A Spring-y Update

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Spring has finally sprung here in Michigan!  [Insert a loud and dramatic sigh of relief].  What a winter this was!  I had a nasty, debilitating virus and CF exacerbation in December followed by three additional viruses over the course of what were some of the coldest months (weather-wise) of my life. Talk about feeling cooped up! My lungs have been aching for a breath of warm, fresh air.

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Lucas’s first ever snowman (who he named “Dusty”) is now…

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…a memory. See you next winter, Dusty!

My latest virus hit right after I wrote my last update.  I had a sinus infection and a sore throat and this time, pink eye.  Lovely. I went to a primary care physician who prescribed drops for the pink eye and told me my other symptoms were viral.  She did encourage me to follow-up with my pulmonary specialist, however, and I just happened to have a routine appointment on the books for the very next day.

After I got to the appointment and took my breathing test, I knew I was in trouble. My FEV1 was down 13 points.  What a shock!  I knew I was struggling and hadn’t felt great in weeks, but I never would have guessed my lung function had dropped so drastically. My CF doctor put me on oral antibiotics immediately and scheduled another appointment for just four days later.  The antibiotics took care of my acute sinus and throat symptoms within 36 hours (so maybe they weren’t viral after all?) but I continued to struggle with noticeable wheezing and inflammation in my lungs. When my FEV1 showed no improvement four days later, I started on steroids.

I’m now a week into the steroids and a week and a half into the antibiotics and am feeling pretty good.  I’m a little cloudy–the steroids make it very difficult to get a good night’s sleep.  But it feels great to be free from troublesome levels of congestion and inflammation, and although I’m not exactly breathing easy, I’m breathing easier. I’ve felt well enough to be out and about with Lucas, enjoying this warmer spring weather.

Sticks, snow, puddles, mud, rainboots...it's a little boy's heaven out there.

Sticks, melting snow, puddles, mud, rainboots…it’s a little boy’s heaven out there.

Here comes the sun!  (And yes, Jaime and Lucas picked out those boots for me :))

Here comes the sun! (And yes, Jaime and Lucas picked out those *bright* boots for me :))

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Swinging at the park!

Now for an update on Operation Up Scale and Lace Up. I have stayed true to my committment to gain weight and have put on three pounds so far.  I haven’t gained an ounce since I started the antibiotics as they always upset my stomach, but my weight is holding steady.  I know I’ll get those last two pounds on once I finish out the medication. The MyFitnessPal application has been an awesome help in this endeavor again.  It keeps me on track with my calorie goals.

I got back on the treadmill too!  Thankfully I never got terribly ill with this virus or bacterial infection or whatever it was, so once I started on the steroids and antibiotics I recovered enough within a few days to have energy to exercise.  Last week I walked two miles at a 15 minute mile pace three times.  This week I started back on the couch to 5K program and alternated jogging one minute and walking a minute and a half for the two miles.  It’s going well! (Initially I typed cough to 5K. Is that a Freudian slip or what?!)

I have another pulmonary appointment in two weeks and I am hoping to see a big jump in the right direction on my FEV1. Even a little hop in the right direction would be encouraging. I have to remind myself over and over that healing takes time, and to choose patience over panic.

Happy Spring everyone!

An Update and a Non-Update

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Hi All, I’m stopping by for a quick update.  I have some good news to share about Operation Up Scale…a week into calorie counting I’ve gained a pound.  Yay!  I haven’t loved eating all those extra calories.  There were plenty of times this past week where I had to take a deep breath and force myself to finish those last few bites, but I did it.  I’m relieved the weight is returning and I’m hoping within the next month I might be back to my target weight.

I wish I could give you an update on Operation Lace Up, but alas, I cannot.  The very same day I posted that I was working on these goals again, I got sick. It was Saturday and my throat hurt so bad I headed into the clinic at my doctor’s office to have a strep test.  Other CFers may understand what I mean when I say I was really, really hoping it was strep.  I know, that sounds crazy, right? The thing is, strep is easy to cure with a few days of antibiotics.  The alternative, a virus, is much harder for my body because there are no medications available to give me a hand.

But…it wasn’t strep.  My doctor sent me home with strict instructions to rest and sleep and drink a lot of fluids.  She warned me that the viruses she had been seeing were starting out with sore throats and sinus issues and landing in the chest three or four days in. She said that they were hitting [otherwise healthy] people hard. You can imagine the trepidation I felt at hearing those words!  Please, not a repeat of December!

About 24 hours into the virus I noticed a few key differences. First of all, I never got a fever.  Second, my appetite wasn’t nearly as affected as it usually is when I get sick.  My throat hurt like crazy, my sinuses weren’t great and I was very tired, but that’s it.

I’m six days in now and feeling decent, almost normal. I’m still more tired than usual and am trying to be careful about my energy.  Because of that, I haven’t been on the treadmill since last Friday, hence no update on Operation Lace Up.  I’m hoping to feel strong enough to get back to it this weekend.

Although that goal was temporarily sidelined I’m feeling extremely encouraged and so very grateful that I didn’t get too sick with this virus or require medical intervention.  As Lucas would say, Hoooorayyyy!!

Hooray!!

Hooray!!

Things are looking up around here! (Get it?)

Operation Up Scale and Lace Up…Take Two

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As you know if you’ve been following along, I’ve been struggling with my health these past few months.  I’ve lost weight and I haven’t been consistent with exercise since I got sick in December.  This week I decided it was time to get back on the scale and back on the treadmill.  It was time to see exactly what I was dealing with and start working my way back to “normal” again.

Well, sadly, it looks like in both areas I’m back to square one.

[Gasp], Not square one!!

[Gasp], Not square one!!

Yes, square one.  *Sigh.  I have lost all of the 5-6 pounds I gained during “Operation Up Scale” last spring and summer. This is not terribly surprising. I need to consume more calories than the average person simply because I burn more calories breathing and talking and walking around because of the strain cystic fibrosis puts on my body.  I also am unable to absorb all the nutrients in my food. Because of both of these factors, when I get sick (and I’ve had both a respiratory illness and the stomach flu these past two months), I am unable to come close to meeting my body’s calorie demands, and the weight falls off rather quickly.

When I stepped back on the treadmill, I found that I could only walk at 3.5 miles per hour for 25 minutes which totaled 1.5 miles. Right before I got sick in December, I was jogging 2 miles in 25 minutes (at about 4.7 miles per hour) thanks to “Operation Lace Up“.  This big drop confirmed what I have been feeling, that my lungs are struggling.  Even when I started my modified couch to 5K program last July, I was able to start running and walking at 4 miles per hour.  Upon reflection, I realized that at that time, I had a much higher base level of fitness.  With the nice spring and summer weather, I had spent several months outside playing with Lucas and had logged many miles of walking by pushing him in his stroller to the parks, to the bus stop, to Jaime’s office and the local museums. This time I’m getting off the couch for real.  (Hmmm, the couch. So much more comfy than the treadmill.)

Now I’d like to tell you that these setbacks didn’t faze me but the truth is, I was pretty discouraged and upset at first, especially about the exercise. It took me several conversations with my husband, and several conversations with God to find peace with it. It’s hard when you work hard to achieve something and then have to start over due to circumstances outside of your control. On one hand, cystic fibrosis makes these falls harder and faster than they would otherwise be, and the journey back to health is longer and more difficult. But on the other hand, this is just life and these types of setbacks happen to everyone. So after about 18 hours of feeling disheartened and dealing with those negative voices telling me I’d probably never get back to my previous level of fitness and health, I screwed up my courage and got to work.

First I got back on MyFitnessPal and started tracking my calories.  I set my goal at 3200 calories again but cut myself a little bit of slack this week.  I’m still not feeling 100% so my appetite is reduced.  I did notice that I was able to get closer to my goal each day and yesterday I finally hit the target.

I got back on the treadmill the very next day, and the day after that, and the day after that.  I was even able to push up my speed to 3.7 (baby steps).  When I did Operation Lace Up last summer, I only worked out three times per week, but I think this time I’m going to try to walk almost every day.  Because my activity level is so much lower due to this freezing cold and snowy winter, walking more is the only way I can get the base level of fitness I’m going to need if I want to try the running again.  I’ve decided just to focus on walking for a few weeks and once that gets easier, I’ll try that modified couch to 5K again and hopefully work back up to running the two miles.

So!  Here we are, Operation Up Scale and Operation Lace Up, take two.  Hopefully the shock and dismay I felt at being back at square one will turn to joy…

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and laughter…

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when I meet these two goals again.  (I think I can, I think I can, I think I can…)

Operation Lace Up

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I’m happy to report that Operation Up Scale is completed!  Surprisingly, after plateauing for a few weeks, I gained the extra pound and another half pound to boot!  It’s time to start working on my next goal, Operation Lace Up.

I mentioned in a previous post that I used to jog but I haven’t for several years because of pregnancy, childbirth, and general lack of extra energy due to caring for my active boy.  I am feeling strong right now and am ready to give some planned exercise a try.  I’m going into this realistically, however, and if I need to pull back because it’s too much, I’m willing to do that.

There are several reasons why I want to get back into exercising.  Exercise is good for everyone, but it is especially good for CF patients.  It is one of the few things that can actually increase lung capacity.  It also strengthens the body and the immune system.  A strong body means extra endurance for the challenges associated with cystic fibrosis.  And exercise is a natural way to clear the airways of excess congestion.

Exercise is also good for bone density.  People with CF are prone to osteoporosis and osteopenia.  This is because nutrition, lung disease and bone health are related.  If a CF patient has poor nutrition due to malabsorption or low appetite, the body does not get sufficient vitamins and minerals which are essential for strong bones.  Lung infections cause inflammation which can also lead to bone loss.  Sometimes CFers are inactive for periods due to illness and this weakens both muscles and bones.  If that weren’t enough, some common CF medications such as steroids and appetite stimulants cause bone loss.

When I first started thinking about exercise I was considering doing a Couch to 5K program.  However, after careful consideration I’ve decided that running three miles is not necessary for me.  Before my pregnancy I was running and my fastest pace was a 13 minute mile.  In other words, it will take me nearly 40 minutes to run a 5K once I work up to it, and that’s too much time and energy to devote to running right now.  My doctor has stressed in the past that 20 minutes of consistent aerobic exercise will give me all the benefits I listed above.  I don’t need to do more than that.  I don’t want to have to cut back on all the activities I do with Lucas just so I can run a 5K.

I’ve decided my goal will be to run two miles, about 25 minutes of jogging for me.  I found a Couch to 5K program online and am using it as a guide to help me get started, but I’ll be stopping at the two mile mark.  It combines jogging and walking.  At first you walk more and as the program proceeds the ratio changes until you’re only jogging.  If the pace is manageable, it will take me about six weeks to work up to running two miles.

Lucas picked out some awesome pink running shoes for me for my birthday.  He was very excited to give them to me.  He will be happy to see my wear them.

imageI’m ready to lace them up and hit the road!  This is going to be very difficult for me.  I know that.  When I get discouraged I’m going to glance down at my bright feet and think about my boys.  I’ll remember how much they love me, how much I love them, and remind myself that many worthwhile things in life don’t come easy.

Operation Up Scale Update (and the zoo)

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Things are going well with Operation Up Scale.  I’ve gained four pounds which is just a pound shy of where I’d like to be.  I’m having a difficult time getting that last pound on and I suspect I will have to add even more calories to my daily intake if I want to gain it.  My body seems to be resisting more weight and it’s hard to know how much to push.  I feel comfortable at my current weight, I just wanted a little extra cushion 😉 because I’m hoping to add focused exercise into my life soon.  I often drop some weight when I start a new exercise routine.  But 3200 calories a day is about all I can stomach :).  Okay, enough with the puns!

It also seems that in order to maintain this higher weight, I will have to continue eating this much.  I’ve been at my current weight for several weeks now in spite of the higher calorie intake.  Between my CF needs and active days caring for my boys, I must be burning lots of calories.  I get tired of eating, and I’m not thrilled about continuing at this rate, but if this is what my body requires, I just need to do it.

The calorie counting (made tolerable by MyFitnessPal) has caused this process of gaining weight to be so much easier than it ever was in the past.  It has kept me on target.  And it has shown me some of my shortcomings when it comes to getting enough food.  For example, last week we went to the zoo.  We had a great time!

Lucas liked the fake animals almost as much as the real ones!

Lucas liked the fake animals almost as much as the real ones!

Elephants!

Elephants!

Lunch Break!

Lunch Break

Flamingos!

Flamingos!

I ate a good breakfast before we left.  I packed a decent lunch.  But a zoo trip takes a lot of energy!  I pushed Lucas around in the stroller.  I lifted him up to see various animals.  I chased him around on the playground.  And we walked a lot (we clocked it later and it was nearly two miles) to see all the exhibits.  It was also very hot and humid at the zoo (a big appetite killer for me) so in spite of all that activity, I didn’t feel like snacking.  I ate a good dinner but not a high calorie one.  I had an event in the evening, and when I got home I realized I hadn’t inputted any calories for the day.  When I finally did, I was almost 1000 behind my goal!  Thank goodness for Trader Joe’s dark chocolate peanut butter cups; there’s 200 calories in just three.  With those and a few other (healthier) high calorie choices, I was able to make up the difference before bed.

This type of deficit is common for me if I’m not mindful because we are out and about a lot.  If I don’t pack plenty of snacks, I don’t get the calories I need.  I’m working on being better about making time to take care of my own needs before leaving the house, not just Lucas’s.  I never forget his snacks, but I forget mine quite regularly.  So next time we are out, whether we are at the zoo, a museum, the park, a play date, or the pool, I’m bringing along my peanut butter cups!  And maybe some other snacks too.

Operation Up Scale – Calorie Counting

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I’m a little over a week into my quest to gain some weight and things are going pretty well.  I mentioned in my first Up Scale post that I have to count calories in order put on weight.  I hate counting calories.  However, I found something that has made it so much easier!  A friend of mine told me about MyFitnessPal (http://www.myfitnesspal.com/), a free online tool and smartphone application that tracks calories and exercise.  Most people use it to lose weight, but it is possible to adjust the settings in order to make a weight gain goal.  I added a target number of calories I wanted to consume each day and I was on my way.

It’s a really cool app.  I can scan bar codes off a package with my phone and the nutrition information will come up.  From there I can edit the serving size and it modifies the calories for me.  I can also search the database for foods that don’t come with bar codes like fruits and vegetables, and all the nutrition info is added in.  I can input recipes that I make regularly and it calculates the calories for each serving.  Each day, I simply enter what I eat under breakfast, lunch, dinner,  and snacks.  It deducts the calories consumed from my target amount of calories, and even adjusts for exercise.

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It shows me what percentage of my calories are consumed in carbohydrates, fats, and proteins. I can also see some of the major vitamins and minerals.

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I found out that I wasn’t always getting the recommended daily amount of sodium (adjusted for the higher calorie intake) which is especially problematic for me since I need extra salt.  This is because when a CF patient sweats, the sodium and chloride (salt) that carries water to the surface of the skin are not reabsorbed into the body like they should be (this is part of the basic defect), so I lose lots of salt, especially during the hot weather months.  In fact, you can actually see grains of salt sitting on my skin on the hottest summer days.  Low salt levels lead to weakness, dehydration, and other problems so it’s important for me to be aware of how much I’m getting.

With the help of this application I’ve been able to consume roughly 3200 calories each day for about 10 days running now.  I’m not going to lie, I’m sick of eating.  (Anyone else out there lose their appetite in hot weather?)  But I have gained more than a pound already which is motivating.  I’m happy to be on my way, and thrilled to have found a way to make it easier!

 

Operation Up Scale

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I’ve been thinking lately about setting some goals for myself.  But sometimes when I decide I need to make some changes, my eyes get too big.  I start thinking of all the areas in my life where I could be doing better and I decide to tackle them all at once.  That’s a good recipe for failure.

I also set unattainable goals sometimes. For instance, after my big CF health crisis in 2006/2007, I set a goal to get my FEV1 back into the 60s.  I had previously spent lots of years in the 60s and low 70s, and I really wanted to get back there.  I worked very hard to achieve that goal.  I rested and slept, I reduced my stress level, I ate healthy foods and I gained back the weight I lost during the extended illness.  I worked up to jogging, I lifted weights, I did all my treatments and therapies, and I took all my medications.  But I never made it back into the 60s.  It couldn’t be done.  Rather than feeling like a failure for not getting there, I should have felt like a success for doing everything in my power.

And so this time I want to set achievable goals.  Instead of tackling them all right now, I’ve decided to address one at a time.  Once I meet one goal or at least get a good start on it, I’m going to try to add in another.  Manageable is the key, right?

I’m going to start with gaining a few pounds.  Many CF patients have low body weight because thick mucus obstructs the pancreas and blocks the body’s natural enzymes needed for breaking down food and absorbing nutrients.  Taking digestive enzymes helps, but they don’t completely solve the problem.  Also, living with reduced lung function and constantly fighting off infections uses lots of energy and burns lots of calories.  Because of this, people with cystic fibrosis need 20-50% more calories than the average person.

I recently changed my diet which has helped me to feel better overall.  (I’m working on a post about it right now).  One of the changes I made was cutting out dairy.  Dairy has links to asthma, congestion, and is somewhat difficult to digest.  Within a few weeks of eliminating it from my diet I had a less congestion and more energy.  But eliminating dairy has contributed to some weight loss.  I relied on dairy products for easy calories.  It’s time to find a way to gain the weight back and keep it on sans whole milk, cheese, yogurt, and shakes.

Before you start wishing to be me, know that it’s neither fun nor easy for me to gain weight.  Because my caloric needs are already higher than average it takes a lot of effort to actually gain weight.  I have to think about food all day, remember to eat many snacks, eat beyond when I feel full, and count calories.  It’s a pain.  Some people dream of being able to eat whatever they want.  That usually translates to junk food of some sort.  But eating unhealthy foods only complicates other health issues and so I certainly don’t want to gain weight that way.  I need to give my body foods that fuel it and enhance its performance, not foods that cause digestive issues, inflammation, and sluggishness.

So why all the focus on weight?  Healthy body weight is linked to higher lung function and the ability to fight off infections for CFers.  Having a healthy weight also strengthens the immune system.  Plus, when I’m at my optimal weight, I feel more energetic.

So on Monday I’m starting Operation Up Scale.  I’d like to see the scale go up about five pounds.  I’m starting to stock my cupboards.

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I’ll keep you posted on how I’m doing.  I’m hoping that blogging about it will keep me accountable.  So here’s to a weightier me!