Non-School Related: How I lost 40 pounds

So, if you're Facebook friends with me or follow me on Instagram, you've probably seen a couple of posts updating people on how much weight I've been able to lose in the last several months. I've had several of people message me like "Hey, what are you doing to lose weight??" so I thought I would write out pretty much everything I've done so far to get to where I'm at.

I kind of officially started all this about 11 months ago in mid September after seeing some of the photos of myself from vacation and what not.

As much as I want to make an excuse for myself as to why I was the heaviest I had ever weighed, there still really isn't any good excuse for it. Yes I was going to school full time and yes I was working part time during the week and on the weekends. And because of that, I had allowed myself to eat fairly unhealthy and had pretty much zero exercise. The end result being my gaining an additional 10 pounds my last year of college. Not accounting for the extra I had already gained the previous years of college.

I was really unhappy with where I was. Growing up as a kid, I would say I was always on the border between whatever "normal" was and being overweight. I never considered myself skinny by any means and that's just how it was. I was okay with it. What I was not okay with was how all that weight had crept up on me while I was studying my little behind off at school. I mean, it makes sense now that I look at it. I'd be at school all day, come home and study or do homework the rest of the night, eat junk, do no exercise. Duh, of course I was going to gain weight.

So a couple weeks into September last year, I decided I was going to make a change because I was tired of seeing that number on the scale as well as myself in pictures and in the mirror.

I bought myself some desperately needed new running shoes (my previous shoes were over 4 years old) and probably splurged a little more than normal and got the ones I really wanted in hopes that it would motivate me to do more. I also used some of my birthday money to get myself a polar heart monitor watch that would track my workouts with how many calories I burned, etc.

I also started to change my eating habits. I stopped buying the sugary "little kid" cereals that I loved so much. I stopped buying the stupid amounts of soda that I would drink. I didn't really have a specific diet that I stuck to, but my overall effort was to just to eat less.

I then started using my new shoes and heart monitor to go for short runs. I got started by using a Couch to 5k app on my iPod. For those that don't know how those work, it literally starts you running maybe just a minute at a time and then will have you walk a few minutes, then run another minute, then walk and so on. With every week of progress, it slowly increases your running time to 3 minutes at a time or 5 minutes at a time with the idea being at the end of 8 or 12 weeks (however long your program is), you should be able to run a 5k without stopping (or 3.1 miles).

That was rough getting used to. Being at my heaviest, I'd never gotten so tired so fast. Even a couple weeks down the road, after I could tell my lungs were starting to get used to it because I wasn't breathing so hard, my legs would just hurt and hurt while I was running because they probably weren't used to the extra weight I was carrying around.

At my white coat ceremony at the beginning of October
I had lost around 7 pounds at this point.

And that was basically all I did at first. I lost about 11-12 pounds within a couple months. Nothing super drastic, but it was certainly a start.

Then I plateaued. I think part of that was due to Thanksgiving and Christmas. That and winter quarter of school was a lot harder than our fall quarter and I had kind of stopped my exercise routine because I was so stressed out over school. 

At the end of February over our spring break, I decided I was going to start again. I fortunately had not gained any of the weight back that I had lost previously, so it was like I was picking back up where I left off. But I picked it back up with a little more intensity this time around.

I started calorie counting. I know, I know, it seems like over-doing it to a lot of people and seems like its tedious. But, it wasn't until I started doing this that I realized just how much I was overeating. I limited myself to 1200 calories max a day. Some days I'd barely break 1000. I used the MyFitnessPal app to count everything that I ate. And wow, did it work.

As far as food goes, I started using protein shakes and protein meal bars as meal replacements (each about 200 calories). I'd have a small banana and protein shake for breakfast. A small snack before lunch. A protein meal bar for lunch. A small snack when I got home from school. And then a Lean Cuisine frozen meal for my dinner.

I'd be lying if I said this wasn't hard. But unfortunately that's just part of it. For the first month or so, I often went to bed hungry. It wasn't comfortable, but I knew it wasn't supposed to be so I endured on because it was helping drop that number on the scale.

Left: August 2013
Right: March 2014 about 19 pounds lighter

In addition, I picked up running again. But this time, instead of using my Couch to 5k app, I just started going for longer distances. There's a nice 5 mile loop trail very close to where I live. I started jogging it/walking it/jogging it or whatever I could do. As long as my legs didn't feel like they were about to fall off or that I was going to collapse because I felt like I couldn't breathe, I was running. And when I needed to stop, I stopped and walked. This would usually take me about an hour to do and I was doing it at least 4 if not 5 times a week. My heart rate monitor told me that I would burn somewhere between 600 and 700 calories each time.

Once I started this combined with my new eating plan, the weight literally just started falling off. I'm pretty sure I lost another 10 pounds in the course of just 2 to 3 weeks. By the time the school year was done, I was down a total of 30 pounds.

It's been almost 3 months since then and I've dropped another 10 pounds since. I'm not quite as strict on my diet anymore but instead have tried to maintain the mindset of "everything in moderation". Like, yes, I do want that ice cream when I'm out with my family or friends, but I'm going to order the small size and enjoy it. I figure if you let yourself have small treats every now and then, you're going to be less likely to binge later and eat everything in site on account of going crazy from restricting yourself so much.

Another mindset I've been trying to adopt lately, and as cliche as it might sound, is "Eat to Live and not Live to Eat." I'm pretty sure I've always been an emotional eater since the start and I was definitely the type to grab something to eat if I was "bored". Now, simply I'm just trying to eat for the purpose of sustaining myself and keeping my energy where it is needed. Again, it's not an easy thing to adapt to, but I am leaps and bounds ahead of where I was a year ago and because of that, I am super happy with how far I have come.

One more comparison
Far right: About 38 pounds lighter than from the far left

I'm still running a lot when I can. I did a 10k (6.2 miles) at the start of July and finished it in just barely over an hour at about a 10 minutes a mile pace. It was a pretty tough course with running up rocks/jumping over water/etc. so I think that time was pretty decent considering where I was at 6 months before that even. However, right now, I'm just ready for cooler weather! The highs are still well in the 100s in Phoenix, meaning that if I want to run, I have to do it super super early in the morning when it's still only in the mid 80s. I am SO ready for fall! Haha.

About a mile into my 10k race in all my sweaty glory, haha

And that's about it! I am still working at dropping my body fat percentage just a little bit more and attempting to build up some more muscle. Easier said than done because in order for muscle to be gained, you need to eat more, which is the opposite of what I've been doing. It's a learning experience for sure.

Left: White Coat Ceremony October 2013
Right: Friend's Wedding Reception August 2, 2014

If you're reading this for the purpose of wanting to lose weight yourself, then I hope it helped! I know that everyone's body and metabolisms are different and what worked for me might not work for you and vice versa, but this was my own personal story of what worked for me. Honestly, it's a lifestyle change overall. You have to be able to be okay with the fact that it might take a little while to get to where you want.

It might be hard, but trust me when I say that it was all worth it in the end. I honestly have never had so much energy and have never felt so good before which makes me just want to keep it up.

Longest Overdue Post Ever: 1st year = Check

So...you might have guessed it, but grad school is pretty busy. And hectic. And just everything. I was pretty much way overwhelmed with everything the entire quarter and was still just as much even once I was done with my last test. Which...might explain why the last thing I posted was in February. Sorry about that.

I actually might have gotten something written and posted, but the end of the quarter ended up being a little crazy for multiple reasons that I won't dive into. Ultimately in the end, I passed all my classes and am officially considered a 2nd year optometry student now. PLUS I had to hop a plane to Iowa literally the day after my last test to see family and help celebrate my grandma's 80th birthday. So all of that = no post from Sherah.

But! Here I am in the end.

So! What all has happened in the last 5 months? Glad you asked.

As far as skills and practice go, we learned a couple more crucial ones this last quarter.

1. Keratometry

This was a pretty quick one and we only spent one class period and lab learning it. The thing above is called a keratometer and we use it to measure how curved a person's cornea is. This gives us pretty important information for things like contact lenses. It was a little tricky to learn at first, but by the end of the one lab, we all had it down pretty well.

It basically just looks like a miniature telescope. This is what we're looking at when we're doing the actual "measuring" in case you were wondering.

2. Retinoscopy

This might have been one of the hardest things to learn, but is ultimately one of the coolest things (I think) once you start to get the hang of it.

Despite it's name, a retinoscope is not a scope that directly looks at the retina - that would be an ophthalmoscope. I bring that up because we had exam questions written by our basic science faculty (non-optometry of course) that would give a scenario where an optometrist was performing "retinoscopy" and noted certain findings of the person's retina that would indicate (insert whatever eye disease we learned here). So wrong. So! Here's what it REALLY does!

This is how we can estimate someone's prescription without the patient telling us anything. This piece of equipment shines a long narrow beam of light across the patient's eye and we move it back and forth and side to side over the person's pupil. Based on the optics of the person's eye and how light travels itself (which is a whole entire optics lecture in itself that I won't go into), the light will either move in the same direction as you move the scope across, or it will move in the exact opposite direction. What we're looking for is no "movement" of light ultimately and that the whole pupil simply lights up when we move the light across.



We do this by adding lenses in front of the person's eye. Once you get the correct powered lens in place, the whole pupil will simply light up and the power of that lens will be roughly what the person's prescription is. AND they didn't have to tell you a thing. Cool, right?

Side note: This is what is used for small children or babies that would be unable to physically tell you what looks clear or not in the event that they need some sort of correction for their eyes.

I pretty much just made it sound really easy. This took a lot of practice to get used to and to be completely honest, I would only consider myself semi-ok at it. Our professor ensured us that this skill would be something we'd be perfecting pretty much all throughout school, so I'm not too worried.

And lastly...

3. Refraction!

This was the skill that the majority of us were sooo anxious to learn because it's what you mostly associate with optometry. I loved learning it because it's so cool getting to be the one on the other side of everything - helping the person in front of you go from seeing nothing on the chart to seeing 20/20 or better.

So! If you've ever been to the eye doctor before, you probably recognize that thing that's in front of my face up above. This is called a phoropter and it's an awesome tool. Within it is a huge set of lenses that we can control by putting them in front of someone's eye to simulate a pair of glasses.

A lot of times, the doctor will first do retinoscopy (what I just talked about above) and get an idea of where the person's prescription is, especially if they're a brand new patient and have no idea what their eyes are like. They'll then put that "ret" prescription into the phoropter and then somewhat "fine tune" it based on what the patient says that they like.

So this is where we get that whole "1 or 2" thing. We give the patient options with certain lenses. We make the changes based on what they say. If we can get them to 20/20 - great! We stop, write out their prescription, and that's it. Little bit more to it than that of course, but ultimately, that's what's going on.

Other Classes

So, all of the above we learned in just our theory and methods class this last quarter.

Adding to our ocular anatomy class that we took winter quarter, we had to take ocular physiology in the spring. Lots of rote memorization. For those that don't know, anatomy refers to the physical structure of something while physiology refers to how it works. I actually did better in this class than ocular anatomy and overall it wasn't too bad. Lots of studying, but what else is new, right?

We had another quarter of geometric and physical optics course this quarter as well. Basically a giant math based/physics class. These are the kind of classes I do best at (fortunately). It's one thing to be able to memorize a whole bunch of things, but I honestly do better when I have to apply information to a problem. So that class went pretty well. We will be moving onto ophthalmic optics this next year and will be getting more information that's a little more applicable :)

And lastly, we are DONE with our basic science courses, or as we called them Basi. I mentioned a little before about how they worked, but this class was literally the epitome of time consuming. Anywhere from 10 to 14 hour lectures a week (all on Tuesday thru Thursday) with a test every week Tuesday morning at 7 AM. This class was the reason why my weekends were gone. I had a huge test to study for every week, so naturally you have no choice but to use that free time on Saturday and Sunday to study because you HAD to, or you failed.

This class accounted for almost 15 credit hours this quarter for us (sectioned into 3 official classes that you got grades for) with the last one being the gross anatomy of the head of neck. This was the messy one because we had to spend at least 6 to 9 hours a week in our anatomy lab. Imagine a huge room with 22 metal tables, every single one containing a human cadaver. And they left all the dissecting to us.

We were assigned groups and one body for the remainder of the quarter. For whatever reason, I was the only girl in my group and was with 7 other guys - 1 of them optometry, the other 6 being dental students, and of course our cadaver was male as well. We used scalpels and other tools to cut through skin, muscle, tissue, you name it. My least favorite day was the day I stood there for an hour and a half straight just scraping and removing fat off of our person's shoulder region so we could get a nice clean look at all the muscles/nerves/arteries. I don't gross out easily, but that was definitely one of those days where I was glad I didn't eat much before hand in fear that it wouldn't have stayed down. I got a stronger stomach further down the road, but I definitely had trouble when we had to decapitate our cadaver. I'll just leave that at that.

This was a really tough course as we had practicals physically based on the cadavers. We would have questions where they might tie a string around one little artery in the cadaver's face and we had to be able to name the specific artery of the specific branch "x". They loved "higher end" questions that required you to know multiple things too where they might put a pin in a muscle, but instead ask what nerve innervates that specific muscle. So...you had to know what muscle it was in order to answer the question and then know the other information on top of that.

Tough. Really tough. Especially muscles and nerves in the face because they're tiny.

Anyways. After all that, I survived. Barely. I don't think I've ever been so excited to be done with a class. Ask me that again though once I am finished with second year, haha.

And that is my (very long) recap of our last quarter. School starts up again on August 25th and I am doing my best not to do anything these next 2 weeks, haha. Well, at least anything that requires a high amount of cognitive activity.

I will be doing a couple more posts here soon before school starts: one talking about the upcoming year and the other briefly talking about my weight loss journey and basically how I managed to lose 40 pounds in under a year, with almost 30 of those being since the last time I posted on here at the end of February (crazy, right?). So watch for those! I will be posting links to them as I finish them.

Until then, hope you have a great day!

Grades are all posted and Winter Quarter is Over! Recap

*Insert huge sigh of relief here*

Firstly, I know I've been slacking on the posts. Once we came back from Christmas break, we were immediately hit with multiple tests and practicals, and honestly there for a while, it was all I could do to get enough study and practice time and still manage to just get an okay amount of sleep. Most Fridays after class was done, I would just come home and sleep.

Looking at my last post, I almost chuckled a little because the big thing we were doing was learning to flip a person's eyelid inside out. And we considered that mildly invasive. Since then, we've come a very, very long ways on our clinical skills as well as what we now consider "invasive". And it'll probably just keep getting worse from here on, haha.

So, since it's been a while, here are the things I've learned how to do and have been tested over and considered proficient in thus far:

1. Slit Lamp

Late night practicing with one of my fellow classmates, Celine

I mentioned in a previous post that we were just getting into the basics of slit lamp when we first came back from Thanksgiving break. Now, I am able to perform an entire slit lamp exam on the anterior segment of the eye - meaning I know how to look at all the different structures of the front part of the eye like the conjunctiva of the eyelids (lid flipping), sclera, the cornea, the iris, the lens inside the eye, etc. Although it sounds easy to just "look" at something on the eye, each structure requires a different illumination technique in order to really get a proper look at it. For example, my left hand is on the illumination tower and it moves on a full 180 degree axis. I can create different widths of light with it too. Depending on what you're looking at, you need a different width of light with a certain angle of the illumination tower to look at the cornea as opposed to the lens. It was a little overwhelming trying to learn how to do everything, but with many hours of practice (and 2 practicals), I've finally gotten the hang of it.

When we are tested over the use of this in our practicals, our proctors can view what we are looking at through a "teaching tube", which you can actually see coming out the other side of the instrument right by my head.

2. Goldmann Tonometry

I'm pretty sure I'd never heard of this before school. I kind of knew the word "tonometry", but that was it. Tonometry is just the act of measuring someone's eye pressure. Lots of clinics will have the "air puff" machine that can do this (worst machine ever), but this is another way of doing it.

This also required us getting used to putting drops in each others eyes. Since this thing actually touches your eye, your eyes have to be numbed (otherwise it'd probably hurt a lot). Essentially, the tip touches the cornea and flattens it out with "x" amount of pressure. However much pressure it takes to flatten the cornea is said to be the intraocular pressure. We do this on the slit lamp and we're looking at something like this when we do it.

The half green circles show up when the tip is on the cornea and is made by a fluorescein (yellow) dye put in the eye (the yellow turns green because of the blue light we use). We know we have the pressure right when those circles are equal size to each other and they are just barely touching on the insides...as opposed to this.

Essentially, we have to move the slit lamp to vertically/horizontally align those circles. Then we make the insides "touch" my adjusting the pressure applied.

I know the tip consists of a type of prism that makes these circles, but I'm not entirely sure of how the light/optics work going through them to give us what we're seeing. I just know this is how we do it, haha.

This took a lot of practice to get good at. The thing that stinks about anything like this in school though is to get practice, you have to be willing to sit for other people to practice on you. So I had my eyes numbed plenty of times in order to get decent at this technique. It also took a bit to be "not afraid" of this, considering the nature of it.

3. Direct Ophthalmoscopy
Last one, I promise, for this quarter anyways.



This is something we learned pretty recently and had to get semi decent with because we had a practical over it 2 weeks after we learned it.

So this tool just allows us to look at the back of someone's eye through their pupil. So you can see the different parts of the retina and the optic nerve, along with the blood vessels and everything. The first time we worked with it, we all had one eye dilated to make it easier.

Once I got the hang of it, it was actually really cool. We learned how to asses the optic nerve, the blood vessels, and the background of the retina.



Essentially, we're looking at bits and pieces of the picture above. That round yellowish circle is the optic nerve. We all had these pictures taken of our eyes last quarter in the clinic.

Then, to test us over it, during our practical I had to look at my patient's optic nerve with my ophthalmoscope, get it in focus (the person's prescription will affect if it is in focus or not), and try and get a good look at the back of the eye eye. During the test we had to do this undilated, which is much much harder because the pupil is so much smaller and constricts a lot because of the light shining in. Once I was done, I was given 4 pictures that looked similar to the one above and I had to identify which one was my patient's. This was actually pretty difficult, but I did get it right, so woot!

My other classes for the quarter

So, everything above was just for one of my classes this quarter, which is my clinical skills and methods class.

We were still taking our basic science class (10-14 lecture hours a week) with our test every Tuesday at 7 AM over the previous week's material. I think we are all slowly burning out on this class. It's a huge time commitment itself between class time and study time, especially while trying to manage stuff for our actual optometry classes.

We finished our ocular anatomy class, which had a lot of memorization. Our tests were pretty tricky and long. Our midterm was over 60 multiple choice questions and the final that I had earlier this week was 105 questions. Not easy multiple choice questions either. Our professors love "which of the following is not true" type questions and will have 3 different answers for some followed by "all of the above" or "only two of the above". Sometimes one question will require you to know at least 3, 4, or 5 different facts about what they're asking. I hate those types of questions, haha.

And I just finished our geometric optics class yesterday. This class was very much like a math or physics type class, which are the types of classes that I actually like better, even though the tests were a little brutal. The picture below is our equation sheet from just this quarter. To be completely honest, after all the studying, I pretty much knew the majority of these and didn't really use it much on our final. But it gives you an idea of how much we covered in the last 10 weeks or so. Fun stuff.

And really, that about sums it all up. This quarter was definitely way more challenging than the fall quarter just with the amount of everything. Just in the last 10 days, I had 7 separate exams. A few weeks ago, we had a crazy 2 and a half week time period where we had 8 exams.

We actually had 20 exams just this quarter - over a 10 and a half week time period. That's not counting all the homework, assignments, presentations, and quizzes either. I've really had to crack down on how I manage my time because it really does matter. But, I'm still hanging in there. I definitely slept a lot yesterday and last night. I probably needed it. :)

And now we are off and out of school all next week for Spring Break. I think we're all relieved to get a little bit of time off and rest.

Hope you all have a great weekend!