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Postpartum recovery: PT, hormones and keto

“9 months on, 9 months off” they say. Well, some of them say, anyway. I’ve found with each subsequent bebe those goalposts creep back a month or two, so let’s just say as Zelie rounds the bases to month 9 ex utero, I’m still looking and feeling much of the effort it took to bring Zelie earthside.

However, some vast improvements have been made. I want to record them here for posterity’s sake, and because in many ways I felt like I was charting my own course for recovery and healing, belonging as I do now to a rather exclusive club of moms of many.

Even my doctor, a nice pro-life guy who delivers plenty of babies a year and is comfortable around an NFP chart, was relatively clueless about what I could do to speed the healing process, to correct hormone imbalances, and to restore my body to a state of reasonable functionality.

What I’m about to share with you is my experience alone, and I’m not a doctor or any kind of medical professional, so grain of pink himalayan salt and all, okay?

First things first. I’ve had a contentious relationship with food since forever. If I could turn back the clock, I would have sworn off the Chic-fil-a milkshakes and the bags and bags of white cheddar popcorn I consumed this time around. I think Zelie is at least 30% popcorn cheese on a cellular level. Her pregnancy was a rough ride emotionally. We were living in a friend’s house for the first 6 months of it and commuting an hour each way to school. In my spare time I enjoyed meeting up with our realtor after a 55 mile drive with a carful of kids and looking at dozens and dozens of houses which for various reasons did not work out. 70, to be precise. So yes, I did a bit – a lot – of stress eating.

Having always gained massively with each baby, I figured weight was weight, whether or not I was working out and eating well. This premise proved faulty, as I would discover in the harsh hospital lighting on day one post delivery. I was at my all time highest weight, and had delivered a modest 7 pound peanut to show for it.

I waited the requisite 6 weeks postpartum and then started watching my calories, cutting back on sugar (more on this later), and began a swimming regimen that had me accumulating 400-500 laps a week. I kept this up until about 5 months postpartum at which point I had lost an additional (wait for it) … 3 pounds.

If you do the math you’ll realize that 7 pounds plus 3 pounds is 10, and having racked up something north of 60, I was…not doing great. I brought my concerns to one doctor who suggested that perhaps I was eating more than 1200 calories and just didn’t realize it, because “apps aren’t all that accurate”  and suggested I could up my gym regimen to 7 days a week instead of 5.

Long story short, but I eventually ended up at a women’s health care clinic that specializes in whole woman care. They did some targeted hormone testing and identified a deficiency that was making it almost impossible to lose weight, and which also contributed to anxiety and depression.

I also found an incredible physical therapist who specializes in postpartum recovery and pelvic floor injuries, just from reaching out to my circle of local friends. As frustrating as it was to have to hunt and peck for the right doctors and the right diagnoses, I feel exceptionally blessed to live in a big city with a wide array of healthcare options, and to have good health insurance to be able to defray some of the cost. I do wish some of the less “mainstream” therapies were covered, but I’d be remiss to not acknowledge my privilege. Do I wish postpartum PT and hormone assessments were standard of care for new moms? You betcha. But for now I’m just glad to have found some good help!

The last piece of the puzzle for me has been diet. A lifelong yo-yo dieter, I’ve tried all the things. Atkins. South Beach. Weight Watchers. Whole 30. LightWeigh. Plant based. Low fat. You name it, I’ve done it. I had a pretty good handle on things by my mid 20s. I was exercising regularly, eating moderately, and had, well, the metabolism of a twentysomething who’d never been pregnant. I could kinda eat whatever I wanted, and I did. After spending ages 15-23 deep in the throes of an eating disorder, it was a relief to have a less fractious relationship with food. 

Once we got married and the babies started coming fast and furious, I remember being shocked by how swiftly and with what vengence the eating-disordered thinking returned once the scale started moving north as I grew our babies.

Nobody had warned me how triggering it would be to see my weight skyrocket over those 9 months of pregnancy, and my provider at the time kind of waved my fears aside and encouraged me that eating intuitively and moderately was good for me and good for baby. If I could do things over again, I’d escort my 27 year-old-self straight to therapy as soon as that second pink line appeared, but hindsight is 20/20, and as it turns out, I’ve learned and grown tremendously not in spite of motherhood, but through it.

I can honestly say that today, at age 35, and still significantly heavier than I’d like to be, I am more at peace with my body than I have been since childhood.

I can see the goodness of my childrens’ existence, acknowledging the sacrificial love that motherhood requires (in whatever form it may take for each particular woman), and the devastating unhappiness so many women feel when confronted with the disparity between their actual bodies and the idealized image the culture projects on us.

For some of us, the sacrifice is excess weight we never wanted to gain and struggle mightily to lose. For others it might be a flaring autoimmune disease, an injury, a tragic loss, the burden of infertility. Motherhood is costly, at any rate, and none of us can predict the cost ahead of time.

But it’s so worth it. And as I’m discovering after this magical fifth baby, God heals on His timeline, not ours. As I find myself making peace with my body at long last and in spite of its many imperfections, I marvel at the worldly illogic of it, that having a larger than usual family would result in better body image and deep healing. In God’s economy, the numbers work differently.

But back to the recovery process. If you follow me on Instagram you know that the biggest win for me the past few months has been discovering and implementing the Keto diet. Again with the disclaimers, but I’m not a healthcare professional, so do your own research, etc.

In a nutshell, Keto is almost an inversion of the FDA food pyramid. It’s fat focused with moderate protein and low carbs. Under 20 grams per day is my goal, and most days I end up around there. It’s no grains, no sugar, and no starchy veggies or sugary fruits. It is lots of eggs, spinach, broccoli, asparagus, lettuce, avocados, bacon, sausage, steak, chicken, fish, shrimp, full fat dairy, and a little bit of nuts. If that sounds restrictive, I suppose it was for the first week, but when I looked at the scale and found 4 pounds missing after months of stubborn inactivity, I was hooked.

The best part for me has been the weight loss (22 pounds in 9 weeks so far) but the surprisingly close second has been a radical reorientation of my relationship with food. I no longer crave specific foods, nor do I struggle much resisting “off limits” foods. For a girl who loves to eat, this feels like a miracle.

And I do still enjoy food! But now I enjoy food that makes me feel good before, during, and after eating it. I have seen a 180 degree turnaround in my energy levels between meals. Hanger is gone. I feel satiated and content for long stretches between eating, and have even been able to incorporate a little bit of intermittent fasting for the last month. For someone who used to be faint and weak from hunger on Ash Wednesdays and Good Fridays, this feels huge.

Do I think everyone should eat this way? I really don’t know. I think it is a healthy and helpful way to eat for people who struggle with hormone issues and blood sugar and certain mental health conditions, but I also know people who feel great on the Whole 30, which is decidedly higher carb.

I have a working theory that perhaps there is no one “right” way to eat, and that there are all kinds of makes and models of human beings out there. Some run on gas and others on diesel. I feel like I’ve found my perfect fuel, and that makes me feel great. I don’t force my kids to eat this way – I’ll often make rice or beans or gf pasta to serve alongside whatever fat + protein + veggie we’re having for dinner, but overall it has tremendously cut sugar from our diets. And we’re seeing some great immune system benefits to that.

If you are interested in anything I’ve shared here today, feel free to message me privately over at IG or drop a comment or an email. I’m an open e-book, as always. And if you’re a mama trying to get your groove back after baby, give yourself plenty of time and grace. You’re doing God’s work, and He will not abandon you in it.

21 Comments

  • Claire

    There’s definitely no one-size-fits all diet solution for everyone. Last November I started doing Lightweigh, which is a Catholic program to help with weightloss and other addictions. It doesn’t eliminate any food group, but focuses on portion control combined with spiritual principles. I’ve lost almost 40 pounds, after thinking I was going to be fat for the rest of my life. I do think drastically reducing sugar would benefit pretty much anyone across the board, but otherwise I think different programs are going to work for different people.

  • Gwen

    I did this and ended up crashing over time with rebound weight gain. I learned why from a video by a doctor whose book I read (Survival of the Smartest in two parts on youtube by Dr. Schwarzbein).

    I learned the hard way that I can’t just eliminate a food group to remedy a deep metabolic issue. Low carb stresses adrenal glands. I had read this while doing it, but the weight benefits made me ignore it until I was leveled.

    I appreciate an article that clearly exemplifies the ridiculousness of the “calories-in-calories-out” crowd who obviously have no idea what they are talking about! 🙂

  • Nancy S.

    To the above poster, Claire, thank you for the info about Lightweigh. I will look into it.
    Jenny, another wonderful post. You write so honestly and beautifully that your posts are a true pleasure to read. I am well past my days of bearing children but I had the same type of weight gain you did, and it seems I never lost any of it after each child. I am now 71 and have been to Weight Watchers more times than I can count, and also did Nutri-System (old program) which worked well but because of the lack of vegetables with vitamin K, I was one giant bruise and had a superficial clot in my leg. All this to tell you that a few years back, in utter desperation, I decided to read a book I had had for years – “ Entering the Zone” by Barry Sears, Ph.D. It was begun as a cardiac rehab eating plan but people found they were losing weight and type II diabetics were losing the need for medication. The beginning of the book is a lot of biochemistry and why it works to reduce inflammatory responses in the body and bring about weight loss. I lost 56 lbs in 12 weeks and was never hungry. I got off it a little after returning to PA (too many tempting things like soft pretzels, cheesesteaks, etc) and I had gained some back but over the last year lost 40 while having a small amount of ice cream almost daily. Ice cream seems to be the thing I cannot do without and it keeps me from all the other not so good for me things. We each have to find what works for us.
    You mentioned your newest child being made of Chick-Fil-A’s milkshakes as well as cheddar popcorn. My eldest was made of something Dairy Queen used to make – a Mr. Mistee float. It was soft serve in a Slurpee-like beverage. It was about the only thing I really craved, and had no particular cravings with my sons.
    I wish you the very best on your journey to find the body weight you want, but I am sure your family loves you as you are.

  • Ari

    This is SO me, except I haven’t gone keto like you have, nor have I gotten testing or PT like I probably should have. I have low progesterone, major blood sugar issues, and who knows what else. I’m 8 months PP and pregnancy and breastfeeding seems to have kept my blood sugar and autoimmune issues at bay, but I can feel them coming back. Sadly, 9 months of survival and just eating what I wouldn’t vomit has left all my good eating habits in the rearview mirror. I want to try this. Would you mind sharing what deficiency was identified in your blood work?

  • Lindsay

    OH MY GOODNESS.

    Hormone assessments and natural replacements.

    Last year, my second daughter was born right around the time your Zelie was (so I’ve very much enjoyed and found relief in your pregnancy and postpartum posts!), and I had no idea what was going on with me, but something felt very, very wrong in the months after her birth. I was constantly tired, had deep and unpredictable mood swings, got sick about once each month, and just felt like complete and total crap. Needless to say, taking care of two littles while feeling this way (with a husband who works full-time and has gone back to school in the evenings) was kinda rough.

    A few months ago, however, some hormone assessments revealed I had low thyroid function. My wonderful doctor prescribed Armour therapy, and it has worked wonders! I’m energetic and not constantly craving sweets and processed carbs, I have way, way more happy das (my husband says it feels like he’s finally gotten back the girl he fell in love with), I’m no longer getting sick, and I just feel like a brand-new person.

    I’m so beyond thankful for the care and medication I’ve received, but to be honest, I’m also kinda angry that all of those months and months of misery could have been healed with a simple blood test and hormone evaluation. How many, many women endure postpartum (and beyond) misery that could be so easily diagnosed and resolved? Thank you so much for sharing your story of healing and recovery. Hopefully, some new mama out there reads it and is inspired to seek whatever care and healing she may need. Our society seems to project an unspoken message that looking and feeling like crap is just a part of motherhood, but that is just not true. There are sacrifices we make out of love for our children and the Cross, yes. But the painful mood swings and depleted energy? I don’t think so.

  • Kathleen

    Thank you for the post. I’m 42 and can say without a doubt that as we age, we must move our bodies. That line about metabolism slowing as we age is not a myth. I can’t eat the way I did 5 years ago. I’m at a point in my life where I can exercise 1 hour day, 5 days a week, so I’m a little lax in the diet department because I’m burning 400-500 calories each time I go to the gym (Orangetheory Fitness). Overall, the exercise is critical to our physical health and mental well being.

  • Melissa

    So timely. I’ve been spoiled in that breastfeeding usually takes care of my pregnancy gain for me, and in a relatively quick amount of time. But I’m 4 months postpartum with baby number 4, and now 30 years and I am NOT losing this weight. My problem is that I am hesitant to take on what seems to be to be a huge lifestyle change (a specific diet) during a time when I’m already in survival mode, and can’t even fathom having one more thing on my plate. Where do you find the motivation to make that kind of change when you’re already completely tapped out?? I admire your hard work and dedication to figuring out how to best take care of yourself… hopefully I can get there someday

    • Lindsay

      Hey, Melissa!
      I know how you feel — who wants to worry about a diet when you’re just barely keeping your head above water?
      I was struggling so much when my baby was born earlier this year, and I just turned 30 as well (and noticed a big difference in how much longer it has taken me to recover!). However, I felt so much better when I made healthier eating, hydrating, and exercising habits. I started to realized which foods made me feel more energized and positive, and which made me sluggish and moody. Maybe if you try to not think of it as a diet, but more so as one healthy choice at a time, you’ll start to notice a difference, too? I’m not at all trying to be preachy, but I felt the same way you described: how do you find the motivating when you’re already tapped out? However, I just found that when I ate less-processed foods, more healthy fats, and lots of protein, fruits, and veggies, I felt so much better that it was all the motivation I needed to keep going.
      On the other hand, I’m currently typing this with a glass of wine in one hand and a chocolate bar in the other… so… there’s also that 😉

      • Jenny

        Yeah, I see a huge difference in mood when I fuel on fats/proteins versus carbs. I have a much longer fuse, am less fuzzy and forgetful, and can go longer between meals without a blood sugar crash.

  • Dee

    Hi Jenny, thanks so much for this post. As an above commenter asked- would you be able to chat more about the hormones that the doctors measure/look into? Ironically have my annual visit with the OB this week (2yrs pp #3) and was going to ask her about hormones, etc. in a nutshell, my thyroid is fine but just think my body and mind took a big hit after #3. I eat the healthiest I probably have in my entire life and have nothing to show for it. Exercise is an issue (time and gym $$$$ or lack thereof, ha!) but other than that I think I am doing everything else ok ???
    Anyhow, thanks for sharing with us!

    • Jenny

      Have them check testosterone, progesterone, and estrogen! The big one for me was T – mine was almost 100 points lower than it should be for my age.

  • Emily

    As a Denver local, I’d love to know which medical clinic you found. I live close to Boulder, so while ALL the alternatives are up here, it seems none are in-network and few take insurance at all.
    I’m so happy you’ve found an eating formula that works well for you. I’ve done a few whole30s and feel best on a paleo diet, but struggle with what feels like near constant obsessing over every morsel that enters my mouth. I heard a podcast where a woman spoke about whole30-ing a few times each year as an act of worship because it’s the best way she knows how to take care of the one body she’s been given. It was (wait for it) good food for thought for me (!) and a welcome change of perspective.

  • Cami

    First off, Jenny, thank you for sharing and I’m glad you’ve found the right help. I can’t even find a pro-life doctor in my new uber liberal state. ☹️ We did keto for awhile too but aside from losing weight it felt unnatural to us to eat so much animal products and have our digestion slowed as a result. Another issue for me is that we already consume too much meat in this country (US) and keto increases that. Our nation’s demand for meat has caused us to arrange for it to be raised on other continents. Rainforest land has been cleared to raise our cattle. The destruction has caused people to think we are over populated which then feeds the promotion of sterilization and abortion. It’s a mess. I don’t like being a part of that domino effect even if it’s partially a misunderstanding regarding the over-population myth. My understanding is that prior to The Fall, Adam and Eve were plant based. There was no conflict in nature. Animals did not hunt each other. All creation was in harmony. So that makes me wonder about God’s intentions for us. I don’t know the answers. But I ponder this a lot. If we were left to hunt and clean and prep and cook all our meat on our own, would we eat as much? I love a good Chick-fil-a deluxe chicken sandwich but personally could not slaughter any animal. This site gives some good stats on meat consumption and how we as Catholics can improve in that area to reduce the unnecessary impact on the planet. https://catholicclimatemovement.global/shifting-diets-toward-sustainability/ The documentary “What the Health?” also made some good points about our human teeth and digestive system in comparison to serious carnivorous creatures. We don’t seem to be designed for heavy meat eating. But again… I just ponder these things. I don’t claim to have it all figured out. Does anyone know if St. Francis of Assisi ate animals? Based on what he emphasized in caring for God’s creation I can’t imagine him chewing on a turkey leg, ya know? For now, we are plant based with a bit of cheese, eggs and occasional meat. But I’ve had all 4, nearly 5 children in my 30s and the weight always lingers for me. I appreciated a lot of great comments here on the topic! Thanks, ladies!

    • Kathleen

      100% agree. I just posted on Jenny’s IG the same thing. It takes 1,799 gallons of water to produce 1 lb of beef. One pound of pork = 576 gallons of water. As humans, I think we have a responsibility to think about how our diet impacts the environment.

    • Jenny

      Hi Cami! Interesting thoughts. I don’t think the Church has a definitive position on whether or not Adam and Eve ate meat, but Jesus certainly did (unless you’re counting fish as something other than meat) as did the Apostles. I can’t think of a vegan/vegetarian saint offhand, though I’m sure there are some! I don’t think it’s helpful when we sort of weaponize non-moral issues like dietary choices in these conversations. Not saying you are, but several other commenters here and on IG have implied that it is morally reprehensible/unconscionable to eat meat and eat a lot of it. This simply isn’t true, and God doesn’t give us any kind of directives on what we should eat other than urging us to do so “to the glory of God” and not to engage in drunkenness. I agree that there are more responsible ways of eat, like buying organic/sustainably raised when possible, but as you know from having a large family, it is not always financially feasible to make the best choice at the grocery store. I do not agree that by eating meat I am contributing to the destruction of the rainforest or feeding the overpopulation myth. I’m doing the best for my body and for my family, like I’m sure everyone else here is trying to do as well. (Also it’s worth reminding everyone that Have an autoimmune disease and am severely gluten intolerant, as are two of our kids, and other grains don’t work well for my body either. Eating the SAD would not be best serving the actual body that God has given me.) Thanks for chiming in!

      • Cami

        Jenny, I wasn’t trying to make anyone feel badly. I’m sorry there has been unkindness on IG. I don’t engage in social media, so much of that misses me. I tried to stress that these are things I ponder but do not claim to have the definitive answers on. Of course I understand the cost of feeding a large family. We are low-income, single income, have lost loads of money in relocations, moved to a more expensive state to save my husband’s career, and cannot afford to go all organic or anything like that. I’m just hoping someday I can try growing my own food a bit. No clue how to begin, however! We also have allergies in the family including gluten and dairy. I have found though that we tolerate Einkorn flour well which has been exciting and enables us to enjoy nutritious homemade pizza and pancakes without the reactions. I buy it in bulk on Amazon and keep it in the freezer. But aside from lots of fresh produce, we do a lot of rice, oats, and potatoes to supplement meals. Please do not take my comment as generally unsupportive. I did share a source with stats on the impact of being a heavy meat eating country. You share information too that is worth thinking over. This is a blog that encourages thought and community. I definitely wish you good health and well being! By the way, totally craving fish sandwiches this pregnancy! 😂

    • Melissa

      For me i think this falls under the category of personal priority. it would be impossible to invest time and energy in everything that may be important. I simply don’t have the budget to buy all organic, so I don’t worry about it and just do my best. Likewise I don’t have the mental energy to research every parenting issue, or know where all the meat my family eats comes from. For us, there are more urgent priorities, like taking care of my families mental health issues (three out of the six of us see a therapist and a psychiatrist). I wouldn’t be able to maintain that and also source all our food locally and make everything from scratch, or ever spend time with my kids. If you DO find it to be a priority and you have the time and mental energy to devote to it, that’s awesome. But we all have different capacities and priorities.

  • Rachel

    Hey I was just wondering why you stopped following Trim Healthy Mama? Your blog is what got me started on it! And also I am curious if you noticed that keto had an impact on your milk supply? As a Degreed Nutritionist/IBCLC it makes me sad that your original Doctor told you to restrict calories even more and exercise 7 days a week thats crazy for a postpartum mom! I am glad that you are finally on the road to recovery though 🙂

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