Day Forty-two: last fast of the year

The Christmas season is always a challenge for those of us with food control issues, so despite feeling more relaxed and confident than I can ever remember, I didn't set my expectations too high. My plan was to fast as normal the Monday before Christmas, and for most of the day on Tuesday, and then not again until yesterday. 

As it turned out, I got through Monday just fine until an overwhelming desire for a glass of wine hit me in the evening, which I caved into. Hey, it's Christmas. I made it 'til about 3pm on the Tuesday and then gave up altogether. This has shown me that doing 2 fast days back to back would not be a great idea for me. However, it was possibly the emergency trip to Sainsbury's tipped me over the edge. We had booked a fabulous Christmas Day lunch at a local pub, which was sadly flooded and couldn't open, hence the trolley dash to buy ingredients for cooking at home. As always, Dream's fabulous kitchen skills saved the day.

We had a wonderful time, and I indulged myself with whatever I fancied to eat, which actually wasn't nearly as much as I used to. But by the end of Friday I felt in need of regaining some control, so I decided to fast on Saturday. It was a great relief and I felt so much better by the end of the day.

I fasted again yesterday, my last fast of the year. It was more effort than the Saturday, probably because I'd only had one normal day in between. But I made it under 500kCal and feel I'm all set to start the new year in great shape to achieve my new goals.

Happy New Year!

Day Thirty-nine: the 26 hour fast, pre-Christmas results and pelvic progress

I fasted for 26 hours without food from around 6:30pm on Thursday to 8:30pm on Friday. I then had a delicious 300cal meal from Cook (http://www.cookfood.net/menu/shop/chicken/Chicken-Noodle-Laksa-COOK-Pot/ - highly recommended) and didn't eat again for another 12 hours. I was rather proud of myself but honestly it wasn't that tricky. 

I was reasonably busy the whole time, including my second physio treatment. After last week's hip realignment I was pleased with the improvement in the ease of walking but my back and neck had been quite stiff and achey. Yesterday she worked on mobilising my spine and waking up various muscles that haven't moved for an unknown amount of time, which I can already feel helping my posture. Unfortunately the treatment involved a fair amount of intense shoving which has left me feeling rather battered today. Apparently I have visible bruises on my back. As always, I'm being very well cared for at home by my marvelous support team, and I'm sure it will be worth the short term discomfort for the long term gain.

In the meantime, I weighed myself this morning, prior to the expected indulgence of the coming week. I'm absolutely delighted to report that I lost another 1.5kg in the past 3 weeks, taking me down to 15 stone 5 pounds, below my 10% goal and 3 pounds short of a full 2 stone loss since starting. When I set the goal at the start of September I wrote that this seemed like a massive amount to lose (24 pounds) and it still does, I can't quite believe it. I'm enormously pleased with my early Christmas present and feel I can go from strength to strength.

Having achieved 2 of the 3 goals I set at that time (http://darklingplainfast.blogspot.co.uk/2013/09/goals.html) I need to now look forward. My shrink goal of getting my waist below 80cm is still a way off, so here are my next mini weight loss goals:

1. Lose 2 stone (3 pounds to go)
2. Get to under 15 stone (6 pounds to go)
3. Lose 15% of my starting weight (11 pounds to go)

I'm not planning to weigh again until late January/early February so I hope to make good progress by then.

Happy Christmas everyone :)

Day Thirty-eight: food allergies and locked knees

I'm fasting on a Tuesday for a change. I had to work in the office yesterday as I had a team lunch to attend, so fasting wasn't an option. It felt very odd, particularly after a rather boozy pre-Christmas weekend, I found myself rather missing it. To make matters worse, I had a nasty reaction to the delicious food laid on at the posh Japanese restaurant. I have a known crab allergy, and despite being careful I suspect I accidentally ate some. The rest of the day was spent lying quietly in a darkened room. I've never looked forward to a fast so much before! I'm much better this morning and enjoying feeling empty and healthy! I'm also wearing one of Dream's old dresses - the excellent news for both of us being that it is now too big on her, having lost over a stone, and it fits me instead :)

I'll be fasting again on Friday this week - not my usual Thursday as I am out the night before and don't fancy it on the inevitable hangover! I then plan to fit one more in next Monday before giving over to Christmas indulgence completely. Normal service will resume the following Monday 30th December. I intend to weigh next weekend and then not again until 1st February to give myself plenty of time to recover!

In the meantime, I had my first session with a physio for my PGP on Friday. I'm delighted to report that she knew exactly what the problem was and was optimistic that she could improve things a great deal, to the extent that I should, at some point, be able to resume walking regularly. She didn't set a target timescale, as this will depend on how well I respond to treatment. My right pelvic bone (ilium) is canted forward at a slight angle, causing the pain and mobility issues. She made some adjustments to my pelvis and hip joint which have left it moving much more freely but also caused rather a lot of lower back pain - to be expected as muscles and joints re-align. 

I'm attempting to be mindful about my posture - not an easy task for a lifetime sloucher - and to prevent my knees hyperextending. Apparently I have hyper mobile ligaments which contribute a lot to the problems. This picture isn't my leg, but mine looks much the same, you can see the weird reverse curve. 

When I make the effort to unlock my knee, my leg straightens and my pelvis aligns into a more natural position. Amazing. This skeleton diagram shows the knock on effects on the pelvis and spine:

No wonder everything hurts! I'm determined to overcome this, so I'm  being mindful not just about my eating but my posture too. Next appointment with the physio on Friday. Things can only get better.

Day Thirty-six: bits and pieces

The GP was sympathetic last week, if not exactly brimming with advice. She had not dealt with PGP before but after prodding and poking a bit, during which I attempted not to terrify the other patients waiting outside with too much screaming, she agreed that I needed referral to physiotherapy. My next challenge is therefore to find a therapist with specific PGP training, who is also covered by my health insurance.

I also got a lovely email from a lady at the Pelvic Partnership with lots of helpful advice and support, including this:

Some people are enormously overweight and don't get PGP, and other people are stick thin and do. Carrying excessive weight doesn't help the joints and muscles to cope, but it's not the cause of the misalignment or rotated joints which almost always turn out to be the cause of PGP.

Exercises, crutches, support belts and painkillers can help relieve some of the symptoms but as they do not address the underlying cause of the pain; they will not "cure" PGP.

So I feel quite justified in kicking up a fuss for some treatment now!

In the mean time, I have officially retired my size 20 trousers. I put a pair on for work last week and they looked so ridiculous I had to take them off again. Luckily I have lots of size 18s saved from years ago to keep me going, and I generally wear a lot more dresses these days anyway. I think I might keep one or two of the biggest items at the back of the cupboard to remind me where I have come from.

I did a little review of my goals. I hadn't reset my 10% after adjusting for the new scales, and am delighted to see I'm only 3 pounds away from it. I've added in some other milestones to my tracking document, measuring progress in different ways such as amount lost in stones, pounds or kilos, or as a percentage, and hitting certain round numbers weights like getting below x stone. Once I hit the 10% goal my next marker will be a total loss of 2 stone - four additional pounds needed for that one. After that I can set my sights on getting below 15 stone. All these different ways of looking at it are just a few pounds apart so I can feel a real sense of achievement as I take small steps along the way.

I've settled into a fast day routine of not eating at all during the day, and then having a small meal in the evening. I don't think I'm hitting 500kCal in that one meal, probably less than 400 and I'm full up. I'm really noticing that I don't need to eat as much in between now too - two meals a day is enough most days. I'm sure if I was going more physical activity I would need more, so fingers crossed I can get some treatment that will let me make that a reality.

Day Thirty-five: off topic - pelvic girdle pain

Apparently, some studies show that intermittent fasting boosts brain power. I'm not entirely convinced today, as I'm struggling to write a particularly troublesome report for work. I'm putting my difficulty with concentrating partly down to having to deal with fairly constant pain in my hip. So this post isn't about fasting, but brings together various themes which are related to my journey, namely health, gender, pain and weight.

Just over 5 years ago I had a baby, my second child, another beloved daughter. The pregnancy and delivery were pretty much a nightmare from beginning to end, and the consequences of the experience are still with me today. I could point at various mistakes and oversights made in my health care during that time and continuing since then, but I don't think there is any positive reason to do so. The reality is that I have to deal with where I am now.

Since the end of that pregnancy I have suffered intermittent intense pain in my groin. This ranges from an unpleasant ache to agonising stabbing pain, the feeling that my pelvis is coming apart, and shooting pains down my legs. Turning or moving my leg in a particular way can leave me literally gasping for breath and unable to move. I can go months without any symptoms at all, and then something will trigger a flare up and I'm back on walking sticks. Triggers tend to be any kind of exercise more rigorous than a gentle stroll to the end of the road and back. As a result I have done next to no exercise over this time - each attempt has ended in more pain.

I have asked for, and been referred for various types of treatment over the years. Some have been covered on the NHS or my health insurance, others I have paid for myself. I have worn support belts, I have had obstetric physiotherapy, osteopathy and chiropractic. As I can avoid pain by basically being a couch potato, I'm not considered an urgent case. The last time I asked my GP for help following a particularly acute episode this summer, I was told there was no point getting treatment unless I lost weight. As it turns out, this was the kick I needed to get started on 5:2, for which I am grateful. However, now being in the middle of another flare up, I find I am no longer prepared to wait until I reach some arbitrary desired weight before attempting to seek treatment again.

I've tried Googling many times before to see if there is any advice or treatment I could research, but most of the information I found was related to how to manage the problem during pregnancy, which didn't really help me. Part of the problem was not knowing what the problem was called, or if it even had a name. While I was pregnant I was told it was called "Symphysis Pubis Dysfunction", or SPD. It was then renamed "Pelvic Pain in Pregnancy", or PPP. Again, this didn't help given that I am no longer pregnant, so none of the information was relevant. I finally found that the current term used is Pelvic Girdle Pain or PGP, and hey presto, I found all sorts of useful information, including acknowledgement and treatment of this as a long-term problem.

My new friend is the Pelvic Partnership - http://www.pelvicpartnership.org.uk/

Here is what I have learned. Pelvic girdle pain is usually caused by an asymmetry or change of normal movement or alignment in the pelvic joints – a mechanical joint problem. Frequently in PGP one of the three joints in the pelvis, often one of the SI joints at the back, becomes slightly stuck and the joints start to move asymmetrically. This then puts extra strain on the other joints which start to move differently and can become irritated and inflamed, leading to PGP.

In pregnant women this is usually triggered by abnormal pressures on the pelvis, by the loosening of the ligaments that hold the pelvis together due to the hormone relaxin, and in some cases by childbirth itself. Women are often told that their pelvic pain is due to:

• round ligament pain
• hormones
• sciatica
• trapped nerve
• normal aches and pains of pregnancy
• low back pain
• nerve irritation; 

and that it is not treatable and will get better on its own, or as soon as the baby is born. Many women have discovered later that it was pelvic girdle pain and could have been treated as soon as symptoms occurred. PGP also occurs in sportsmen, such as rugby players, and they are treated quickly and effectively with the same range of techniques as those used for pregnancy-related PGP.

This all gives me some hope, but also slightly depresses me. I have definitely been in the camp of thinking that this was just something I was going to have to live with, as a woman and a mother, and as a person who is obese. It has limited my lifestyle choices drastically over the last 5 years, ranging from not being able to exercise, to sometimes not being able to participate in normal family activities like playing with my children. Maybe I should have shouted louder, but all the professional feedback I have had is that it's too vague and too difficult and I should take care of it myself by doing Pilates and stop complaining.

I'm going to see a new GP this evening and am hopeful that armed with my new knowledge I can start down the road to recovery. If my GP is not helpful at least I know where to look for better information and support.

Day Thirty-three and a half: the day of reckoning

The rooms in my post-divorce house are quite small, but my post-divorce bed is very big (do you see my priorities here?) so it only just fits in my bedroom. It's possible to walk between the end of the bed and the wall quite easily up to one corner where an old chimney breast sticks out a bit and makes the last bit of the gap quite about two-thirds the width of the rest. At the time I bought the bed, I could just about squish through, with a bit of wriggling, as long as I was wearing something reasonably smooth. I avoided doing it if at all possible.

Yesterday morning I slipped through the gap with no problems. I still touch the sides but I think I'd have to be a stick insect not to. I wouldn't have thought of setting that as a goal or way of measuring my progress, but it's unexpected things like this that show me in a very practical way how far I've come.

Despite this, I wasn't very optimistic about weighing myself this weekend. After the unscheduled encounter with the scales two weeks ago I wasn't expecting much. I made an extra effort this week however - no alcohol at all during the week and my Day 33 fast came in at under 200 kCal even though I found myself at home with a sick kid all day.

But, my diary said weigh day today, so I stepped on the scales first thing this morning and was delighted to find another 4 pounds gone! Hurrah for me! So the total now stands at 21 pounds off (= 1 and 1/2 stone or 9.5kg). I'm now under 100kg (99.3) and absolutely delighted. I have another 5 pounds to go to hit my 10% goal that I set at the start of September. My other goal from that time was to get my waist measurement below 31.5 inches which is still a fair way off - here are my current stats:

	2 Aug 13	1 Dec 13
Waist	47	41
Under bust	42	38
Full bust	46	44
Hips	54	50.5
R thigh	30	27.5
R arm	14.5	13

With Christmas coming up I'm not going to worry about achieving much this month. I will carry on as normal and then weigh in three weeks time, before Christmas week itself. I'll be quite content staying where I am, a stone and a half lighter than I was 4 months ago.