I've been working as a substitute special education paraprofessional (para) at a high school since the beginning of the school year. Teaching has never really been a serious career option for me; I didn't think I'd like working in that environment all day every day for the next 30 years of my life.
How teaching applies to life with RA
But as it turns out, here I am going to school every day and working with students who have behavioral problems as well as mental, physical and learning disabilities. Probably needless to say, it's a really challenging job. But I've been pleasantly surprised at how much I like it. I really like the kids, for the most part. Sure, there are days when I want to tear my hair out and never look at or listen to another obnoxious, whiny teenager again. But the often-rare times when I feel like I'm actually connecting with them and that I'm able to help them with something--whether explaining math problems, giving encouragement in gym class, or teaching a kid how to tie her shoe--it's a rewarding, special experience and doesn't feel like just a paycheck or a tedious time filler. It's also an interesting situation to find myself in, helping teenagers who have varying degrees of limitations and disabilities when I also struggle with my own limitations from having RA. I think about that often when I'm with them, and I hope that connection helps me to be a more empathetic, understanding teacher.
Lose RA weight using SMART goals
But what does this have to do with RA other than that I'm hanging out with a bunch of kids with disabilities? One of the special education classes I help out in is a "life skills" class, comprised of a small number of students who most of the time are more interested in messing around on their school-issued iPads and ignoring the teacher than learning any life skills. They could really care less, it seems. I, on the other hand, am finding myself liking this class more and more and could see trying to apply some of the topics and issues we talk about to my own life. One class recently was about goals: defining goals, setting goals, working towards goals, keeping goals. Each student was supposed to fill out a worksheet concerning a goal using the "S.M.A.R.T." goal model that he or she was going to commit to fulfilling during the school year. I walked around the class, trying to help the kids fill out their sheets and to think about goals they might have to use for the assignment. As I talked to the students and kept looking at the questions I thought--hey, I should probably do this too.
A SMART Goal
A major goal of mine is to lose weight, and it has been for a long time. This isn't easy for most people, but it's especially difficult when you have a painful chronic illness like RA. How are you supposed to exercise when your joints are swollen and inflamed and it hurts to even get out of bed? How can you stay at a healthy weight when you're constantly pumping your body full of medications, especially ones notorious for weight gain (steroids, anti-depressants)? Achieving the goal of losing weight in a healthy manner takes a lot of focus, willpower, determination, and dedication. That's hard. Really hard. I often feel like I get trapped in a vicious cycle of being in pain, being fatigued (physically and emotionally), feeling demoralized and overwhelmed. It's hard to stay on track and pumped up about losing weight, even if it's a goal you really want to reach, when your body (and mind) wants you to lie on the couch watching TV and eating chips instead of going for a bike ride and choosing healthier foods. But it's not impossible, and I know that.
Exciting news: I have lost about 15 pounds in the last year and a half! But I still have a long way to go to get back to my normal, healthy weight that I was about 9-10 years ago (I still need to lose 30-40 pounds).
So what does S.M.A.R.T. stand for?
S - Specific: Does your goal clearly and specifically state what you are trying to achieve?
M - Measurable: How will you (and others) know if progress is being made on achieving your goal? Can you quantify or put numbers to your outcome?
A - Attainable: Is achieving your goal dependent on anyone else? Is it possible to reframe your goal so it only depends on you and not others? What factors may prevent you from accomplishing your goal?
R - Relevant: Why is achieving this goal important to you? What values in your life does this goal reflect? What effect will achieving your goal have on your life or on others?
T - Time-bound: When will you reach your goal? If your goal is particularly large, try breaking it down into smaller goals with appropriate incremental deadlines.
Example SMART worksheet
1. What is your goal in one sentence?I want to lose 20 more pounds.
2. The benefits of achieving this goal will be?Losing weight will help me to look better and feel better mentally, emotionally, and physically. I'll gain more self-confidence and self-esteem and I will have more energy to do the things in life that I want and need to do. I think losing weight will also greatly help with my RA and will decrease my joint pain, especially in my feet and ankles. Losing weight will help me feel a LOT better and healthier in so many ways.
VERIFY THAT YOUR GOAL IS S.M.A.R.T.
Specific: What exactly will you accomplish?
I will lose 20 pounds. And in doing so, I will feel and look and be healthier.
Measurable: How will you (and others) know when you have reached your goal?
I already have regular weigh-ins at my doctor appointments (every couple of weeks) and I will keep track of how many pounds I'm losing (or not losing) during this process. I should buy a dependable scale to use at home, too.
Attainable: Is attaining this goal realistic with effort and commitment? Do you have the resources to achieve this goal? If not, how will you get them?
Yes, I think attaining this goal is realistic, even though it often feels daunting and impossible. If I work hard and stick with it, I think I can reach my goal. I do have some resources to reach my goal, such as using an online calorie and fitness tracker (www.sparkpeople.com), and having access to the Internet in general to help with finding healthy recipes and cooking ideas. I also have a bike and small hand weights to use to help me get more exercise.
Relevant: Why is this goal important to you? Hone in on why it matters.
Similar to what I already stated, I just really want to be healthier and to get back to feeling like my "normal" self regarding my body weight and appearance. I want to have more energy, and I want to look better and have my clothes fit me well again. But most importantly, I want my RA and joint pain to decrease.
Time-bound: When will you achieve this goal?
From what I've read and heard from doctors and nutritionists, a healthy way to lose weight is to lose no more than two pounds per week. So if I can lose an average of approximately two pounds a week, it should take me about 10 weeks to reach my goal. However, realistically, there will be ups and downs while doing this, so it will probably take me closer to three or four months? I will set my goal at three months though.
Action steps to reduce RA weight gain
1. Get my bike tire fixed so I can go riding again (biking and swimming are basically the only types of exercise I can do due to my bad ankles)
2. Log back into my Spark People account and start tracking my daily food and exercise again
3. Make a list of healthy food and groceries/meal plans
4. Cut out eating foods with chemicals and preservatives (Diet Coke, pre-packaged stuff) and try to only eat whole foods
5. Buy a good scale
6. Tell my doctors about my weight loss plan/goal
7. Call the Courage Center to find out information about getting a pool pass and/or aquatic exercise classes (I've taken classes before there, the warm water pool is great!)
8. Get on a regular bedtime schedule (in my bed, not on the couch in front of the TV) and get enough sleep each night
9. Don't skip meals
10. Cut back on snacking--especially for emotional reasons (boredom, anxiety, depression)
11. DRINK MORE WATER
12. Talk with others who can be supportive and understanding of my goal
Addressing potential challenges
Hunger/Cravings! According to my Spark People account, in order for me to lose weight my daily caloric intake is only about 1200-1600 calories. That feels like hardly anything! Although I know from the past year of successfully losing some weight that once I get past a lot of the cravings, especially carb cravings, a lot of the "hunger pangs" go away. So I need to stay strong at first and just get through it. And/or make sure that I'm eating foods that are high in fiber and will fill me up and sustain me better than empty calories.
RA Pain - This is a huge challenge to losing weight. When I'm in pain, I do not want to exercise. And I want to comfort myself by eating "treats" (bread, chips, pasta, sweets, junk food). Of course if I'm having a bad flare-up, it's probably not a wise idea to jump on my bike or go walk 10 miles or anything like that. But even just the daily pain that's always there--I need to find some way to deal with that not using food to make me feel better. Any tips?
Medications (Prednisone) - Unfortunately I just started taking prednisone again because of my right foot and ankle flaring up. Actually the left ankle is flaring up too, but not as bad as the right one, as usual. This is so frustrating and disheartening because one of my main arthritis goals in life is to stay off the dreaded (yet wonderful) prednisone. It's a great treatment for decreasing inflammation quickly and efficiently. However this potent drug has some nasty side effects, such as increased appetite, mood changes, water retention, anxiety, insomnia, and the list goes on. I've been off of it since early June so it's really disappointing and depressing having to go back on it again. The prednisone is helping my ankles and foot though, so that's a relief. And, I have lost weight in the past even while taking prednisone, so I know it's possible. I just have to be extra careful about watching what I'm eating while taking this medication.
Impatience - One of the biggest challenges I always face when trying to lose weight is feeling impatient and frustrated at not seeing results quickly enough. Then what happens is that I get so frustrated and disappointed that I usually give up and go back to my normal eating habits, not paying attention to what I'm eating or doing. I know there is a science to this thing--that you have to burn or cut out 3,500 calories to lose just one pound. Unless you have a crazy high metabolism or you're starving yourself, the pounds aren't going to all fall off at once (starving oneself isn't a great option anyway). It's hard to remember that when you feel like you're working really hard and nothing is happening. Reminding myself to be more patient is definitely something that I will need to do and continually work on if I want to reach my weight loss goal.
I'm sure there are more challenges and obstacles I could list, but I think these are the main ones.
So this is my S.M.A.R.T. goal plan: LOSE 20 POUNDS! A lot of people do it, and I know I can do it, even while having a painful chronic disease. If anybody has some good advice or tips to share with me, I would love to hear them!
Thank you for reading and sharing in my new weight loss goal and journey!
("S.M.A.R.T. Goal Worksheet" courtesy of Spring Lake Park High School)
After the past 2+ years, how do you feel about telehealth appointments to manage your RA?