fat vs. pain

[pintopiaffe]

Just having a moment…

Fibro pain is almost gone. The creature gnawing underneath my right shoulderblade hibernates a good amount of time. I’m doing a LOT more with the horses, really excited about that…

And I’ve gained back quite a bit of the weight I’ve lost, and kept off for FIVE YEARS. (lost 70lbs in two+ years, have kept it off for FIVE, until now.)

Cymbalata isn’t supposed to have weight gain… I lost a little even when I first went on it thanks to the jaw thing and nausea…

Not sure if it’s that or the rotation of NSAIDS.

It’s just frustrating! Diet is ridiculously healthy, between 800-1600 cals/day, usually toward the lower, but varying because I go into ‘famine’ mode very easily… Drinking water. Got rid of MSG, artificial sweeteners… keep to low carb 96% of the time–A1c was freaking 4.8 last check (!) you can’t tell me I’m not eating right with that.

Doctor is blowing me off. I gained a little in the fall, but this is a rather sudden gain since Feb. or so. Oh–yeah, does coincide with working mids… :uhoh: Doc blowing me off.

So the choice… quit the Cymbalta (taper, w/ Docs help–I know!) and ‘see’ if the pain comes back? Is it even the Cymbalta?

I think it’s thyroid, (was 2.99–VERY high for me!) but, as I said, Doc is blowing me off, says that’s still ‘normal.’ (barely–even the new rec’s say 3.0… )

So here I am, feel really good to work with the horses for the first time in a couple of years, and yet gaining back all the weight I worked SO hard to lose.

ARGGGHRRRRRRRRR… Growl. :mad:

</rant> Just wondering if anyone else deals with this? I feel like I have to choose–feel better and be morbidly obese, or lose weight and hurt.

[WaningMoon]

[QUOTE=pintopiaffe;4852798]
Just having a moment…

Fibro pain is almost gone. The creature gnawing underneath my right shoulderblade hibernates a good amount of time. I’m doing a LOT more with the horses, really excited about that…

And I’ve gained back quite a bit of the weight I’ve lost, and kept off for FIVE YEARS. (lost 70lbs in two+ years, have kept it off for FIVE, until now.)

Cymbalata isn’t supposed to have weight gain… I lost a little even when I first went on it thanks to the jaw thing and nausea…

Not sure if it’s that or the rotation of NSAIDS.

It’s just frustrating! Diet is ridiculously healthy, between 800-1600 cals/day, usually toward the lower, but varying because I go into ‘famine’ mode very easily… Drinking water. Got rid of MSG, artificial sweeteners… keep to low carb 96% of the time–A1c was freaking 4.8 last check (!) you can’t tell me I’m not eating right with that.

Doctor is blowing me off. I gained a little in the fall, but this is a rather sudden gain since Feb. or so. Oh–yeah, does coincide with working mids… :uhoh: Doc blowing me off.

So the choice… quit the Cymbalta (taper, w/ Docs help–I know!) and ‘see’ if the pain comes back? Is it even the Cymbalta?

I think it’s thyroid, (was 2.99–VERY high for me!) but, as I said, Doc is blowing me off, says that’s still ‘normal.’ (barely–even the new rec’s say 3.0… )

So here I am, feel really good to work with the horses for the first time in a couple of years, and yet gaining back all the weight I worked SO hard to lose.

ARGGGHRRRRRRRRR… Growl. :mad:

</rant> Just wondering if anyone else deals with this? I feel like I have to choose–feel better and be morbidly obese, or lose weight and hurt. [/QUOTE]

I am confused. Cymbalta is an antidepressant. You take it for pain? I was just reading the makers site because I thought I must be wrong but that is what they said and did not mention it being a benefit to pain. Is that an off label use of the drug?

[pintopiaffe]

No, it is now also approved for Fibromyalgia. It was originally an off-label… though Cymbalta has always been marketed “for the pain of depression,” they found out that it worked really well on the aches and pains that go along with depression.

But it is now approved for Fibro (though my insurance co hasn’t caught up. :mad: )

[tothepointe]

I had a similar experience with Depakote. I gain 60lbs in about as many days which erased a few years of hard weight loss work. Then my thyroid went too. I really don’t believe when they say a medication that effects the brain doesn’t cause weight gain. What they REALLY mean is it doesn’t cause massive weight gain (see above) even in my case where it was glaringly obvious the medication caused weight gain the Dr claimed that it wasn’t the meds.

You need to find a Dr that will treat your thyroid based on how you feel and not soley on TSH. My TSH right now is 11 but I feel totally fine so sometimes the TSH is not always the magic number. Treating you thyroid will also make your medication more effective in a lot of cases so that alone is worth it

[WaningMoon]

[QUOTE=pintopiaffe;4852817]
No, it is now also approved for Fibromyalgia. It was originally an off-label… though Cymbalta has always been marketed “for the pain of depression,” they found out that it worked really well on the aches and pains that go along with depression.

But it is now approved for Fibro (though my insurance co hasn’t caught up. :mad: )[/QUOTE]

I see. Thank you for taking the time to tell me that. I have worked in the animal and ppl health industry before I became disabled and am not as up to date on meds as I used to be.

I am glad it helps you so much and hope you get the weight gain side effect under control, maddening Im sure since it is so hard to lose weight to begin with.

[Proud_Preppy_Pony_Mo]

Fair warning…I write like I talk, so this is a LOOOOONG one!! LOL

I’m there with you, Pinto…

Though I’m no longer the rider in the family (that’s been taken over by my not-quite-4-year-old), I am responsible for all the barn work she cannot due because of her age/size. I mean, seriously, can you imagine her trying to put a bridle on her pony? Ain’t happenin’!!

But I was lucky enough to find a provider who would treat ME, not my test results! Check with your insurance company; see who’s out there, in your area. Sometimes a few phone calls can do the trick and you can find amazing providers who care about YOU as a person.

My best luck has come from Nurse Practitioners, NOT actual MDs. I’m not saying all docs are bad, but I find nurses seem to be more “in touch” with the patients, and a CNP is a nurse with a whole lot more training and can do 95% of the things docs can.

When I felt like docs were blowing me off, or when the office staff was acting like their collective heads were up their 6-points (ask me if you don’t know what that means, tho I’m sure you can figure it out!! LOL) I found that a nice, rational, professional chat with the office manager helped a LOT!!

As for your final question, I will give you my .02, take it for just that:
I also have Fibro, as well as SLE, a recently fused C-spine, severe degenerative disc and joint disease, and three herniated discs in my lower back that will be fused this year. There are times when my legs give way from the pain. Yet I cannot show how much pain I’m in, because being a SAHM means you’re “on” 24/7 with your child.

After my c-spine fusion (19 Jan 10), I was on Dilaudid for pain. When the surgeon berated me for being on it, telling me I was weak, both body AND mind :eek:, I weaned myself off of it, without withdrawl symptoms, and for the first time in 20 years, I am on nothing more than ES Tylenol.

Since the surgery, I’ve lost ~30lbs, by simply changing my eating habits. I can’t exercise much, just parking a little further away from the store (unless I have the kidling…too much trouble) and walking an extra lap around the mall before I allow myself to do any shopping for myself. I still eat the same foods as before, just a lot less at each sitting and spreading it out over 5-6 small meals. I also took out a contract on myself on www.stickk.com. It holds me accountable to a referee and my supporters, who light the fire under my tush when I need it.

I know, since you’ve lost the weight before, you know exactly what I’m talking about, so I won’t go any further. But my thought is this: If the Cymbalta is keeping you pain-free (more or less), then bump up the exercise a notch or two each day. If you have a Wii, there is a “Biggest Loser” game that KICKS MY A$$ 3x a week…but it has helped! Then, once the numbers start going down, start weaning off the Cymbalta. You’ll be stronger and probably won’t need as much in the way of pain meds…at least that’s what I’ve found. :winkgrin:

Now, if you’ve gotten to the end of all this without saying “STFU, lady…I’ve heard it all before!!” know that if you DO decide to take out a contract on StickK, I’m happy to be one of your supporters!!

Keep your chin up…

[Tiki]

PP, for one thing, the TSH is only ONE of the parametes to look at. What were your other values, T4, free T4, T3 or Total T3. Were any of those run too? TSH alone proves nothing.

If your TSH is high borderline and your T4 is low borderline, have them run anti thyroid and anti nuclear antibodies for you.

I’m asking because I have Hashimoto’s thyroiditis and I’ve had 2 physicians try to send me for a psych consult because I was sooooo tired all the time, falling asleep all the time and complaining that I had all the symptoms of hypothyroidism. Well, I did, I had Hashimoto’s. That is an autoimmune disease that produces anti thyroid antibodies, so it kills off the thyroid hormone as fast as the body can produce it, ergo, hypothyroid symptoms with normal lab results. I also had a thyroid ultrasound which showed a clear pattern of Hashimoto’s.

What did that do to me? Well, hypothyroidism (diagnosed or not) weakens the collagen matrix and thins and weakens the tendons. In fact, by treating me for what they assumed was a trochanteric bursitis, i.e. giving me cortisone shots, is what tipped the cart - so to speak. So… I wound up tearing the gluteus minimum tendon right off the hip and tore the gluteus medius muscle. No one would believe me. They kept treating me for a trochanteric bursitis. I got worse and worse and finally got to a sports medicine doc, got a good MRI and they found a joint replacement specialist who said he could repair it. (At first they told me no one could). I am now almost 5 months post surgery, still very weak on my left side for walking or climing stairs, but for the first time in about 10 years I can stand up straight. I always slouched and just thought it was due to bad posture as a kid. I’m slowly walking better, have less of a limp without my crutch and very slowly gaining strenght. The surgeon says it will be a year to get the tendon to fully heal back to the bone and get all my strength back, but I finally have hope.

In the meantime, I finally found one endocrinologist who didn’t try to send me to a shrink and has been treating me for about 5 years.

It’s a very easy diagnosis, but most docs would rather send you to a shrink than consider Hashimoto’s. Don’t know that’s what you have, but anti thyroid and anti nuclear antibodies and a thyroid ultrasound are the ONLY way to rule it out and most docs don’t want to do it.

Good luck!

[Hunter_Mom]

Anohter vote for finding a GOOD endo, as in one who looks at you not only your numbers. 2.99 may not be technically high, but for YOU it may be. That was the problem with DH. We finally got them under control, which was tough.

[DressageGeek_Ribbon]

I am another one who votes for go see another MD.

Know what they call the kid who graduates last in his med school class? Doctor.

'Nuff said.

[Auventera_Two]

Definitely get another doctor. I’m newly diagnosed with fibro and I’ve learned that a good doctor is crucial - absolutely essential. I am doing really excellent on amitryptilene (however you spell it) and am SO happy with my doctor.

I’ve followed your posts on these issues for a long time and you’ve definitely made progress! Just keep pressing on and don’t give up until you get an MD who treats you as an individual and doesn’t just read the textbook to you.

[pintopiaffe]

Tiki!! I had NO IDEA that’s why you had your injury! And I know what a long hard road that has been for you.

There’s a fascinating discussion on About.com’s thyroid stuff about Fibro & thyroid, and hormones and fibro etc. etc. Its a great big circle. I KNOW this because I was Dx PCOS at age 19. The PCOS evolved into IR, which evolved into Diabetes. Now ALL the freaking hormones suck together.

I am going to stop in to the Internal Med Doc’s office on Tuesday at the other hospital I work with. Last Doc who was SO amazing was an Internist. This one comes with a recommendation. We’ll see.

PPPM… you’re no longer winded than I am, and I like the way you write. Some good points. I’m moving more and excercising more lately than in the last few years–because I can thanks to the Cymbalta, that’s what’s so frustrating about the weight gain.

Today is either a flare–or the start of a cold/flu. Got the arm thing, low grade head/neck pain, aches, yadda yadda. Which reminds me how well the Cymbalta DOES work.

Thanks guys. It’s sometimes just hard to remember not to just give up on the upper level dressage dream… But so many ‘professionals’ will tell you you can’t do it if your fat. And I know, right now, I am fat. :sigh:

[DressageGeek_Ribbon]

Screw the fat. This isn’t George Morris hunt seat equitation.

Are you an effective rider? That’s what counts.

And good luck!

[pintopiaffe]

Unfortunately, in the past few years, my teacher has leaned toward GM.

Me, personally, I like channelling Old, Fat Nuno. It works for me.

My teacher is phenomenally brilliant, but his attitudes have changed, and I got a feeling the last time I was there that he’s sort of giving up on me because of this.

[Tiki]

PP, when I was in the rehab hospital after my surgery to repair the tendon, the rehab specialist doc found a paper on the Internet that talked about the relationship between hypothyroidism and the tendon tear. My surgeon fully agreed with that when I went back for my first post-op check. The endocrinologist said, yeah, probably, but since he has been treating me for about 5 years, he feels there is no reason for further tears. I hope he’s right!!!

As I said, if there is real reason to suspect hypothyroidism, see if you can get anti thyroid and anti nuclear antibody studies done, and if positive, a thyroid ultrasound.

[Across_Sicily]

Time for a new endo… or if you don’t HAVE an endo, time to find one that doesn’t suck. I recommend Yelp.com

First thing jumped out at me was THYROID… you and I have pretty similar sounding stories… fibro and thyroid issues. (An interesting note about the Hashimoto’s thing, Tiki, will have to get that one looked at.) Difference is, I’m taking thyroid meds and doing low-carb and have shed about 20 lbs over the past two months. I had to stop taking the thyroid stuff for about 2wks when I ran out and boy oh boy did I see a difference.

Good luck!

[Tiki]

Grrrrrrrrrrrrrrr!!! :mad: Even with the thyro meds I can’t lose an ounce no matter what I do. When I was in the hospital on IV’s I didn’t lose weight. At least I’m not gaining anymore, but I still can’t lose. I asked my endo how he could possibly tell I’m on the right dose by looking at lab results when the lab results were NEVER, EVER able to tell anyone that I had Hashimoto’s. It was all by anti thyroid, anti nuclear antibodies - which were waaaaaaaaaayyyyyyyyyy off the chart, and a thyroid ultrasound. So how does he know I’m on the right dose??? I still have all the symptoms of hypothyroidism.

I’m ‘stuck’ in the military system. It was hard enough getting someone to treat me anyway. If anyone knows of a really good endo-thyroid guy in the mid-Atlantic area I might be able to switch when I retire (soon, I hope).

[pintopiaffe]

Tiki, I SO feel your pain on that one.

This comes up from time to time in OC and OT days…

And recently, when feeding my herd with two air-ferns and four ‘normal’ horses, this occurred to me:

Why are we horsepeople SO easy to convince that a horse can keep weight on–even be morbidly obese–on a starvation diet due to metabolism… but are loathe to admit this can happen in humans? With the humans you MUST need to excercise more and eat less… ???

This is really a big bugaboo for me right now. Because of course it’s tied to self-image, self-esteem, “should I be riding greenbeans?” (who I don’t start until at least 4, because I’m a big girl even at my lowest…) etc.etc. etc.

And yet I feel a lot better than I have since getting kicked in the chest 3–4? years ago now. :sigh:

[Chaila]

@pintopiaffe;4857538

Why are we horsepeople SO easy to convince that a horse can keep weight on–even be morbidly obese–on a starvation diet due to metabolism… but are loathe to admit this can happen in humans? With the humans you MUST need to excercise more and eat less… ???

Because horse people think fat phobia is a completely acceptable form of discrimination. Well, not just horse people, but a lot of people. They think fat=lazy and out of shape.

Some of us live in bodies that were designed for famine. Some people like to think they are better than everybody else because they’ve “always been thin!”

I snicker at my “always been thin” smug acquaintances who experience a major metabolism shift in their late 30’s and suddenly they’re “not so thin.” I stay the same rubinesque, but healthy size and they keep getting bigger and bigger…

[Donkey]

I’d take fat over pain any day of the week. I hope you get your thyroid sorted ASAP.

[Invite]

Get a new MD!!!

Listen to Dressage Geek!!! She’s quite brilliant and I often turn to her for advice. I’m not up on how many calories a person should eat, but 800 seems rather low to me. You need a doctor who is willing to listen and is willing to think outside of the box.

As far as weight & horses, I have a couple thoughts. If you are worried about being too heavy to start the babies, get one of those Eponaire (sp?) surcingles that puts 120lbs (I think) on their backs to start conditioning them. Look at the size of the men riding QHs in rodeos. Those are pretty big guys on small horses. Your trainer is not a doctor. If he berates you for weight gain due to meds, find a new trainer! So long as you are balanced and effective, don’t worry about the number on the scale. As a recovered anorexic, I won’t even step on a scale. Numbers make me nervous and affect my eating habits. I have enough health problems without reverting to my anorexic tendencies.

Good luck with everything!