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Kitchen Table Kibitzing 12/17/2023: Progress [1]

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Date: 2023-12-17  

Good evening, Kibitzers. Wow, it’s been a while since I’ve said that! I’ve missed writing and hosting community diaries, so when I was asked if I’d fill in for side pocket tonight, I jumped at the opportunity.

(As a side note, I know that I haven’t been around all that much lately. I want you to know that it’s not because I don’t want to take part in this community anymore. I’ve had some shit going on in my life—shit that is hopefully clearing up soon—and I’ve just found myself occupied in the evening (or passed out) more often than not. I haven’t forgotten about y’all.)

When I agreed to post tonight’s diary, I really stewed over what to write about. I finally decided that perhaps the best thing I could do is provide a bit of an update on what has been going on in my life, since it’s been a while since I’ve really checked in.

Many of you know about the health situation I faced back in May and June. For those that don’t know or don’t remember, a recap: One night in May, I suddenly got the chills and knew I was about to get sick. It was a familiar feeling, at least at first. I figured it was either the flu or, god forbid, COVID again. It turned out to be neither, and was only the beginning of a month-long attempt to figure out what was wrong with me. It didn’t present like anything I’d ever experienced before. I had fatigue like I’d never felt in my life, the kind of fatigue where I got tired just sitting upright. I felt bouts of nausea, and (very uncharacteristic for me, even when I’m sick) I had absolutely no appetite. I still managed to meet my daily nutritional needs, but I started dropping weight like crazy, no matter how much I ate. My heart rate was very high at just about all times, and I couldn’t even walk from one room to the next without being covered in sweat. I woke up in pools of night sweat. Beyond all of the physical symptoms, I also had an overwhelming sense of doom about whatever it was that ailed me—just a profound sense that something was deeply wrong with me, something I felt almost at the DNA level. At one point, I told the BF, “Whatever I have is going to kill me,” and I really felt like it would.

This went on for weeks. Meanwhile, doctor appointment after doctor appointment yielded nothing but more questions. I might have had more bloodwork done during this period than I’d had in my entire life up to that point. Every blood test gave us weirder results, and created more questions. My liver enzymes were off the charts, so that was a pretty big clue. But I was also seeing abnormal lab results in other areas, including the presence of autoimmune antibodies. The doctor started going down the list of autoimmune possibilities, and it started getting really fucking scary. Autoimmune hepatitis (an incredibly rare liver disease that is even rarer among men) was one of the top contenders. Rare as it might be, it did seem to check just about every symptom box, and this theory was bolstered when a specific autoimmune antibody associated with the disease was detected in my blood work. There was another possibility (with a very long name that I don’t even care to look up again at this point) that would probably kill me if I didn’t get a liver transplant. We talked about lupus, we talked about rheumatoid arthritis (I don’t even think that one made sense), we talked about many other possibilities that sort of fit but not really. No answers, though. Just endless speculation while I waited for appointments with multiple specialists.

Eventually, I went to the emergency room in an act of desperation, hoping they’d just keep me until they checked every part of my body. That didn’t happen, but the ER doctor did recommend an excellent gastroenterologist, who was able to get me in way sooner than expected. He’s the one who eventually cracked the case. After a liver biopsy (which I do not recommend if you can help it, by the way), the truth was revealed: nonalcoholic fatty liver disease. That’s it. Well, I shouldn’t say “that’s it,” because mine had advanced to fibrosis. It’s actually not all that common to feel symptoms at all from nonalcoholic fatty liver disease, so the fact that my body was crying out in such a dramatic way pointed to a problem that needed immediate attention. The gastroenterologist recommended dietary changes and a loss of about 10 percent of my body weight in the next year.

My diagnosis may not have been as devastating as I’d feared, but the entire experience was enough to shake me to my core. For the first time in my life up to that point, I confronted my own mortality and seriously considered the possibility that I could die much earlier than anticipated.

So I took the doctor’s advice very seriously. In a way, I had a head start, because I already had a decent base of knowledge about diet and nutrition. But of course, it’s one thing to know—it’s another thing to implement. And I had a very rocky few months after my diagnosis as I tried to change my entire lifestyle. I made some good choices during the week, but inevitably, I fell off the wagon over the weekend and wiped out any meaningful progress I’d made. I faced several challenges that I found it difficult to overcome:

First, and most importantly, I am a black-and-white thinker. Of course, intellectually, I can acknowledge that almost nothing is black-and-white. But something about how my brain is wired makes it extremely difficult to internalize that knowledge, especially when it comes to things like diet and exercise. In my mind, I was either “on-track” or “off-track,” and when I was “off-track,” I was more inclined to say “fuck it” and engage in self-destructive eating behaviors. Because what does it matter if I’m “off-track” anyway? Again, intellectually, I understand how ridiculous this sounds, but tell that to my brain. This is the product of years and years of disordered eating resulting from my head being filled with diet culture. Health crisis or not, it’s very difficult to unlearn this stuff.

Second—and all of you know this—the BF and I are foodies. In a way, we first connected over food, and it remains one of our most important shared interests. We also happen to live in a city perfect for foodies. We love going to new restaurants and trying new things. And, going along with the black-and-white thinking I mentioned above, any time we’d go out to eat, I would feel “off-track,” leading to self-destructive behavior. This led to a great deal of anxiety around any eating situation where I couldn’t have complete and total control. If I couldn’t weigh the ingredients and track every calorie, I was simply “off-track” and the day was written off.

The above issues were mental blocks, but a logistical problem I faced on a daily basis was simply finding the time to cook healthy meals. With everything else going on in my life, from work to home stresses, it was difficult to even find the motivation to cook, much less the time. And when there isn’t healthy food in the fridge, it’s much easier to say “fuck it” and get takeout.

None of these are new problems, considering that I’ve been struggling with lifestyle and eating choices for much of my life. But my health issues made it all the more important to finally tackle these problems, and I realized that I was unlikely to do it alone. So, for the first time, I started seeing a registered dietitian (which, I was surprised to find out, is fully covered under my health insurance). At first, I was convinced that it was just a waste of time and insurance money, because I didn’t really learn anything “new” in my initial sessions with her. But over time, I came to realize how important it was to talk some of these issues out with a professional. She’s not my therapist—I have one of those, too—but that was nevertheless the role she took on at times. When I felt low, she would lift me up and give me a dose of motivation. She was also able to give me many practical tips for making small and sustainable improvements to my diet. Over time, I started incorporating this advice. I ate more vegetables, using different preparation methods than I used before, which not only added nutrition to my plate but also filled me up more effectively. I made a point to work in at least one serving of fruit per day, which helped with my sugar cravings. I started challenging myself to consciously recognize those moments when I was engaging in destructive (and false) black-and-white thinking. For a few months, I felt as if I was making very little progress, mainly because the number on the scale was barely budging. In reality, though, I was building necessary long-term skills that, ideally, I should have learned years ago (but later is better than never).

So here I am, approximately six months after I received my diagnosis. I have not lost a dramatic amount of weight, but I’ve lost some. I’m getting close to the 10-pound mark, and I want to lose at least 15 more pounds after that. I’m taking it slowly and giving myself grace, because it’s not all about weight, even if that is one of my goals. I have also made substantial progress in the problem areas I mentioned above:

I do still engage in black-and-white thinking from time to time, but I am better equipped to recognize and stop it now. My “fuck it” moments have not completely disappeared from my life, but they have dramatically diminished. Now, I can find myself in the middle of one of those “fuck it” moments and convince myself to stop. At some point, something in my brain just “clicked,” and I realized that I could either live my life going back and forth between black and white, or I could accept and embrace the fact that life is full of gray and just do my best. Instead of harshly restricting myself, I have given myself more grace and more calories. It’s counterintuitive to me (having learned the punitive rules of diet culture from an early age), but it works. The scale has noticed the difference, and I’m losing weight even as I allow myself to eat more on a daily basis—because I’m no longer falling off a cliff every weekend. Lately, I’ve even been allowing myself to eat things that I would have considered “bad” before, and I’ve been practicing not saying “no” to myself all the time. I will often end my day with a cookie or two. Because I’m no longer saying “no” to things I used to consider off-limits, I’m able to stop at one or two, knowing that if I want more, I can have some the next day. My dietitian said something that stuck with me: “Some foods are good for the body. Some foods are good for the soul.”

The BF and I still go out to eat. Most of the time, I try to make the healthiest choice I can while also eating what I enjoy. If we go out for Tex-Mex, I let myself have the chips and salsa, because what is life without chips and salsa? But if there’s a tasty looking salad on the menu, I consider that a viable option. Or maybe I just let myself have the enchiladas I crave. At the end of the day, unless I’m eating Tex-Mex all the time, it doesn’t matter all that much. What a change in thinking from where I was before! I no longer get anxious if we go out to eat, or if we go to a family dinner, or if we travel somewhere. Last night, for example, we had friends over for a get-together, and I ate more than my share of pizza. The old me would probably be punishing myself today to “make up” for it, but it’s a new day, I don’t feel any guilt, and my soul is nourished. It’s a freeing feeling.

Time and motivation are still issues if I want to eat healthfully on a daily basis. But sometimes, corners can be cut. I’ve leaned in to convenience foods as a necessary part of a healthier lifestyle. Sometimes, I simply heat up a Trader Joe’s frozen meal and supplement it with roasted broccoli and some kind of whole grain, and I’m set. I don’t need to feel guilty about it, and it’s better than getting takeout.

Progress has happened slowly, but my diet is almost unrecognizable from where it was before. I started tracking my saturated fat (something I especially need to keep an eye on) and sugar, which has helped me make better choices for myself. I rarely eat red meat anymore, and indeed, sometimes I don’t eat meat at all. I eat more fish, chicken, and beans. Olive and avocado oils have replaced butter and bacon fat. Whole grains have mostly replaced simple carbs (although I do make an exception for white rice from time to time). I have something green on my plate at most meals (usually roasted broccoli, which seems to go with everything). I’ve been eating more fruit as “dessert,” which has led to me discovering “new” (to me) fruits. For a while, I got really into Sungold kiwi (possibly my favorite fruit of all time), but since I can’t find that lately, I’ve been eating a lot of mango in recent weeks. Most days, I’m well under my saturated fat and sugar goals, and I don’t even feel like I’m denying myself.

The number on the scale—while decreasing slowly—is far from the only positive effect I’m experiencing. I just feel good, physically and mentally. In fact, I don’t even remember the last time I’ve felt this good. I have more energy, and that energy is radiating to every corner of my life, from the classes I teach to my relationship with the BF to just about everything else. I still face many challenges, but I don’t know that I’ve ever felt better equipped to handle them.

So I guess this was just a longwinded way of saying that I’m doing great. In a way, I’m grateful for the health scare I went through—I almost certainly wouldn’t be where I am right now without it. I still have work to do, but I’m happy with the progress I’ve made so far.

I’m back to hiking! From a lovely hike I took a few weeks ago

What do you want to kibitz about tonight?

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