Lessons Learned & Learning 21: 630 Days of Maintenance

Ejourneys

"Wait, what?" Edition

Prior maintenance updates: 30 days, 60 days, 90 days, 120 days, 150 days, 180 days, 210 days, 240 days, 270 days, 300 days, 330 days, 360 days, 390 days, 420 days, 450 days, 480 days, 510 days, 540 days, 570 days, 600 days.

The vertical red lines on my chart for average weight indicate the day that I had started taking anastrazole, the drug I'm on to try to prevent cancer recurrence (day 355) and the days of my bout with what was likely E. coli (days 580-581). More on anastrazole and its effect on weight is in my 540-day update. Both events directly precede a shift in the way my average weight trends. I've also added a graph showing how my rest days have trended throughout maintenance.

Here's how my 21 30-day maintenance periods compare:


My twenty-first 30 days looked like this:


Weight: I had reached my goal weight of 150 lbs. on Dec. 17, 2013. According to MFP, that would place my net calories at 1600 for maintenance.

Between days 601 and 630 inclusive my weight averaged 148.1 and ranged from 146.5 (Sept. 1) to 150 (Aug 13 and 14). My body fat percentage on day 630, using AccuMeasure calipers, shows me at 26.5%, which is on the border between "lean" and "ideal" for someone my age. This marks a decrease from 29.8% on day 527 (considered "ideal").

The weight loss confuses me, but I'll take it! More on my confusion, below.

Exercise Calories Burned: I took 5 rest days (0 calories burned) during maintenance days 601-630, which ties my fourth 30-day period for the most rest days taken. Rest days are now graphed above.

My average exercise calories burned for this period (including rest days) equaled 382/day. My highest burn was 1591 (if Fitclick is to be believed) on August 9, representing five hours of weed-whacking because between carpal tunnel flare-ups and my bout with E. coli, my yard had -- *cough!* -- gotten a bit shaggy. Not counted is the calorie burn from my Better Bones and Balance workouts, because I have no idea what that burn would be. In this 30-day period I have done 12 BBB workouts, all with a 10-lb. weighted vest. Also added to my regular cycling workout is six 30-minute sessions on my manual treadmill set at a 10-degree incline, all with a 10-lb. weighted vest.

On Aug. 12 I passed the 15000-mile mark (since Sept. 1, 2012) in my Virtual Ride Around the Equator (or as close as I can get to it) on my stationary bike. This places me at the longitude of Rodrigues Island (dependency of Mauritius). Ten thousand miles to go to get back home! :-)

Total and Net Calories Consumed: Total calories for maintenance days 601-630 averaged 1798/day and ranged from 1222 (Aug. 10, a rest day after my mega-weed whacking session) to 2334 (Aug. 13). Net calories (total calories minus exercise calories burned) averaged 1416/day (88.5% of maintenance) and ranged from 741 (again, if Fitclick is to be believed, on weed-whacking day) to 1776 (Aug. 18, a rest day).

Why I'm Confused

I wrote in my prior update that I thought I might have found a new, lower maintenance calorie goal that sufficiently offsets anastrazole's weight gain side effect. (For analysis on my weight gain despite increased calorie burn and decreased calorie consumption, see the "Analysis" section in my 540-day update.) During days 571-600, my steady weight gain following my start on anastrazole had finally turned around, with some unwanted help from E. coli.

The numbers from my maintenance period just completed throw that "lower goal" theory out the window. Average net calories are higher than they've been over the past three maintenance periods. Average exercise burn is the lowest it's been in 300 days. True, I don't count my Better Bones and Balance workouts, but they provide very little in the way of aerobic activity, and I don't think squats and lunges with a 10-lb weighted vest is going to drive any weight loss.

In addition, my latest blood work shows that my thyroid is functioning at decreased capacity, which should contribute even more toward weight gain. (I'm very happy that I'm back where I want to be -- but how?) My TSH has been in a near-steady climb for years (the higher the TSH, the lower the thyroid function) and has now busted out of the normal range:



The years 2011 and 2012 are missing because I had skipped my check-ups. Those were especially tough caregiving years for me and I had neglected my own health as a result. There's a good reason I signed up on MFP in September of 2012: I had seen my weight pass the 200-lb. mark.

Lower thyroid function also relates to higher cholesterol, but my recent cholesterol numbers are the lowest I've ever seen them, with total cholesterol at 161.

From what I've read so far, anastrazole does not cause or contribute to hypothyroidism. According to the Mayo Clinic, radiation therapy (mainly to the head and neck, but also to the upper chest) can cause subclinical hypothyroidism. My GP does not believe this applies to my own radiation treatment, and considering my near-steady climb in TSH I agree with her. Aging can also cause hypothyroidism, especially after one passes 60. I'm not there yet, but at almost-57 I'm getting close.

My GP will have me tested again in about six weeks. Depending on the results, she may recommend levothyroxine (generic Synthroid) to increase my thyroid function. According to Drugs.com, anastrazole does not interact with levothyroxine, but anecdotal evidence suggests that anastrazole may make levothyroxine more bioavailable. I've given that info to my medical team.

My partner had been put on levothyroxine for a TSH level lower than mine (but still high). Unlike me (but see caveats 1 and 2), she had been suffering from various symptoms of an underactive thyroid.

Caveat 1: My partner has MS, which might also have caused some of her symptoms.
Caveat 2: I experience what I have been calling leftovers from chemo, but maybe part of that is the hypothyroidism kicking in.

My Vitamin D levels are low-normal at 33 (lower-bound of normal is 30), so I have increased my supplementation. (Vitamin D aids calcium absorption; I've been taking calcium to fight against bone loss from the anastrazole.) My GP recommended 1000 IU/day, but I had already been taking that amount since May 8, 2014 (the day I started chemo) and had raised it to 1500 IU/day on Dec. 6, 2014 (the day I started anastrazole). I again increased my dose by 800 IU beginning on August 5 with the addition of a multivitamin at the suggestion of my oncologist. My low-normal D reading had therefore come despite my taking 2300 IU/day for the previous two weeks. I've now thrown another 1000 IU into the mix and have informed my medical team. (For comparison, my partner had been told to take 5000 IU/day to raise her low Vitamin D level several years ago. She now takes 2000 IU/day to maintain a normal level.)

If I do end up on levothyroxine, it'll be interesting to see what that does to my number-crunching here.

Meanwhile, my hair has reached that certain length:



My chemo curls freak me out more than my baldness did. I've been having fun watching this strange (to me) hair as it grows. I've combed the curls out here, but they're especially tight when I first wake up.

I've created more coloring book outlines.


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These next two are not quite as intricate. We played with them during last month's meeting of the Creativity Heals group that I facilitate:


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