Relationship Between Cortisol and Estrogen - Part 1

By Maggie McCarey

 Last Saturday, I watched Les Miserables. I enjoyed the movie, felt the characters’ pain, grieved their deaths, but I wasn't a wet mess of tears at the satisfying shmultzy end of the movie.  Just a few days earlier, I was so emotional, I blubbered over a Carnival Cruise Triumph news report. At that time, my left ankle had begun to swell and fill with inflammation, a sure sign that my body was on the verge of a “lipedema break out.”  But why? I had not been sleeping well and I was experiencing a lot of intense emotions. I needed to find out fast.

 
For some time, two question marks have been bobbing up and down in my brain:  cortisol and estrogen.  I know that cortisol is triggered by stress, one of the major causes of our lipedema inflammation.  And, anyone who has ever had pre-menstrual “blues” knows that overflowing emotion—stress-- is estrogen driven.  But do cortisol and  estrogen work together?  Are they related to each other?  These questions are the subjects of my research and now this blog.  Were cortisol and stress causing me to be a blubbering diva?

Cortisol, Stress, and Inflammation


Under stressful conditions, cortisol provides the body with glucose by tapping into protein stores via gluconeogenesis in the liver. This energy can help an individual fight or flee a stressor. However, elevated cortisol over the long term consistently produces glucose, leading to increased blood sugar levels. Cortisol functions to reduce inflammation in the body, which is good, but over time, these efforts to reduce inflammation also suppress the immune system. Chronic inflammation, caused by lifestyle factors such as poor diet and stress, helps to keep cortisol levels soaring, wreaking havoc on the immune system in the process. (www.todaysdietitian.com/newarchives/111609p38.shtml)

Translated:  Your adrenal glands are the conveyor belt in the famous I Love Lucy chocolate factory skit, but, rather than chocolates, your factory functions to produce what you need to keep you healthy through both urgent, but momentary, and chronic life-sapping external events. One of its favorite defenses is cortisol, which is produced via cholestrol in the adrenal glands located above your kidneys.  As your body goes through anything from a missed appointment to the death of a loved ones, it calls for cortisol (literally little protein bars stored in the liver).  Obviously, the more chronic your life, the more cortisol you have unleashed until, like Lucy and Ethel shoving chocolates in their mouth, under their hats, and down their fronts, as the conveyor belt speeds faster and faster. Eventually, your adrenal glands burn out but not without a fight. 

Watch Lucy at the Chocolate Factory:  

Our bodies try to store the extra cortisol first. How?

One way to store the extra cortisol is via visceral fat storage. Cortisol can mobilize triglycerides from storage and relocate them to visceral fat cells (those under the muscle, deep in the abdomen). Cortisol also aids adipocytes’ development into mature fat cells. The biochemical process at the cellular level has to do with enzyme control (11-hydroxysteroid dehydrogenase), which converts cortisone to cortisol in the adipose tissue. More of these enzymes in the visceral fat cells may mean greater amounts of cortisol produced at the tissue level, adding insult to injury (since the adrenals are already pumping out cortisol). (www.todaysdietitian.com/newarchives/111609p38.shtml)

Researchers have discovered that cortisol eventually overloads the adrenal glands which work so hard for so long, they eventually produce less active cortisol, and  thus leave the body vulnerable to other hormones like over abundance of estrogen, whose excess is stored forever in the liver.

YIKES, SO WHAT IS ESTROGEN?

What is estrogen? It is primarily a combination of three chemical messengers who travel by body fluid to affect all stages of reproduction, sexual behavior, and female characteristics in both men and women.

Estrogen is an entire class of related hormones that includes estriol, estradiol, and estrone. Estriol is made from the placenta. It’s produced during pregnancy. Estradiol is the primary sex hormone of childbearing women. It is formed from developing ovarian follicles. Estradiol is responsible for female characteristics and sexual functioning. Also, estradiol is important to women's bone health. Estradiol contributes to most gynecologic problems, including endometriosis and fibroids and even female cancers. Estrone is widespread throughout the body. It is the only estrogen present after menopause. (http://women.webmd.com/guide/normal-testosterone-and-estrogen-levels-in-women).

                  THE NEW BUZZ PHRASE:  ESTROGEN DOMINANCE

Dr. Christine Northrup, arguably the world’s leading women’s health advocates, explains estrogen balance and dominance so well, I am just crediting it to her and adding it to this blog.  She explains:

WHAT YOU NEED TO KNOW

The conventional medical mindset is that menopause is an estrogen deficiency disease resulting from ovarian failure. Women have been led to believe that at the slightest symptoms, they should run out and get estrogen replacement. While estrogen levels will decrease during menopause, the truth is, estrogen levels do not fall appreciably until after a woman’s last period. In fact, far more women suffer from the effects of "estrogen dominance" during the transition—that is, they have too much estrogen relative to progesterone. And some women can suffer from the symptoms of estrogen dominance for 10 to 15 years, beginning as early as age 35.

LISTEN TO YOUR BODY

The symptoms listed below, as well as many others, often arise when estrogen over stimulates both the brain and body. All of these symptoms are exacerbated by stress of all kinds. Many women in their thirties and early forties find that they experience moderate to severe symptoms of estrogen dominance as they approach perimenopause.

                            Decreased sex drive

                            Irregular or otherwise abnormal menstrual periods

                            Bloating (water retention)

                            Breast swelling and tenderness

                            Fibrocystic breasts

                            Headaches (especially premenstrually)

                            Mood swings (most often irritability and depression)

                            Weight and/or fat gain (particularly around the abdomen and hips)

                            Cold hands and feet (a symptom of thyroid dysfunction)

                            Hair loss

                            Thyroid dysfunction

                            Sluggish metabolism

                            Foggy thinking, memory loss

                            Fatigue

                            Trouble sleeping/insomnia

                            PMS

Estrogen dominance has also been linked to allergies, autoimmune disorders, breast cancer, uterine cancer, infertility, ovarian cysts, and increased blood clotting, and is also associated with acceleration of the aging process.

WHAT CAUSES THIS

When a woman’s menstrual cycle is normal, estrogen is the dominant hormone for the first two weeks leading up to ovulation. Estrogen is balanced by progesterone during the last two weeks. As a woman enters peri-menopause and begins to experience an ovulatory cycles (that is, cycles where no ovulation occurs), estrogen can often go unopposed, causing symptoms. Skipping ovulation is, however, only one potential factor in estrogen dominance. In industrialized countries such as the United States, there can be many other causes, including:

                            Excess body fat (greater than 28%)

                            Too much stress, resulting in excess amounts of cortisol, insulin, and norepinephrine, which can lead to adrenal exhaustion and can also adversely affect overall hormonal balance

                            A low-fiber diet with excess refined carbohydrates and deficient in nutrients and high quality fats

                            Impaired immune function

                            Environmental agents 

http://www.drnorthrup.com/womenshealth/healthcenter/topic_details.php?topic_id=118

Next: Surprising Research on Estrogen Dominance. Tests at home to determine if your adrenal glands are too fast or to slow.  How I  tested my hypothesis and stopped my estrogen overload with herbs and watched Les Miserables without tears.

Relationship between cortisol and estrogen, part II
Relationship between cortisol and estrogen, part III

Men with lipedema

By Tatjana van der Krabben

“There are only two known cases of lipedema in males.” Does that line look familiar? The overview papers are quick to quote this line. Too quick.

This blog is because we care about the men in our lives and share the concerns of women who suspect their male relatives may have the same genetic flaw.

Seven cases found in literature

N. Laleman (2011/2012) wrote the dissertation Lipoedeem: Pathofysiologie, diagnose en behandeling (University of Gent, Belgium). She has traced seven cases of lipedema in male patients with reference to the following papers:

* Langendoen et al (2009) Lipoedema: from clinical presentation to therapy. A review of the literature.

* Fonder et al (2007) Lipedema, a frequently unrecognized problem.

* Chen et al (2004) Painful fat syndrome in a male patient.

Seven cases she found. Not one or two, which is usually being quoted off each other. What I also like about this dissertation is that Laleman states that only seven cases were described in literature. Not that there only are seven cases. That brings me to my next point.

Not every case is mentioned in literature

That’s right. Despite the fact it’s still rather unique in literature, not every doctor coming across a case has jumped to the opportunity to publish on it. My first (digital) encounter with a male patient was in 2008, just after I got diagnosed. I’m a research junkie and got a lead: liposuction. At the time it was more difficult to find information, so I also checked out forums. I came across a depressed man, desperate for liposuction, but without funds and so far no help from his health insurance; he had lipedema. He implied he would kill himself if he couldn’t get liposuction and look ‘normal’ again. I was feeling rather frail myself, coping with my own diagnosis. I wasn’t at that place in my life where I felt strong enough to reach out. I lost sight of him.

The second time was when brainstorming for the book Lipedema: Help, Hope, Healing. We were unhappy with the lack of practical information, awareness and support. We wanted to do something with that. While going over genetics, Maggie McCarey pointed out she not only had female relatives with lipedema, but also male relatives: both her father and grandfather had lipedema. Her father was formally diagnosed, but never made a paper. Looking back, Maggie realized her grandfather must also have been among the long line of relatives with lipedema.

Through Big fat legs (www.bigfatlegs.com) we know of 3 more cases. Two formally diagnosed and one currently getting tested in a renowned clinic to get diagnosed. Big fat legs (by Maggie McCarey and Stefanie Gwinn Vega) is commonly found by people who have had quite a journey already with their symptoms, but are struggling to get diagnosed or just got diagnosed. People, yes, sometimes men as well, trying to figure out why they have unexplained ‘fat legs’.

And there’s more, although not formally diagnosed at this point. Some women with lipedema have expressed their concerns on forum about their sons, having unusually large legs in comparison to the rest of their body.

How male cases are more or less being dismissed

Each male patient was also diagnosed with a hormonal imbalance (Laleman 2011/2012). As a medically untrained person I say “So?”. With women it tends to flare up with hormonal changes. It’s not like we’re so well balanced hormonally at these stages of our lives. Although not in the literature yet - that is to the best of my knowledge - several doctors (Herbst and Huijberts) have gone on record in lectures pointing out the risk of contraception with hormones in case of lipedema. It can cause the lipedema to flare up. They mostly spoke of birth control pills, but in recent years many women have been getting rid of coils with hormones and HRT etc. and are feeling better for it. That’s nothing formal, tested, medically acknowledged at this point, but still.

Another point is that (modern) diet/food, stress, sleep (deprivation) also affects hormonal levels. What is stable in this context? When is it as it is supposed to be? But I’m digressing here.

With so few cases on record it’s tempting to rule out male cases in front of your nose. It’s so rare, so this probably isn’t lipedema. Mind you, some papers even dare state only women are affected. What if your primary happened to google one of those papers? Rare, I hate that label. Rare is an excuse to dismiss it. Lipedema in women is even still being referred to as rare. No, it’s not rare, it’s often not diagnosed due to lack of knowledge of lipedema and fat bias. In men it may be rare, but it does exist. The notion is not even new: the first male case that made literature was among the 119 case studies by Wold, Hines and Allen in 1951.

With the hypothesis spreading that it is (part) genetic, we must acknowledge that men are very much part of our gene pool. They may be carriers or worse, get afflicted. For all those looking to get help for their male family member(s): if he does have lipedema, he is not alone. For sure.

The Power of Words

by Christina Routon

We know the power of words. They can empower us, they can hurt us. We know this all too well as most of us have been hurt by someone else's careless words. But one issue with words are the words we say to ourselves.

We say things to ourselves we'd never say to anyone else. We put ourselves down in many ways, often several times throughout the day. It's no wonder we have low self-esteem and it's difficult for us to believe anyone likes us, let alone loves us.

Part of loving ourselves is paying attention to the words we speak, especially about our appearance. In Song of Solomon, the Shulamite woman says,

Dark am I, yet lovely,
    daughters of Jerusalem,
dark like the tents of Kedar,
    like the tent curtains of Solomon.^[c]
6 Do not stare at me because I am dark,
    because I am darkened by the sun.
My mother’s sons were angry with me
    and made me take care of the vineyards;
    my own vineyard I had to neglect.

(Song of Solomon 1:5-6)

She explains she's tanned and why, and that she neglected her own body because of the work she had to do. In her culture, dark skin meant you worked for a living, typically outside. She knew others would fault her appearance, but she knew there was reason for it. 

Why don't we say, 

I have lipedema, but I am lovely. 

Don't stare at me because of my large legs. Something happened that no one fully understands at this moment in time. Yet I am more than my body. I am a wife, a mother, a sister, a friend. I laugh, I love, I cry. Know me for who I am, not how my body appears. 

One of the most beautiful verses in Song of Solomon is then said on their wedding night. The woman's husband spends time praising her beauty and says this: 

"You are altogether beautiful, my darling; there is no flaw in you." (Song of Solomon 4:7)

We need to see ourselves this way. Make this an affirmation. Say it to yourself daily, especially when you may be tempted to complain about your legs. Say it as you dry off after your shower, as you get dressed for the day or undressed at night. Care for your body by using sweet smelling lotions and perfumes, styling your hair and using good makeup. These things are important, but we also need to tame our tongue and speak words of life instead of words of death. 

Don't allow words of death from the past to overshadow you any longer. Release them, and know you are altogether beautiful. There is no flaw in you. 

These are declarations spoken over us at a small group and retreat we attended in December. Speak them out loud, over yourself and others, if you want. 

LIFE Declarations (From Living in Freedom Everyday, Church of the Highlands)

I declare that you are blessed with God's supernatural wisdom, and that you have clear direction for your life. 

I declare that you are blessed with creativity, with courage, with ability, and with abundance. 

I declare that you are blessed with strong will, self-control and self-discipline. 

I declare that you are blessed with a great family, with good friends, with good health, and with faith, favor and fulfillment. 

I declare that you are blessed with success, with supernatural strength, with promotion and with divine protection. 

I declare that you are blessed with an obedient heart and with a positive outlook on life. 

I declare that any curse that has ever been spoken over you, any negative evil word that has ever come against you, is broken right now. 

I declare that you are blessed in the city. You are blessed in the country. You are blessed when you go in. You are blessed when you come out. 

I declare that everything you put your hands to do is going to prosper and succeed. 

I declare that you are blessed!

Finding My Identity

by Christina Routon

Two years ago this month, my husband and I divorced.

Yes, you read that right. At the end of February 2011 I sat in a lawyer's office and signed divorce papers. It was one of the hardest and most painful things I'd ever done in my life. It was also a wake up call from God, and through this day He's led me on a journey of discovering my identity.

Ending up at the attorney's office wasn't an overnight decision, of course. And God had been working in me for some time, nudging me, inspiring me, to do certain things, to change certain things. And I ignored the nudges. I turned away, I disobeyed, I flat out said, no, why should I change? HE should change. Other people need to change, not me.

And the result was a broken marriage and a broken woman, crying on the floor of my bedroom, feeling more alone than I'd felt in a long time. And it was there that I submitted to God, that I begged for forgiveness from a God I truly believed was fed up with me and who hated me. And I asked for healing, for myself and my marriage, even though in my heart I felt it was too late.

Instead, I felt a wave of peace wash over me. There was no hate, there was no anger, there was no bitterness. There may have been some frustration, but He never pushed me away. Instead, He said to me, "Finally! Now, we can start over." And little by little, he began to rebuild me.

This started with my self-esteem. As my husband shared in his post, my self-esteem had been shot for a long time, mostly over my appearance. I hated my body. I hated how I looked and how I felt. Now I was in a position where I hated my character. God began telling me and showing me how much I was loved, how nothing I could ever do, say or feel could separate us. He had to start with my character because I felt unwanted and unloved at that moment. I didn't feel worthy of love. He led me to music, He led me to books, He led me to movies, and spoke through them each time.

I began to write affirmations on index cards. I put them on a bulletin board and read them every day.

I am an honored child of God.
I am a beautiful, sexy woman.
I am living a wonderful, beautiful, abundant and creative life.

He sent me the song "Beautiful", by Mercy Me, and I still play that song and listen to it almost daily.

So what does this have to do with lipedema? All of this happened before I discovered lipedema. But I was on a quest for answers. It started with Who am I? God answered this, and continued to tell me and show me how important I was to Him over time. Then it changed to What am I called to do? And he answered that as well, and I finally submitted to the call to be a writer. It's strange when life throws you a curve ball and you end up where you never expected. You no longer have any fear. I stopped being afraid to go after a dream, and I just did it. I was inspired to write a short story, so I did, and sold it within a month. I was inspired to start a website about running a transcription business, so I did, and after a year and a half it's started to gain a following and make money. I finished a book I'd been working on since 2003 and self-published, then I started writing another book.

God began working on my ex-husband as well, and our son, and issues we had as a family. Six months later, in October, 2011, we remarried, and we're more in love now than we were at 18.

Then it was time to get back to work on my health. I'd been working out and dieting already for two years and hadn't seen any real results. My legs were still large and I'd only lost thirty pounds. Since the divorce, I'd been working two jobs - a full-time job during the day and in the evening I'd come home, eat a bowl of cereal, then work transcription jobs until 10:30 or 11:00. I wasn't taking care of myself anymore and after a couple of months it was time to start again. So I made my doctor's appointments and started using my insurance benefits. I continued to ask questions, I continued to search for answers, until last June I got my answer. I had a condition, with a name, but no cure and no treatment. And it broke me.

Once again God had to rebuild me and remind me of my identity. As I left the pharmacy after picking up the medication the endocrinologist had prescribed, I was almost in tears. I clutched my husband's hand as we left the grocery store and the song on the PA system changed - Lionel Richie's "You Are So Beautiful."

I stood in the parking lot of the grocery store with my husband and cried. I cried for the lost hope, the lost dreams, the possibilities of a future filled with pain and loss of mobility. Never wearing dresses or skirts again, never wearing a pair of boots. A lot of that seemed silly, but these were things I really wanted and hoped for. I wanted to be normal. I wanted to be on the outside the person I was on the inside. It's taken some time, but I am finally learning - and believing - the truth, and not the lie.

Our identities are NOT this disorder or any other medical condition we may have in addition to lipedema. Our identities aren't our large legs or arms or butts. Our identities are not our jobs or our families or our social status. Our identity is this, and this alone:

You are an honored child of God.
You are here for a purpose.
You are loved.
You are beautiful.

Love and Relationship with Lipedema

by Scott Routon as told to Christina Routon

I met Christina in third grade. She'd moved to my small town in Georgia after her father separated from the military. I was fascinated first by her hazel eyes and by the fact that she was wearing a skirt when most other girls in school wore jeans every day.

We became best friends, and on Valentine's Day in third grade Christina asked me to marry her, and I said yes.

We had some growing up to do, of course, and as time went by and I switched schools we saw less of each other. Then one day this beautiful young woman stopped her car and asked if I needed a ride. We spent the afternoon together and ended up dating for the next two years before getting married in 1990. I was 19, Christina was 18.

There was a sexy librarian-sharpness about her that intrigued me. She's one of the smartest people I know. There was something I found fascinating about her, I can't put it in words. We did have our differences and our issues, though, and while I was in the military and away from home I sent her a break-up letter. I had second thoughts, though, and called her. I couldn't imagine being without her, and I didn't want her to be with someone else, and this time I asked her to marry me.

When I saw Christina on our wedding day, she took my breath away. She was beautiful. When we did the garter toss, I did notice she'd only put the garter up to just under her knee. I didn't know why. I knew Christina had been complaining about her weight and her legs, but I didn't see anything wrong with her. I love curvy women, and I liked seeing her in dresses, skirts, shiny hose and heels. I didn't see anything wrong with her legs. They were just part of her.

Over time, I did notice Christina was gaining weight and some of the clothes she wore didn't seem to fit as well as they used to. We didn't know anything about lipedema at that time. When Christina gained weight when pregnant with our son, that's when I noticed a change in her legs. I was concerned, and I still thought she was beautiful, but we both figured that after the baby was born she would lose the weight and she'd look the way she did before. She's always had a pear-shaped, hourglass figure that I love, and I did want her to get that back.

When we moved to Alabama and Christina joined the gym, I'd never known anyone to work harder. She was going to the gym almost every day, running on the treadmill, lifting in the weight room. She and those other ladies kicked my butt in the spin class! I couldn't keep up, and that blew my masculinity to pieces. But we were both concerned when she continued working out and cutting out junk food and yet only lost thirty pounds during those two years. That was when we started to suspect something else was going on.

I'll never forget when the jerk online said something about her legs. She'd been posting on a well-known bodybuilding forum and had asked for advice about her program. Christina was discouraged because her legs weren't changing no matter what she was doing. This jerk came on the board and replied to her post, basically calling her a liar about her workout and diet and saying horrible things about a picture she'd posted on her profile page. This was one of those times I wanted to hunt someone down and hurt them they way they'd hurt my wife. She cried for a long time and came very close to giving up everything she'd worked so hard for.

This was also the event that made her want to seek out more information. She'd struggled for so many years with her weight and her legs. The way her legs looked was so tied to her self-image that it did affect our relationship and our intimacy. I've always believed she was beautiful and shapely. It didn't matter that I told her she was beautiful and I loved her shape and yes, even her legs. I hated that she didn't wear skirts or dresses anymore and wanted to hide her body from me. When she talked about seeing an endocrinologist to find out what else may be going on I supported her decision.

When Christina started taking medication and she finally started losing weight, we both had hope. I wanted her to wear dresses again. I wanted to get her a pair of boots to wear with a skirt and tights. But when her legs didn't change that much, the doctor said lymphadema. Christina, ever the researcher, began to search for answers and that led us to lipedema.

Everything she found said no cure, no treatment. I was furious, I was upset. It was unfair. It's hard to explain how crushed I was. I felt I'd never get the Christina I'd known back. I still loved her very much, but it was hard. And she'd been working so hard to lose weight and I wanted her to look the way she felt.

For Christina, it had a name and that was a relief. But I need an enemy I can fight. This was something I couldn't conquer. It was hard to accept, and I needed hope. I needed to hear something, anything, besides to accept it and get through it with God's grace. I needed to hear God can and will heal, that's there's medical treatment, something.

When Christina started the wrapping therapy, it was hard for me to see Christina go through it day in and day out, but it made me feel proactive. I felt like we were doing something and that felt good, it gave me hope, and I could let some of this anger out.

I'm still angry that there's no medical treatment or a lot of research in the United States for this. I also hate that a lot of plastic surgeons don't know about this or if they do, many won't touch it because of possible physical complications. I hate that many doctors don't know about this and continue to hurt and discriminate against women who have this disorder.

I completely support liposuction as a treatment for this, and if Christina and I have to go to Germany to have it done then that's what we'll do. Until then, we'll continue to learn as much as we can, continue to experiment with diet and exercise, and even if I have to have a pair of boots custom made, I will see Christina in a skirt and boots one day.

Happy Valentine’s day!

By Tatjana van der Krabben & husband

1993. Girl meets great guy. Almost 20 years later, we are married, have 2 lovely children and live a good life in suburbia. Girl is now a woman, definitely more curvy and diagnosed with lipedema. When we met there were no obvious signs. Well, not with the knowledge I had at the time, which was nothing, nada, zilch. I can write lengthy prose on my journey and what it was like for me, but this blog puts the spotlight on my partner. What was it like for him?  

“I never really had a type I would be attracted to. I did like dark hair, but otherwise looks were not key. I liked smart girls. When I saw you I was attracted to your face. As we actually met it was your personality, you had something to say and you were levelheaded. I didn’t notice anything about your figure.

After our eldest was born I could tell your body really changed. At first I figured that’s normal after pregnancy, but later I started thinking. I particularly noticed the changes in your arms and legs, but more so your legs.  Initially I did consider it was your eating habits. We ate quite healthily, but I wasn’t always around. I did put some thought into it. Was is genetics or snacking? Even if you were prone to gaining weight because if genetics, the change was quite dramatic. What really struck me was that you worked out at the gym quite frequently and it did nothing for you. That was odd.

One day you brought up lipedema. After a while you also wanted to pursuit a diagnosis. I had my doubts: and then what? I never heard of it and I figured that a diagnosis would not change much. I tried to be open minded; maybe there was a point to taking that hurdle. And there was. Things started to make sense: genetic flaw, reinforced by an adverse reaction to perfectly normal food. How to get fat when you’re actually trying hard not to.

It also meant your old figure was out the window, yes. I was disappointed, I admit, but it could never be a deal breaker. Really, walking away because your wife doesn’t look the same as she did on your wedding day? That’s lame. Not much of a marriage or not much of a man if that is all it takes to walk out. Try selling that to your kids!

After that came exploring liposuction. I thought it was risky business, I was very skeptical. But I tagged along to the appointments, got to meet the doctor you chose and that made me a little less worried. In hindsight I was very happy you went for it. It gave you so much relief. Just look at you: before you could take the stairs like two times a day. I caught you resting on the couch more and more. It was a vicious cycle – how do you break free of that? Yet you did.

Your next target was changing your diet. I’m totally cool with that, just as long as you don’t force it on me. Some stuff I dig, but seaweed and stuff… You only work the really tasty stuff into the family diet. What’s to complain? You differentiate between things you need and what others don’t need per se. Also, you can’t stand the cold and can’t keep up with my snowboarding. Yet, you don’t deny me that. We work around things so we both get what we need and want. We don’t deny each other things we love to do, just because the other can’t keep up or doesn’t share the same interest.

As for the future… I’m not really scared the lipedema will flare up again, but I sure hope not. Just stick with what you do. It’s working!”

I know you hate the spotlight, as well as spelling things out. A lot goes without saying, especially after 20 years, but sometimes it’s great to hear it out loud. Also, it never hurts to get a male perspective.  Thank you for doing this for me. Happy Valentine’s day!

I’m o.k. – did I just say that?

By Tatjana van der Krabben

In November 2010 I had my first liposuction procedure. In November 2012 I had the last one of four. Yes, the last one. I’ve reached a decision: I’m done. Of course I still have bumps and bits. I’m also in that awkward spot between sizes: size 14/16.  And yet… It just stopped serving a purpose. This is me and that’s o.k.

Why liposuction in the first place
I embarked on this journey to get less pain and become more mobile. My legs had that distinct lipedema look and feel, I just didn’t expect much result in the cosmetic department. I also didn’t want that to be a factor. To me, this was strictly a medical procedure. To my surprise I got a very decent cosmetic result. It gave me more self-esteem. I was still the same, it was just looks and it mattered. Not just to me, but also to loved-ones and friends. The fact that carrying around a couple of pounds less was such a big deal in this day and age was hurtful. While admiring my new figure I told myself over and over again this was not why I did it and those stupid 15 pounds should not matter that much.

The fog has lifted                                                                                                                                           While being on a healing rollercoaster it was very difficult to see the bigger picture. Whenever I could feel what strength and mobility I regained, I was planning the next surgery that would also temporarily set me back. I postponed the last surgery, simply because it was difficult to fit into my schedule. First and foremost I’m a mother of 2 kids who still very much need my care and help. So I was truly feeling the physical benefits for the better part of 2012. Until November, when I had the last one.

I cherished the benefits. I enjoyed being more fit. Being thrown back in November after surgery on my arms made it quite clear to me: this better gives me less in pain in the long run, because for cosmetics only this is not worth it! I was in pain, hindered in my mobility all over again and recovery was sloooow. It’s been 3 months. Healing has progressed sufficiently to be able to conclude I did benefit again. I will have to fight again to regain all my strength, because I was unable to work out for over 2 months. Yet, there’s also that blissful sensation of being virtually pain free! The fog has lifted. I’ve got my bearings again.

Results                                                                                                                                                                  Size 14/16, so what? I may never have looked like a really bad case to many of you, but I was in a lot of pain. I have hypermobility. It counted for cool tricks when growing up, now it just means it’s a weakness in the system, a gateway to pain. Pregnancy set me way back. I never truly recovered. There are exercises I could do for that, if I were actually able to. But I’m not, thanks to the lipedema. I cannot pull enough strength out of my legs to support me with those exercises. Also, if the lipedema is bad like in the past, I also get more pain and mobility issues from the pregnancy souvenirs. I can do the mild exercises for that again, thankfully. I rarely drag my leg anymore. I owe that to liposuction. I can climb the stairs again, when in moderation virtually pain-free. I experience less fatigue, get more done in a day. I also experienced reduced swelling in areas not treated by liposuction. Like breaking a dam, the circulation improved. The 2 surgeries that gave the most result were the inside of my legs and my arms. They had a distinct impact on my mobility and new found energy and strength. More energy means I feel like I really need to sit down and put my feet up for a bit in the afternoon as opposed to feeling like napping.

The last surgery brought on such a painful recovery it really put me off. Did I really want to do this again? I took my time to think about it. I’ve come to realize that my butt sticks out like a sore thumb. I’ve got junk in the trunk all right! Does it hurt? Barely. Can I work around it with clothes? Yes. Would I want to risk a sagging version of it just to get it reduced in size? NO!! I have one last little thing, that’s the back of my upper legs. They were never ‘done’. There wasn’t all that much fat, but it’s quite tender. Yet, not that bad. These were the final issues going through my mind, but they didn’t bug me enough to do something about it. The rest wasn’t bugging me anymore. There’s some loose skin, which can be treated with external laser, but no more liposuction. It was o.k. - I’m o.k.

I’m not complaining it boosted my confidence. I’m generally in a better mood, regained hope to find further improvement through diet, exercise and supplements. More importantly I feel o.k. about myself, remaining bumps and everything. The only thing that could ever bring me to do it again is if menopause would make it worse again, pain included.

Results from my Whole 25

By Christina Routon

I did not complete the Whole 30 challenge. I got through day 25 and I'd had enough.

The Whole 30 is not easy to complete. It wasn't just about giving up the grains and the sugar as I'd already been wheat-free and sugar-free for some time. It was actually harder for me giving up the dairy - the cheese in my eggs, the cream in my coffee. To do this takes planning and preparation, and it seemed the more the month went on it just became more difficult and time consuming.

I learned a lot about myself, and this trumps any results I had with weight loss or inches lost. I learned about emotional attachments I have to food. After a rough day, I wanted pizza and ice cream. The last thing I wanted to do was go home to chicken and vegetables and spend another hour in the kitchen prepping for the next day. However, I know that food will not make me feel better and I believe doing this is helping me break those attachments.

Since going without any type of sugar or sugar substitute for almost a month, now that I can use the sweetener again I find my taste has changed. Before I used about four packets of Splenda in a cup of coffee or tea, trying to mimic the sweet taste of sugar. Now, I may use one and it tastes fine.

I was surprised at how many foods contain sugar, wheat, and other additives. I will definitely continue to read labels and make the best choices possible when buying groceries.

I've learned a new appreciation for vegetables, including vegetables I never would have tried before. My husband makes excellent mashed cauliflower. I love the recipe for jicama home fries and chocolate chili from the cookbook, Well Fed. I've eaten sweet potatoes, butternut and spaghetti squash, broccoli, cauliflower, jicama and so many other vegetables I can't remember. I've learned new ways of cooking and new ways of seasoning food to make it taste good and be interesting every day. I've learned shortcuts such as prepping vegetables ahead of time in containers, pre-cooking ground meat to use in a variety of recipes and using my slow cooker for a roast or chicken. I've made homemade mayo and salad dressing. It was definitely an experience.

As for physical results, I lost two pounds. I'd hoped to lose four or five, but I know lipedema slows weight loss and as I was already wheat-free and sugar-free I didn't expect to lose as much as those going from a typical SAD diet to a Whole 30 plan. I did lose inches, mostly on my arms. I did some exercise, not as much as I'd liked, but I plan to include healthy movement into my days. It may not be a scheduled exercise program, but I am going to do something to move my body and keep it healthy.

I did notice recently my calves feel softer than they did before. I've been using lotion on my legs and for a long time my calves had felt hard. This is important, because lipedema fat on the calves tends to get hard (fibrotic) and lumpy and this affects the way lymphatic fluid moves through the legs. The fact that my calves are softer and actually jiggle (who would have thought I'd be happy to have more jiggly fat?) tells me my body is changing, even if I can't see it.

I'm going to continue a more primal style of diet, predominately paleo but including cheese and butter. This is going to be my diet 95 percent of the time. I'm going to include corn on a limited basis, more in the form of corn tortillas and grits than whole kernal corn, and until Stevia is a bit more affordable I'm going to have to stick with Splenda as a sweetener, if I use one at all. I'm learning more about Omega 3 and Omega 6 fats as well, which I'll share soon, and plan to add more Omega 3 fats to my diet.

I'll probably do another Whole 30 in the fall, maybe around August or September. I'm glad I did it. I learned a lot for my first go round and I'm looking forward to seeing what changes take place as the year progresses.