Pre-Op Ramblings – Part Two

Over the next three months, while the Powers That Be decide whether or not my op is worth funding, I have regular appointments with a dietitian and a physiotherapist.

Last Tuesday I saw the Dietitian. She asked me questions about the food I eat, how often I splurge on takeaways and what I have if I do (still too much, too often… working on it). She seemed generally pleased with my progress and simply advised to keep on doing what I’m doing; logging calories in myfitnesspal, and keeping an eye on things with the Fitbit. She also put my mind at rest on the sticky issue of the funding decision. She said if I didn’t get funding it would be because the operation is not considered safe for me at this moment in time. However, it would appear things are looking positive and I should keep on keeping on until the next stage of the process is reached.

On Thursday I had my first appointment with the service’s new Physiotherapist. I had no idea what to expect having been through nothing of the sort in the past. Another new appointment, another assessment. This time a lot of questions which really brought home just how ruddy lazy I’ve been. The questions, and tests of my walking pace, ability to run (hilariously poor) etc were to establish a baseline, a point from which we can measure progress.

She then set me a daily exercise routine. Ten minutes, three times a day, when I would normally be sitting on my arse staring at my iMac. Since the appointment I’ve done these exercises twice.

I have to admit, exercise has always been a problem for me. And ten minutes of stepping and what-have-you seems like ten hours. The prospect of doing this three times a day does not fill me with joy. I know that if I’m to do this, I need help.

And, unfortunately for my metal-loving husband, that help is in the form of dance hits from the 90s:

And some unadulterated cheese from the 70s:

In my next instalment of pre-operative blether, I’ll share the first few days from my activity diary. Will embracing my inner English Disco Lover make any difference? I think it might. Blame it on the boogie.

Sleep Remedies

Last year, I was diagnosed with Obstructive Sleep Apnea and issued with a CPAP (Continuous Positive Airway Pressure) machine to help control my breathing as I sleep. I have had a love/hate relationship with this machine from day one; I find it helps me stay asleep but makes getting to sleep a bit of a challenge. So, as a result I’ve ended up using it less and less. Those taking care of my treatment obviously wish for me to persevere, so I’m giving it another go and this time I’m going to have a little help getting me to the land of nod in the form of over-the-counter sleep remedies.

Friday Night: Antihistamines

The humble hay fever pill doubles as a handy aid to restful sleep. I took one before settling down to sleep and found it mellowed me out almost immediately and helped me drift off soon after.

Saturday Night: Kalms Sleep

“May make you feel sleepy.” And they did. I took four (maximum dose) an hour before settling down to sleep, and decided to give the CPAP a try. So, masked up and dosed up I got comfortable (well, as comfortable as you can be with a plastic cup strapped to your face). I slept for nearly 11 hours with no interruptions. I’d call that a win.

Sunday Night: Sominex Herbal

The cuddlier herbal version of Sominex, made with similar ingredients to Kalms. I had high hopes for these, mainly because they appeared to be a stronger mix. Sadly, they didn’t suit me and I had what passes for a “normal” night with many false starts and frustrated fiddlings with the CPAP mask.

According to my Fitbit, Saturday night was indeed the most successful sleep – over 11 hours at 100% efficiency. I’m aware that the effects of sleep remedies vary from person to person, and other factors need to be taken into account. So while the Sominex Herbal didn’t work so well for me this time, it wouldn’t put me off trying them again. For now, though, the best choice for me appears to be the Kalms.

Am I getting any benefit from using CPAP again? I think so. Once I’m asleep, it’s a better quality sleep. I’m still not sure if I need it. I’ve lost over 60lbs since my diagnosis last year, and I’ve noticed an improvement in my breathing, so I’ve made arrangements to be tested again to see if treatment can be discontinued. In the meantime I’m doing my best to endure the less appealing aspects of wearing the damn thing and enjoying some deep and lengthy sleep as a result.

Losing Weight with MyFitnessPal and Fitbit

I’m fat. I could really do with being less fat.

Inspired by Sam, I’m working on it with the help of two online services and one little gadget. I’m a geek, so if the solution to any problem can involve wireless syncing and iPhone apps, it’s a good solution.

The eating side of things is tackled by a site called MyFitnessPal. It’s a terrible name, but a very effective online service for counting calories. The activity side is helped along by Fitbit, which is like a very clever pedometer that reports back to their online service. I’ve talked about the Fitbit before, so here I’ll concentrate mainly on MyFitnessPal, then update a bit on how I’m getting on with the Fitbit after more time using it.

MyFitnessPal

Counting Calories

The idea of a calorie counting site is fairly simple, and it is, ultimately, the key to weight loss. Burn more calories than you eat, and you should lose weight. Admittedly, as with so many things, it’s a little more complicated than that in reality, but that’s the basics. To do the job, a calorie counting service needs to know how many calories you’re eating, and how many you’re burning.

That means you need to tell it about everything you eat and drink. Everything. If you miss things out, they don’t get counted, and any figures you work on will be wrong. It’s absolutely vital to any such service that entering the food and drink you consume is as easy as possible. That’s where MyFitnessPal does really well.

Users can add items they eat, and enter the nutritional information. You can search for stuff that’s been added. You can also add your own, but with so many users adding things, it’s rarely necessary – I haven’t needed to add anything yet. Adding your own cooking can be a bit of a chore, if you add each ingredient separately. There are often pre-calculated ‘meals’, that you can use if you don’t mind being a bit approximate, and for the most part they should be near enough.

There’s An App For Fat

My favourite feature, though, is using my iPhone as a barcode scanner. Choose to add a food, pick a meal, tap the barcode button, and point the iPhone’s camera at the barcode. It does surprisingly well at reading barcodes at strange angles, and partly ripped codes don’t seem to be much trouble, as long as the rip has left at least one straight path through the code. It looks up the barcode online, and usually brings up the right item within seconds.

MyFitnessPal counts several other things along with calories, like sodium, fat, and protein. I haven’t taken too much notice of them so far, but I have noticed that quite a few user-added items have some of their information missed out. You’d probably need to double-check, and perhaps re-enter, quite a few things if you were trying to accurately track, say, your sodium intake. For my purposes it doesn’t really matter.

I’ve been using MyFitnessPal for over two months now, and haven’t knowingly missed out anything I’ve eaten, so it certainly seems to be practical enough for me to use.

My Problem, and MyFitnessPal’s Solution

I’ve come to realise that the key problem for me with weight loss is that I don’t tie short-term sacrifices in to long term gains well. The same problem means I’m not naturally good at saving money, or generally planning for the future, especially long term. I see a biscuit. I see a decision. The down side is a possible weight gain and reduction in health over years if I keep repeating the decision to eat the biscuit. The up side is I’ll be eating a biscuit that looks delicious. To me, the decision has always been easy. Nom. I ate all the biscuits.

And all the cheeseburgers. And at least some of the pies.

MyFitnessPal attempts to connect these short term decisions together. Because each thing you eat adds to today’s total, the biscuit reduces the chances of me hitting my target that day, or means I won’t be under by as much. It reduces my score that day. Immediately. The pay-off for not eating the biscuit has moved forward. It’s become somewhat arbitrary, about balancing some numbers, but it’s now. That makes quite a difference to me.

In addition to that, at the end of each day, when you close your food diary, it calculates an estimated weight loss over five weeks if you did the same every day. That connects the decisions I made today with a longer term event, but one that’s soon enough to seem quite real. If it tells me my weight in five weeks will be notably lower than it is now, I know that’s as a direct result of the things I decided to eat today. And the things I decided not to eat.

The weight loss idea feels more real, and more immediate, so I care about it more. Enough that it really isn’t difficult to turn down a cream cake, or to avoid adding ketchup, or to have less potatoes with my meal.

Sometimes, I decide something is worth eating anyway. I ate an entire tub of Ben & Jerry’s Cherry Garcia last night, and it was worth it. I’d done ok for the rest of the day, though, and it was the frozen yogurt version, so I still managed to stay within my calorie allowance. Win.

Calories Burned

The other half of the calorie equation is what you’re burning. Everyone thinks of the calories used in exercising, but most are actually burned just by your body’s basic functions. Breathing takes energy. Your heart uses energy to keep beating. All this stuff forms your Basal Metabolic Rate. MyFitnessPal can calculate a reasonable estimate of this, based on your weight and height, so it knows how many calories you generally use. It also asks you how much general activity you do – it makes a difference if you’re generally sedentary or if you have an active job. It can add these activity estimates on to your BMR to get a good idea how many calories you normally burn.

If you do more on a particular day, you can add exercise to MFP, and it can add this to its equations to work out your weight loss (or gain!).

Keeping track of how much you do each day, though, and trying to guess how much activity you’ve done relative to ‘normal’, can be difficult. That’s where Fitbit comes in.

Fitbit

I’ve written before about what the Fitbit is and what it does. The very short version is that it’s a clever pedometer that counts steps and ‘floors’ climbed, and wirelessly syncs the data with their online service.

I took a few steps today.

The interesting part for our purpose here is that their online service can be connected to MyFitnessPal, and will feed the same data to them. If you’re more active today than you normally are, Fitbit tells MyFitnessPal about it, and you get a credit for exercise added to your daily totals.

If you’re easily motivated by changing arbitrary numbers, as I am, it can really help you to get more active. I don’t mind popping down stairs for something as much when I know I’m going to get some ‘credit’ for it – even if the credit is just changing a number. Because of the way MyFitnessPal ties those numbers in to my long term weight loss, the number feels important and relevant. So I do more.

Working Together

Both of these services are useful, and could help on their own. The combination of the two, working together, is what makes them work really well for me, though. The Fitbit watches what I do, with very little effort needed on my part to make it work, and means I can compare activity levels on different days. MyFitnessPal uses that data to give it a more complete picture of your inputs and outputs, so it can calculate your calorie equations better. It does seem a little like it’s making a ‘game’ of activity and weight loss, but if it works, I’m all for playing.

If anyone wants to join me, I’m pigpogm on both services. Profiles here:

…or straight to the sites’ home pages:

Fitbit Ultra

The Fitbit (Amazon UK, Amazon US) has been around a while, but has only recently started to seem like an interesting idea to Sam and I. We both need to lose some weight (ok, maybe a lot), and to get a bit more active (ok, maybe a lot more). A couple of years ago we used to be able to go for a walk and go pretty much anywhere in town, and now the hill we live on means we could probably walk anywhere, but we couldn’t get home again without the aid of a winch.

Sam has been using MyFitnessPal to help with the food side of things, and it has been going well for her. I decided to join her in using it, and we decided to both get Fitbits too.

What Is It?

It’s essentially a very clever pedometer – those things you can clip to your belt that have a vague guess at how many steps you take each day. It contains a 3-dimensional accelerometer to monitor movement, and an altimeter so it knows if you’re heading upstairs. There’s also a wireless connection to its base station that you leave plugged in to your computer, so when you get home, it can upload its data automatically.

Wearing it is easy, thanks to the design – the whole thing is the shape of a slim clip, so it just pushes onto your waistband or belt. For thicker belts, a little holder is supplied, that can open a bit wider – and isn’t as expensive if it snaps. I’ve been keeping mine clipped to the neckline of my t-shirt, which seems to work well. They say it can also work reasonably well in your pocket, if you don’t want it on display, or don’t trust it to stay put.

Controls and Display

It has just one button and a small blue glowing LED display. Pressing the button cycles through the display information. Pressing and holding starts and stops a stopwatch, which tells the Fitbit you’re doing some sort of activity.

The display can have various features turned on or off. I’ve turned most of mine off, and I’m left with:

  • The Flower

The Flower at its shortest. I wasn’t moving much.

The flower grows if you’re active, and shrinks if you’re not. It has just one leaf above, because I wasn’t moving much. Leap around enough, and I’m told it can grow up to eleven leaves. I may never see this happen. It’s all relative, though, and as you get fitter, and are more active normally, your flower becomes harder to grow.

  • Step Counter

I took a few steps today.

The step counter just counts how many steps you’ve taken, just like a standard old pedometer, though it should be a bit more accurate.

  • Stairs Counter

Twelve flights of stairs today – quite a climb.

This sort of counts how many flights of stairs you’ve counted. Hills count too, though, so it’s really counting how many multiples of ten feet you’ve ascended by. This seems less accurate in my testing, but better than a ‘normal’ pedometer – going up stairs is hard, so you deserve credit for it.

How Well Does It Work?

Seems to work pretty well in my (so far limited) testing. The step count seems reasonably accurate, which is more than can be said for most pedometers. It certainly seems to know when I’m going up stairs or up a hill, so I feel like I’m getting ‘extra credit’ for the extra work I’m doing. Beyond walking, running and going up and down stairs, it can probably only really guess at how much energy you’re burning when exercising, but that’s fine for me – I don’t go beyond walking and going up and down stairs.

Speaking of stairs, I have found if I’ve done a fair bit of walking, even if it’s completely level, it sometimes registers stairs that I haven’t climbed. The altimeter is presumably based on air pressure, so if the pressure drops while I’m walking, it probably thinks I’m going up hill, or up stairs. It means you sometimes get credited with more stairs that you’ve really done.

In terms of motivating me to do more, I really haven’t tested yet. I decided when I got it that the first thing I would do was to establish a sort of baseline. I’d just do what I’d normally do, and let it measure my current levels of activity, then slowly try to increase that.

No, I really did plan to do that.

I failed. As soon as it was there measuring my activity, I started trying to increase it. On one day, we weren’t going out. I put my boots on and took two trips down to the bins, for the sake of increasing my ‘stairs’ count to meet my goal. I guess that means it worked quite well at getting me to be more active. It probably also means I’m gullible and easily tricked, and will go to a surprising amount of effort in pursuit of a tiny pixel leaf.

Sleeping

Well, that’s all good, but does it just sit there by the bed when you’re sleeping, doing nothing? No. No, it does not. You attach it to your wrist with the supplied wrist band, and it monitors your movements to work out when you’re sleeping. Each morning you get a graph showing you how good (or otherwise) your sleep was.

It’s confirmed for me that I sleep quite well, with nice long uninterrupted stretches. Sam has sleep apnea, and you can read about how she’s used her Fitbit to monitor the difference the CPAP machine makes.

The Future

I’ve no idea how much I’ll stick with it in future, and if it will continue to motivate me, but early signs are good. Using it takes so little effort that even limited benefits would be worth it, so I can’t see why I’d give up.