Asian pear, 1 bottle green tea (16 oz, 34 cals)
Snack around 3:30pm: Apple
Dinner around 7:30pm: Stir fry (chicken, onions, carrots, broccoli), rice, applesauce with cinnamon
Snack around 9pm: 1 cup green tea, 2 rows dark chocolate
Also drunk during day: 5 glasses water

Miles since May 21st: 35.9
Miles out of Hobbiton: 2899.7
Miles out of Minas Tirith: 62.7
Miles to Hobbiton: 1562.3

Comments

[chamois-shimi.livejournal.com]

On the making water more interesting front, my mom is really fond of the TrueLemon and TrueLime packets you can get at the grocery store. It's pure crystalized lemon or lime juice, no sugar, so it's just all flavor. I like 'em too, but find I have to use about 3 times as many as she does to be happy with the flavor. :)

[annathepiper]

The nutritionist mentioned that very stuff, in fact! I looked for it at Whole Foods yesterday but didn't see any. I'll have to see if I can find it.

[chamois-shimi.livejournal.com]

I get it at Safeway, in the um .. hmm. Not the powdered drink section, it's like by the ... by the soy milk, maybe? Gosh. Can't remember. :P They must have it at Fred Meyer too, since that's about the only place my mom shops.

[annathepiper]

Thanks for the tip! I'll have to check the Safeway nearest to our house and see if they have it there. I tried one of the other stores I usually shop at, the Thriftway, and two different workers there weren't able to tell me if they had the stuff.

This is something in packets, right? Not something that has to be refrigerated? Or does it?

[technoshaman.livejournal.com]

Yay Stunt Boob!

*blinks* Miso soup for breakfast?

OTOH, with all that green tea? You'll likely make it to 2069 and get to go to WorldCon in Luna City... :) (/me hopes so and further hopes you enjoy it...)

[mdlbear]

Miso soup makes an excellent breakfast, preferably with a few cubes of tofu on the side, and a couple of the flattened-and-grilled little fish that the Japanese serve instead of bacon.

[annathepiper]

*nodnod* It was definitely a component of the traditional-style Japanese breakfasts we had a time or two visiting Japan for Worldcon.

[mdlbear]

Didn't go for Worldcon, but I've been there a few times on business; the hotel serves an excellent Japanese/Western buffet brunch.

[annathepiper]

Cool. Yeah, that sort of buffet was available at a couple of different places we went to during the course of the convention as well as the tour we went on after.

[annathepiper]

I was having a lot of miso for breakfast during the radiation treatment, and decided to resume that, because I like miso soup. :)

And yeah, I dig me some hot green tea. This one particular brand Dara's been buying is quite tasty, very clean flavor to it.

[neutronjockey.livejournal.com]

The bad (albeit expected) news was that I need to bump up my fruit and veg intake,

What the...?!

Fruits and veggies? That's what the food eats!

[annathepiper]

*snicker* I hear that. But I was expecting that since this handout I got that talks about foods that are good cancer preventatives is all about the fruit and veg. And if I really want to be aggressive about this weight loss thing, well.

[mdlbear]

Yay for stunt boob! Mom's been wearing hers for 50+years; I doubt anyone not in the know ever noticed in all that time.

Another thing that helps is a big serving of salad as the first course. Takes the edge off the hunger and starts filling you up, for a very small cost in calories.

[annathepiper]

Yeah, the nutritionist was a big fan of salad, especially once we told her that Dara's been growing fresh greens in the garden. :)

[kissare.livejournal.com]

Stunt boob... just saying it cracks me up every time! Glad it's comfortable and nice-looking. :)

[annathepiper]

Hee, yeah! The bra they gave me to wear it in, not so much--I've had to adjust it a lot to make it comfortable. It's weird going back to a more traditional-style bra after wearing sport bras and Decent Exposure bras most of my adult life.

[kissare.livejournal.com]

Do you have to use their special bra? Will it not fit properly in a regular one? Hopefully as you wear it longer, it will conform to your body and become more comfortable.

[annathepiper]

Well, the deal with the special bra is, it's got a pocket in it to hold the thing. There would be the question of whether having it rest directly against my skin would be annoying, and whether that would be more or less annoying than seeing if someone cleverer with a needle than I am could properly alter my current bras. This will require experimentation!

[bloody-keri.livejournal.com]

I'm glad she advocates free weights. In my little fitness 'journey' I've become a HUGE fan of free weights. They really are the most beneficial, I believe, in stengthening the body through every range of motion.

I eat a ton of fruit, but I'm a little lax on the vegetables myself. They're just so bland. I don't know if you like 'buttered' veggies, but I always did and since that was just about the only way I'd eat them, I just didn't eat them much after I started my diet program, because I didn't want the butter. That was until I discovered "Smart Squeeze", which is a very butter/margarine-like squeeze spread that has NO oils or butter at all, and is very, very good. So, now I find I can stick with a few staple favorites - broccoli, carrots, cauliflower, corn, etc. - by steaming them and putting some of that Smart Squeeze on them. It definitely tastes enough like butter to make it good, and now I'm a lot closer to getting the amount of vegetables that I need (although I'm not there yet).

Food logs may seem boring but I think they're a great idea, especially if you have a particular goal in mind, like losing weight or changing portions, eating healthier, etc. It's amazing how much it helps to track it.

[annathepiper]

See my other comment re: free weights, yeah. I've got this spreadsheet of various exercises that kathrynt gave me, which she in turn pulled out of Weightlifting for Dummies. I just need to get back into doing the exercises on the spreadsheet, and setting aside proper time to do it.

Thanks for the tip about the Smart Squeeze stuff. :) I actually kind of like fresh broccoli and carrots, and it helps as well that solarbird plants fresh greens in our garden, which makes for really tasty salad.

Hi

[jackiehl99.livejournal.com]

Not sure if you remember me, I went through a DCIS diagnosis last September, and had my mastectomy (by Dr Towbin). I am very sorry to learn that you had a recurrence of the DCIS. Good choice about going for the mastectomy. Some DCIS patients I know who opted for lumpectomy+radiation, all said they wish they had a mastectomy, even with no reccurence, as the chances of reccurrence in the same breast are always higher.

I also consulted with Dr McMillian (sp?) for reconstructive surgery, but ended up choosing Dr Drew Welk at the Polyclinic in Seattle, who was highly recommended to me by two friends for whom he had performed reconstructive surgeries. I am now at the final stage of the reconstruction (it takes several months!) and I highly recommend Dr Welk. At the least I would recommend you would consult with at least one more surgeon before making your choice, and talk to patients if possible.

Also, regarding Tamoxifen, I am surprised you were told to stop taking it, as it is supposed to reduce the chances of DCIS in your healthy breast. Was that Dr Kohn's advice? (she is also my oncologist)

Finally - one thing I was told by Dr Kohn is to reduce my soy intake, since my cancer was Estrogen Receptor positive (as I'm assuming yours was, since you were prescribed Tamoxifen) and soy is supposed to be a pseudo-estrogen.

Best of luck on your journey.

Jacqueline Lee

Re: Hi

[annathepiper]

Hi there, I do remember you! Thanks for coming by and updating me on your situation.

Re: the Tamoxifen--actually, no, that was my decision. The reason for this was because my partner and I are looking at the possibility of having a child, and since it'd be me who'd have to actually carry the child, I can't be on Tamoxifen if I want to do that. By the time I came off the five-year course of it, I'd be 45, which is uncomfortably late for pursuing such things.

Dr. Kohn I think would have recommended that I stay on it, but she understood where I was coming from given the possibility of pursuing a pregnancy. I asked her about the risk factors of staying on it vs. not; there were some risks both ways, e.g., the possibility of Tamoxifen causing endometrial cancer as well vs. the possibility of pregnancy hormones screwing with my system in other ways. But since I've had the mastectomy, staying on it would be purely preventative and would not actually be treating anything, so she was reluctantly willing to let me try dropping the Tam.

This is what led me into now aggressively monitoring my diet. That was the big alternative thing she mentioned that I could do myself to reduce my risk of a recurrence. I've read recently, and the handout she gave me about foods backed this up, that obesity is a risk factor for cancer... especially in the belly area. And that's pretty much where I'm carrying all of mine. ;P Dr. Kohn recommended I get down to my ideal body weight to minimize that risk, which means I get to try to lose 50-55 pounds.

Re: the reconstruction... what sort of reconstruction are you doing? Dr. McMillan told me about a few different kinds, and given that I'm young and fairly active, she recommended that I go down the route of using a muscle off my back to rebuild my right breast (with some tweaking of the left just to make it match better).

I have a pretty good vibe from her in general, and will probably go ahead and pursue this with her, for a few reasons. She was very thorough about offering me a wide set of options, and supportive about my various personal priorities. I really appreciated that. But I'm very happy you're pleased with your surgeon. :)

Re: Hi

[jackiehl99.livejournal.com]

I opted for reconstruction with tissue expander and an implant for two reasons:
(1) Due to my build I wasn't a candidate for the reconstruction using muscle or fat from another spot in my body
(2) I didn't have radiation after my mastectomy which makes me a good candidate for the tissue expander approach.

Both Dr McMillan and Dr Welk recommnended I go that route. The disadvantage is of course I might need to replace my implant later in life, so for the long term, reconstruction using your own muscles is better.

By the way, Dr Towbin initially referred me to Dr McMillan, but when I told him Dr Welk was going to do my reconstruction, he was very excited; he knows him really well, and Dr Welk is one of the top reconstructive surgeons in the area. One thing about him though is, although he is brilliant, he is not the warm and fuzzy type; and you seem to have a good connection with Dr McMillan, which is great.

Re Tamoxifen, I see why you dropped it. I would probably have done the same, if I were in your situation (I am 41, but I already have 2 kids, ages 10 and 12). And I have to say the hot flashes induced by the Tamoxifen are not so pleasant.

One thing I haven't done and shoud do is see a nutritionist. Do you mind sharing the name of the one you see? Is she at or near Evergreen Hospital?

Thanks for your reply, and keep your spirits up.

Re: Hi

[annathepiper]

Glad to hear that Dr. Towbin thinks highly of Dr. Welk. :)

The nutritionist I saw is on the staff of the UW Woodinville Clinic, which is where I go for general practitioner sorts of stuff, physicals and the like. Her name is Deborah Katz. I found my talk with her quite productive! I hope she'll be helpful for you.