Side Effects

Last week I had to have my bone density checked again (something I do every 2 years), and this week I got the results. They weren’t encouraging. For some reason, I hadn’t made any improvements over the past two years, and I was filled with a sense of deep frustration. I’d been doing everything I was supposed to, after all, but my aggravation really stemmed from the fact that the reason this is an issue at all is because I lost weight.

Now, I know that you’re supposed to consult a doctor before losing weight (or so all the diet commercials tell you), although I’ve always found that a bit difficult to swallow, since most overweight people I know avoid doctors like the plague. Additionally, I’ve never been completely sure what the point of this consultation is. Is it so the doctor can tell you not to go on a grapefruit or starvation diet? Or that you should exercise? Anyway, as you might have guessed, I didn’t do that. At the time, I didn’t even have a doctor in Portland; the closest I had to a doctor at all was the one I saw when I was a kid, back in Casco. I do wonder if some of my unanticipated side effects (like bone density issues) might have been prevented had I followed this suggestion.

Then again, it would likely depend on the doctor. For instance, I doubt anyone would have told me at the beginning that losing weight might give me knee problems. I’d heard the reverse plenty of times, but never this. On the face of it, after all, it makes no sense. Shouldn’t my knees be happy to be carrying less weight? Then you look deeper and realize it has a certain logic. My knees and legs were overdeveloped to handle a lot of weight; removing it threw them out of whack. My legs, especially thighs, lost a lot of muscle mass, simply because I wasn’t walking around with an extra 100+ pounds, which meant my knees weren’t as stable. Throw in the fact that I walked and sat differently, crossed my legs sometimes, and used my knees much more by being active, and it starts to all make sense. But I still don’t think a doctor would have told me that up front.

So, then, what about my hormone levels? Would any doctor have actually told me back then that it’s not abnormal for women losing that much weight to get hypothalamic amenorrhea? (I.e, a fancy way of saying they would stop menstruating?) And further, that 20% of such women (a rather high figure) never get back to their normal cycles? It’s one of those things for which there is no known cure. My acupuncturist said she had a lot of success with it, but I saw her for two years with no luck, so I’m not sure what to make of that. Another doctor told me she’d only seen women recover after being pregnant (still possible, but with assistance), as if that reset them somehow.

But maybe a doctor would share that because many women would consider it a plus. No mood swings, no cramps, no mess, no worries about going swimming or hiking or wanting a romantic evening. Sounds perfect, right?

Except, of course, it also means no estrogen in your system. No estrogen means, among other things, loss of bone density. I cannot tell you how horrifying and shocking it was to find out, when I was 30, that I had osteopenia, the stage before osteoporosis. I was 30! But I’d wanted to avoid the pill as a long-term solution because too much estrogen can increase the risk of breast cancer. That’s why I opted for the NuvaRing, which has very low doses of estrogen. Problem is, some studies have shown that if the doses of estrogen are low enough, it can prevent gains in bone density and even cause bone loss. We’re still trying to figure out if that’s what’s going on with me. It’s just frustrating, because as my doctor pointed out, I’m a “unique case”, wanting enough estrogen to protect my bones, but not enough to increase my changes of breast cancer.

Another issue with lack of estrogen is a thinning/drying of reproductive tissue. I actually got an abnormal pap result once not because I had HPV (although that was the initial diagnosis) but because my cells looked like those of a post-menopausal woman, and it threw off the people looking at the cells because I was only 32. Not having a period doesn’t seem quite as exciting when you consider all that.

It’s possible that someone might have told me that keeping a certain amount of fat in my diet is actually important, and that most women need around 20% body fat to maintain a normal cycle. Especially someone like me, who had been used to lots more than that. I don’t know if that would have helped, and I’ll never know now.

Now, I’m not going through all of this to scare women away from losing weight. (Men, I have no idea what you’d go through – sorry.) It’s more that I don’t want people to be blindsided by these things as I was. If you’re comfortable consulting your doctor, I would suggest you do that, and if they’re a good doctor, they might even listen and take you seriously. That way, if you experience any of this, they might be able to help you a little more proactively. But with any luck, you won’t go through this at all, and will just experience the joy of a thinner self.

Toxic Sugar

I always knew that sugar wasn’t a health food, but I never considered it particularly evil. I was therefore quite surprised when I first went to my most recent acupuncturist, and one of the first things she did was put me on a “sugar detox” diet.

“Sugar is a toxin,” she explained.

I didn’t quite know what to say. I knew that I had once been addicted to sugar, and that eating it to that extreme wasn’t good, but considering it toxic? Still, I did the detox diet, even though it was pretty extreme. It consisted of only eating proteins, fats, white rice, broccoli, and cauliflower. The reason I agreed was because I only had to follow it for 24 hours, after which I could go back to my normal eating. I still don’t quite know what it was supposed to accomplish. I didn’t go through withdrawal or anything, nor did I feel particularly “cleansed” in the end.

Then one of my myriad doctors recommended that I go on the Schwarzbein Diet. In general, it’s pretty reasonable, suggesting that you balance your intake of carbohydrates, proteins, fats, etc., so that you get moderate amounts at every meal but not too much at any one time. But it also doesn’t allow any sugar – even natural sugars, like maple syrup and honey, are suspect.

I actually did that for about a year, but eventually it got to be too wearing. I wanted to be able to have a piece of cake on someone’s birthday, or partake in at least some holiday sweets, or not drive my friends crazy with my eating restrictions when I was visiting.

I was reminded of all this recently when a woman from church (let’s call her Church Lady) commented about a friend of hers who definitely subscribes to the idea the “toxic sugar” idea. The friend had come to help out for a couple of weeks after Church Lady had surgery, and by the end of it Church Lady was more than ready to say goodbye. “I was afraid to bring anything with sugar in it into the house,” she said. Considering that she has two kids, ages 7 and 2, that must have been particularly trying.

Or, you could go the route of my acupuncturist and not let your children have any sugar, pretty much ever. That’ll keep them free of whatever evils are in sugar (and likely disappoint dentists by keeping their teeth exceptionally healthy), but I would worry about that. What happens when the kid goes to school, or visits friends, and eventually tries sugar and decides they like it? Will they binge on it? Will it make them sick? Will they be ostracized?

I don’t advocate eating hordes of sugar, nor do I eat much of it myself. I can get through a day without it, and I don’t crave it the way I used to. In fact, it’s taken me until now to get through all the frozen things I had, between Christmas, New Year’s, Girl Scout cookies, and a box of chocolates I got in May. It takes me this long because I limit myself to one item a day (with rare exceptions), which somehow doesn’t seem like a toxic amount. For me, it’s all about balance.

I also like thinking about it the way Indians do for their new year, Dhivali. As a friend explained it to me, they have sweets to make the new year sweet. I typically have my treat in the morning, to make my day sweet, and it seems to work quite well. May you find your own balance and sweetness.

A Time of Plenty

It’s been rather strange having an actual spring and summer in Maine, and to have them at “normal” times, as opposed to the delayed response we normally have. Everything is ahead of schedule, from a growing perspective, and it’s actually throwing me off.

Take blueberries, for instance. Normally they’re just getting towards peak in mid-July, but instead, they’ve been at peak for a couple of weeks and are on the downslide! It was quite disappointing to discover that my favorite blueberry field didn’t have the plethora of berries I’ve come to expect, but still, I’ve been able to sneak in a couple of visits to pick a few quarts. It’s not as many as I’d like, but it’s certainly better than nothing.

And then I had planned my menu a little around what I thought was going to be available at the Farmer’s Market – only to arrive and discover that I had some of it all wrong. Sugar snap peas, for instance, are just about done. But we already have corn! Zucchinis are also producing at a prodigious rate (as is their custom), tomatoes are out, green beans, green peppers, peas, cucumbers, onions, potatoes, broccoli, tons of greens, and even some eggplant! I also discovered a new type of beet that I wanted to try, and the fresh garlic was equally enticing.

The strange part about visiting the Farmer’s Market these days is that I feel like a kid in a candy store. I want to see everything, since different farmers have different foods available, and then decide what to get based on relative prices and availability. Except really, I want some of everything. I know that as one person, there’s only so much I can eat, but I had a hard time turning away from certain produce. I also had to keep reminding myself that I have some of my own food growing – the lettuce is lovely, I’ve gotten two tomatoes (!), and baby zucchini and cucumbers are on their way. Even so, when I stopped at Rosemont Market on my way home, I saw a baby sugar watermelon for just $3, which I simply couldn’t resist. The result is that my fridge is stuffed. I hope that I can eat as much as I think I can.

What’s strange to consider is that if you actually put me in candy store now, I might be interested in seeing the varieties of candy, but I wouldn’t want to try them all. Fresh fruits and vegetables, though – these will have me salivating at just the sight, the gorgeous hues of green, purple, red, yellow, orange, and more, a whole rainbow laid out as a feast for my eyes. I’m glad of it, and glad, too, that I’ve lost weight, since all that produce is quite heavy to carry around. The good news is that I can go a little crazy on eating it and not be too worried, unlike with candy. The other good news is that I live in a place where such food is easily available right now, and for that, and this time of plenty, I am deeply grateful.

Camping Food

In honor of 25 years of going to Baxter State Park, I thought I’d write a little about our camping food.

Now, I can’t say for sure, because I’ve never camped with anyone other than my family, but I think we tend to eat better than some, perhaps too well. When I was growing up, we often stuck with a certain pattern.
- Saturday lunch: packed lunch and ate in Millinocket
- Saturday night: pasta, salad, pie
- Sunday morning: eggs, homefries, bacon or sausage
- Sunday day: gorp, hard-boiled eggs, power bars, etc.
- Sunday evening: burgers, veggies, chips, cookies
- Monday morning: pancakes, juice
- Monday lunch: again brought food for sandwiches and ate in rest area

The pancakes were a bit different than what most people would have, made with apple or orange juice as a milk substitute (this was back before other milk alternatives were readily available), and sometimes with blueberries collected from the mountain. And we often had to fight with squirrels and chipmunks over our trail mix, particularly peanut M&M’s, especially one year when one chewed a hole through my mom’s backpack to get to hers. We also had an unfortunate incident once where a raccoon ate the remainder of our blueberry pie! Since then, we’ve gotten better about putting all our food in the car overnight or anytime we’re not eating.

As far as what we eat, in the years since Jeremiah and I have been involved in the food, we’ve gotten a little more elaborate. (Well, particularly Jeremiah.) For instance, the first year that he was in charge of supper Saturday night, I noted: “Jeremiah, typical of himself, hadn’t brought anything as boring as pasta. He and Janice were making stir fry with beef that had been packed in dry ice that Janice had got from work, peppers, snow peas, carrots, and rice noodles.” (Janice, incidentally, is a chemical engineer.) And for smores, we used some marshmallows that had a liquid blueberry center, courtesy of an Oriental market in the Boston area.

We took to making more ployes for breakfast for a while, since those can mixed onsite for any amount and just need water. Now, in deference to gluten issues, we’ve gotten back more to the eggs and homefries, and also parfait. Other newer favorites are chili, or sometimes taco salad, stopping at Subway on the way up for sandwiches instead of packing them, and getting breakfast at the Appalachian Trail Café on the way out. We’ve also added a little more complexity and work because we stay an extra day to our stay.

And as always, I’m amazed at how long all of this takes to prepare. For instance, I spent quite a lot of time pre-cooking chicken for stir-fry, hamburgers, bacon, a frittata, and hard-boiled eggs, plus I had previously spent time making strawberry-rhubarb pie and strawberry-rhubarb crisp. When shopping, I probably spent more time than I should have considering the different trail mix, granola, and energy bar options at Whole Foods, and I don’t even know how many e-mails Jeremiah and I exchanged figuring out who was getting what for produce, between the Farmer’s Market and his CSA share.

But there’s no doubt that once we’re there, we’ll be eating very well, and enjoying not having as much fuss or clean-up because of all the initial work. We’ll be eating:
- Saturday lunch: Subway sandwiches
- Saturday supper: rice, stir-fry (chicken, zucchini, broccoli, and peas), salad (various greens, tomatoes, scallions, garlic scapes, cilantro, Chinese cabbage, and more), strawberry-rhubarb pie and crisp
- Sunday breakfast: yogurt, granola, and berries (fresh raspberries, blueberries, and black raspberries), bacon
- Sunday lunch: trail food
- Sunday supper: hamburgers, chips, steamed broccoli, sugar snap peas (they’re amazing this year), cookies, smores
- Monday breakfast: frittata and homefries
- Monday lunch: PB sandwiches with homemade rhubarb jam, peppers, cucumbers, and whatever else we have leftover
- Monday supper: taco salad, other leftovers, hot chocolate
- Tuesday breakfast/brunch: Appalachian Trail Café

Now I just have to make sure I do enough hiking to burn it all off!

Sunscreen

It’s that time of year to be putting on lots of sunscreen, and almost every time I slather myself in the stuff, I remember something I read a few years ago. I don’t remember where it was, but someone commented, “All things being equal, fat people use more sunscreen.”

I remember how annoyed I was by that when I first read it. The fact that I still remember it, and that it still rankles, shows just how much it impacted me. I understand what the person was saying, which is that fat people have more surface area because of their larger size. That much I can’t and won’t argue with.

It was the “all things being equal” bit that still gets to me. Whoever wrote that, I thought, couldn’t have ever been fat because then they’d realize that there’s no such thing as equal in that realm. Yes, fat people have more skin, but they are far less likely to expose that skin to the sun and therefore require sunscreen.

It’s not just that they’re less apt to be doing lots of physical activity, although that’s certainly true, but they’re also less likely to be venturing outside at all. For instance, I spoke recently with a man who once weighed 642 pounds, and he commented that when he weighed that much, he never went anywhere except for work and maybe the grocery store. I don’t think for him it was even a matter of being self-conscious – it was just that physically it was exhausting for him to move around much. So he wasn’t going to be using sunscreen.

Even for those who do venture out, I suspect we’re far more likely to cover up than people with more svelt physique. I was thinking of this while watching my niece put on sunscreen before going swimming in her two-piece bathing suit. At her age (14), I never would have worn a bathing suit like that. I hardly wore bathing suits at all, or shorts, or short-sleeve shorts. As a result, I never really ran into the issue of having to use sunscreen except for on my face and maybe my lower arms, and those areas are only marginally slimmer than they used to be, if at all.

So, yes, I suppose if all things were equal – if fat people could get around as easily as thin ones, and if they exposed all that extra skin to sunlight in the same amounts as other people – then yes, they would use more sunscreen. But we’re not in that world. In this one, nothing is equal, and I think I could pretty safely say that thin people, in fact, use more sunscreen.

It’s that time of year to be putting on lots of sunscreen, and almost every time I slather myself in the stuff, I remember something I read a few years ago. I don’t remember where it was, but someone commented, “All things being equal, fat people use more sunscreen.”

I remember how annoyed I was by that when I first read it. The fact that I still remember it, and that it still rankles, shows just how much it impacted me. I understand what the person was saying, which is that fat people have more surface area because of their larger size. That much I can’t and won’t argue with.

It was the “all things being equal” bit that still gets to me. Whoever wrote that, I thought, couldn’t have ever been fat because then they’d realize that there’s no such thing as equal in that realm. Yes, fat people have more skin, but they are far less likely to expose that skin to the sun and therefore require sunscreen.

It’s not just that they’re less apt to be doing lots of physical activity, although that’s certainly true, but they’re also less likely to be venturing outside at all. For instance, I spoke recently with a man who once weighed 642 pounds, and he commented that when he weighed that much, he never went anywhere except for work and maybe the grocery store. I don’t think for him it was even a matter of being self-conscious – it was just that physically it was exhausting for him to move around much. So he wasn’t going to be using sunscreen.

Even for those who do venture out, I suspect we’re far more likely to cover up than people with more svelt physique. I was thinking of this while watching my niece put on sunscreen before going swimming in her two-piece bathing suit. At her age (14), I never would have worn a bathing suit like that. I hardly wore bathing suits at all, or shorts, or short-sleeve shorts. As a result, I never really ran into the issue of having to use sunscreen except for on my face and maybe my lower arms, and those areas are only marginally slimmer than they used to be, if at all.

So, yes, I suppose if all things were equal – if fat people could get around as easily as thin ones, and if they exposed all that extra skin to sunlight in the same amounts as other people – then yes, they would use more sunscreen. But we’re not in that world. In this one, nothing is equal, and I think I could pretty safely say that thin people, in fact, use more sunscreen.