The close-out of my medical fitness program

March 28, 2025Angel Ackerman 1 Comment

Monday is my last session as part of the Thrive medical fitness program at St. Luke’s. Working with the trainers in the program has reminded me of some hard truths– and the part that’s hard is the reality of your own habits and thinking patterns.

The numbers show some nice progress. I lost four pounds of fat and gained one pound of muscle. (And had I eaten better imagine what those numbers could have been.) My blood pressure according to their records has stayed the same, but based on my home readings has gone down and requires less medication. The strength-based tests– well, I kicked butt.

I certainly feel better, and stronger, though I still have work to do on my cardiofitness. That won’t really improve until I commit to more cardiovascular exercise, even if it is just walks around the neighborhood. I would love to return to riding my bike again, but there’s a fear factor there. It’s an activity I don’t want to do alone, which is also true of walking.

But here are the lessons:

When my body hurts and locks up, strength-training stretches all those muscles and gets rid of the pain.
I can only lose about a pound a week if I eat well and exercise at least three times a week. Diet alone won’t do it. And my food choices don’t have to be perfect but they have to be solid.
Salt is my nemesis. Too little and I experience orthostatic hypotension and lightheadedness, too much and I end up with as much as five pounds water weight.
I must be choosy about my fast food. Domino’s or Little Caesars pizza will put me in a coma, and I will sleep so well, but the impact will show on my heart rate, blood pressure and weight. Wing Stop has no benefits, only the effects of the salt. I now keep various processed chicken products in the freezer because while they are not a wholesome choice, I can make my own sauces to replicate Wing Stop and save the truly detrimental health effects. Taco Bell in small doses can be tolerated, and I usually get a cheap box deal and make the items all vegetarian. It adds some extra fiber and vegetable matter to the mix.
And out of all the fast food chains– I can navigate the menu at Chick-Fil-A and not notice any real impact. Their fruit cup and kale crunch salad, especially when paired with grilled nuggets, are solid choices. They also have a chicken (or vegetarian) cool wrap, which, while it is calorie dense, is easy and quick to eat– with a good portion of lettuce and cabbage. (Yes, they also have amazing salads, but those big salads are realistically three portions. That’s a lot of salad and chicken. A lot.)

Do I have the discipline to not only continue but improve upon this progress? I don’t know. Honestly. IF I made a commitment to meal planning and cooking, I could. But with money and time always an issue, I don’t know. With stress leading me to seek comfort in my favorite foods– did you know they have Sour Patch Kid Jelly Beans? Eva says they flipped Sour Patch Kids inside out… With fatigue influencing my choices– caffeine and sugary carbohydrates, anyone?

Will I get up in the morning, drink a glass of water, and commit to some sort of exercise in my home gym?

Damned if I know.

Stay tuned.

The Ups and Downs of February

March 2, 2025Angel Ackerman Leave a comment

Lately, I’ve felt like nothing about my life is out-of-the-ordinary or interesting. Maybe that’s true, maybe it’s not.

But this week has been a humdinger. On Monday night, I came home from my supplementary part-time job (because as I’ve heard other people phrase it, “Winter is a hard time for small business” and I found what I think might be an awesome 10-hour-a-week job for me– if my body can handle it). I took a few Tylenol PM because my body was aching and I hadn’t used that particular medication in a long time. But, it’s spring kinda-sorta, and I haven’t been consistent with any antihistamines so I choked on the damn pills because of the allergy-related mucus.

Now, that’s not the end of the world, except I managed to recoil away from the bathroom sink and hit my face on the wooden shelf we use as a cabinet. I hit right along the cheekbone and it hurt like heck and managed to leave a narrow bruise almost parallel to my nose.

Now– some update/backstory as I move forward here– I am two months in to my three-month program at St. Luke’s medical fitness program Thrive. I have worked with several of the trainers (Alex, Claudia, Jim) and I can feel a difference since I returned to the gym. And this week I trained with Alex after several weeks primarily with Jim and Alex noticed I needed to up a bunch of my weights and he’s looking into changing my program.

Jim taught me some stretches for my IT band, because I’ve been having some new issues with spasms in that region, and my chiropractor had determined during our visit Wednesday that I had locked up my right knee. That’s totally new.

My blood pressure and heart rate has been weird. My heartrate has been high at random periods and at one point on Monday it dropped from 120 to 60 and went back up to 130 which could be a sign of afib. And then my blood pressure would come in at 120/65, which normally my blood pressure is 115/70 or 95/65 and now it’s blending the two.

I really have the feeling that to keep my weight and blood pressure under control I have to be very meticulous about what I eat. I am still struggling with that same five pounds. If I do my strength training and my workouts, walk at least 5,000 steps a day, and eat what a lot of people would call “clean” foods, I can lose weight and keep my blood pressure low (with an occasional salty snack when it dips too low). But even if I skip a workout, the weight comes back. It got so frustrating– that nothing ever changes– that I stopped tracking in my fancy fitness journal. And if I’m discouraged now, what happens in April when my program ends?

Thursday evening I had another great workout with Alex. I was mentioning that it had been almost two years to the day since I had my afib incident. I’m really starting to wonder if the change in the weather, and allergies, has something more to do with all this.

Thursday night I came home, showered, and went to bed, only to discover that one of the household cats was in my room and did not want to be. So I got up to let her out. And when I turned to get back into bed I don’t know if I tripped over something or if I misjudged where the space was to walk, but I fell.

Onto a stainless steel litter box.

Hard.

I took a photo of the bruise on the back of my knee today (it’s Sunday) and it’s blurry because it’s at a strange angle. I have another on my arm, that one’s less vivid but bigger.

On Friday, I did a lot of work for Parisian Phoenix Publishing and even agreed to pick up some extra hours Saturday night at the part-time job. Then, I had a really nice business meeting to brainstorm some strategy for 2025 and that included a beer and some wings (and some really yummy thin Triscuits. I had never had thin Triscuits before).

But then Saturday, I woke up with some sort of gastrointestinal issue. It didn’t seem severe enough to be a stomach bug, but I couldn’t come up with any food items that would have given me food poisoning. So I found someone to cover my shift and slept most of the day (and read Fourth Wing when I was awake).

Because I barely moved yesterday my body is painfully protesting walking. My lower body muscles don’t receive messages from my brain like they are supposed to, that’s due to the cerebral palsy. When I have a lazy day like I did yesterday, my legs literally forget what to do. There will be stretching today.

And it’s interesting that I think spring might have something to do with the stuff that keeps happening in March– because March is Cerebral Palsy Awareness Month.

Gunk and other updates

December 28, 2024Angel Ackerman 1 Comment

It is Saturday, December 28, around 8:30 a.m. when I start this. Do not expect much eloquence from me, as the gunk Eva passed on to me from her recent illness is still interfering with my ability to think and sleep. It has instead given me a lovely cough, which now after more than a week is getting “wet” and “productive.”

I FINALLY finished my medical intake at the St. Luke’s Medical Fitness program. Because of my paused membership, I’m not sure when my end date in the Thrive program is but let’s assume mid-February for now. This whole journey started in early November when I visited my neurologist-physiatrist to talk to her about my recent mobility issues and any concerns she had about me returning to an exercise program.

The older I get, the more I worry that my cerebral palsy will cause me to hurt myself because I tend not to notice when my body is doing the wrong things.

Eva has worked really hard on remodeling the garage and including a space for a home gym, so I need to pay some attention to myself in that regard. But I’m out of shape, and falling more than usual, so I’m scared.

My neurologist referred me to the medical fitness program, and I had my first medical intake appointment on November 11. My blood pressure spiked during that appointment, so they sent me home without doing the baseline exercise portion of the intake. I returned two days later, and they almost sent me to the ER because my blood pressure was still bad.

Here are the previous entries recalling all of that, when it was happening.

Two trips to the primary care doctor, two trips to the cardiologist, and two or three falls (depending how you count, one was a trip, but I still believe it happened because of balance issues which makes it a fall) later, my blood pressure seems under control again.

And of course, yesterday, when I turned up at the gym in the basement of the hospital, it was 130/90.

Since I’ve been fighting the gunk, I almost canceled the appointment, but I filled a water bottle with my electrolyte flavor, grabbed a scarf, forgot a mask, and hopped in the car. My fear was that if I canceled the appointment, the intake would have to wait until after my colonoscopy and I was worried that one thing would lead to another and I’d never get this done.

When I arrived, I forgot my water bottle in the car, still couldn’t find a mask, and realized I had no idea where my membership/gym tag was. In the back of my mind, I knew I had packed a gym bag at my last attempt and that the tag was in the gym bag. But where was the gym bag? And what bag did I use?

Lots of hand sanitizer and frequent hand washing and I refused to shake the young man’s hand. I also told him if I continued to cough and he had to send me home, I understood. But I reiterated that I had had many trials to get to this point and I would rather be sent home than continue the cycle of not trying.

Onto the fancy scale I went (168) and I know that body fat percentage was in the forties, wish I could remember what it was when I was super lean a decade ago. Turns out that information may only exist in paper journals in my attic.

39-year-old Angel … with something to prove before hitting 40

The Angel in the pictures is 45 pounds lighter than me, and I think those 45 pounds, age and stress have had a ridiculous impact on my blood pressure and my mobility. (And for the record– the sweatpants worn by Angel in the pictures were my favorite sweatpants ever.)

I have learned that my body reacts strongly to salt and sugar, and that I “do better” when I cook, and that I have no self-control with processed snack foods like potato chips and doritos.

The trainer I met with yesterday talked about maximum heart rate and how hearts slow down as we age. The highest my heart rate reached in 2024, according to my AppleWatch, was 186. 207 was the highest since I got the watch. The online calculators I have seen suggest that my maximum heart rate for my age is between 170 and 179.

The trainer, and maybe his name was Ryan but maybe I invented that, would like to see me four times a week. I still have the mental mindset to make this work, but my physical stamina and fortitude have worn me out to the point where I can talk myself out of my own efforts.

I found this post from when I started my journey with Apex Training in 2021.

Maybe, someday, I will get my discipline under control and be one of those old ladies who powerlift. Screw the whole red hat/purple dress thing.

Meanwhile, Monday is my first colonoscopy. It was supposed to be the Monday after Thanksgiving but the doctor had a death in the family. Tomorrow I start my official bowel prep, and it scares me, because I get shaky without food, and low blood pressure without salt, and I already have a mobility disability. Then they will knock me out on Monday, and I tend to have a heavy reaction to medications and anesthesia. So none of this makes me comfortable. The actual colonoscopy, that doesn’t scare me. But everything else does.

So tomorrow, unless I experience miraculous healing today, I will be expelling mucus from my lungs and all the poop from my bum.

Day 5 of Omada: Wondering if it’s a scam

August 2, 2024Angel Ackerman 2 Comments

I feel like I have said a lot of this a lot of times so bear with me as I say it again.

The background

About 10 years ago, I decided to try to lose five-to-ten pounds. Approaching my 40th birthday, I needed to shed some weight before my annual physical. I worked at Target at the time where I walked 14,000 to 17,000 steps a day. I started weight training again, primarily because I had broken my right hand at work and could not untwist the soda fountain nozzles at night. No hand strength left. I worked primarily closing shift and I would get up, do my weights and walk 2-4 miles around my neighborhood. Every day. I counted calories and perfected my macronutrients and I felt invincible.

I lost 30 pounds in less than six weeks– while weight training. I dropped too much too fast and I had to buy a fitbit to make sure I was eating enough.

I worked really hard to regain weight and muscle.

But now, I’m approaching fifty. I have reached an all-time high with my weight– weighing the same thing I did on the day my daughter was induced 20 years ago. I have gained a little more than 30 pounds in the four years since the pandemic and a lot of other personal events.

And as someone with a mobility disability, that weight impacts everything even more than it does for the average person. I went to the gym religiously for three years, but I didn’t have the willpower or the finances to stick with good habits. Because it’s cheaper to eat the $1 McChicken and $1 diet Coke than it is to make your own chicken sandwiches.

The present decision: Omada

I know what to do. I understand nutrition and everything I do wrong. But I need someone to hold me accountable because my personal discipline is gone. Today is my sixth day participating in Omada– a free-to-me program through my medical insurance company– and I went on a small binge last night.

Perhaps my opinions will change, but I think Omada is a scam. And I think the bulk of the program is driven by AI.

But let me summarize the philosophy of the program.

There is no calorie counting. No exercise tracking but steps. So if you want your weight-training to count you have to convert it to steps, which makes no sense. I understand the idea behind tracking meal choices and not calories or macros. The program wants you to study your choices and habits to make meaningful change.

I’m using the Omada app AND MyFitnessPal and I’m still not making good choices or creating positive change. I’ve participated in my group’s discussions. And I’ve sent a long introductory message to my coach. And I reported a tech issue regarding my scale the day I received it.

I remedied the problem with the scale, so I thought they saw that I was using it and that’s why they didn’t get in touch. Turns out, it just took a week.

So I told my coach my history, and after the first day of tracking she mentioned she saw evidence of stress eating in my day’s choices. I thought to myself, “Really?”

Now to me, stress eating is eating a family size bag of Cool Ranch Doritos. I reviewed my first day’s food. For lunch I had one leftover slice of pizza because I came home from a meeting extremely hungry, and in the evening I had a small individual bag of vegan gummy bears. My calorie count for the day ended around 1400.

Did she think I ate a whole pizza?

I replied, “It was just a busy day. I had a lot of meetings, but I think I made good choices.”

She asked, “Would you like some strategies for eating on the go?”

And I responded, “I have my strategies, but many of them include food I can’t afford right now like my KIND oatmeal breakfast bars that have 8 grams of protein perfect to tide me, and I don’t eat out because my grocery budget is around $100/month.”

Which if you ever read my posts on grocery shopping, you’ll know that’s true.

She responded with tips like eating slower and putting my utensils down (which my message to her pointed out that I did not eat before the meeting, came home very hungry and then took the easy way out, which has nothing to do with eating too much at meals) and how to be smarter about eating out (when I said I don’t have the money to eat out). I believe this list of suggestions came from a chat bot who recognized the phrase “meetings” “busy” and “on the go.”)

No mention of the fact that my grocery budget is below poverty level. A person might want to address that first.

The research

My reporter’s instincts kicked in at this point.

I was already perturbed that it gave me a step goal of 7500 a day without any consideration of my health, my current activity level or my goals.

As a person who works at home at my desk for nine to twelve hours a day I get about 4000 steps on an average day. If I walk to do my errands or take a leisurely stroll around the mall, I get 6500 steps. The last time I hit 10,000 steps I spent the next day in painful muscle spasms. My point is– you need to gradually increase your activity level, especially if you have preexisting conditions.

To qualify for Omada, you need to have a weight problem, a heart condition or diabetes (or prediabetes). I am overweight, ended up in the hospital with Afib last year and had gestational diabetes which puts me at risk for prediabetes. AND I have cerebral palsy.

For people with heart conditions or obesity, is it safe to suddenly walk 7500 steps a day?

I looked online. How does Omada get paid?

Insurance companies pay Omada based on how much patients interact with their devices.

So, Omada gets paid every time I step on the scale.

This is bullshit.

And last night, after a day of decent eating, I added on an extra 500 calories of a peanut chew-style candy, gin and juice and freeze-dried fruit that I didn’t put on the app.

Assessment for medical nutrition

June 26, 2023June 26, 2023Angel Ackerman Leave a comment

WHAT THE DIETICIAN SAID

I had a meeting today with “medical nutrition services” at the local hospital to see if the dietician had any idea what I might be able to do to get myself on track via diet.

She recommended getting more sleep, and specifically 9 hours, which to me would mean going to bed at about 6:30 p.m.

And she applauds my effort to get off screens and read physical books before bed, but wants me to keep my bedroom dark and between 64-68 degrees. Which will mean using the air conditioner. And remembering to open the curtains for the cockatoo in the morning.

She requested that I cap my water intake at 64 ounces or so, based on the color of my urine because she’s afraid I’m flushing all the salts from my system.

She put me on a 1300 to 1500 calorie limit, and asked me to do more meal prep and meal planning as is my custom, but also to eat breakfast within an hour of waking up. Which, because I have so little wits and already have a busy routine, requires meal prepping breakfast in addition to lunch.

As for dietary guidelines, she wants to see me track my food and eat as “normal” as possible, not worrying about sugar and salt per se.

And I need to find a healthy outlet for stress.

Don’t we all.

FOOD DIARY

4:30 a.m: morning meds, 12 ounces water, half a cup of my favorite peppermint accented medium roast coffee with half and half
5:15 a.m.: about 8 ounces water with Electrolyte Powder Plus in raspberry
6:15 a.m. one serving of pretzels and 3/4 of a serving of JIF peanut butter.
8:30 a.m.: one serving Cabot cottage cheese, one golden kiwi, probably one serving “corn bake” and 20 ounces water.
12:30 p.m.: 16 ounces water, Baclofen and one slice pesto pizza
3:30 p.m.: repeat of this morning’s coffee and a Kind Breakfast Bar
4:30 p.m.: about 16 ounces of electrolyte water at the gym
6 p.m.: finally had my Hungryroot schnitzel– a thick pork chop coated with the dry batter of Hungryroot’s ancient grain pancake mix and “hot potato salad” of creamer potatoes, parsley, and balsamic vinegar. I was very very pleased with the texture of the pancake coating.

Weight: 160, Sleep: 7 restless hours, Morning blood pressure: 120/76 (it’s normally around 110/65 at first check), Equilibrium: day 8 of ears ringing, slight headache and lightheaded

Heart rate about 100 bpm while standing at station, folded 100 fixes (100+%)

Socks: T-Rex drinking coffee

Hopefully my next blog entry, I can tell you more about my TedX interview.

Friday food and health

June 23, 2023Angel Ackerman Leave a comment

This will be a shorter blog entry to record my health update. And my food diary. I hope to follow it up with a real essay. On being prepared for the unexpected side of advocating for yourself when it comes to your needs and your disability.

I woke up even more lightheaded today and by 9 a.m. I felt like I might either fall over or faint, so I took my intermittent medical leave and clocked out at 9:14 a.m. When I got home, I took a one hour nap, after which I could at least hold my head up without swaying. My heart rate was experiencing some highs and lows– highs of 130, lows of 44, within a short range. My blood pressure was111/67.

Food “today”:

7:30 p.m. yesterday: after not having dinner last night, I watched an old episode from season 2 of Rescue 9-1-1 and ate about 2.5 servings of Sahale Asian Sesame Edamame Bean & Nut Mix– with around 15% of your RDA in sodium and 6 grams of protein per serving.
4:30 a.m. Don’t judge me, but this morning I had about 10 ounces of water and a Coke Zero for breakfast. Despite having almost 8 hours sleep, I could still barely get myself out the door.
8:30 a.m. I was hoping food would help me feel better. I had grabbed the Brekki oats again as I ran out the door, but today they didn’t have my Greek yogurt in the breakroom so I grabbed a serving of JIF peanut butter to fatten up my dairy-free, gluten-free, vegan and goodness knows what other trend oats.
12:30 p.m. After my nap, I reheated my leftover pasta with jarred red sauce, a tad of mozzarella, and some tiny pieces of meatloaf for meatballs. My water level for the day, besides the 10 ounces this morning, is an additional 24 ounces.
1 p.m. peppermint coffee with half and half.

Baby steps: Attitude and habits to fight anemia

July 7, 2021July 7, 2021Angel Ackerman Leave a comment

Although my current quest is to understand (after decades of life existence) my cerebral palsy, recent bloodwork has shown that my body continues to flirt with anemia. I see my doctor at the end of the month.

It is time.

The last two years have been stressful— the dissolution of my marriage, a job that threatened my emotional wellness, helping teenager two, raising my own teenager, the pandemic, and the menagerie. This time frame has posed challenges and offered delights.

But the heavy fatigue I feel in my bones is not the change to a second shift schedule nor is it due to working in a warehouse with my disability.

I was diagnosed with anemia circa 2009-2010. My daughter was in kindergarten. I survived a stint in non-profits then, in a position that drove me to panic attacks.

Very similar to my situation today. Hopefully I have learned from my mistakes.

Emotional eating has been a huge part of my existence and unemployment may have also caused my nutritional habits to plummet. And now my body feels the loss.

My largest downfall— not including the impulsive fast food buys and late night junk food binges— is not liking fruit. Not a big fruit person. That brings me to anemia tip #1:

Vitamin C helps the body process iron.

Pair iron-rich foods with fruit or vitamin C laden fruit juice. Example: cream of wheat with fresh strawberries.

Symptoms of anemia, by the way, include mixing up words, not being able to move your body as quickly as you are used to, and fatigue not lifted by caffeine, sleep or sugar. Your nails can pale. Your hair can weaken. I also have increased balance issues.

So I am now recommitted to improving my eating habits. Luckily, a lot of my favorite foods are iron rich. I believe that’s my body saying I need more iron.

But I am not a big carnivore and typically people turn to beef and other meats. I move more toward nettle tea, dark leafy greens, nuts and beans.

I also bought some liverwurst. I’m not a fan of “sausage” or organ meats, but it contains close to 30 percent of your daily iron and lots of coblamin, part of the B-vitamins, which promotes healthy red blood cells.

“Whole Foods” and lots of fresh vegetables provide nutrients your body needs.

I’m a fan of spinach and kale wherever I can add it, and like mentioned above, iron-rich nuts or beans can top many dishes.

And even though it seems impossible to function, it’s important to limit caffeine.

Reducing coffee consumption can allow your body to absorb more iron.

But when you’re in the throes of anemia, coffee becomes an IV fluid. So it’s a double-edged sword.

And it’s important to know your particular symptoms and take supplements if needed— talk with your doctor and find out what supplements will benefit you.

You can often tell by your bowel movements if you are taking too much iron. The more iron in your system, the darker and harder your stool becomes.

Supplements can help, and can increase the body’s stored ferritin. Note that the body will deplete vitamin D before iron, so vitamin D supplements often go hand-in-hand with iron.

Regular blood work, a healthy diet and the right supplements can get your body back on track but it often can take months to fully recover.

And if it’s summer, the heat will sap your remaining energy.

Fire Up the Ninja

March 14, 2018March 14, 2018Angel Ackerman 2 Comments

While I was recovering from my minor winter ailment, somehow I stumbled upon Gaz Oakley, the Avant Garde Vegan on YouTube. I’m not even sure how or why, but something mesmerized me.

I spent eight years as a vegetarian before my daughter was born and went vegan for six months back in my twenties. I never was a big fan of meat and I hated touching it. I also disapproved of factory farming practices and the use of hormones and antibiotics in our meat. Basically, I never had a problem with eating meat, but I did have a problem with the big business of food production and the amount of processed foods and chemicals in the standard American diet.

When my daughter was young, I made 90% of her baby food, most of our bread products and bought a lot of our food from local farms. Not the Farmer’s Market but the actual farms. I also gardened and preserved our food in the almost-lost art of canning.

As life got busier, I lost some of my good food habits. And I burned out a few food processors making homemade nut butters, blending dates for use in snacks and grinding my own flours. Oh and I made ridiculous amounts of hummus.

Something about Gaz and the way his cooking style incorporated the types of foods I like had me hooked. It was his high protein meal prep that truly mesmerized me and made me want to eat it all. I needed to cook again. Really cook.

And he did the things I used to do when I destroyed my blender.

So what did HE use?

A Ninja.

I read all the comments on his videos about the blender system and its comparison to a Vitamix. Now frankly, I don’t want a Vitamix. It’s a blender. I have a nice Black and Decker blender with a glass pitcher that suits me. I need a food processor.

Then I saw it at Target. The Ninja Professional. $199.

I wanted it so bad. So I made a Facebook comment. Suddenly, my family is offering to buy me a Ninja.

I had no choice.

I bought a Ninja. And started cooking again.

I have cooked for four days straight. My husband teases that I can’t make a meal without firing up the Ninja.

I am in love.