Tuesday, May 21, 2013

Weight Loss Challenge: Two months and 162 pounds down!

Yay! We have finished two months of the weight loss challenge and everyone is doing so well! As a group we have now lost 162 pounds!!! The program has been drawing in a lot of new people so when we finish the 3 month challenge we are going to continue. Also, it has now been picked up as a national program so all health PCVs in the Dominican Republic will be trained on how to start a weight loss support group in their community! Exciting times ahead!

This month we have been working on the social aspects of weight loss in the Dominican Republic. We have had issues with the community gossiping about the weight loss participants. As I have explained in previous blogs, Dominicans view weight in a much different light than Americans. For most Dominicans (at least in my community) a heavier person is considered healthier. As you can imagine this makes a weight loss support group a very controversial thing. There have been rumors that the people in my group are going to die because they are losing weight too fast (nobody is loosing more than 1-2 pounds a week) or that they aren't eating at all (not true). Obviously this can be very discouraging for the participants. I decided that we needed to discuss it in our support groups and come up with a plan of action. We discussed all of the different rumors people had heard, and different ways to combat them. We worked on changing all of the negative rumors into positive statements. For example, when they hear someone gossiping about them losing weight they can say "I am not dieting, I have changed my lifestyle so that I can live a longer, healthier life." or "I want to be healthy, and in my case that means I need to lose some weight". Obviously this is going to be an ongoing problem that we will have to continue to face, but I am happy to say that so far nobody has dropped out of the group due to gossip.

Besides that we have continued to have individual meetings, group meetings, and exercise classes on a weekly basis. The participants have also started their own walking groups based on where they live and when they have free time to exercise. I can't leave my house in the morning or evening without seeing a women out exercising(its too hot in the afternoon). It makes me smile to see that exercise has become such a strong presence when it so scarcely existed before. Even though I know it is going to take a long time for the community to accept that weight loss is a good thing for some people, at least I know that exercise is slowly becoming an acceptable norm thanks to some brave participants setting a good example. 

Wednesday, April 17, 2013

Weight Loss Challenge: One Month Down


Hi Everyone,
I am sorry it has been so long since I updated you on the weight loss challenge. I have been really busy with all of my work here. Plus, I wanted to wait to update you because, as expected, Semana Santa (Easter Week) was a disaster! A lot of the participants gained weight during the two week festivities of Semana Santa. In the Dominican Republic, Semana Santa is a time when all the family members come home to the campo, everyone goes to the beach, everyone drinks, and eats habichuelas con dulce (Dominican treat- sweet beans). Anyways, I looked up the calorie content of habichuelas con dulce because I was curious to see if the treat was really the problem or if it was just the all around feasting/party attitude. I am sure that it was a little of both, but I thought that I had prepared them really well going into the week. I found out that a 12 oz cup of habichuelas con dulce averages about 500 calories, although recipes vary a little. Now the problem with this is that they don’t just eat one cup… each family makes a giant vat and drinks it all day every day. Anyways, we had a few bad weight loss weeks (but really fun on the other hand). I was really nervous that after a few participants gained weight they would be discouraged and quit the program so we did a lot of motivational activities, and I made some of the stronger group members be mentors to some of the weaker group members. It worked really well, and we had no drop outs after Semana Santa!!!! We did have two drop outs for other reasons (moving and sick family member), but none due to weight gain or discouragement. In fact, we even had a few more people join the group. We now have 21 participants, and I have closed the group off for the time being. I would like to let everyone join who wants to, but it is way too difficult for me to have individual meetings with the 21 I have right now (plus all of my other work!). 

Review of Month 1:
The first month of the weight loss challenge has been a success. Like I said we had a few rough weeks, but overall all of the participants have lost weight, gained confidence, learned a lot, and made healthy lifestyle changes. I think the most important change I have seen is the boost in confidence. A majority of the participants are women, and in a lot of their homes the men have all of the control (or so they think). I have seen the women really step up and take control of their diet and exercise, and I have seen a huge difference in their attitudes, especially in the individual meetings. I think they are enjoying the realization that this is one aspect of their life in which they have total control. Plus, the boost in energy and confidence that comes along with living a healthy lifestyle and loosing weight never hurt anyone!

We continued the whole first month following the same format of two meetings a week per participant. One individual meeting where we get the personal stats (weight, % body fat, blood pressure, blood glucose, body measurements etc. ), talk about the ups and downs of the week, review their food and exercise journal, and make a plan for the next week. We then have one meeting as a group. The group meeting is set up like a support group. We spend time sharing success and failure stories and celebrate the people who lost weight (the person who loses the most according to % pounds lost gets a healthy prize).

In the group meetings we also have a small lecture every week. This month we discussed the emotional, spiritual, and physical aspects of weight loss, how to change negative thoughts into positive thoughts, how to eat healthy during parties and holidays, choosing healthy snacks over high carb high sodium snacks, how to substitute with vegetables, the importance of exercise, different exercise methods and how they affect your body, how to take your pulse, your heart rate and what it means, how to make small daily changes that will result in long term results, the importance of moral support, what does “metabolism” mean, how to we increase our metabolism via exercise and diet, etc. I think the most exciting mini-lecture for me was the one about how to take your pulse and what your heart rate means. I can never exercise in this country without someone telling me to rest because my heart will explode. I just always say okay and kept going… but when I started encountering this with my women during exercise classes it started to bother me. In the beginning we would speed walk for 2 minutes to warm up, and people would be telling me that they needed to rest so their heart didn’t explode or so they didn’t start sweating (ps I did medical histories with everyone and nobody has any condition that should inhibit them from walking for 2 mins FYI). Anyways, we calculated each persons Max heart rate, and they all know what it is and how to do it. I love it because when people tell me they need to rest after doing basically nothing we just take their pulse together and keep on going. Later on in the workout when we are actually working hard I have to let them rest, but at least I don’t have people pooping out after the warm up anymore.

The last thing we do in the group meeting is exercise! Depending on how long the meeting lasts we do anywhere between 30 minutes and an hour of exercise. The participants really enjoy doing circuit style training so we have been doing that a lot. We go to the park and I split them up into groups of two. I usually have about 5 stations set up, and they rotate through the stations in 2 minute intervals (this changes weekly depending on the types of exercises). It has been going really well, and the women actually work hard now! They sweat and everything! I think the “heart rate lecture” and the “how many calories do you burn in each type of exercise” lecture really convinced them that they need to work harder J

One of the largest hurdles for the group has been water intake. There is a place in their food and exercise journal to circle a number every time they drink a glass of water. In the beginning I was noticing they were only drinking an average of 3 glasses of water a day (and we live in the Caribbean!!!). In the individual meetings we discussed reasons why they were not drinking more water and why it is important do drink a lot of water. A lot of them asked me how I managed to drink so much water and I explained to them that I always carry my Nalgene with me. A lot of them started carrying around disposable plastic bottles with water to try to up their water intake. Anyways, I decided to buy them all reusable plastic water bottles so they can bring them to the exercise classes and hopefully carry them around so they drink more water.

Below are the group stats from month 1. If anyone is interested in individual stats let me know. I have them all in an excel spreadsheet so I can easily send them out (without names of course). I also have more body measurements (chest, arm, hips etc) , BP and blood glucose. I am just giving you the most important stats below J

Month 1 Group Stats:
Pounds lost: 106
Average pounds lost per participant per week: 1.5
% body fat lost: 24.6%
Average % body fat lost per participant: 1.64%
Average inches lost in waist per participant: 1.13

**Note: Not all stats include all participants due to the fact that some of them just recently started. 



I finally got them to run!!!!!!!!!!

Working out in rolos.




These are the water bottles everyone received. 

Saturday, April 6, 2013

chicken in a bed. deuce in a bag.

Hiiiii my peeps. I have two funny peace corps stories for y'all. Get excited :)

Now those of you that have been reading my blog know that I have a serious chicken problem. I share a plot of land with two other families, and they have TONS of chickens. Now this wouldn't be an huge issue except for the fact that when the chickens have little baby chicklets they turn into crazy-mutant-angry-hens. Its straight out of a comic book. You take one step in their direction and its BAM chicken in the face. They also really enjoy coming into my house to eat skeeters dog food. If you have ever been stuck between a crazy-mutant-angry-hen and the door you will know how scary this can be. Imagine a chicken in your face screaming, jumping up in the air, scratching at you with its talons, and trying to peck your eyes out with its beak. Crazy ish. Anyways I take it out on them by eating them and their eggs bwahaha. So I guess the moral of the story is Chickens... you can't live with them you can't live without them.
So back to my real story...The other day I was out on my front porch drinking my coffee, reading my email, and sending all the passers by on their way with a good morning. I was out there for a good long while, and then I realized I should probably go change my clothes and attack the crazy weed situation in my front yard (no joke them weeds are on steroids). So I entered my room and... BAM! chicken in the face! It scared the bajezus out of me. Once I came to my senses I realized I needed to get this thing out of my room. This resulted in a five minute battle that could have been straight out of a cartoon. It left me bleeding, and my room a disaster. I took a deep breath and was a about to laugh when I saw it. A beautiful little white gem in my bed... the crazy-mutant- angry-hen laid and egg IN MY BED! gross.

Ok. Before I start story number two let me say.... please do NOT continue reading IF you are grossed out by bowel movements, you are romantically interested in me, or there is a chance you may be romantically interested in me in the future. just saying.

If you were a peace corps volunteer, or you have ever spoken with one, you know that about 80% of our conversations revolve around poop. It is a very natural, very comfortable topic for us which can be awkward when we speak to people from home. So I apologize ahead of time. Now before I tell you my poop story I have to tell you that ever since I got back from Christmas break my community has not had water. I have a tap in my yard that would get water for an hour or two every 5 days. So during that time I would have to fill up a big 50 gallon drum to use for the rest of the week. Well our aqueduct dried up, and they now have to build a new one.... sooooo we haven't had water for over 3 months now. This means that we have to go to the river to collect water, or the wealthier people have dug big holes in their backyards to use as wells. Luckily, I have a latrine so I don't need water to flush (i only need it to bathe, wash dishes, clean my house etc). People who have regular toilets have to flush them by dumping a bucket of water in them at the perfect angle with the exact amount of force. Now the "clinic" (aka empty building) in my community has a regular toilet. I am lucky because I get to hold my meetings there since nobody is using it.... but at the same time, nobody is using it, so there is no water tank or ANY source of water. This usually isn't a problem because I am only there for a couple hours at a time, and I can go to the house next door to use the restroom if I need to. Well, the other day I was there for a REALLY long time doing the individual consultations with my weight loss program participants. I had a 30 minute break in between participants so I was planning my lecture for the next week when all of a sudden I felt "the drop".... dun dun dun. Now I like to use the term "the drop" when you have had a rumbly tummy for a while, but nothing too crazy, and all of a sudden you feel the plumpfff or "the drop" when whatever craziness inside of you all of a sudden relocates itself right outside of your anal sphincter ... or in other words the " oh sh*%# I need to find a restroom in the next 30 seconds before I explode" moment. Well, it happened. In the clinic. So I ran next door to the latrine... and it was occupied. I knew I wasnt going to make it so I ran, clenching with all my might, back to the clinic. I don't even know what happened next... it was a very stressful time and I don't remember the series of events.... but the end product was a deuce in a plastic bag. I was so shocked, disturbed, whatever you want to call it that I had to sit there (after disposing of the bag of course) and process. I just kept saying "I just shit in a bag. I just shit... IN A BAG" After the initial shock wore off (and a very supportive phone convo with fellow PCV James) I was finally able to laugh about it, and I guess I felt the need to share it with y'all. Im sorry about that haha.

Okay on to serious stuff. We just finished all the Semana Santa (Easter Week) celebrations which include lots of church events, lots of habichuelas con dulce (sweet beans), alcohol (for the men), and trips to the river and beach. Everyone that lives in the cities comes to the campo to visit family and go to the beach which is great for the Dominicans but SUCKS for the peace corps volunteers. Its like the first week in your community all over again. Nobody knows who you are, everyone thinks you know nothing about dominican culture, and they assume you are a lost tourist. Anyways, I took the opportunity to hang out with the kids and explain the american tradition of easter egg hunts. They enjoyed dying the eggs, but they thought I was CRAZY when I tried to explain that a magical bunny comes and hides them in the yard and then all the kids have to go find them. In fact, they thought I was so crazy (even after a few HOURS of explaining it to them and showing them pictures on the internet) that I decided to skip the whole hunt part and just dye the eggs. This worked out okay anyways because the kids ate all the eggs immediately after dying them.... so there wouldn't have been any eggs to hide anyways haha.




My host mom and I making habichuelas con dulce.


Work has been going well. I have been super busy with the Reto de Rebaja (Weight loss challenge). I will be writing a complete update on that shortly. I want to take a few pictures of one of our exercise classes before I write the blog. I am still giving english classes twice a week, working with rural health promoters and teenage peer educators, and still waiting for my grant money to build the clay stoves. If I stay this busy the next 6 months are going to fly by!

Friday, March 22, 2013

Weight Loss Challenge: Week 1


Reto de Rebaja : Week 1

Great news! The first week of Reto de Rebaja was a HUGE success! I met with all of the participants individually and we created a personalized diet and exercise plan with daily, monthly, and weekly goals. We also took their measurements, blood pressure, blood sugar, body fat percentage, “before” photos and discussed their target weight along with their 10% and 15% weight loss goals. We also reviewed their food and exercise journals and talked about ways to improve them.

 At this point we have 20 participants between the ages of 17 and 59. Three of the participants are male and the remaining 17 are female. Using BMI we classified each participant as having a healthy weight, over weight, obese, or extremely obese.  I am not a huge fan of using BMI, but it is a good way for the participants to visualize their weight loss goals. We are starting with 4 overweight participants, 15 obese participants, and 1 extremely obese participant. The average starting BMI is 33, and the average starting body fat percentage is    .  I am very happy to say that in the first week the group lost 62 pounds!!!! That is an average of about 4 pounds a person (4 people have not been weighed yet).

The participants will continue to meet with me individually on a weekly basis. We also have one mandatory group meeting every week and two optional exercise classes. In the group meeting this week we talked about how weight loss is a physical, emotional, and spiritual journey, how to count calories, negative thinking and how to change negative thoughts into positive ones, and how to eat healthy at special events. The last topic was very important because Semana Santa or Easter week is next week. It is usually a time of vacationing, drinking, and eating a lot (especially habichuelas con dulce- a very high calorie Dominican treat). We also spent some time to congratulate the group on their success, and I gave out two healthy prizes to the participants the highest percent of weight lost. We also created a group goal of 500 pounds, and if we reach it each participant will get a water bottle. (I chose a water bottle as the prize because while reviewing the participants food journals I realized that most of them are not drinking nearly enough water.) We finished the meeting off with 30 minutes of exercise J

Here are a few of the “before” photos of the participants:












Saturday, March 9, 2013

Conferences, Weight loss, and Amanda-isms.


Hi my lovely internet friends and family! I have been extremely busy the last couple weeks and I have some great ish to share with you. Get excited!

First of all, those of you that know me know that on any given NORMAL day I can suppress the embarrassing weird-ling that lives inside of me… but when I get stressed out my energy is diverted elsewhere and all bets are off. Well, last weekend I was super stressed when I went to a conference for our rural health promoters and my fellow PCVs met the weird-ling. It was a weekend full of sing and dance and noises. The second I got into my nice hotel room (ballin) I decided to have a party with myself while I was waiting for my roomies to show up. I painted my nails while singing and dancing and naturally threw the brand new bottle of blood red nail polish clear across the room to create this beautiful piece of artwork (crrrrrraaab cakes!)

Later that day when we made our way down to the first meeting of the conference with 100+ Dominican women I decided to sit in the back so that I could work on all of the crazy ish that was making me so stressed. Two of my fellow PCVs did the same, and they sat on either side of me. I put my grant-writing-hat on right away and got to work. I wasn’t paying attention to anything that was going on… so when I heard the two PCVs arguing over me about who was going to go do “it” I thought they were talking about a dinamica (ice breaker type activity that we use to start every meeting. Consists of the PCV acting like a complete idiot and makes the women laugh). So naturally I said “Don’t worry about it guys I got this one” in my best condescending, I cant believe you guys aren’t used to doing these things by now, voice. I proceeded to walk up to the front of the room and act out different emotions while talking to my pen… when I got back to my table feeling very proud of my excellent performance the other PCVs informed me that they did not ask for a dinamica… they simply wanted us to introduce ourselves. Pooper scooper!!!!

Anyways, on to some serious talk. The reason I was so stressed out was because I recently just had a TON of work put on my plate… and here I thought I was going to get to relax a little at the end of my service (silly Amanda). I just started my Reto de Rebaja (weight loss challenge) which takes up about 4 full days a week with individual consultations, exercise classes, and nutrition classes. I am teaching an English class that somehow has been advertised all over the country. I have people coming from all of the surrounding communities to learn English which sounds great… but it really isn’t. If you have ever visited a Dominican school you would know why. The teacher usually stands in front of the class and talks while all the kids talk amongst themselves and pay no attention whatsoever. Well, when you are not a native Spanish speaker and you are speaking Spanish to teach native Spanish speakers English ish can get confusing and it is kind of important to be able to hear yourself think. So I am working that… My boss also just told me that he wants me to take over 40 groups of rural health promoters and teenage peer educators that will require me to apply for a $15- $20,000 US dollar grant. YIKES. Lets just say I would be happy to do this if I was just starting my service. The fact that I have 6 months to do this (we have to close out grants a few months before we leave) is SUPER stressful. He seems to think that I will stay longer than my two years… but I beg to differ HA. I mean don’t get me wrong I love the DR and I wouldn’t take back my service for anything… but get me some running water and electricity (know what im sayin..)

Reto de Rebaja:

Okay so I am really excited because this week I had two meetings for Reto de Rebaja. The first one was just to register all of the people who are going to participate and the second was to tell them the rules, how to use their food journals, and the basic food groups.  The first day was a little depressing because I only had 8 people show up, but it was to be expected because in my community being fat is a sign of wealth and health so most people see losing weight as a bad thing. However, I now have 19 people enrolled in the course (which is perfect because I wanted maximum 20 people). All 19 people seem to be really excited about it too which is great! I made a manual with basic nutrition and weight loss information (including info on diabetes and hypertension). Each participant got a manual, and the manual also has a spot for us to fill in all of their goals, weight loss data, and a food journal. In the second meeting I taught them how to use their manuals. We also did an activity where they had to put a whole bunch of different kinds of food in their food groups. The winner got broccoli and carrots!
Next week each participant has an individual appointment with me. We are going to go over their goals and make an individualized diet and exercise plan. I will also be weighing them, taking their blood pressure, body measurements, % body fat, and blood glucose levels. Plus, we will have a meeting as a group to learn about nutrition and do some exercise! Oh and I am doing the program with them… because lets face it I need to! Get excited y’all! 

Sub-Regional Conferences:

I also just recently held two sub-regional conferences, one for my rural health promoters and one for my teenage peer educators. I have never had to put on an entire conference by myself before… and let me tell you it is not so easy. Both conferences ended up turning out better then I had hoped, and we had a lot of fun. The conferences were focused on teaching the participants how to “share” the information they acquired in the course. Each participant had to give a mini-lecture on a relevant health topic, and the health promoters also learned how to do home visits. 
The best part of the conference was why my Hogares Saludables Regional Coordinator got up to give her lecture on breast feeding. When I first got here she would stand in front of a group, look up at the ceiling with her hands behind her back, rock back and forth on her feet, and speak really quiet. I have been working with her on her public speaking... and she was AWESOME. She walked back and forth between the group, spoke in a loud voice, made eye contact with the participants, used her arms and body, referred back to her visual aids, asked questions, and involved the audience! I was so proud! 
Luz Maria
On our way...

Escojo Coordinators 

Rural Health Promoters

Me doing a "dinamica"

Participants doing the dinamica with me.

Planning

Rural Health Promoters

Planning

Teenage Peer Educators
Oh, I also have a new problem in my house... something is burrowing up and leaving me surprises like this! Grrrrrrr...... better not be the ghost of Hootie! (If you don't know who Hootie is.... read this http://aappel.blogspot.com/2012/10/under-attack.html )