Follow-up on Medication

After taking phentermine for a month, I stopped because I ran out before I had a doctor visit. I had difficulty falling asleep on this stimulant.

At my doctor visit, I asked about other ideas. We thought of the generics of Contrave, which are buproprion (Wellbutrin) and naltrexone. Wellbutrin costs less, but not the naltrexone. It cost more than $100 for a month's worth. He prescribed Metformin to control blood sugar, and Wellbutrin as an experiment.

Ultimately, I tried Wellbutrin and Metformin. I stopped taking the Metformin because of the bowel symptoms. I stayed on Wellbutrin for 2 months with few results. I fluctuate within the same weight range since giving birth last year. I never returned to my PCP because the only medications left cost the weight of an arm and a leg.

I lost 2-4 lbs. when I went to sleep before 10:30 for a week. Going to bed on time, had a greater effect than anything else I have tried.

So what should be my goal? Go to sleep by midnight every night!

I bought a Fitbit the end of June. Now I have more information. I realize that I eat the same amount of calories as I burn most days. I usually hit 8000-10,000 steps a day and have active minutes from doing housework.

Since coming off the Wellbutrin, my appetite may have increased--due to stress. I have binged on several times when I felt bored or stressed. I gained 6 lbs back during my trip to see the eclipse and family.

My new fresh-out-of-residency psychiatrist said that Wellbutrin alone won't have much effect on weight loss. We discussed changing my mood stabilizer to topiramate and my antidepressant to buproprion, which are both ingredients in weight loss medications. My previous psychiatrist discouraged topiramate since brain fog is a symptom. My current psychiatrist said that symptom only occurred in some people. The "brain fog" at a lesser degree clears racing thoughts.

I am thinking of changing my psychiatric medications now. My mood stabilizer has worked for 11 years, and my current antidepressant has worked for 5 years. Neither of them cause weight gain. Changing medications takes several months. Those medications aren't guaranteed to work for my bipolar 2.

For now, I need to focus on going to bed earlier (barring my baby waking at all hours in the night), eating less and reducing stress.

Weight loss is such a puzzle.

Update:

I started the topiramate.

Trying Medication

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I talked with my dietitian three weeks ago about taking medication to lose weight. We discussed the different options--fat inhibitors or appetite suppressants. One medication I can't take because it conflicts with my current medications.

I thought my dietitian might be able to write the prescription, but she said she couldn't.

I asked about Lipozene and she couldn't find it in the normal drug database. She googled it. Lipozene is just fiber from the konjac root. It helps you feel fuller. It is fiber.

At the visit, I weighed the same as I did in February. The five pounds I gained came off. The big difference was when I stopped tracking my food and exercise. Tracking caused me stress.

I said my goal would be intuitive "living" by listening to my body's hunger and sleep cues. I still need to go to bed on time, eat veggies and fruits, and add some exercise. Just not stress about it.

I made an appointment to see my primary care physician. I used my preventive visit to make it "free". On my cell phone, I checked which prescriptions my insurance would cover--none of them. I took medications that put on the weight that insurance paid for. Why won't insurance pay for medications that take it off? 

Really, my insurance pays for several dietitian visits as preventive visits, and a specialist copay after that. Dietitians help more than medication since they impart wisdom.

My doctor said fat inhibitors like Orlistat can cause diarrhea and incontinent bowel movements. Joy. He said eating enough vegetables would inhibit fat too without diarrhea. Instead, I vowed to eat more veggies.

We decided on an appetite suppressant to try for one month. I have taken it for a couple weeks without weight loss (as far as I can tell). I feel hungry less often and eat less. The medication is a stimulant, which has interfered with sleep to some degree. I take a sleeping pill anyway.

I weighed myself more than once a week, which caused me stress. My new focus is on what I can control instead of what I can't control. I can't control the number on the scale, but I can control what I eat. I can exercise. I can.

To the Mocking Teenager

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I was talking with a friend while we were chilling in the hot water. We were talking about the effects of time on our bodies now that we are in our mid-30s.

As I climbed out of the hot water, a teenage girl loudly said:

"Is that what I will look like when I get old?"

I said:

"Give it ten years!"

This is the first rude teenager I have come across for some time. Most teenagers may be sassy, but rarely rude. Hopefully, she is nicer most of the time.

I have advice for this mocking teenager so she never looks like me:

1. Never engage in sexual intimacy
2. Never develop a mental illness
3. Never develop a physical illness
4. Never stay up late
5. Never stress out
6. Never have babies

I am serious about no intimacy, hormonal teenager. Hormonal birth control can cause weight gain. Depo-Provera causes weight gain in a fourth of its users. I estimate that birth control caused 30 lbs to collect on me. Any intimacy runs the risk of pregnancy with or without birth control. Thus, lifelong abstinence is the best option.

Really, it's a lottery whether this young woman gets some type of mental illness or suffers some type of trauma in her lifetime. Some medications are notorious for gaining weight. Six medications from this list out of the dozen I've taken over the years packed on 55 lbs (I'm taking out 10 lbs for birth control). I have worked with my psychiatrists over the years to have neutral medications, but sometimes those stop working. I have to weigh the benefits versus the costs.

Any physical illness can cause weight gain (or loss). Almost my entire life, I was so congested that I had a hard time breathing and had frequent colds and sinus infections. Three years ago, I had sinus surgery and my turbinates reduced. I have more active days now.

Reduced sleep probably contributed to my weight gain the most over the years. I eat more calories when I stay up too late. Then I am tired the next day and choose less healthy foods. No late night parties, young lady!

Stress might be the biggest contributor to my weight gain. So, young woman avoid any stress in life! Really, learn to cope with stress in healthy ways.

Again, I suggest lifelong abstinence so a woman never becomes pregnant. First, pregnancy messes with female hormones. Then the newborn takes away your sleep for the next two years. The dad suffers from sleep loss too. Children bring stress...and joy.

Overall, young lady, never live. Never enjoy life. Then you will never look like me.

One Month After Dietitian Visit

Via Public Domain

I weighed in at 241.2 lbs at the dietitian last week. So I gained 3 lbs in one month. The culprit was a bulk size of Red Vines. I ate most of the package over several days. My boys ate some, but I ate the bulk of it. Moderation in all things!

Also, I had an ingrown toenail taken care of. I didn't exercise for two weeks because I limped around. I finally started exercising again last week. I probably could have rode more on my stationary bike in the meantime.

My former roommate started a Biggest Loser challenge that I joined. I wonder if that was a smart idea or not. Does it depress me more? Or does it motivate me? I have tried to exercise more since I began the challenge. One good benefit. But I am more preoccupied about my weight.

I have tracked my food intake for one month now! It is a lot easier with a phone app. Before I used pen and paper or had to log on my desktop computer. I only got a smart phone a year ago.

My new goal is to create a social rhythm, such as go to bed on time and exercise. I have bipolar 2, which is a circadian rhythm disorder besides a mood disorder. A schedule helps control mood. I have been out of whack with the time change and spring equinox. This article explains it.

Free Preventive Visits

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My insurance pays for several dietitian visits as part of the preventive visits. I am taking advantage of these free visits (not really free since we pay thousands in insurance).

I have worked with this dietitian before. Since then, I've gotten pregnant, had a baby, bled for four months and took a bunch of hormones. Those wrecked havoc on my body. So this is my fresh start.

I set new goals:

1. Go to sleep by a certain hour for 5/7 days for four weeks.

A week into this and I have gone to bed one night at this time. Other nights I made it within an hour of that time. Another night, I stayed up feeding my infant. That counts as going to bed earlier because that was what I started to do before he cried.

2. Keep a food journal 4 days a week.

Last week I recorded half a day on paper. This was not simple enough for my lifestyle. Last night I loaded an app on my phone to track my food. Since I am on my phone when I feed my infant, I have time to track then.

3. Eat 2 vegetables a day.

She suggested trying to add a vegetable to lunch and dinner. Add a snack or side salad. She mentioned that I don't want to have the same vegetable all the time in case I tire of it. I've worked on some more vegetables. I already get my fruit in most days.

I have been exercising around two times a week. I saved money by buying a used stationary bike. This has helped me exercise more. I chose not to make this a goal since I have incorporated it into my week already. Though it is an underlying goal.

Next time, I may work on dealing with stress. It has been crazy with four boys and my other responsibilities over the last month.

The dietitian said to keep my goals realistic enough that I will do them. I need to be comfortable with them. Broken goals mean no progress. So one step at a time.

Post D & C Surgery

"Woman" by George Hodan

I have been frustrated with my body because I just want to be in peak condition. I had a D & C done on Monday to stop my bleeding. I had a slightly thicker endometrial lining than usual.

My aunt asked if they figured out why I was bleeding.

Um, I have no idea--stress, hormonal imbalances, endometritis (infection of the lining), anything under the sun?

The gynecologist wanted to put me on a different hormone instead of the D & C in order to save my IUD. No! One day of hormone and I felt so depressed and anxious I cried at the drop of the hat.

I don't think so.

I started a bath on Tuesday. My husband rushed in the bathroom and told me I shouldn't take a bath for two weeks. You've got to be kidding me! My husband was sure on top of it. I swear the doctor said I only had to wait 24 hours. I let the water run for a few minutes and then showered instead.

So now I am bleeding less. It will last for probably another week or two. I want to exercise and be more active. I thought my body should have bounced back quickly, but I had severe cramps for three days after vacuuming and doing laundry. I haven't felt crampy today. My exercise plans are on hold. I did this so my body will return to normal!

I have been going to bed by 10:30 pm most nights. That's good. Somehow it is never enough sleep. My infant wakes up once in the night, and I am toast the next morning. Maybe 9:30 pm ought to be my target.

For the past week, I have tried to eat a salad here and there. Good job, Eileen! I have struggled more with overeating when my neighbors have kindly brought over such good food after my surgery.

So this post is full of complaining, but why not? I can complain to the world at large. My husband is probably glad not to hear it.

I hope to exercise more and retire to bed earlier. And I hope a $100,000 arrives in the mail today.