Monday, April 27, 2015
Changes In Weight Mean Changes In Diet
A couple of weeks ago Thomas went back to the doctor to get a follow-up on his ranitidine for his stomach. Before going in, like they always do, they weighed him. I had noticed lately that it looked like Thomas had been putting on weight but I really wasn't sure how much. All of his clothes still fit him but he definitely looks like something's changed. He stood on the scale and the nurse wrote down his weight and then we went back to the room.
While in there Thomas and I talked about what had begun this whole process in the first place which was the pressure he felt in his chest. Many of you might not remember but he had had a delusion attached to that feeling of pressure that he had something evil inside of him trying to get out. Since we discovered the issue though, Dr. K. and I worked to unravel that delusion and coupled with the visit to the doctor and the new medication, the pressure has decreased some and the delusion is gone. Thomas and I talked about this and I was thrilled that he's doing so much better. He had also had pain in his ribs that he had never mentioned to me and the doctor discovered that that was related to acid reflux. Now with the ranitidine in him, the pain is gone and he's doing much better.
This is what breaks my heart about Thomas though. He is just not in touch with his physical body at all and had the chest pain but didn't identify it and didn't apparently feel like it needed to be talked about. I hate this part of his illness, and I blame the illness, because he lives with so much and doesn't say anything because he isn't in touch with it. I often wonder how much he suffers, and with what exactly, that he isn't telling me about or doesn't know how to tell me about. The chest pain and pressure were both things I happened upon by sheer luck and both things had been around a long time. I feel terrible for him!
Then the primary care provider came in and we talked for a bit and then she mentioned Thomas's weight. He had gained over 12 pounds since January!!!!
How did that happen?
Well, he had been snacking a lot but not 12+ pounds worth I didn't think. We talked to the PCP and we agreed Thomas should start to limit his soda intake (he's started drinking a lot of that lately) and try to replace it with healthier alternatives...like water. Water. Yeah, try to get a 20 year old to cut back on anything and replace it with water. I knew, then, that we had our work cut out for us because I knew there were a lot of things that Thomas needs to cut out of his diet, not just soda.
Since that day, I have worked with Thomas to help him change his eating habits. It's not easy though. He leaves the house and hangs out with friends and they go and buy snacks. His last snack consisted of two 12 ounce soda's and a big box of cookies! I don't know how to stop this! Then the other day we were running errands and he asked me if, when we were done shopping, we could stop at Burger Kind and gets "two extra-long burgers and some chicken fries".
Wait. Two burgers and chicken?
I had to gently tell him that that was a great deal of food and that because he had gained so much weight that his better choice would be just one burger and I'd buy him a chocolate milk at the grocery store to go with it (as opposed to soda). He sadly agreed and I felt horrible. It's so unfair that he is 20 and has to now start watching his weight especially after enjoying years of being a tall, lanky kid who could eat just about anything and it didn't stick to him.
Then the other day we were driving to the bank and I asked him,
"How do you feel about your weight gain? Do you think it's something serious and needs to be changed? Do you want gentle reminders from me to help you watch what you eat?"
I felt like the meanest person in the world because there's nothing worse than having someone get after you about your weight. You're miserable enough, you don't need someone telling you how to live you life and that what you're eating is packing on the pounds. That's how I feel anyway.
He told me he wanted the gentle reminders and that he is "kind of" worried about his weight. I told him that with his meds he was more likely to gain weight than the average person because the meds cause weight gain. I said that unfortunately he wouldn't be able to eat like his friends anymore until he loses the weight. Two soda's and a box of cookies was now out of the question for him.
Again, I felt horrible.
Since our talk, I have watched him cut back on snacking and seems to be trying to make better choices about how much he eats when he does eat. I did come home the other day and he shyly admitted that he had had a Kit Kat candy bar but that "it had been just one." I hated that he felt he had to admit that to me like some kind of criminal. This is just so unfair!
So, I'm keeping an eye on him and his eating. He's been depressed a lot lately and I'm certain that the depression is fueling the desire to eat. That and perhaps boredom. I don't know for sure but I know he needs to watch what he eats now for a while. I need to get him more active too but tearing him away from his computer and forcing him out on a walk isn't easy. I'm hoping that with a little time he will take over his self-care and maybe pick up walking every day, just a little bit, and he'll continue to cut back on his eating. I hate that it's come to this for him but ultimately I worry about his health. He could develop diabetes or a whole host of other health issues if he doesn't get this under control. I told him that but it's up to him to make the right choices and to start caring about himself and his health. I will help him, though, along the way.
Written by Melanie Jimenez
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