Losing a Lot to Keep More

The last time I updated you all on my COVID long-hauler journey was in April, after completing a one week course of high dose steroids. Not long after that, I had a follow-up visit with my doctor. After discussing the improvements from the steroids and my options, we decided to put me on a month long dose of Prednisone (the steroid) to fully knock out any and all remaining inflammation. The course lasted four weeks, with the dose tapering lower each week. Throughout the four weeks, I jumped on every opportunity to start building back my stamina and strength. I did yoga, went for walks and bike rides, and even started using my dusty elliptical machine regularly. I wanted to gain as much ground as possible before the steroids were done, in case the feelings of normal energy didn’t last once the course was finished.

I could tell by halfway through the course that the steroids were causing elevated blood sugars in me (after two rounds with gestational diabetes, I am familiar with the feeling) but no longer had my glucometer to check how high they were getting. For about a week or ten days after the final dose, I seemed to be doing great. Then came a day when, within a few minutes of eating lunch, I had significant stomach and abdominal pain. It had been an unusual lunch for me – I had found some frozen egg rolls to try at the grocery store – and I assumed they were too greasy or fatty and didn’t agree with me. The discomfort continued off and on for the next day and then WHAM! Midday on a Friday I was hit with intense abdominal pain. It got steadily worse, and was wrapping around to my back. By this time, the new glucometer I had ordered had arrived and my sugars were definitely elevated. In fact, even after hours of not eating due to the pain, my sugars were over 200. Being a nurse, I recognized that my symptoms were classic acute pancreatitis. It is uncommon, but steroid-induced pancreatitis can happen.

Me in early April 2021, rapidly rounding out thanks to inactivity from fatigue and steroids.

I avoided fatty foods and carbohydrates for a couple weeks and the symptoms resolved themselves without me needing to go to a hospital, thankfully. My blood sugars continued to be elevated every morning before I ate breakfast, however. I had a virtual visit with my doc and filled her in on all that had been happening. At first she thought the blood sugars were a rebound effect from being on the steroids for so long, until I reminded her that I am already at increased risk for diabetes after two pregnancies with gestational diabetes, and that my hemoglobin A1C (which is a measure of how well your blood sugars have been controlled for the previous 3 months) was already borderline high before I ever had COVID. That was when she confirmed my suspicions that I might now be pre-diabetic. COVID has been causing some people to develop diabetes, but the steroids certainly could be a contributing factor as well. We’ll never know which it was in my case (likely both), but at this point I’m toeing the line of a full-blown diabetes diagnosis. So basically, I traded one chronic, life-long, awful condition (the extreme fatigue and brain fog) for the possibility of another (type 2 diabetes).

Me at the end of April 2021, with the classic steroid-induced “moon face” and at my heaviest weight ever. But hiking! Getting exercise! Not confined to a couch out of exhaustion from living in a chronic inflammatory state.

I made up my mind then and there that I was going to do everything I could to prevent this from happening. My energy levels and brain clarity were still greatly improved – back to normal – and began exercising whenever possible, sometimes multiple times in a day. I massively reduced my carbohydrate intake. One of the most useful tools for me has been the My Fitness Pal app. I use it to track everything I eat as closely as possible. It helped me realize I was eating way more calories each day than I needed to, and also crazy amounts of carbs, sugars, fats and salt. I have completely overhauled how I eat (although potato chips and french fries are still my personal kryptonite). Since mid-May when I started this, I have now lost over twenty pounds. After the weight gain from the steroids, I was a good thirteen pounds over the upper limit of “healthy” for my height. However, it was more than fifty pounds above where I was before ever having kids. I don’t plan to get back to my pre-kid weight; I had always been underweight back then and that isn’t healthy either. However, I do know that I am “small boned” and am healthiest toward the lower end of the “normal weight for height” range. That means I have about another ten to fifteen pounds to go to reach my goal weight. My hope is to be there before Thanksgiving so I can bump up my daily calorie limits to the “maintain my weight” range instead of the limits required to actively lose one-to-two pounds a week.

Me last week on a date with Zach. You can’t see the change in my face thanks to the mask, but the slimming down everywhere else is evident. In fact, I’m wearing a new shirt I bought because I’ve dropped more than two sizes in clothing.

My ultimate hope is that this weight loss and diet changes will not just accomplish my goal of preventing diabetes, but also lower my blood pressure and cholesterol that have been elevated ever since I got sick back in March of 2020. I also want to be stronger, less prone to injuries in my back, neck and shoulders, and have more energy and stamina for doing fun things with my kids. And, dare I say it, for the first time in my life I actually find exercise to be something I want to do, something that is good for my personal health. It is time that I am spending taking care of me for the first time in a very long time. In fact, I don’t think I’ve ever before in my life actively done something for my own health and wellness on a regular, sustained basis. Even long before I had kids, I never concerned myself about my physical health. I was underweight and couldn’t gain weight to save my life, so I didn’t worry about what I ate. I hated exercise, loved nothing more than to lie around with a book all day, so I never did anything to seek better health that way. Maybe part of it is the maturity and changes that come with age, but I think the biggest factor is finally having the motivation to take care of myself. I do not want to spend the rest of my life as a diabetic. I’ve seen how hard that is just through the course of a pregnancy. So I’m putting in the work.

Me, coming to terms with the fact that there is absolutely no place in my house to take a decent selfie. Finally succumbed to using the room divider as a backdrop.

I am really darn proud of myself for what I have already accomplished this summer. Twenty pounds in three months is no small thing (that’s three of my kids put together as newborns!) and I’m recognizing that accomplishment in myself. I have my yearly visit with my doc coming up in September. We’ll recheck my hemoglobin A1C and cholesterol levels. I’m already noticing a small improvement in my blood pressure. No matter what, the steps I’m taking can only help.

No more moon face! And okay, yes, my hair is falling out from stress related to working a COVID hotline in a state full of anti-vaxxers, anti-maskers and outright idiots, but check out my waistline! I HAVE a waistline now!

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