Are You Moving Less While Working From Home?

Working from home is with many of us, perhaps for longer that we may have initially envisaged. It is very important for all of us, but most especially those with arthritic and other chronic conditions where movement is beneficial, to ensure we don’t fall into the trap of becoming more sedentary! Most of us working from home are sedentary enough already, bound to our desks and laptops as we tend to be.

The good aspect is we now have the opportunity to put the commuting time to better use – we just have to make sure that IS what we do!

I am now balancing being back in an accounting role with my medical need to keep movement levels up plus the continuation of post-surgery knee rehabilitation exercises. What have I learnt already? I let my rehab exercises slip a couple of days, I ate at my desk twice and one morning I sat for WAY too long without getting up! Not good. For some inexplicable reason I found myself drinking more coffee and less water, so I’m being more aware of that now.

My daily physical activity commitments currently are:

  • 40 to 45 minutes of formal walking
  • achieve a total of 7,500 steps a day (limited due to post-surgery)
  • 40 minutes of rehab exercises

Swimming and weight training aren’t in the list as the gyms and pools are still closed in Melbourne due to Covid-19.

There is the need to avoid that dreaded boom/bust cycle and pace all of the above accordingly with working hours. These are not necessarily considerations for people without underlying health conditions: even so, worth bearing in mind!

Although the rehab routine is not tiring, the walking can be; especially if one has worked all day. Fatigue IS a symptom many of us live with. Mine is now minimal (thank you risankizumab), but I remember the days when I suffered quite badly from the fatigue. So rest time is important, it has to be part of the routine we establish.

I’m still at the stage of developing a daily routine. Finding what works for me. For a WFH day, I eat breakfast, walk for 25 minutes, then get ready for work (do my hair, pop on the lippy etc – all those video meetings!). Watch out for those back-to-back meeting days! The sitting time can easily extend to three hours. If you don’t have a sit/stand desk (mine is arriving soon!) this can be a trap. Watch your calendar: suggest different times for meetings if you have too many one after the other. Remember to take regular breaks from your desk.

Make sure to take a lunch break. This is important: move your body, stretch, sit in a different chair, break the mental exertion too. Do not eat at your desk.

I’m still working out the best time to do my rehab routine. If I do it in the morning, I need to get up earlier. If I do it after work, I’m becoming fatigued and I still have another 15 to 20 minutes walking to do. I’m thinking lunchtime might actually work best and will try that this coming week. The second walk is important because the one thing we lose while WFH is incidental exercise. No campus to walk around, no walking to and from the car park or tram stop. Those activities all add to our step count for the day. But we do have that extra time from the commute we no longer do, as mentioned earlier. It is finding the right balance.

Catching up on activity on the weekend is usually not an option for those with chronic conditions. Catching up just initiates a boom/bust event and none of us need that. So consistency is our friend. It is finding the right routine for each individual that is critical. What works, what doesn’t work?

Consistency is our friend

Weather can also throw all our plans completely out the window. I walk in the rain and in the cold – I can’t manage the heat. The heat intolerance that came with the hyperactive thyroid does seem to be finally abating: I found it much less troublesome last summer. I hope that persists! For others, the cold could be an issue. Weather is not related to WFH specifically, but working does mean we have less flexibility to juggle our physical activities around the weather.

Walking in the Rain

On days I physically go into the office (few and far between) I know I will get more incidental steps walking around the campus, to and from the car park, etc, therefore I don’t worry about a second formal walk on those days as long as I hit the 7,500 step count.

It is important to keep moving, get outdoors (mask up!) and not become glued to our desk and laptop. And on that note, I am now going to move, because it is Saturday and writing this is enough sitting for today!

An Announcement

I have made the decision to no longer offer personal training services. I will still write and share chronic condition experience, research and information. I am available to participate in applicable research projects and very open to speaking engagements.

I’ve made this decision slowly over the last 12 months. The primary factor that drove my decision was my responsibility to clients. Personal trainers are required to maintain current first aid and CPR certifications. The last time I did my CPR certification I struggled maintaining the position required due to my knees and my back. Now I’ve had a total knee replacement kneeling is challenging (not impossible, just challenging).

I don’t want to paint a bad picture – my operated knee is fantastic and my back rarely bothers me except for certain positions, giving CPR being one of them. I am well aware that were I struggling to maintain a CPR rhythm due to my physical limitations, that could be disastrous.

In addition, recently I have found my physical strength is not what it used to be. Partly this is due to the limited strength training I have been doing myself, partly it is due to the simple fact I’m not getting any younger. I find loading a 20 kilogram weight onto the leg press a challenge and as a working personal trainer I should be able to do that for clients.

While I am a firm advocate of Movement is Medicine and exercise has done absolute wonders for me and my condition, I don’t feel I am strong enough myself to provide the level of service to which I aspire!

It is spring, the blossoms are out, time for new opportunities!

Keep MOVING! I will be!

Thirteen Weeks! (Knee Arthroplasty)

It seems like months ago, yet really it is no time at all! Thirteen weeks have flown by.

I kept up the rehab exercises every single day for twelve weeks. With the approval of my surgeon, I have now dropped to every second day but I have increased my walking. I was aiming for my first four kilometre walk today, but missed it by 120 metres – slight miscalculation on my part! It is important to keep up mobility work on your knee, so I do.

With the encouragement of my trusty physiotherapist, I’ve even managed to do single leg glute bridges. I was doing 30 glute bridges a day, now I’m doing 30 every second day. Unless I get super bored by Covid-19 lockdown and then I might still do sequential days.

What can I say? I. LOVE. MY. NEW. KNEE.

I think at thirteen weeks it is safe to say that! I’ve even knelt on it – not too often and not for too long as yes, kneeling on it does feel very odd. I don’t think I’d be out kneeling for long periods weeding a flower garden, for example. Plus the risk of kneeling on something sharp and not feeling it is always a possibility – to be avoided at all costs.

I can now walk down stairs normally, rather than the bringing the two feet together on one step method employed initially. My flexion was last measured (about week 10) at 145 degrees: I was very happy about that!

My right (the still natural knee) decided to be nasty almost a month ago. My physiotherapist said in her experience this is not unusual and should settle with some love and care. It seems to be settling down this week, possibly a load issue due to the operated knee not doing its fair share for a few weeks.

The only remaining issue I had at 12 weeks was a bit of pain around the kneecap getting on and off the toilet. However, even that seems to have resolved. I had adjusted one of the rehab exercises to strengthen the muscles used in that action and it seems to have worked. Plus the glute bridges, of course!

I recognise I’ve had a very successful knee operation. My surgeon is great, my physiotherapist is great and yes, I was dedicated to doing my rehab consistently and effectively. Between us we got a great result.

A word about rehab exercises. I used the word effectively in the paragraph above. From my experience, that is critical. It can be tempting to “back off” if an exercise causes a little discomfort (most don’t). Especially I found the stretches can really feel as if you are stretching! I’m not suggesting suffering pain, but at the same time don’t back off at the first twinge of discomfort either. Check with your physiotherapist if you are unsure.

One of the extra exercises my physio gave me was to lie prone (face-down) across the bed with a weight on my ankle and let my leg be stretched that way. Let me tell you, trying to take a photo of yourself lying face-down in this position is not easy, so I’ve drawn a little stick figure to give you the idea. CHECK WITH YOUR PHYSIO FIRST before trying this at home. Everyone is different!

I’m using this exercise to illustrate the discomfort factor. I started with one kilogram for 30 seconds. I can now do two kilograms for over a minute. Yes, it does hurt a bit this one. Not the actual knee, but the muscles. In my specific case we have been working on getting those muscles working properly again. I persevered. No, I didn’t let myself get into a really painful place (a martyr I am not), but I didn’t stop as soon as I felt a twinge either. The physio did warn me it would hurt a bit. The benefit is I have 145 degrees of flexion!!

We are all different, we all have different pain tolerances. Even so, we should feel as if our exercises are doing something.

The flip side of that coin, of course, is not to go to the other extreme and overdo things. When I was leaving rehab, I asked the physio how far was I allowed to walk, one kilometre, two? She looked at me and in a stern voice said, “I was thinking the end of the street”. One of her colleagues, who had worked with me on some days I was there, piped up from the other side of the rehab gym, “Just make sure she doesn’t live on Dandenong Road!” For those with no knowledge of Melbourne, Dandenong Road is very long, a major arterial road. I got the message.

I was splitting my walks, one in the morning, one in the afternoon. However with Melbourne in lockdown, where we are only allowed to leave the house once a day for exercise, I’m increasing the single walk.

I miss the gym, swimming and hydrotherapy pool. I was hoping to be back on the leg press by now! All in good time.

Oh, did I mention? I. LOVE. MY. NEW. KNEE. 

Previous:

My Total Knee Replacement
Home: Now the Willpower Kicks In

The Gods Brought to Their Knees by the Invisible

Humans are Earth’s chronic condition. We destroy at will. We see our species as the pre-eminent beings on the planet. Although many believe in a God or Gods in the heavens, here on Earth the human species is all-powerful.

This year the God-like species has been brought to its knees by something it cannot see. A tiny, minuscule, virus. So insignificant, it is not considered to be living. Yet this unalive molecule coated in protein has shut businesses, grounded air traffic, overloaded the health systems of several cities and killed nearly 700,000 people (at the time of writing). We wear masks, socially distance and in Melbourne we are now under a curfew. Many work from home, many are not working at all. The human worship of the great God Economy has been called into question most dramatically by the state of our aged care homes.

Despite great advances in science and technology, humans are losing the battle. The front-line defence, healthcare workers, are dying.

Some leaders are performing brilliantly trying to save and protect their constituents. Local leaders Dan Andrews of Victoria and Mark McGowan of Western Australia spring to mind. The New Zealand Prime Minister has achieved what many deemed impossible. Others are intent on using the virus as an excuse to denigrate these leaders and undermine their efforts. Tim Smith and Tim Wilson are two examples in Australia.

I am the beneficiary of advances in medical science. I have a prosthetic knee and I’m on a clinical trial. If I was living 200 years ago it is possible I’d be severely immobile, yet in 2020 I am lucky enough not to be. While I recognise the wonderful things we, as a species, are capable of, I also recognise how damn stupid we can be.

I don’t need to provide links, nor do I want to, highlighting the ridiculous conspiracy theories and “my rights” people. The inability of some to accept the existence of something they can’t see is one problem. The selfishness of the “it is my right to go maskless” brigade is another. The lack of numerical literacy, where people cannot comprehend growth rates and infection rates, is a problem.

At the moment there is much talk of vaccines. I hope as much as anyone that a vaccine is developed: I am also aware it will be the first coronavirus vaccine. To date we have not developed one, partly because coronaviruses have not previously been so contagious and deadly/damaging. Then there is the question of availability. Will only the rich be able to afford any vaccine, or will a vaccine be made available to all? The great economy, you see, would not like a free vaccine.

The human species has been brought to its knees. Not by aliens, not by flood or fire (yet, that’s coming) but by an unseen molecule. Humans are reminded despite our belief in our own pre-eminence, that we are vulnerable. Humans can, indeed, be on the receiving end of the same brutality humans dish out to other creatures on this planet. We steal and destroy their habitats, we shoot them for sport, we really don’t care if other species become extinct through our actions. Now we know how it feels. We’ve lost the freedoms we took for granted: the freedom to crowd supermarkets, to fly to the other side of the world on a whim, to get a haircut when we feel like it.

The fragility of nature

We ignored the beauty and fragility of our world because we did not feel fragile. We redefined beauty to be tall skyscrapers, fast cars and electric lights.

Human’s biggest enemy has always been other humans. Wars. Killing each other. Now humans have a new enemy. It isn’t the first and according to science, this will not be the last.

I wonder if this is the wake-up call we need. Time to re-evaluate our way of life. Re-evaluate our disrespect for the flora and fauna with which we share this planet. Re-evaluate our worship of the God Economy.

Managing the economic and social costs of the survivors suffering chronic illness is going to be a challenge. As I have written before, as a society we do not cope well with chronic conditions, I worry that many are going to suffer greatly in the years ahead.

How we cope with the aftermath of this pandemic is going to be a major test of the humanity of the human species.

 

Telehealth – Let Us Keep This Innovation!

The Covid-19 pandemic has brought sadness and pain globally: job loses, businesses closing, the high death toll in many parts of the world. The loss of family members, colleagues and friends is devastating for those affected, irrespective of the death toll of any given country.

One positive that has emerged is telehealth. In Australia telehealth was already available in certain regional areas: during the pandemic it has become widespread. The Guardian published a very good article from the perspective of the medical profession, “The genie is out of the bottle: telehealth points way for Australia post pandemic“.  Here I present my perspective as a patient.

Telehealth is fantastic! Especially for me and I suspect for many other chronic illness patients who see a collection of doctors. Apart from the obvious Covid-19 related benefits of limiting unnecessary contact and thereby maintaining isolation, there are other benefits.

  • Many chronic illnesses have a tendency to flare, meaning even without Covid-19 travel to and from a medical clinic can be an unpredictable physical challenge.
  • In situations like my current one, awaiting total knee replacement surgery, the main focus has been pain management (I’m pretty healthy other than the knee). My GP has been wonderful, keeping in touch, ensuring I’m managing, reviewing the pain management plan, faxing prescriptions to the pharmacy when necessary.
  • My endocrinologist really doesn’t do much with me physically during my visits – observations such as weight, blood pressure and temperature I can provide (although she didn’t ask – this may be an area where some practitioners have to develop a bit of patient trust!). Aside from my description of my health, in my case at this point, it is mostly blood test results that drive decision making, plus an annual ultrasound of my thyroid. Telehealth worked perfectly and saved my travel time, fuel and parking costs. She emailed me a pathology request for my next appointment in July.
  • My psychologist used Zoom, which worked really well. Again, saved travel time, fuel and parking (although that parking location is free in my case). For me it was clinically no different to sitting in her rooms, yet I was in my slippers and had a coffee on hand!
  • Hospital pre-admission appointment for surgery. Yes, my surgery is actually happening, next week! While I was to have a face-to-face appointment at the hospital to go through pre and post surgery planning and preparation when my surgery was originally booked for April 8 (then all surgeries were cancelled due to Covid-19), I had that appointment by phone yesterday. It worked well, everything was achieved as it would have been in a face-to-face appointment, including my being able to confirm I can take nail polish in with me to apply post-surgery.
  • I can see benefits for working people too. A 15 minute phone consultation is a lot easier for a working person than taking several hours off work to go to the doctor. Let’s face it, it does take several hours: travel to the clinic can easily take 30 minutes or more, wait time (minimal if your doctor runs on time), consultation time, maybe a stop at a pharmacy, travel back to work depending on the time of day. I suggest most of us would not return to work after a 4 pm appointment, for example, or go to work before a 9 am appointment.

I have long-standing relationships with my doctors: I’m not sure I’d like to have an initial consultation with a new doctor by phone, although video conference may be fine. I’d prefer my GP and specialists used video and I think that will come in time.

Clearly telehealth doesn’t work for everything: my surgeon is not about to slice and dice me over the internet. The physician couldn’t do his pre-operative physical examination over the phone. I couldn’t get the ‘flu shot remotely.

For on-going management of existing conditions it works beautifully from this patient’s perspective.

There may be opportunities for people such as myself to assist patients with technology in their homes. I notice the article linked above mentions this:

Dr Chris Bollen, a GP in Adelaide who cares for many elderly people living in their own homes, has spent much time recently teaching patients to use FaceTime and other digital platforms. He is excited by the potential for telehealth to help support older people to live independently…

The article also points out that the current arrangements are planned to be temporary.

These temporary arrangements are due to end on 30 September, and the health minister Greg Hunt has flagged his support for their continuation, although many questions are yet to be answered about the rollout and impact of these services.

I hope teleheath stays. It also has environmental benefits which are discussed in the above article. It works for many situations, it is now proven. Let’s keep it.

A Clinical Trial – Patient Journey – Part V

Catching up?

Apart from draining trial participants of blood every visit, as I have mentioned before joints and entheses are assessed for improvement – or not.

For my first 26 weeks of the trial, the period we now suspect I was on placebo, there was no real change in my hands or feet. Other areas are assessed but for illustrative purposes, I am only going to talk about hands and feet. Many of the joints subject to assessment, such as hips and temporomandibular joints (TMJ), I have not had problems with, so not much point in talking about them!

Now if you don’t know how many joints are in your fingers and toes, let me tell you – quite a few! They test 28 total in the fingers and 20 total in the toes on my trial.

While my finger joints were never my major trouble spot, my feet were a different story. Every single joint would light up with pain when assessed. In some cases, big red siren type lights.

Four weeks ago there was certainly a reduction in the number of joints that lit up and most of the ones that did react to assessment, were as if the dimmer switch had been activated.

Today? Today only TWO toe joints lit up and even those were a faint glow. That is two out of 20!

The hands? Not one of the assessed joints lit up. NOT ONE! Yes, I am still splinting those two trigger fingers at night, but that is not a finger joint issue and they are also improving.

One of the other aspects I am very pleased about, given my past medication experiences, is NO SIDE EFFECTS! Obviously there can be clinical side effects from medications that I, as the patient, would not necessarily recognise, which is one of the reasons they take all that blood. Are my kidneys OK? Is my liver still happy? But from my day to day living experience I’m not having any side effects like I had with the four previous treatments I have been on.

From here on in, I only visit the research clinic once every twelve weeks. The hard part is over. I don’t expect to have any really news to share for the remainder of the trial, providing everything continues to go well. Yes, there is a possibility I could stop responding at some stage in the future, but I’ll cross that bridge if and when it happens.

That just leaves me with the problem knee, but there have been announcements this week surgery will be commencing again and joints are on the list so I am hopeful that will also be resolved ….. shortly. I’ve already been on the phone to my surgeon’s office, so I’m waiting for a date!

I am very happy with the results. I love the team at Emeritus Research, it really is like dropping in to see good friends. Very professional good friends: as a trial participant I feel very well cared for and valued. Great atmosphere. Just watch the coffee machine if you like flat whites, it can overflow!

Glute Bridges on the Dining Table

Finding new ways to do things in our #StayAtHome world is a must!

Situation

  • Bung knee (click for details)
  • Due to above, can’t get up off the floor!
  • Gyms are all closed
  • Live in an apartment (no space for gym benches)
  • Need to keep glutes activated (part of good knee support)

When I was able to go to the gym, I would ask one of the trainers to haul me up off the floor after my floor exercises. Now that is not possible.

Solution

While I probably could use a strategically placed chair to help myself get up off the floor, I have found a much easier solution. Use my dining table as a gym bench. The bed isn’t firm enough. Also works for sit-ups.

I can get on the dining table quite easily using a chair as a step up. Much easier to get down off the table than up off the floor!

Glute Bridges

As the name suggests, this exercise is to activate, tone, strengthen your glutes. Glutes are the muscles in your posterior. Maximus, medius, minimus. The minimus is under the medius.

Image Credit: Visible Body

Once you are safely perched on your dining table, place your legs as shown and lift your butt by squeezing your glutes. Keep your spine neutral. Hold for a count of 5, lower. Repeat.

Due to both my knee and the fact I was trying to take a photo at the same time as execution, my butt isn’t as far off the table as it could be!

Progressions (making it harder):

  • Move one leg further away from the body
  • Lift one leg off the surface altogether (this is not me at this time!)
Move one leg further away from the body

Getting On and Off the Table

  • Place a dining chair roughly where you would before sitting
  • Lean butt against/on edge of table, hold onto the back of the chair
  • Lift one foot onto chair, followed by other foot
  • Wiggle back on table.
  • To get off, reverse the above.

I’d film it if I could, but that’s a bit difficult to do by myself.

Of course, if you can do these on the floor, GO YOU!

My Personal Weight Management Under #StayAtHome

Yesterday I tweeted:

I did not expect the reaction! I promised to write in more detail what I am doing to achieve this, so here it is. I want to stress this is what works for me, given my current circumstances. It is really intended for people of similar age and in similarly physically challenging circumstances. While the #StayAtHome situation is common to most of us, of course the knee issue is an added complication. Unlike my recent short videos, this will be a long read, so buckle in folks!

Situation Summary

I have been in self-isolation since March 1. The gyms closed, the pools closed. I am a weight training person: suddenly I couldn’t even do upper body or hydrotherapy. The knee is preventing any lower body weights work or walking. I am also nearly 65. We all know as we get older it becomes harder to manage our weight than when we were 25.

I was terrified of gaining weight and making my knee pain worse. Due to several changes of medications and predisolone off and on over the period in question, I had gained a few kilos during late 2018/early 2019. I have been very successful in reversing that trend, especially once my clinical drug trial got underway, with the suggestion and support of my endocrinologist to adopt the philosophies of Dr Michael Mosley. I’d never known it was considered safe to eat 800 calories a day. I do now! Before you stop reading in horror, I’m not eating 800 calories a day now! But it is a damn good kick start to get you going and I do still apply the macro principles espoused by Dr Mosley.

Comfort Eating

Several responses to the above tweet raised the issue of comfort eating. This is an issue that is exacerbated by isolation, anxiety (e.g. about the current health crisis of Covid19) and boredom among other drivers. A chronic illness patient I know once said to me she stopped comfort eating when she realised she was “eating her pain” – and she didn’t just mean physical pain, she meant emotional pain as well. Once she had that epiphany she was able to stop. She looked for and found other ways to deal with her pain.

I find boredom can be an issue for me, especially when I can’t go to the gym or swim and I am locked away. For me, the recording (discussed below) helps immensely. I can see what I’m eating instantly.

I have no great solution for comfort eating, I am sorry, as it is a bit out of my field of expertise. I would suggest perhaps consulting a psychologist if it is impacting your weight management efforts. Mental health is a critical factor and if you have a chronic illness, in Australia you are entitled to a Mental Health Care Plan. Use it.

Understand Your BMR

Before we even look at food, my recommendation to anyone on a weight management journey is to understand your Basal Metabolic Rate (BMR). This is the number of calories your body burns being alive. Nothing else, just being alive. Our BMR drops as we age. This calculator at MyDr.com.au is the one I use: http://tools.mydr.com.au/tools/basal-energy-calculator

Pop in your details at various ages and you will see the BMR drop. Of course this is a average. If, like me, you are an avid weights person you will have more lean muscle mass and your BMR will be higher. Conversely, you may be on medications that actually reduce your BMR as a side effect. Even so, as a place to start, it is a good indication.

If you do no exercise and you eat more than your BMR, you will gain weight. There is more to it than that if we want to delve into the science, but for our purposes, it is that simple, really. Note well: exercise in this context includes NEAT!

Be very aware though, your current weight may drive your BMR reading up. If your BMR says 2,000 calories a day, you don’t want to be eating that if weight loss is your goal. Try putting your target weight into the calculator – work from that.

Net Calories

If I am exercising in my normal manner, I live by net calories. My calorie target for the day plus what I “earn” exercising less what I eat. When I cannot exercise “properly” as is the current case, I aim for less than my BMR. At the moment I aim for 1,200 calories a day or less, with the odd 800 calorie day thrown in for good measure.

When I fill up my car the fuel tank capacity limits how much I can put in. Unless the car burns the fuel, no more will fit. Humans are not limited in the same way – if we don’t burn it, we just expand to make room (store the fuel).

Record, Record, Record

I cannot stress strongly enough to record your food intake. If you are anything like me, you forget that snack you had at 10 am. Or you don’t realise that SMALL muffin you grabbed en route home from the pharmacy was actually 530 calories! I use My Fitness Pal, there is Cronometer and various other apps out there. Find one that you like.

Recording means measuring. Get food scales. Measure.

Dietary Protein

My next tip is to look at your dietary protein. Are you eating enough protein? From talking to people I suggest many, especially older people living alone, are not eating enough protein. Without enough protein we can feel hungry and snack (usually on carb heavy stuff) unnecessarily.

My interest in dietary protein came about from my own experience. I noticed my protein levels had dropped when I reviewed my My Fitness Pal recording at one stage back in 2017. I was also in more pain from my psoriatic arthritis, although I wasn’t thinking of a causal link. I upped my protein for general health reasons and suddenly my pain levels dropped. Hmmmm, I thought. At the physiotherapist, I picked his brains, “Are you aware of any research around dietary protein and pain levels?”. No, he wasn’t aware of any so I came home and researched. This is one of the articles I found, which I rather like as it is succinct in stating the findings.

Effects of inflammation and/or inactivity on the need for dietary protein

Remember too that a 100 gram steak is NOT 100 grams of protein. It is about (depending on cut, quality, etc) 23 grams of protein. Know your protein sources.

Serving Sizes

All food packets have a recommended serving size. These are guidelines, not mandatory rules. Most bread packets have a serving size of two slices. I do not need two slices of bread under my omelette (see main photo above), I won’t burn that extra fuel.

My favourite high fibre muesli has a serving size of 45 grams. I have 35 grams with 160 grams of high protein yoghurt. I don’t miss the 10 grams, but over a week it adds up to less calories.

Adjust serving sizes to suit your circumstances. When I’m able to lift weights again, I’ll go back to 45 grams of muesli!

Ease of Preparation

Some people love cooking, others do not. Other people have physical challenges around standing chopping up vegetables, for example. Some of us have days where our medical conditions flare. Living alone can result in wastage as fresh vegetables go off before we use them. How I deal with this is frozen vegetables. No, I don’t find them particularly wonderfully cordon bleu – but they serve a purpose. Prepped, pre-measured, 2.5 minutes in the microwave. Here is one instance where I double the serve – as each bag contains two standard serves.

Another variety with chicken.

I’ve found this frozen spinach great for omelettes!

Two blocks of this (about 50 grams) with two eggs. I microwave it per the first half of the instructions, drain and pop in my non-stick pan for a minute or so, pour beaten eggs over. Cook. Greens and protein in one simple meal.

I stick to fresh salad vegetables such as lettuce, cucumber, mushrooms and tomato. They are easier to buy in “as needed” quantities. Of course, as I am in isolation and receiving grocery deliveries, that is more difficult. Another benefit to frozen vegetables at the moment as I’m not dependent on deliveries to have vegetables.

Meal Replacement

Eating the increased amount of protein as discussed above and keeping calories down can be a challenge. I was also told by a friend (I have NOT substantiated this) that in some cultures older people eat very little late in the day, but it makes sense, especially when there are reduced levels of activity.

I have been replacing most evening meals with a protein shake. This brand was recommended to me by a work colleague who is a amateur marathon runner. I chose this product.

I’ve tried various meal replacement shakes and work out protein shakes over the years, but I really do like this one as it is virtually all protein and suits my particular needs well at this time. Once I’m back in the gym, I’ll change to one of their “work out” formulated products and probably not use it as a meal replacement but as a work out supplement.

The cost is $2.13 a serve, which is cheaper than a steak! I buy the large container because it is cheaper per kilo and is delivery free.

Carbohydrates

You will notice not one photo of potatoes or rice. I am a very low carb, healthy fats, high protein eater. I do eat fresh fruit: bananas, peaches, apricots, apples, grapefruit, plums, mandarins. While sugar is the bane of my existence, as it is in everything, fruit has other health benefits. I do limit my intake to two pieces of fruit maximum a day.

Did you know there is 11 grams of sugar in a cup of milk? Anything low fat is often high/added sugar. I tend to triple check the sugar content of anything that is labelled “low fat”. The version that isn’t low fat may actually be better for you.

I found a great low carb, high protein bread that is really nice, highly recommend!

Watch out for “hidden” carbohydrates. This label is a classic example.

Knowing the calorie value of each macro (fats X 9, carbs and protein X 4) my mental arithmetic could not see where the 337 calories was coming from. See the red arrow? Yes, glycerol. 4.32 calories per gram. A whopping 14.3 grams! In the USA it is required it be included in the total carbohydrates. Not in Australia, it seems. Read labels, be aware of possible hidden stuff you don’t want.

Emergencies

Have healthy food you can prepare with no effort if necessary. This prevents grabbing something carb/sugar heavy. I keep four of these in the freezer for flare days. I like these ones, but everyone’s tastes are different. Find ones you like that you can have on hand for emergencies. These two are usually on special for $4.00 each, other varieties may be dearer.

I also have tinned salmon which requires no preparation or cooking. Never run out of eggs!

Treats

Yes, treats. Gotta have treats! At nearly 65 and not aiming to appear on the cover of Vogue anytime soon, I’m not going to be a martyr.

At the moment I am alternating between two treats I allow myself, ONE treat a day.

20 grams of this:

or 67 grams of this:

The 20 grams of chocolate is basically 50% sugar – not really a good choice, I’m eating 2 teaspoons of sugar. But we have to cut ourselves a little slack!

The ice cream (comes in chocolate too) is a much healthier choice as you can see from the label. This is a serving (on a bread and butter plate).

If I am out going to the doctor or the pharmacy I may well indulge in a skinny flat white and a sweet treat – but that would be once a week at the most. More likely once a month under our current #StayAtHome rules and doctors doing telehealth!

One-liners

  • Drink plenty of water – helps you feel full
  • Watch how many coffees you have – can be 50 calories an instant coffee (4 grams raw sugar)
  • Get enough sleep (lack of sleep affects cortisol levels)
  • Eat breakfast
  • Eat slowly (mindful eating is a thing)
  • Eat ice cream with a teaspoon
  • Use smaller plates, the meals I have pictured here are on my entree plates
  • No or at least very minimal alcohol – empty calories
  • No soft drinks (unless used as a small treat)

In Conclusion

I’m reiterating: this current regime of mine is for a particular set of circumstances: minimal activity, isolation, age, pending replacement knee surgery (so very important I not gain weight), pain management requires weight management.

This is certainly not how I eat when I am weight training three or four times a week and swimming two or three times a week. It would not be how I would eat if I was 25.

Some of my weight loss this last month will have been muscle, which concerns me, but there is little I can do about that at the moment.

ALWAYS check with your health care professional for your specific circumstances!

Please ask questions in the comments, as anything you are wondering about may be a question other readers have as well.