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. 

Hydration commitment.

 I have ignored the advice to drink more water and I run around dehydrated all day. Today I made a commitment to start a new habit: I will drink at least 5 cups of water a day. This is on top of my coffee and tea habits. I set a notification ad I'll try to remember to drink every time I go to the bathroom.

This morning I woke at around 7:30 after a night of broken sleep because I had to get up to pee two times. But at least I fell back asleep. I got out of bed around 8 and had my morning lemon water. Weight was 179 so I am under the 180 threshold again! Then I took my morning walk but this time I went to the cafe on Saratoga, September. It's a much nicer walk than going down Broadway under the elevated tracks. It's a few more steps as well as I saw when I checked my Health app on my phone. I manage to turn on the step counter. A cup of coffee is smaller and a dollar less than at Covert. Breakfast was cottage cheese, blackberries and ground flax seed.300 calories and 24 g. of protein. Now I am going to kick back until my Alanon meeting. No more lying in bed until 10 or 11. Now I'm up and have my walk and then my breakfast. I wish I could find the Youtube video that set up this walking while fasting idea. This one explains that biology of walking before breakfast. so does this one:

 

Cherry Blossoms

 The Brooklyn Botanic Garden has a cherry blossom watch map that tells you which trees are in bloom and which are past peak bloom. Rosemary, Maria, and I went on Friday morning and saw the tree-lined allée and lots of happy people. Then we went and had lunch at Mado cafe which is close by on Washington. The food was good and I had crispy hake which turned out to be fried in a light batter (so not exactly in my diet) but it was light and not greasy so I just logged it in my calorie counter app and enjoyed it.

 

Good habits

 I lay in bed and listened to two podcasts before getting up to have my lemon water and my morning walk, but I did it! I have connected my Health app on my phone so now I can count my steps. Its 1945 steps to the cafe and back. I'm feeling as if I'm gaining some stamina. Tuesday at our DMP session we'll be talking about tracking so I'll see what Andrea our coach recommends. I'm tracking my food, water, walking and now my steps. Today I weighed in at 179 and My Fitness Pal told me I'd lost 11 pounds and that I should feel proud of myself. I do! But it's been hovering around the 179-181 axis for a week now so I'd like it to go down again soon. Yesterday I was way under my calorie count and the app told me it wouldn't give me a reading because it was dangerous to undereat like that so I forced myself to eat some hummus and baby carrots to bump it up. I have black beans to finish off today, some green beans and broccoli to steam and some tomatoes left as well. Next up is lentils.

Habit

Yesterday I went to see a nutritionist. I am not sure that she told me anything I didn't already know or that I haven't already started implementing in my management diet. But I am going to see if there are any steps I'm skipping. Today I did my morning walk again~just to the cafe and back. Yesterday I also walked to the clinic and back. That's 20 minutes each way. I was dragging my ass but I did it. I'm hoping that I'll stop being so tired if I do this every day. Tomorrow I'll join Maria and Rosemary to see the cherry blossoms in the Botanic Garden so I'll get a lot of walking in then: ten minutes to the subway, another ten minutes to the park, at least a half an hour around the trees, then the same in the other direction. More if we go eat somewhere.

 

Day 3

Day 3 of new morning routine: up at 8:30, lemon water, walk to cafe, black coffee, walk back home. Breakfast at 10 within intermittent fasting window--cottage cheese, blackberries, ground flax seed. It's not a long walk but it's a start of a good habit. I'm choosing to do what I can instead of beating myself up that I don't want to walk the 20 minutes to a different cafe. 

I went to see Rosemary and Arun's new apartment. My back hurt on the walk to the L but it was better on the way home. More walking! Their place is small but cute and the best thing about it is that they are happy with it! It's right around the block from a stop on the M line which is quick to get to from the L. Transfer at Myrtle-Wycoff. We made tentative plans to go to Arun's work on Friday night. He's working Friday and Saturday nights at a speakeasy called The Binc near the High Street station on the A/C line. We went for dinner at an Italian place around the corner called Il Gigante. Good pasta with lamb ragu--i went off my diet but didn't get any alcohol. I went over my calorie allowance but not by too much. Offset by the walking I did. I only had brussel sprouts for lunch but ate nuts so added some calories there. Walnuts are good for you but also very fattening! Tomorrow I need to eat the spinach and green beans and some of the black beans. For the morning walk I will count the walk from the J to the clinic. Leave at 9 bring a magazine. I will have coffee there. I will eat brunch when I come home.

Changes I have made

I stopped drinking alcohol. I was having a tall beer for dinner about 4 days a week. No alcohol for the last six weeks. I stopped eating most white foods like white rice, bread and pasta. No more almond crossaints at the cafe. No more sushi. No more huge bowls of pasta with Rao sauce for dinner.I also stopped eating cheerios. I never drank sugary drinks and I don't have smoothies so no change there, just reinforcement of a good habit. I don't eat anything with high fructose corn syrup. I stopped eating bagged salads because of the bad oils in the dressings. I started buying bags of green beans and brussels sprouts and cooking them right away so they don't spoil. Also spinach. Now going to drink lemon water every morning. On day two of walking when I wake up. Hope to increase the time soon. Continuing to eat beans on a regular basis. Eating avocados for the good fats. Only cooking with olive oil when oil is needed, like roasting brussels sprouts. Eating sardines and herring every other day. Cottage cheese and berries, not cheaping out at the price of berries. Blackberries and raspberries, with the occasional strawberry box. Steel-cut oatmeal. Non-fat Greek yogurt with berries. Spoonfuls of ground flax seed on my yogurt or cottage cheese. Responding to the urge to snack by making tea instead of eating something. Green tea mostly.

Lemon water

So one of the videos I saw on YouTube said that drinking lemon juice in a big glass of water can have a beneficial effedt on fatty liver if done first thing in the morning. So I got some lemons on one of my walks and chugged down a glass of water with half a lemon's juice last night and this morning. One thing to watch out for is a bad interaction with tooth enamel so I ordered some biodegradable straws to avoid that. This morning I got out of bed late but I got dressed and left the house immediately to walk to the cafe and have my coffee while reading one of the many New Yorkers I have cluttering up my table. It felt good to walk and I didn't get tired. I'm going to try to do this every day for a week and then think about extending the walk to twenty minutes each way.One small step at a time. The idea is to stimulate the body with walking before breakfast. I would like to get up earlier but I'm allowing myself to wake up naturally because a good night's sleep is also high on the list of healthy habits. Quest is on spring break so I don't have anywhere to go later in the day. Tomorrow I will got to Rosemary's new apartment to see it and have dinner with her and Arun in their new neighborhood. The are right next to a subway stop on the M line so it will be easier to get tottheir place now.

exercise block

This morning I set my alarm for 8 am and planned to get up and walk 20 minutes before having my coffee and breakfast. I ended up staying in bed until 9:30 and then took a ten-minute walk to the Covert Cafe and had black coffee. On the way back I stopped at the big grocery store that I never go to and checked for cans of calamares, which they had. Everything else is about a dollar more expensive than my little grocery store--tomatoes, raspberries, broccoli, Rao's tomato sauce. I got a huge pack of TP and carried it home. So I didn't walk for 20 minutes but I did walk for 10 each way. I'm going to keep on tryng to get up and get dressed and walk on the days when i don't have another activity planned. Now I need to do some at-home strength training with YouTube videos. Some squats and knees up. The session on Tuesday will be about exercise. The point of walking before breakfast is that I watched a video saying that the liver is primed to release visceral fat after sleep and before food sends the blood sugar up, so a 20 minute walk will be optimum for burning visceral fat. Today I did 20 minutes but not consecutive so I don't know if it will have worked. But I did get up and get out the door, so there's that. Tomorrow maybe I'll walk to Cup of Brooklyn which is 20 minutes away.

Taxes done!

Overcame my procrastination and did my taxes. I use a service that I used to get for free when my income was lower. Now I pay for the state filing but not the federal. I'll get a total refund of $849. That plus some unexpected refunds from my health insurance mean I'm banking some extra money this month. I need to get to the credit union to deposit the checks. I have lost theh checkbook from my Brooklyn Coop FCU and I'm out of deposit slips for BluPeak FCU. I need to dig around in my drawers to see if I stashed the checkbooks somewhere. Next on the list of things to do!.

yahoo~

Milestone! I went below 180 for the first time! I was getting discouraged at bouncing around 181-184 but this morning I came in at 179-177. We'll see if that's where I am tomorrow but it's movementn in the right direction!

Showing Up

I went to the first day of my diabetes prevention program today. I got there ten minutes early and made myself a cup of coffee. Each week we will be weighed and as expected my weight was 4 lbs more than it was at home this morning. Some of that is clothes and shoes and some of it is just fuck you weight. We each got a binder with two sets of handouts: ones that will stay in the binder and ones that will come home. There are logs for food and exercise and a goal-setting sheet. My weight loss goal is to lose 7% of my body weight or 13 lbs in the next six months. That should be doable. The walk to and from the subway is significant enough to be logged as my cardiovascular exercise of the day. My left ankle is twinging.Could be the osteopenia flaring up. I've been very faithful with my My Fitness App. I use it eevery day and log all of my food and drink. Next on my list of steps to implement is to drink water. I've been watching YouTube videos about liver cleansing and one recommendation is to have lemon water when you wake up and to delay breakfast until after you've gotten some exercise and sunshine. I need to set an alarm and get out of bed by 8AM. No more lying around until noon! i've been saving exercise videos on YouTube so tomorrow I will get out of bed and drink water and do the one that has three exercises for seniors: sit-to-stand squats getting out of a chair, wall push-ups, marching in place with arm swings. Those feel approachable. I have a stretchy band that has been hanging on my bathroom doorknob for months now. That will be my next exercise goal: to add some upper body workouts with the band. The room was full for our session. Everyone there said they wanted to beat their diagnosis of type-2 diabetes. A few people were returning or had been working with our coach Andrea one-on-one. There is this one guy Carlos who talked compulsively. I hope he drops out. Andrea dealt with him well, affirming the positive things he was saying. If I leave the house at 9 I can get the J before they shut down for their midday track replacement work at 9:15. It's not a long ride. The walk from Delancy-Essex takes me by some blooming forsythia and dafffodils.

steel cut oatmeal

It's a commitment. It is one of the healthiest things I can eat now becuase of its soluble fiber. Research shows that eating them is beneficial for type-2 diabetes and high cholesterol. But you have to spend 30 minutes cooking them stirring every five minutes or so and then scrub the pot. If I cook 1 cup at a time I have leftovers that I can eat for 3-4 days. So right now I have a timer on and I'm going to eat them with blackberries and ground flax seed.

Diabetes prevention program

I saw my primary care physician and brought her up to date on the results of my blood work.She had some more done so we could get information about my cholesterol and blood sugar levels. Not good. Of the two liver enzymes, one has returned to the normal range, yay! There's a score that indicates what the average blood sugar has been over three months. Mine is in the pre-diabetic range, 5.9. Today's session at the Manhattan location of my clinic was an introduction. The course starts next week and goes on for a year. It meets once a week for six months and twice a month for the next six months. It's a real commitment to making changes and has shown results. And it's free! It will involve food and eating habits, exercise, sleep and stress, access to resources and making a cohort community. I need to treat it like my job. The challenge is going to be the exercise. I need to start doing home exercise with youtube videos.