Oncologist check-in

 I saw my oncologist today., after my DPP class in the morning. We reviewed the results of the blood work my liver doctor ordered and I asked about the meds and liver markers. We agreed that the progress I have made in lowering my A1C, my glucose, and my liver markers, and the good results of the Fibroscan, are all signs that I'm doing the right thing by making diet and exercise changes for reversing fatty liver and prediabetes symptoms. She noted that I am due for some more scans: a PET scan to follow up on the endocrinologist's recommendation for monitoring and a chest scan for the nodule on my lung. I scheduled the chest scan for two weeks from now.

I had a big kale salad at the Delancy-Essex marketplace and regretted my choice because it had some higher calorie ingredients (although healthy ones). Walnuts and dates and pumpkin seeds pushed the calorie count up. But I had a chicken breast and leafy greens, cucumber and tomato, garbanzo beans and tahini dressing and no rice; all healthy choices and only a few calories over. I was tired while walking but I got in my steps and went up and down a bunch of stairs, I checked my phone app for step and stair counts and got in quite a few.

 My Rancho Gordo bean box included lentils so I have been eating them for the last few days. Earthy and lots of fiber!

patience

Weight trending down! Finally! I was getting discouraged because it was just bouncing back and forth from 181-184. Now it's down to 177.7 for two days in a row. I need to be patient. I looked back at my timeline and I'm on track even though it was not quite so linear. I've been doing a good job sticking to my calorie allowance and healthy food choices.

On the exercise front it's not so good. For the last three days I have not gone for a morning walk. The first day it was fatigue from all the steps I logged the previous day, but the last two days I just have been lazy. I'm in my pajamas now and would need to change to go mail the checks I need to deposit. I will get up tomorrow and do that on my walk to the cafe.  

UPDATE: took my walk today! 177! 

Good news!

 Today I met with the liver specialist at Mount Sinai. I managed to sleep about 6-7 hours but was up at 7:30  to get ready for the long subway ride. I was moderately nervous about this consultation---would I need a liver biopsy? was there so much scarring that I had cirrhosis? As usual the trip and the waiting were tedious but I was seen after only a half an hour wait. That counts as on time!

I was relieved that the doctor saw no need for a biopsy. She had access to my earlier blood work and I showed her my more recent tests which showed improvement. She had my blood drawn and referred me for  a FibroScan, an ultrasound that is their first test that's non-invasive. I was lucky and they squeezed me into the schedule after the blood draw which took forever because I was dehydrated and my blood wasn't flowing. The scan was at the hospital down the street where I'd had my brain surgery. Ah, memories!

Good news. The test showed that I have little to no fat and no scarring! Apparently my weight loss and visceral fat reversal habits have actually paid off! My A1C is also down into the normal range: 5.4! they didn't test my glucose or other liver markers. No hepatitis of any kind. I almost don't believe it but 

One value came up high: GGT or Gamma-Glutamyl-Tranferese a liver enzyme that help protect the liver from damage. So there is still some inflammation. I still have metabolic syndrome. 

Tonight I'm going to meet Rosemary, Arun, and Paloma for Japanese food at Ozakaya, that place on Vanderbilt in Prospect Heights (take the C, leave at 5:15 and get off at Clinton-Washington).

new routine

 Today was Diabetes Prevention Program. My weekly routine is to leave the house early so I can get the J before it starts skipping my station for track work. Then the hike to the clinic--it's a lot of steps! I can have coffee there so I don't make it at home. Today's session was a review for me of sensible eating advice. Eat whole foods, the healthy plate method, skip the sugary drinks. Nothing new but it's a good reinforcement of what I've been putting into practice. My treat of the day is to have a salad with squash, broccoli, cherry tomatoes, pumpkin seeds with a chicken breast on rice at the Delancy Essex Market. Since I skipped breakfast, so I'd get my fasting walk in before class, I had calories to spend. I didn't quite finish the rice but everything else was delicious and healthy. Next time I'll try a different salad.

Tomorrow I will leave the house at 8:20 to get to the liver clinic by 9:45 for a visit with a specialist. I hope I will not have to have a biopsy. I hope the MRI was clear enough to show what level of damage there was. I hope that my adherence to a liver damage reversal  program will be enough. I wonder if she'll have a blood draw to check my liver markers. I wonder if she'll have an opinion on my medications. 

I'll have dinner with Rosemary before she leaves town for 6 weeks!

 

The Binc excursion

 I switched up my walk route to overcome my sadness about missing my Berkeley garden walks. It's spring now and the trees are leafing out. Instead of walking up to Broadway and dealing with the trashy street and the overhead subway, I'm turning left and walking through the park and over to Saratoga. I went to September and they gave me a bigger cup of coffee this morning. I then walked over to the library and returned a book. I walked back the way I came, feeling like my legs were tired. But I did it, I took my walk. I got 7 and a half hours of sleep last night--a midnight text and awake at 7:30. I lay in bed until 9 and dozed a little, then up and out. Now I'm waiting for my brussels sprouts to roast for lunch. I am going to join Rosemary and Arun for dinner at the bar he works at called The Binc. It's a short walk from the High Street station on the A/C line. I looked at their menu and it looks as if the grilled shrimp is the most diet friendly. I may treat myself to an expensive mocktail---both my tax refunds were deposited!

Psych meds and liver

 I had an appointment with a psychiatrist to talk about whether or not I should change my psych meds given my elevated liver numbers and pre-diabetes. The upshot of our conversation was that the meds are working for what they are prescribed for and I am doing what I can to reverse those negative numbers so I'd like to continue as is and check in with him in a few months and with my primary care physician as well when I see her in July. My symptoms before I took this med were so severe that I really an afraid of a relapse. He said that Metformin could help with the blood sugar. I didn't tell him that I'd already had a course of Metformin when I started and it didn't seem to help. So now I get to see if my diet and exercise changes are enough to reverse the negative numbers of my liver markers and glucose. My last blood work did show improvement. My glucose was 90 and my AST was in the normal range. My ALT was still high though and my A1C was 5.9 (the threshold is 5.7) not too far off the limit. I will see the liver specialist in a week. I sure hope she doesn't want to do a biopsy.

Lots of steps!

 Today is Tuesday so its the Diabetes Prevention Program --DPP--meeting at the Henry St. clinic in Manhattan at 10AM. This meant that instead of a neighborhood walk when I got up I walked to the J and then from the J at Delancy/Essex St to the clinic. After class I walked back and had lunch at the food mall there and then back to the clinic for an appointment with a psychiatrist to talk about my meds. We agreed that I'll keep my olanzapine dose the same and see how I do with my weight loss and activity program and meet again in 2 months. We talked about whether it made sense to add Metformin and I opted to wait. Then I walked back to the subway. So I made 4 short trips and ended up walking over 8000 steps. Now that I have my Health app on my phone set up to count steps and distance I can add that information to my weekly reports to Andrea in DPP. Tomorrow I'll go to Quest at 10:30 but I need to work around the J repair schedule so I'll leave here at 9 and get to the Joe cafe for coffee and to buy a sandwich for lunch. I should finish reading Hamlet. I don't know what they'll be talking about since I missed the last class but I have a ticket to see a performance at the BAM this coming Sunday with the National Theater company from London.

Tomorrow I will not do my morning walk but instead walk from the subway to Quest and back. It's probably going to rain.