It's gotta be done

As you know, I've been on Prednisolone for nearly a year — I came off it last month, thank goodness. But it's left quite a harsh legacy (apart from the restoration of most of my vision, which I acknowledge is a Very Good Thing™). The steroids have given me (possibly permanent) glaucoma, NASH (non-alcoholic steatohepatitis, ie fatty liver disease), high blood pressure, and an extra 15 kg of weight. And I was "extra curvy" to start with  :/

Yellow Iris in my mum's garden, Cobargo NSW

I absolutely have to lose the extra weight — apart from truly hating the way I look, it is essential for the health of my liver and blood pressure. I could be looking at a liver transplant down the track if I don't do something. I've struggled with my weight since I was a kid, so this is a huge bugbear for me, physically and psychologically. I have also developed osteoarthritis in my feet and ankles (legacy of years of hip problems / short leg etc), which makes my feet very painful all the time, and makes walking horrible.

So — aaargh! What to do?! My liverologist (hepatologist, I know, I know; liverologist sounds so much better, and is less likely to be confused with a reptile specialist) said to 'Be much stricter about your diet'. My diet isn't really that bad to start with — I don't eat practically any take-away food, cook most meals from scratch, don't have deep fried foods, don't keep lollies or cakes in the house and so on, but clearly there was room for improvement (portion control, for one thing!). Exercise is also a problem, what with the restrictions from my artificial hip (no running, jumping, high impact anything) and arthritic feet.

The basic ingredients for weight loss are, of course, less energy intake + more energy expenditure. For the exercise I'm following the plan in the Body for Life for Women plan (which my doctors have endorsed) - alternating days of aerobic exercise (exercise bike, swimming, short walks, bellydancing, gardening etc, starting slowly with 5 minutes  per time, working up to 30 minute sessions eventually) and weights (I started slowly with 1 kg weights, am nearly up to 2.5 kg weight now). My knees aren't thrilled about the aerobic stuff, but I do quite enjoy the weights, I must say. Hopefully increased weight loss and fitness will help decrease the knee and foot pain (and increase the life of my hip prosthesis too).

For the food, I'm actually counting calories (OMFG!), but this chore is made so much easier with a nifty free app for my iPod called MyFitnessPal. It's accessible online too, and runs on all sorts of mobile devices. It has a massive database over 1 million foods (including Australian brands), and you can add your own recipes and foods etc. It remembers your frequently used foods and meals, and makes the whole record-keeping process very quick and easy. Research keeps proving that people who write down what they eat each day tend to lose a lot more weight (accountability and embarrassment, I guess!). It's also rather eye-opening learning the calories of various foods (it doesn't show Kj, although you can do your weight in metric). Ricotta cheese? OMG ...

So. I'm just doing it.  And it's got to be something I do forever. I figured if I can't devote 30-60 minutes a day to looking after my own health and own body, how sad is that? No-one else can do it for me, after all.

As for the neuro-sarcoidosis, it's being well controlled with CellCept (mycophenolate), thank goodness, and I'm on much less medication than before. I've not had a hospital appointment for a couple of months (and I was averaging one a week for the last year). I do struggle with fatigue still, but my vision is OK and stable. I've got about 5% permanent vision loss (central vision unfortunately so it's very noticeable still). I use a few vision aids (bright lights, increased text sizes etc) and am a client of Vision Australia (who are wonderful, by the way). The side-effects from the Prednisolone are more of a problem, really!

There's a ticker at the bottom of my blog now. I'm nearly 3 kg (6.6 lb) down, after 2 months, and about 20 kg (44 lb) or so to go (to be an even healthier weight than when I started on Prednisolone a year ago). My GP is very happy with how I'm going so far. It has to be slow loss, too, as rapid weight (apart from being bloody impossible to do, bad for you, and hard to maintain) stresses your liver too much. 

That's me being accountable and telling you about it (despite my tendency to keep it private). That's something else that's supposed to help, enlisting the support and encouragement from your friends and family, and 'going public'.  :)