Pain

The Art of Maintenance

flidfit Disability, Emotional well being, Maintenance, Mounjaro, Pain
March 2025 75kg (11st 11lbs)

There’s a quiet stage of life that doesn’t get celebrated very much.

It’s not the dramatic beginning.
It’s not the triumphant transformation.
It’s not the crisis.

It’s maintenance.

This week alone has been full of it. A new, larger radiator installed so the kitchen is properly warm. Clearing wardrobes of clothes that are now two sizes too big. Adjusting my glasses prescription. Tweaking medication doses. Bringing forward recruitment plans for Mum’s care. None of it headline-grabbing. All of it necessary.

For years, my life felt like it was about change. Losing weight. Recovering from injury. Adapting to mobility challenges. Learning how to live well in a body shaped by Thalidomide. Those were visible milestones. They felt measurable. Applaudable.

But maintenance is different.

Maintenance is choosing not to keep the size 18 “just in case.”
It’s planning meals because appetite suppression isn’t quite what it was.
It’s stretching daily, even when nothing hurts too much.
It’s booking the eyesight test before things become a problem.
It’s upgrading the radiator instead of just putting on another jumper.

Maintenance is a decision to stay steady.

With Mounjaro, the early months were about loss — weight coming down, food noise quietening, habits tightening into place. Now I’m at my lowest weight ever. I’m not trying to lose more, but I am determined not to drift backwards. That requires awareness. Planning. Honesty about increased hunger. A willingness to adjust rather than pretend nothing has changed.

Maintenance isn’t passive. It’s active stewardship.

The same applies to Mum’s care. To charity work. To relationships. To our home. Things don’t hold themselves together. They require small, often invisible inputs of energy. Quiet decisions made early enough to prevent bigger problems later.

There is a certain satisfaction in this stage. A maturity to it. I am no longer constantly reinventing myself. I am tending.

And tending, I’ve realised, is a skill.

It takes discipline to stay at a healthy weight.
It takes humility to ask for help when needed.
It takes foresight to recruit before there’s a crisis.
It takes confidence to throw out the clothes that no longer fit.

Maintenance may not look dramatic from the outside, but from where I’m standing, it feels like strength.

Steady doesn’t mean stagnant.
It means cared for.

And at this stage of my life, that feels like success.

Mounjaro Journey – Week 37 (5mg every 5 days)

flidfit Disability, Exercise, Mounjaro, Pain, Recipes, Travel & Holidays

A nice quiet week, ahead of what promises to be a busy one.

The most exciting event was a visit to our chiropractor. We tend to go every couple of months for a “maintenance” appointment. I first started seeing him just under five years ago after a fall on holiday in Majorca, when I tripped, fell forwards headlong to the ground, hitting my head on a wall on the way down.  Because of my shortened arms, I wasn’t able to break my fall properly and sustained a severe whiplash injury.

Immediately afterwards, I had no sensation in my legs and intense pins and needles in both arms — like shards of glass embedded in my hands. I was whisked off to hospital by ambulance. Unfortunately, unlike in the UK, there didn’t seem to be any assessment of neck pain or altered sensation. I suspect quite a bit was lost in translation, and perhaps the paramedics didn’t fully grasp that I had effectively head-butted a wall.

Thankfully, the fall happened right outside our hotel, and the receptionist — who spoke excellent English — came out to interpret for the paramedics.  I had to request that they fit a neck brace before they moved me, as at that point, I knew I’d damaged my neck and potentially my cervical spine.

I was x-rayed, told my neck was fine, and sent back to the hotel in a taxi. I was in excruciating pain and hadn’t been offered any pain relief. I took ibuprofen and paracetamol, and the following day, attended a different hospital where I was properly examined and given stronger medication. The remainder of the holiday was slightly marred by pain. On returning home, my GP advised me to go straight to hospital to rule out a possible bleed on the brain.

Thankfully, there wasn’t one.

That episode led me to our wonderful chiropractor, whom I’ve been seeing ever since. Treatment involves consultation, manipulation, exercises, traction machines, and six-monthly progress reviews with x-rays and posture imaging. The visits keep me relatively pain-free and have made me much more disciplined about daily neck stretches and limiting too much time at the computer. The staff are lovely too — we always feel genuinely welcomed.

It looks like an instrument of torture, but this neck traction became part of my regular routine for a while!

The weather this week has been rain, rain and more rain — until Saturday, when we were treated to bright blue skies and sunshine. It was bitterly cold though. The log burner has been on all day, most days, and turned down low overnight.

On the Mounjaro front, I’ve definitely noticed an increase in appetite and a drop in appetite suppression. I’m mindful not to let that derail my efforts. I plan my meals carefully so they’re ready to go, which prevents me from reaching that point of ravenous hunger where anything in sight seems appealing. The 5mg dose still takes the edge off, thankfully, but it’s a reminder that the habits I’ve built over the past decade really matter.

Cooking has been simple and satisfying. I made a delicious tomato soup using tomatoes from last year’s harvest — pulp that had been cooked and frozen. A small bowl is incredibly satiating. We’ve also had salads, prawn stir-fry, sticky beef stir-fry, and steak with mushrooms and onions.

I dusted off the bread maker and made a couple of malt loaves — far superior to anything from the supermarket. Once cooled, I slice and freeze them in two portions so we can enjoy them over several weeks. We took one over to Mike’s grandson’s family on Sunday, which was very well received.

A quiet week perhaps — but the kind that quietly reinforces routines, resilience, and gratitude.  Time to appreciate home-cooked food and my love of cooking!

Weight this week: 55.4kg (about 8st 10lb)
Last week: 56.1kg (about 8st 11.5lb)
Weekly loss:  0.5kg (about 1lb)
Goal weight: 55kg (about 8st 9lb)

Mounjaro Journey – 15 weeks 7.5mg

flidfit Disability, Eating Out, Eating Out, Exercise, Mounjaro, Pain, Travel

Ever since I started taking Tirzepatide, many of those whom I’ve told ask me the very same question.  “What happens when you stop taking it?”

The short answer is, I don’t know.  Taking Mounjaro long-term at a reduced dose may enable me to maintain my weight in the future.

What I do know is that the extra boost I get from the drug in terms of appetite suppression and switching off my “food noise” has really made a massive difference.

The use of Mounjaro to assist my weight loss journey is just one small step or strategy helping me to stay on track with my weight loss journey.  A journey that has been over 13 years long.

13 years is a long time to be diligently logging food, weighing every item that one eats and drinks, keeping within a daily calorie limit and never really taking one’s eye off the ball.  Social occasions, days out and holidays present a challenge.  I need to stay on track and continue as best I can with my journey.  One bad day or a week’s holiday cannot derail me.

Of course, I do relax a little when I’m on holiday, but I soon realised that I can’t really ever take my eye off the ball…. I used to, but then I came to recognise that it’s very easy to gain weight that has taken me a great deal of time and effort to lose.
Inevitably, I am eating and drinking more when I’m away from home.  I’m unable to weigh my food portions.  I am also moving less.  Without my gym ball, my daily exercise routine doesn’t happen.   I am much more reliant upon my wheelchair.  At home, although I’m not particularly mobile, I still move about when doing housework, walking from room to room, preparing meals, etc.  Each day starts with my exercise, about 45 minutes of stretching and bouncing.

The other thing I have recognised this week is the huge wealth of valuable knowledge and experience I have around losing weight when you have a physical disability that severely impacts on your activity levels.  It’s time to share that with – whoever wants to hear about it – and I am sure that there are many out there who (like me!) have used their impairment / illness / lack of mobility as an excuse as to why they are overweight and why they can’t lose their additional weight.

When I started on my weight loss journey, the road ahead was long, and of course I wanted to lose that weight quickly and without effort.  Once I accepted that it would take time and I could reap the benefit of my effort and see regular small weight losses, things became much easier.  I just accepted that I needed to do my best every day and to keep on keeping on, things became easier.

That was my starting point.  A severely obese (BMI of 44), very short, disabled woman who ate to excess and didn’t move at all.  I sat in front of my computer or in front of the TV.  Then went to bed to sleep.
If anyone had told me in 2012 that I’d lose 4½ stone in 18 months and would be exercising daily, I’d never have believed you.  Of course, written like that, it seems an incredible achievement.  I never set myself a specific goal.  I didn’t go from zero to one hundred in days or even weeks and months.  I began slowly – doing what I was able to do and gradually increasing the amount I moved.  My confidence grew in my ability to set and achieve weight loss and fitness targets.
A little corner of our garage provided me with my own gym
I have covered my introduction to exercise in the very early days of my blog.  I had a few sessions with a personal trainer from the Physio clinic I attended to explore cardiovascular exercise that I could manage.

From there, I progressed to strength training and HIIT (High Intensity Interval Training) in my own home gym equipped with a treadmill and other small items of gym equipment.  A little corner of the garage provided me with the perfect gym – just a few steps from my front door.

During 2014, we cared for a terminally ill relative who lived with us for the final 14 months of their life.  The garage gym provided me with a welcome respite from the situation.  Whatever the weather, I could be “at the gym”.  I didn’t have to worry about traffic, suitable weather or finding a parking spot.  I could fully immerse myself in my exercise session.

This was to stand me in good stead for dealing with the period of the two Covid-19 lockdowns in 2020.

I started to run!  I gradually built up my stamina to walk for sustained periods initially (on the treadmill, whilst holding on to a support bar.  Later I began to walk faster and then run using the Alter-G anti-gravity treadmill, which was available at a private hospital just a 10-minute drive from my home.  Running was something I had never done.  The last time I ran was at secondary school, not wishing to end up too far back in the very long lunch hall queue….

This week, I’ve started vlogging…. I am aiming to share aspects of my weight loss journey with those who may be looking for inspiration or ideas.  I’m using CapCut and YouTube, but – be warned – I’m learning new skills along the way.  Rather like this Blog, it will be a bit rough and ready as I get to grips with how to achieve what I want and the capabilities of the software, which is streets ahead of my own video-making capabilities!
Weight loss this week:
Last week’s weight:  62.7kg, this week 62.0kg
This week’s loss: 0.7kg (1½lb)
Total loss since starting Mounjaro, 2nd June 2025: 9.4kg (1½ stone)
Total loss in 13 years and 7 months:  – 27kg – down to 62kg from 89kg (4st 3½lb)

 

 

 

 

 

Weight loss injections – Mounjaro

flidfit Disability, Emotional well being, Mounjaro, Pain

It’s been a little quiet around these parts lately.  I’ve been struggling.

The weight loss has plateaued at about 70kg – 14kg (2 stone) more than I’d like it to be (my goal weight).  Which is 57kg.

The additional weight isn’t particularly noticeable to others, but I can feel it.  It impacts my mobility, and it probably increases my pain.

I had three holidays in a row (December 24, January 25, and February 25) – my weight jumped from 69kg to 75kg!  I have managed to shift some of that (currently 71kg), but it’s becoming a slog.  My measly calorie allowance for weight loss (1,100 calories a day) leaves me feeling hungry, and I turn to snacks.  I am still meticulously weighing and logging all of my food and drinks.

A couple of small snacks (usually afternoon and evening) are enough to push me over the upper limit.  It’s quite depressing…

I began to research weight loss injections – which do seem all over the news at the moment…  I found articles about the psychological process of turning to medication to assist with weight loss and to accounts from those who are already using the medication.  I also booked a call with the Thalidomide Trust’s GP, who alongside her role working for the Thalidomide Trust, works for the NHS in Tier 3 weight loss services, working with dieticians, nurse prescribers and others offering weight loss services and care to the NHS.  Whilst it is likely that weight loss injections may become more widely available via the NHS in the Summer – and that I’d be eligible (with a BMI 30+), I just feel I can’t afford to wait any longer for the weight to continue to (potentially) creep up any further.

I’ve been very happy that I have never returned anywhere near to my start weight (88kg in 2012) but my age and likely deterioration in mobility and fitness are working against me.  Food and calorie counting have taken over my every waking moment!

It was after a lot of research and discussion with others that I have made the decision to try out Mounjaro and see whether it can help me in the way that it’s helping many others.

“Patients could achieve at least 20% weight loss after using tirzepatide for 72 weeks (18 months) when combined with healthy lifestyle changes”

– which, should I achieve – will take me to my goal weight.  I have already made the healthy lifestyle changes, my head is in the right place…. I now just need that little boost!

It is possible to pick up weight loss injections via on-line pharmacists, but I have opted to sign up with Voy, which alongside sending out the prescribed medication provides me with a network of support and further advice should I need it.

My first delivery arrived over the weekend (posted out in a refrigerated/insulated package) and yesterday was my selected day to take my first dose.  You take one dose each week, for four weeks starting at 2.5mg – which is gradually increased each month  (so 2.5mg, 5mg, then 7.5mg, then 10mg, then 12.5mg and finally 15mg) depending on how well your body tolerates the dose and the body’s response.  There can be side effects – however, there are resources on the website to help you in managing and dealing with these.

So the first injection went into my system, yesterday – so far, so good.  I don’t feel any differently yet, but it’s expected that you start to feel the effects after about a week.  I’m looking forward to the “food noise being switched off” that so many report!

In the meantime, I am making full use of the Voy App to monitor my meals and try and tweak the balance of those meals.  I’ve already identified that I have probably not been eating enough protein each day to keep me feeling satiated and full (to prevent between meal snacking)

Join me on this journey and message me here via the Blog – or privately if you’d prefer.

Oh, and if you feel inclined to give Voy a try, let me know.  this will take you to a link for 25% off your first order (and I’ll get 30% off my next order in return….)

Back to exercise

flidfit Disability, Exercise, Pain

I’ve been exercising more or less every single day since before the COVID-19 pandemic.  My exercise regime involves bouncing vigorously sitting on a gym ball whilst swinging my arms for about an hour and a half.  This is great for increasing my heart rate as well as keeping me moving, flexible and pain-free.

However, whilst on holiday in January, I began to experience an excruciating shooting / burning pain in my right knee.  Anytime I needed to move from being seated to standing, I had to brace myself for the pain that this would cause.  I’d spent a lot of time on that holiday sat in my wheelchair and I believed this to be the cause.  Once I’d managed to get from having my knee bent to straight, the pain would subside.  But it didn’t really vanish.  At night time it was quite unbearable and would often wake me at night.  I’d then find it really difficult to get back to sleep.  By the start of May I was relying on Paracetamol to get me through the night.

My daily exercise regime had to stop.  It was just too painful.  I was really missing my exercise – not just the physical side of it, but the emotional escape too – time for myself. As there was no other non-weight-bearing exercise that I could do, I was planning to go back to swimming and see whether that would be a suitable alternative way to keep myself moving.  The difficulty with swimming is that I need support from another person to go swimming, in terms of getting myself changed and dried.  Plus it wouldn’t be something that I could do daily.

The thing I most love about my bouncing is that it is something that I can do alone, in the comfort of my home, and it doesn’t matter what the weather is doing.  I don’t have to worry about travelling to a venue and parking or getting my wheelchair in and out of the car.  Once the exercise is finished, I can just continue with my day.

X-rays arranged by my GP revealed “advanced osteoarthritis” – much to my surprise.  I’d not had any sort of pain in this knee before.  I was referred to a consultant specialising in knees.  I was reassured by the fact that he had seen and treated other Thalidomiders.

So on Tuesday 4th June, I travelled to the Spire Bushey Hospital, just over an hour’s drive from where I live.  The consultant showed me the x-ray and said that although a knee replacement would be needed at some point, this wasn’t something he’d want to do immediately.  I must admit I was pleased to hear that, as the thought of being immobile following the surgery isn’t something I’d relish – plus, of course, there is always the risk that the surgery isn’t a success.

One of his suggestions was an ultrasound-guided steroid injection (Hydrocortisone) into the joint.  I’ve had steroid injections before into my hip for bursitis.  The first was very successful, and I was pain-free for about six months.  But the following two didn’t seem to make any difference.

I was told that if I chose to go down this path, I could have the injection that day.  I quickly made up my mind to take this option.  The pain was increasing and starting to interfere with other aspects of my life and emotional well-being.

A lovely member of staff gave me the injection, and the pain was reduced almost immediately.  Mind you, I’d had local anaesthetic injected into the site at the same time.

Three days later, the pain was noticeably reduced.  In fact, I could feel pain in my other knee – which I’d never noticed before.

Five days later, I felt confident to try to get back to my exercise.

I’m pleased to report that I’ve been able to resume my exercise – I’m back to my daily 1.5 hours of bouncing!

Let’s hope that the steroid continues to do its job.  I am limited on how frequently these injections can be administered, and, from previous experience, follow-up injections may not be as effective.

But in the meantime, I’ll just enjoy my bouncing.

And getting a good night’s sleep….

The Heart Rate Monitor (HRM) – A useful exercise incentive

flidfit Disability, Pain, Travel

For those who haven’t met me, I have a severe physical impairment. I was born with my arms shortened to elbow length, just three fingers on each hand, and my femurs (thigh bones) shortened to about 30cm on both sides. This is as a result of the drug Thalidomide (see Google for further info on what this was!)

My left leg is about 4cm longer than my right. My lower back has a slight curvature. I don’t have any proper ball-and-socket joints in my shoulders or hips. My walking gait is severely compromised. All of my life, I have been unable to walk very far (about half a mile maximum before I need to stop and rest). Of course, none of this helps with weight and my being able to exercise.

In 2002, whilst I was on holiday in France, I set off on the wrong side of the road (driving) and had a head-on collision with a car coming towards me. Although we both braked and took avoiding action, we met in the centre of the road. The force of the crash was so bad, it fractured my right ankle (through the accelerator pedal) and my car was written off. My daughter (aged 5) and my then husband were both also injured – my daughter my the force of the seatbelt on her collar bone and hip, and my ex-husband (because he put his left arm out and braced himself) injured his left wrist and ankle. Thankfully, neither of their injuries was severe

I had to have immediate surgery to plate and pin my right tibia and fibula. Our holiday was… urrrm, extended (shall we say) and I was flown back to the UK on a private plane (thanks to the holiday insurance company).

I couldn’t walk as I couldn’t use crutches (because of my shortened arms). I was forced to use a wheelchair outside of the house so that I wasn’t housebound. I had my (new) car adapted with a wheelchair hoist to accommodate my powered wheelchair.

My right ankle never healed. Although it wasn’t (prior to the accident) affected by my disability, it failed to regain its full movement/mobility and I was in constant pain. Despite physio, my ankle was swollen all the time. I’d be forced to go upstairs to bed at 6pm just to elevate my ankle and try and reduce the swelling.

About 8 months after the accident and with no improvement, and after getting a second opinion from an ankle/foot specialist, I had further surgery – an arthrodesis. They remove all the cartilage from all parts of the joint and pin all the bones of the ankle to permanently fuse the joint at (approx) 50-degree angle from the leg. The aim was to get rid of the pain and to prevent any more arthritis from setting into the joint (my ankle bones were all moving out of position)

Sadly the ankle isn’t that much changed – I still have pain, it’s still swollen…. I can’t walk even one step without severe pain. I use a powered wheelchair when outside of my house, but it’s kept in the car. I can manage to walk around the house, and I can manage stairs with extreme difficulty (I come down in the morning and go up at night). 

Doing ANYTHING for me requires far greater effort and exertion than it would for most people. Because of my short arms, getting washed, dressed, showered… takes me twice as long (at least) and possibly takes twice as much effort. I haven’t really been able to walk (other than around the house or out to the car) for over 10 years. My weight increased. My (slight) asthma worsened. I was possibly even a bit depresse,d I am guessing (most people would have been I think!). I gave up paid work, and suddenly for the first time in my life I had to arrange for some help around the house with housework, shopping, laundry, etc – and yes, even caring for my daughter (which was really hard…)

So…. back to exercise and my HRM… the treadmill…. walking…..

I’ve been swimming once a week for about 8 months now. I go and swim for an hour on my back (can’t swim on my front because of my short arms and arthritic neck). I wear swimming fins (shortened flippers), which help me move through the water but also provide greater resistance so my legs/ankles have to work harder to power me through the water. BUT I wanted something to help me with cardiovascular exercise.

A week ago, I borrowed my ex-husband’s treadmill with a view to being able to start exercising regularly. Bear in mind, I’ve not walked for 10 years (in the proper sense of the word). I know because of the weight loss that my fitness has already improved. I don’t feel as if I’m having a heart attack when I overexert myself now! My asthma seems to have vanished.

I planned to start by walking a quarter of a mile. However, on my first attempt, I walked half a mile. I did this at a slow pace (1.7 mph), and I had to stop every five minutes. But I did it.I have been visiting a personal trainer (one assessment, one session last Friday), because I recognise that I need to make sure I don’t overdo it. And I bought my HRM because I wanted to monitor any improvements in my fitness levels and ensure that I was giving my heart a really good workout.  

Today I’ve done 20 minutes (with two stops, not letting my HR return to less than 120 bpm). It took me 29 minutes (20 mins walking, 9 mins resting), my average speed was 1.7mph. My average heart rate during the session was 140bpm, the highest it got to was 159. My HRM tells me I burned 390 calories.

I’ve compared this to what I would earn were I “normal” (hate that word, but you know what I mean!)

Regular 20-minute walking on a treadmill would have earned me 53 calories. 

However, my HRM tells me I earned 390 calories during the 29 minutes, which minus background calories leaves me with 281 calories. That’s over 200 calories more than

So – the purpose of this post is to (1) encourage EVERYONE to try and do some form of exercise and (2) to encourage people to use HRMs to give themselves a more accurate idea of just how hard – or not – they are working themselves.

I kind of thought I was burning a lot more than an online exercise calorie calculator tool on the weight loss website was giving me, but I hadn’t realised that the difference would be quite so mammoth!!! 

The Target Heart Rate Zone (65-85% of Maximum Heart Rate) is an area of moderate intensity activity that leads to improvements in your aerobic capacity and burns fat.  This zone provides many benefits for all fitness levels, including those who want to lose weight, those who are training for an athletic event, or those who are looking to have more energy and get fit. 

Exercising below this zone (50-65% of Maximum Heart Rate) is the fat-burning zone, because at this intensity, fat is metabolised for energy use at a higher rate.  This intensity is often recommended to individuals who are extremely deconditioned or new to exercising.  While the name of this zone leads you to believe that you will burn more fat in this zone, there is less cardiovascular (heart) benefit in this zone and less overall caloric burn.  Again, if you are deconditioned, have a heart or respiratory disease, or are new to exercising, this would be an appropriate zone for you. 

The High Intensity/Anaerobic Zone (85-100% of Max Heart Rate) is recommended for highly fit individuals, such as athletes.  This zone places a high demand on the cardiovascular system and does not burn much fat.  Individuals may use this zone as part of “interval training”, where your heart rate reaches the High Intensity Zone for a short period (less than 60 seconds) and is allowed to recover to the Target Heart Rate Zone (65-85% of Max Heart Rate) for a period of time (60 seconds to 4 minutes).

Warm Up and Cool Down

Always remember to start each exercise session with an easy warm-up.  You can use a heart rate zone of less than 50% of Max Heart Rate to guide your warm-up.  As a general guideline, a warm-up can be something as simple as walking for 5 to 10 minutes or just a slower version of the exercise you are going to perform.  Additionally, take 5-10 minutes after your exercise to do a cool-down.  Slow down your movement, stretch and try to get your heart rate back down to less than 50% of maximum heart Rate.

 

Use this chart to estimate your heart rate in bpm for each intensity zone

  50% 55% 65% 75% 85% 95%
Age (220-Age) x .5 (220-Age) x .55 (220-Age) x .65 (220-Age) x .75 (220-Age) x .85 (220-Age) x .95
20 100 110 130 150 170 190
25 97.5 107.25 126.75 146.25 165.75 185.25
30 95 104.5 123.5 142.5 161.5 180.5
35 92.5 101.75 120.25 138.75 157.25 175.75
40 90 99 117 135 153 171
45 87.5 96.25 113.75 131.25 148.75 166.25
50 85 93.5 110.5 127.5 144.5 161.5
55 82.5 90.75 107.25 123.75 140.25 156.75
60 80 88 104 120 136 152
65 77.5 85.25 100.75 116.25 131.75 147.25


Target Heart Rate