In the winter of 2006, I decided that I had had enough of being over 200 pounds. In the nursing home where I live at the beginning of each month, we are taken to the scales and summarily weighed. It is about as horrible as it sounds but no worse than a personal trainer having you do it. On weight day, I always felt like I was going to my own execution. Since my weight stayed pretty much the same, I felt with some work I could lose.
In a nursing home, eating is an activity. I had to break the pattern that had developed over ten years. Much of the food here was not right for me. I needed fewer starchy carbohydrates, and leaner meat without breading. I also wanted to eliminate beef and pork for my diet. Most of the food here is pre-prepared and contains salt and chemicals. I had gotten used to this diet, and knew changing it could make me feel hungry and deprived.
I became accustomed to eating bread. I had toast for breakfast, sometimes a sandwich for lunch, and many times a sandwich for dinner—a total of six slices of bread a day. So I eliminated sandwiches and cut back to two slices of bread or less each day. I decided to eat just chicken, fish, or turkey and to count my calories. I started out slow and cut back two hundred calories a day. I had been on a 1500 calorie a day diet but many days my meals amounted to much more. I cut out unnecessary sweets by requesting fruit instead of cake or pie. I wanted sweets removed from my tray so I would not be tempted to eat them.
I talked with my sister about my plan to change my diet. We both felt I would meet with resistance from the nursing home staff, especially dietary. My sister felt dietary would support me when I got results. So I told the nursing home’s staff that I was dieting in earnest. We wanted the staff to be cheerleaders for me. I talked with the dietary manager about my diet often. My sister and I brought up my diet progress at quarterly care conferences. I wanted everyone to be aware of what I was doing.
I felt some drugs made me feel hungrier. So I told my doctor I wanted to decrease the Valium I took for muscle spasms and anxiety. I was taking 10 mg a day. My doctor suggested I cut back on Valium gradually by following a timetable. I knew it would be more difficult to cut down on a drug in the nursing home because I would have to adhere to a certain schedule no matter what. However, my doctor did allow me some dosage leeway on paper … in case I needed it. The doctor cut me to 2 mg tablets three times a day. From there I gradually arrived at the 2 mg twice a day I take now.
Getting off the Valium was difficult. But doing so while I was cutting back on food was doubly difficult. I ate for comfort and not doing so hurt my psyche. But I concentrated on beginning to lose weight and I was motivated to keep at it. Some days I was shaky from Valium withdrawal and I got stomach cramps and diarrhea. The plus was the diarrhea allowed me to stop worrying about my chronic constipation for awhile.
I stopped eating casseroles, stuffing, scalloped potatoes, macaroni and cheese, meatloaf, spaghetti, potato and macaroni salads, and all desserts. I convinced myself that going without them would make me feel better. I knew that sweets were not helping my constipation and felt I would notice a positive difference. I wanted to eat my largest meal at midday—the way it was served at the nursing home. I decided to eat only chicken, turkey, or fish. I thought that controlling my options would control my appetite.
Since I had eaten protein bars for a snack, I knew they tasted good and filled me up. So I used them as meal substitute and thereby cut even more calories.
I knew that I was an impulse eater, especially when I went out. So I decided that I would limit my eating out choices to Chinese food. Since I preferred chicken and fish that were not fried, I felt I was making the healthier choices. I liked al dente vegetables, which were a big improvement from the nursing home’s overcooked ones. At Chinese buffets, I could choose my portion size, was not tempted by the desserts, and found fresh fruit usually available.
I planned to eat more salads but used fat-free dressing and bought tuna to supplement my diet. I avoided chef salads with eggs and cheese because a large one can exceed my 1500 calorie a day total quota.
My breakfast went from two pieces of toast with peanut butter and Egg Beaters scrambled eggs to one slice of whole wheat toast with margarine. That was difficult because breakfast is usually the best meal in the nursing home. Going to the dining room to linger over one piece of toast was difficult, so I decided to eat in my room. I had to avoid the nursing home’s activities because they usually served unhealthy snacks. I decided if I did go, the snacks would be a meal substitute.
I kept a food diary so that I could not lie to myself about what I ate. I knew that I would feel better by eating less. But I was afraid I would not sleep well at night because of hunger pangs. But surprisingly I did not have that problem. In fact I slept better with less food.
The most difficult part was reminding my friends and family about my dietary restrictions. I did this in a positive way by telling them what I could eat and encouraging them to bring that to me. I learned to eat a little of desserts people brought me and give the rest to others or throw them away. The throwing away part was hard for me. But I realized that it was better to put it in the trash rather than on my hips and belly. I frequently reminded the dietary staff not to reward me by giving me special desserts. I did not want these desserts mysteriously showing up on my plate for me to eat by default.
I did have one advantage. I cannot eat without assistance so I cannot sneak food. I can also only eat when there is someone available to feed me. So I did have a built in checks and balances diet system.
In 2006, I began losing two pounds a month. Some months I lost three and others only one. But by the end of the year I had lost fifteen pounds. I felt good about that considering the fact that I am quadriplegic and cannot walk and move around like other folks. I knew I was a mental battle as well as a physical one and I treated it that way.
I knew if I lost weight my clothes would be too big, but that was the least of my problems. My biggest concern was backsliding and falling into my old habits and regaining the weight. I knew that I could lose fifteen pounds and gain back twenty. So I was very careful over that December’s holidays. I knew I could not eat all of those wonderful goodies. Aides offered me food and I declined, thanking them kindly but reminding them that losing weight was a priority. I would get funny looks but I just smiled and kept going.
In 2007, I was still losing two pounds a month. Then I discovered I had a cancerous breast lump. After a mastectomy for several months, I was unable to lose weight. I was craving things like peanuts and bacon. After surgery, I gave in and ate other things for awhile. I told myself that I would cut my intake in other areas. I was very dejected when my doctors told me that the Arimidex I was taking to keep my breast cancer in check would cause me to gain weight. But I told them I would work harder not to gain weight. I had been through breast cancer before and I knew that the biggest thing I had to fight was what was going on in my own mind. I learned to drink water instead of eating. Or I ate apples or oranges when I wanted dessert … or more food.
It is October 2008 and I have lost thirty pounds. My weight has been down as low as thirty-five pounds, but I have not been able to sustain that. I do have to work very hard to keep the thirty pounds off. I recently switched to oatmeal for breakfast because I felt I needed a boost to lose more weight. I suppose after all this time it has become a type of game that I play against my own body. There are times when I eat out and treat myself. I also have pizza and other goodies once in a while. I also have desserts at times but I do find that I feel strange when I eat them.
People are surprised that I have lost weight. When they ask me how I did it, I tell them I watch what I ate which is difficult. It has been rewarding to see what I have accomplished, but it is still a battle every day.