Now for the Who, What, How, Why, Where, and When of all this.
Changes in Health Care: While I enjoyed certain things about my nursing job, namely, working with the patients, nursing is an extremely stressful profession. Add many of the changes that health care is undergoing in this country, and the trend toward corporate mergers and huge health care conglomerates and their profit-focus, and it becomes even worse for those who do the actual work in the trenches, serving the public. All the money is being siphoned off directly to the top.
This is something you might want to keep in mind when you do go to a physician. Many of them are no longer in independent practices, they are being bought up and controlled by these huge so-called "health care" companies. Physicians are among the employees who do the work in the trenches, and their employers' profit focus also forces them to modify the way they see patients.
Additionally, the increasing use of the electronic health record, while advantageous for information sharing, has been co-opted by a multitude of regulations that essentially have changed the primary focus of the practitioner's time to documentation. It is very difficult to focus on the patient and a face-to-face conversation when there is this computer that demands input that can eat up to 80 percent of the nurse or physician's time.
Finally, some of the political maneuvers happening in my local hospital were apparent to me, and I wasn't going anywhere. I wanted to work with patients and make a positive difference in their lives for wellness, and that just wasn't going to happen inside of that box. It's not a good time to be in health care, at least not in the corporate world of so-called "health care". So I made a decision to take things into my own hands and move on.
Stress Reduction: As soon as I got out I felt better. I had gained a lot of weight, I was up to 132 pounds from 112 in 2007. I was drinking a couple of beers daily. I was running, but I felt horrible doing it, all the weight was a load on my body and mind. I had been eating too much, mostly just stress-related eating, not paying attention to portions, eating comfort foods (I have a weakness for ice cream), eating too many restaurant meals, and in general, just not doing well.
I strained my hamstring sometime in May or June of 2013. I believe it was a couple of weeks after a disappointing performance at a 24 hour race in Cleveland. I wasn't recovered and I continued to run for stress relief. I signed up for two marathons and a few 5Ks in the 6 weeks following the Cleveland race, and felt horrible, and somewhere along the way acquired this nagging hamstring strain that would not go away.
I ended up missing several races I had signed up for in the fall, most disappointing of all was the 24 hour national championships. But in retrospect, I wouldn't have been in very good condition anyway, so I'm glad I didn't go from a performance standpoint.
Once I quit the job my sleep improved dramatically, too. While working at the hospital I had been waking up during the night unable to go back to sleep, I was having hot flashes, and I felt tired during the day. I felt irritable and it was hard to focus or think clearly. My patience with everything was wearing thin. As soon as I quit, the tension melted away and I slept through the night most nights. That led to a much clearer mental focus and ability during the day.
Increased Activity: Having more available time and more energy from sleeping, I began to increase my physical activity to about two hours per day. it wasn't all running. First I needed to heal the hamstring. I took some time off, did some pool running and swimming, and spent time on the bike, which I mounted on a trainer over the winter in my living room. I was doing a lot of studying for some certifications for my new line of work, so I would sit on the bike and spin and ready my study materials. As of the first of the year my hamstring was much better and I began training for the spring racing season.
At the beginning of the year I also changed my diet dramatically, with the intention of dropping the weight I had gained in recent years. I was thoroughly disgusted and sick of carrying around weight, having a belly, having to go up in clothing sizes, and how it felt to be carrying a lead brick around with me while running. My TSH at the beginning of all this, by the way, was 1.0, with Free T4 and Free T3 at about the same place in their respective lab ranges.
One of my patients had told me about a new book that had helped her lose weight, and I am not usually one to pay any attention whatsoever to diets or popular fads. This particular book emphasized a lot of activity, and that alone made it more credible. I decided to check it out. Here's the information if you want to. State of Slim. 2013. Hill, James O. and Wyatt, Holly R. Rodale Press. ISBN 978-1-60961-491-1
It is broken down into phases: I, II, and III. I never formally got to phase III because I just incorporated my new changes into my regular (healthy) diet. Phase I, I did do religiously, and stuck pretty close to Phase II.
Besides the increased physical activity (keep in mind that I had not been doing typical ultra training for quite some time and I was not working out the way I normally do at the time I was reading this book)I found the following guidelines most helpful to me personally:
Portion Control and Keeping Track: I wrote down every thing I ate for about the first 6 weeks. It helped me track how much I was eating and how often. It kept me on track and was a reminder throughout the day that it was time to eat, and I could see what I'd already eaten and it helped me think of what else I could eat- more veggies, different recipes.
Eliminate Sugars and Most grain-based carbs: Within the first two weeks Phase I has you completely eliminate grain based carbs with the exception of oatmeal. There is no fruit in Phase I, either, and this helps you reduce both your sugar intake and consequently, your sugar cravings. Most of your carbohydrates come from vegetables. The emphasis on vegetables is another thing I liked about it.
Eat Frequent Small Meals: I ate 5 or 6 small meals a day. Each meal or snack contained a small amount of protein. I believe this frequency of eating was the single biggest contributor to my success, because I never was hungry, never had cravings, and sometimes it was hard to get to that 6th meal. It felt like I was eating all the time.
New Ideas: I came up with a lot of new, easy, quick, creative ideas for snacks and meals that were healthy and helped me stay away from those sugar cravings. There were some very helpful ideas regarding convenient foods without sugar. I love the powdered peanut butter, that has become a staple for me. I also am now addicted to their pumpkin chili recipe.
I was able to stick to Phase I very easily because it did eliminate the source of my problem: craving sugar. Eating sugar makes you crave more. The blood sugar spikes and crashes are eliminated if you simply eat a small amount of food with protein every couple of hours. I did not cheat at all in the two weeks of Phase I. The hardest thing for me to give up was beer. When you get to phase II you are allowed to have a "cheat" meal once a week. The thing I wanted was not something sugary or sweet, but a beer.
I was able to train intensely and the only thing I eliminated at first were the gels from my training run fuel. I ate some almonds but tried to stick to real food for my runs. I was in phase II by the time I started doing long runs, so I never had a problem fueling myself. I eventually added the gels back in. I also took sweet potatoes with me, and tried to avoid doing gels unless absolutely necessary. Even though the gels are sugary, I used them only while running and they never seemed to cause cravings.
I had a lot more energy all the time and was surprised, during my long runs I didn't seem to need as much fuel.
Does it last? Can you keep the weight off? I've always felt that two weeks is a good time frame for changing a habit, and that seemed to hold in this case too. Within two weeks I felt confident that I wasn't going to relapse.
I lost 7 pounds in the first two weeks, then quickly dropped another 3, until after two months I had lost 14 pounds. I weighed in at 118 a couple of weeks before my race, right before I started my taper. I did slack off a bit in the month leading up to my 24 hour race but I weighed in at 121 pounds a couple of days after the race. I slacked off really bad this past week following my race and I can already feel how bad sugar and overeating makes me feel. So I'm back to phase I to clean out the system again as I finish my rest and go into my summer training for the fall racing season.
I am pleased to say that I have proven to myself that it is possible to lose weight, eliminating the stress was the number one thing that made it easier. But sticking to a tightly regulated intake for a few weeks to re-establish healthy eating patterns, changing the things you eat and eliminating all those sugars and carbs, and getting enough physical activity, are the other parts of it.
Nothing we haven't heard before, but actually taking those principles and applying them in a disciplined manner and allowing them to play out, really worked. It did for me.
Running performance-wise, I ran 11 miles further in 24 hours and improved my 100 mile time by 2 1/2 hours. Earlier this spring I also ran my fastest 50 mile time in about 10 years. And, I turned 50 in March, so age is no excuse.
I'm not saying that State of Slim is the magic bullet, it has it's flaws, it does take a lot of planning, and it's not convenient for people with busy schedules, but it definitely has some good take home points, great ideas, and recipes. I highly recommend READING it.