Day 99 - Pharmaceutical Reductionism

Got the results of my six-week followup bloodwork today: my A1C is down to 6.0; it was 6.8 six weeks ago, and that's with several reductions in blood sugar meds six weeks ago, and going off the insulin about 30 days ago.

 I'm back on a very small dosage of lisinopril for kidney protection, but get to cut the dosage of another med in half to compensate.

Cholesterol is sneaking back up slowly with the drop in meds the last time (only to 104 total, though), so no change on the meds there for now.

Big news is that my last remaining blood sugar med (metformin), which I was on 2g (2000mg) of has been cut in half to 1g. That's two less horse pills a day.

And I'm exercising less now than I was before I started the diet[1]. Still. So nearly all of this medicine cutback (and improved control on my numbers) is all food related.

The doctor seemed to have a hard time deciding today how deep to cut the dosages; She joked that it's easier to write the Rx when things are going badly.

Still aiming for 205 pounds; Doc says to shoot for about 28 BMI. That's about 20 pounds away from here, and given what I can see that remains of my still enormous-seeming stomach, I'm not sure I'm going to stop there.  I want to be healthy, not skinny; But I have no idea what a healthy weight is, so we'll see what happens when I get to 205.

I can already see .... issues with the skin that's left; I'll try not to worry about that (other than doing crunches) until I've kept the weight off for some time.

Another followup bloodwork/visit in six weeks; I aim to cut even more meds and weight by then.

[1] Though I did go for a very nice 10mile bike ride this weekend. Work is about 14m from here, and the first 10m of that is pretty flat. Definitely going to try that one day this month.

Day 64 - Week 9 weigh in

Weight

I have been feeling like I'm plateauing for the last month, which has been killing my motivation.

Of course, on this plan with the average supposedly being 5 pounds a week, anything less than that feels like you're stalled, but looking back over the official numbers the past few weeks, I'm still losing, just more slowly.

I missed the official weigh in on week six because I was in Chicago. Week five was 255, week seven was 250, week eight was 247.5, and today was 245.5; So, over 4 weeks, I'm down 9.5 pounds, an average of about 2.4 a week. So, nothing to sneeze at.

I think the thing that threw me is that partway through week six, I was already at 247, and then I went up before going back down, but the weekly weigh ins show that I'm still trending down. So, time to quit whining about the slow weight loss, especially since...

Meds

I had gotten my insulin usage down to 35 units a day before the long weekend, and then cleverly forgot my freshly packed pen as we rushed out the door on 3 hour car ride away. Realized my mistake about 2 hours into the trip.

So, I figured I'd do a trial run on the long weekend with no insulin whatsover. I figured, my mom is using a very similar type of basal insulin, if my numbers go completely out of whack, I have a fallback plan. I was only on 35 units, and was dropping 5 every few days, so how bad could it get?

As it turns out, not bad at all! My fasting sugar was 86 that morning, I discontinued the insulin that night, and through today, it's been 90, 89, 102, 113, 104; The intra-day checks don't seem to be going over 130 (just as before.)

Now, I had checked with the doctor at the last visit; She told me to keep reducing the insulin as I'd been doing, and if I discontinued it, great. So while I should have done that last 35 units over the course of about 2 weeks, this ended up working, thankfully. Kids: don't try this at home.

So now I've managed to cut my meds needed to about half, and while doing that, have better control than I did with all the meds. And I'll probably be able to drop more after my next six week eval. Now why didn't I do this earlier?

Exercise

Slowly getting back up to speed here. Biking 2-3 nights a week.

My mom just bought our family a Wii Fit, and the entire family loves it. The kids were arguing over who gets to play it last night when I got home, which is 1) typical for them when there's a TV involved, but 2) they were exercising. For fun.

After they all went to bed, I logged about 50 minutes on it myself, doing a variety of cardio, balance, flexibility, and strength training.

I just wish the thing wouldn't say "... Oh!" every time you step on it, like you've put on another 5 pounds and it's afraid to actually tell you.

Day 53 -I am not a number, I am a free man!

The last time I blogged, I had just gotten back from a week long trip, over which I had lost 7 pounds; It's been a week since then, and today is the first day I've gone back down under that weight; currently at 246.5#. So while I did OK weight wise on the trip, it's apparently taken me a little bit of time to get back into the rhythm here at home. Frustrating, but I seem to be back on track now.

Had my 3 month bloodwork done Monday, and a visit to the doctor today to go over it. The numbers there are pretty amazing, considering I've only been on this program for a little under nine weeks. My fasting that day was 78 (on par with what I've been seeing self-testing), my A1C has dropped to 6.8 (down from a career high of 12, 3 months ago it was nearly 9). My total cholesterol is at 95. I just need to work on getting my good cholesterol up a little higher.

So, as a result, the on-again-off-again glipizide is gone, discontinuing the actos, and I've been adjusting my insulin dosage down 5 units every few days, that's currently at 50. I'm free to discontinue it as long as my fasting looks good; I'll keep dialing it back every few days, but I'm going to give it a few more days at this dosage since I'm dropping the other meds. Also cutting the blood pressure meds in half (been a little dizzy on this diet, so that'll help.) I'm also supposed to monitor the BP, if it gets too low, I'll end up discontinuing that and start reducing one of the other heart meds too.

We also talked briefly about a more final weight goal than my current 235; I'm going to shoot for 205 as a long term goal, but let's get to the first one first, mmmkay? Because things are progressing pretty fast here, my followup visit is in six weeks instead of three months.

Day 29 - 4 week weigh in

Whee, a small but measurable loss this week. Especially nice after seeing the daily weigh yesterday. Current weekly weigh in is 260.5, for a one week total of 1.5 pounds, and an overall total of 21.5 pounds. (about 3/4 pound per day.)

Blood sugar is creeping back up, it was 86, 89 respectively the last two days; will hold off on any more insulin dosage changes and get some exercise back in the mix.

Day 22 - Week 3

Official 3 week weigh in this morning is 262, for a net loss of 20 pounds so far.

Still not quite back to my daily low of 261, but since this has come more gradually, I'm sure it's gone for good.

Blood sugar this morning was 65, and I was feeling it. I've been cutting back on the insulin, will continue to do so, and to make sure I'm eating all the carbs I can on this plan. My control has never been good enough to worry about lows before I started this plan. I am now making sure I carry the glucose tabs everywhere, and checking my sugar 3-4 times a day.

Reading Think Like a Pancreas, a loaner from my mother; The short history of diabetes technology over the past 100 years or so was very instructive. (Basically, I have it good and need to quit complaining. =-)

Day 21 - Weekends Suck

So I have typically found it more difficult to stay on program (any program!) on the weekends. When I'm at work, my choices are much more limited, and I can't just wander over to the fridge or the cupboard.

I'm doing much better with this on this program than I have in the past, but yesterday, for example, I basically substituted another real meal for one of the medifast meals.

I think it's great that my “cheating” on this diet consists of extra vegetables and roast chicken, but will definitely have to be aware of when I'm going over. I was obviously completely oblivious before, or my blood sugar wouldn't have been so high: Fasting sugar this morning was 68.

3 week weigh-in tomorrow morning. See you then.

Day 15 - End of Week 2

Had my 2 week weigh in this morning. Down to 267, a 15 pound loss in two weeks. Because I had a slight dip below there, my five day average is 267.5 at the moment.

My fasting blood sugar over the last five days has ranged from 75 to 83. I am now experimenting with a slight reduction in my insulin (was up to 80 units daily) to see if I can maintain the just-below 80 fasting reading with less.

I'm currently 32% of the way towards my initial weight goal of 235 pounds. At this week's current loss levels (ignoring the 9.5 drop the first week), that would put me at about July 1st. It probably won't go that fast, but I still haven't added my exercise back in yet. I plan on doing that this week, and will report back.

I need to start planning how I'm going to do with a week away from home on this plan. I suspect I'm going to have to switch to using mostly shakes and other cold mixes, and carry a lot of bottled water. Anyone have any thoughts on that, please leave a comment.

Day 11 - onward and downward

Yesterday for lunch, the guys at work asked me to go to lunch for sushi; said yes without thinking about it; then went anyway thinking I could find something safe at lunch. Tried out a new Japanese place near Crossgates Mall, had a sashimi platter; at the time I was very hungry, but it kept me full for some hours.

Last night was rough - there was a dinner function the entire family went to, and I had already planned (even before the sashimi) to not eat anything there. I had a bar (my second of the day, even though I'm only supposed to have one a day), but by the time we got home, I ended up throwing together a salad and putting in a can of tuna (which, of course, didn't compare at all to the tuna I had for lunch).

So I ended up doubling up on bars and probably went over on my allotment of meat for the day, too. I was concerned, but woke up this morning after a sound sleep to another 1.5 pound loss, and a blood sugar of 75. Woot.

Day 9 - just another day

Today went by pretty fast.  Brother in law was out yesterday, and I ended up oversleeping this morning, so I got a late start.

Ate out for lunch with some friends (steamed chicken and vegetables); spaced out the meals a little too far the rest of the day. In order to get my full set of meals in, I had to double up on two shakes, even. Though I did that about 3 hours ago. Guess I could have waited, I thought I'd be asleep by now!

Blood sugar was up today, but only to 100 or so; but the weight was down, so it's all good.

Hopefully I'll get a few more days where I'm not constantly thinking about eating and start to settle in for the long haul… and as I'm settling in and things are more regular, I won't be posting every day. I'll definitely post the weekly weigh ins, and anything interesting or unusual.

Please leave a comment if you have any questions about the plan.

Day 8 - First full week!

“Official” weigh-in this morning puts me down 9.5 pounds for the first week!

Sugar up a measly 2 points today to 81.

Spoke to my diabetes educator yesterday; She was cautiously optimistic about my participation on the Take shape for life plan; she doesn't have any other patients who have followed the regimen, so I'll be kind of a guinea pig for her. The initial numbers look promising, but she shares my concern about what happens after the initial low calorie jumpstart.

I'm definitely planning on meeting with her after my next run of bloodwork; I'm going to want as much support as possible going off the powder and onto real food to make sure I don't backslide on the weight or the blood sugar.

Day 7 - Ups and Downs

Ups

First full week of the program ends today. A lot of people have been reporting 10+ pounds the first week, and I was on target for this until this morning's weigh-in cut my loss so far in half. Switched the little widget on the site to report the progress towards goal in terms of the 5 day average (now that I have 5 days of data and every day isn't a loss. =-) My theory on the one day reversal? too many pickles!

Downs

Today's gain isn't demotivating at all, though! My blood sugar is down to 79 this morning. This is low enough for me to (at least today) discontinue one of the blood sugar medications I'm on. This is much more important than a single day gain.

I'm perversely lucky that I have the blood sugar readings to fall back on as another indicator for how well the program is working; Though really, it's one the main reasons I got on this program, and to have it be down in this range after six days is a real win for me.

Tune in tomorrow for the official one week total. Post your guesses in the comments.

Day 6

Blood sugar at 87 second day in a row. Feeling pretty good today!

• Fit into a shirt I haven't been able to squeeze into for a while
  
• Did 35m of cardio (bike riding around the neighborhood). Low impact, but very nice.

Mother in law came over for Mother's day today. Raye grilled some food and the whole family was able to eat together outside together.

Another small loss today, woot. 

Day 5

Heard back from my doctor's office yesterday ; there's a plan now for cutting back on medications as my blood sugar drops. Fasting dropped again to 87 this morning. If it hits 80, there's one I can drop entirely, after that, I can start dialing back on my insulin.

Lunch yesterday was no problem. Got steamed chicken and vegetables. Came with rice, but the waiter at Emperor's was very helpful when I asked for the rice to go before I dug in.  Not having it on the plate made it much easier to ignore. Had some hot sauce on the side. (Just spice, nothing at all creamy.)

Felt like crap last night, tired and weak. Fell asleep (not in bed, sadly!) about 10:30 or so last night, woke up at 10 am. Thanks to Raye for managing the kids this morning (er, that's pretty much every morning).

This is my first day at home on the plan. Hopefully I won't fall back into any old habits today.

Weight loss is proceeding nicely.

If you're subscribing this via a feed, there's a widget on the main page that shows the progress so far. I figured that would be less annoying that daily posts of "another six ounces!".

Day 4

Oh, right, the wife!

I neglected to mention, Coke-focused blogger that I am, that my wife Rachael (a.k.a. Raye) is also on the program with me.; She's been doing well on Atkin's, but switched to this program too. It's not an easy switch to make, and I really appreciate it. I think long term, it's going to be very beneficial for us both to be following the same program. Thanks, Raye!

Raye fired up the grill last night, and I stopped on the way home at the fish market and got some tuna steaks for us both. Best. Food. Ever. I suspect I'll be saying that about every non-powder meal I eat for the next year. =-)

Diabetical

I mentioned in Day 1 that I'm on the diabetic version of Medifast. This basically means that some of the powders (and all of the bars) I get through the program are slightly different; otherwise, it's the same program. Just fewer calories, and different nutritional additives specifically for diabetics…

…And it's working. While I have another small-but-measurable weight loss today, my fasting blood sugar this morning was 98 (mg/dl), which corresponds to an A1C of 5.5; I think my last official A1C was about nine; probably the highest it's been since I was diagnosed five and half years ago.

Here's my fasting readings this week by day:

1. 189
2. 149
3. 129
4. 98
   

And at least so far, the readings were solid all day. Now, I'm on four different medications for my blood sugar, but the reduced calorie intake (in pretty much a complete absence of real exercise) has had an amazing impact.

I am now going to go call my doc and see what we're going to do next: I need to have a plan if this is going to drop another 20-30 points tomorrow. I am very hopeful that I'll be able to eliminate some medication due to the program. Improving my glucose control was one of the main reasons for me to start this program, and to have this feedback in the first week of the program is very helpful.

Finally, I'm also taking my "lean and green" (Medifast-speak for the one real meal you get a day) meal at a restaurant today. I have it planned out what I'm going to get, and I should be able to fit this in to the program.

Day 1

Started the Take Shape for Life program , which uses the Medifast food. I'm on the extra special diabetic plan, which has a lower gyclemic index for type II's like myself.

While I was up to 285 pounds last week, my (official starting) weight this morning was 282. Also have a 48 inch waist to contend with. While I've been bigger in the past, this is as high as it's been in a while.

I am very excited about the program. The local cardiologist's office is running the program, and their meeting with current and potential members was quite motivating.

I'm hoping to improve my general fitness, and see some improvement in my A1C and maybe reduce some of the 10 medications I'm on. (Oy.)

I am hoping that the relative lack of food choices on the plan during the initial phase will be beneficial; no thoughts about portions, no more effort than selecting a pouch when trying to decide what to eat.

After a single day, I don't really feel deprived at all. The food is very nearly un-food like, but it's just fuel. And the one meal with real food I had today tasted great. (It's not all powder and bars.)