Saturday, 31 March 2012

Cleaning House

Well, the inevitable has happened. My baby turned 18.

That means a lot of things, of course. In practical terms, one of the big things is that my ex-husband no longer has to pay child support.  It means my income for managing my personal life and the household suddenly dropped by about 25%.

(In my ex-husband's favour, I must say that he does give the kids pocket money to help them with their education expenses - but that doesn't help with food, rent, etc.)

One of the things which has had to go with the reduction in income was the cleaner. Suddenly, I'm doing my own cleaning.

I don't do it the way the cleaner did. I'm not trying to clean the whole house in two hours. Instead, it's a little bit here and there, breaking down each task into its smallest possible bits and doing just the tiny bit at a time.

But I'm also doing things like sweeping behind the fridge. (No, you don't want to know what that was like when I first looked.) And I'm moving things to clean under them, which is giving me no end of surprises.

As with the kitchen, I have gadgets to make it a little easier to do what I have to do despite complaining joints.

Long-handled cleaning tools.

I use a long-handled dustpan and brush, rather than having to bend down to use the traditional type. And a reaching tool to pick small items up off the floor, again to save bending.

The item on the right in the picture is absolutely amazing. It's for cleaning the bathroom. I don't try to reach across the bath with a spray bottle and sponge.  Instead I use this long-handled sponge/scrubber. I dip it in a bucket of water and disinfectant, and use it to clean tiles, the big mirror on the other side of the bath, anything that I would otherwise have to bend or stretch to reach. After that, all I have to do is give what I can reach a quick wipe with a cloth dipped in the disinfectant water.

The only really heavy job, the vacuum cleaner, I haven't tried yet. On the cleaner's last day with me it broke and I have to buy some fairly expensive parts. (The problem with buying such a high-quality vacuum cleaner/carpet washer, is that the parts cost a bit.) Once I get the part, I think I am going to give the offspring vacuum-cleaner lessons.

Update 13/3/2017 I was sent a link to show how to clean the house.  Can I suggest that if you don't have brain fog, do up to the point of making the detailed checklist - then hand it to a more able-bodied member of the family and go have a nap.  Pro Tips on How To Clean Your Home The Right Way.

Thursday, 29 March 2012

Weight Loss Group: Easter!

My weight: last week 90kg; this week 89.6kg.

This week, it seems to make sense that our weight loss group should look at Easter looming large ahead of us.

For me, the point of Easter is actually a very serious religious festival. But it seems that we can't celebrate it now without chocolate. In fact, one company insists that it's only Easter if it involves their chocolate.

I actually disagree with that. The best Easter eggs I've ever been given were hard-boiled eggs that someone had gone to the trouble of hand-decorating for me.

But aside from that, in the world we live in, we are most likely to be given chocolate. And with the long weekend, and the chance of get-togethers, we're probably going to be exposed to other foods that aren't really everyday foods.

So what do we do? Well, remember the chocolate is OK - in small amounts. The trick is to eat it mindfully - make the most of the little bit we eat. Remember our mindfulness exercise, from a couple of weeks ago? We actually used chocolate as the example and found that if we really paid attention to what we were eating, we could be satisfied with a very little bit of chocolate. So, with the chocolate you're given, have a very small bit each day, and enjoy it thoroughly. If you're given a lot it will take you a long time to get through, but there's  nothing wrong with that.

For other foods - especially if we're going out to dinners or parties over the long weekend, the same rules as  eating out at restaurants apply.

If you know what your choices are ahead of time, that helps you make the decision when the food isn't all in front of you. Once you've made a decision, stick to it.

If you're taking a plate to a party - make sure what you take is healthy food, that way you'll know there will be at least one healthy option available.

Don't go out starving - have a light snack, something like a salad, before you go if you're in danger of wolfing down everything without even noticing what you're eating.

Alternate drinks like wine with sparkling water or diet soft drink - keeps your head clearer as well as minimising calories.

But most of all remember, even if you go over your calories, you haven't failed, unless you give up trying.  If you go over on your calories, all you have to do is minimise the damage as much as you can with your other choices on that day, and start fresh the next day. The person who puts the food in your mouth is you. If you can lose control, you can find it again!

Happy Easter everyone!

Friday, 23 March 2012

Food and Inflammation

Someone suggested to me that I investigate what foods help reduce inflammation - and suggested a particular supplement that she had heard was really good.

So I started reading. The references links below will give you an idea of the wide variety of views that are out there.

There's a lot of myths. If you want to see most of the myths and the actual scientific response to them, check the food myths link. Almost anything can be considered an anti-inflammatory food by someone, but the actual research doesn't back a lot of it up.

If you type "food and inflammation" into Google, you'll get endless options. You can read through it all if you like. There's been an Inflammatory Factor list made up to describe the inflammatory effect of various foods - but unlike the Glycaemic Index, it doesn't appear to have any stringent research behind it. (I'm open to being corrected on this - but I have looked and not found the actual research behind it.)

So what have I learned?  The sites that actually seem to rely on the most solid research encourage the same kind of diet that my Thursday night weight loss group is working on: low in saturated fats, low GI, high fibre, lots of fresh foods.

The other thing to bear in mind is that there is a definite link between weight and inflammation. Excess weight makes inflammatory disorders like lupus worse. (There's also signs that inflammation can contribute to obesity.)

So if you want an anti-inflammatory diet, here's some basic tips, that pretty much all the sites would agree on, without some of the more radical suggestions.

  1. If you have any food allergies or sensitivities (eg gluten, lactose), avoid the foods that you know make you sick. (If you have persistent reflux or irritable bowel, and haven't ever checked with your doctor, it's a good idea to ask if something like gluten or lactose could be at fault.)
  2. If you're eating red meat, cut off the fat. Go for pasture-fed red meat, rather than grain fed. Grain fed has fat marbled all through it, that you can't see. 
  3. For poultry, remove the skin.
  4. Fish, especially oily fish, is good. Just don't ruin it by deep frying, or something gross like that. (Fish oil capsules are also good - although the amount my rheumatologist has me taking should cause me to grow gills.)
  5. Dairy products are a great source of nutrients of calcium, but also a source of saturated fats, so keep to sensible serves, and opt for lower-fat varieties.
  6. Beans, peas, lentils - all kinds of legumes or pulses - are very good for you. They're low GI, low fat, high fibre, and full of nutrition.
  7. Fresh fruit and vegetables are good for you too. Remember that vegetables are colour-coded you want a variety of different coloured vegetables every day.
  8. Nuts, avocados, seeds, olives, etc are a great source of healthy fats. If you're watching your weight, be careful of serving sizes, because they are very energy dense.
  9. Go for monounsaturated oils like olive oils instead of saturated fats (usually animal fats) or polyunsaturated oils. Avoid trans-fats.
  10. Choose whole grains ahead of refined grain products. Pasta is OK but be careful of the company it keeps!
  11. If you eat food as close as possible to its natural state, you will have the benefit of the fibre, and it will usually be lower GI, with less salt, fat and other nasties added.
  12. Following on from point 11, foods with numbers listed as ingredients are not really good. I love the explanation I heard my 18 year old son giving to a 10 year old:  "You can't eat numbers. Numbers are math, not food. Math is always bad for you."
  13. Grill, steam, microwave, stir-fry, oven-bake without fat. Don't deep fry your food.
  14. If weight is an issue with your health - keep your portion sizes sensible, for everything you eat.


Thursday, 22 March 2012

Why You Need Sleep

I don't normally go for the guest blogger thing - I've been doing this for less than a year and still not very confident. But when the following was offered - all ready to go, and very well researched and presented, I felt it was well worth sharing with you.

For lupies, sleep is very important. The only member of the family who naps more than I do is the cat - and I come a very close second. (The geriatric dog is pretty close as well.)  But even healthy people suffer the effects if they don't get enough sleep.

So care of we have information on Why You Need Sleep.

You Need More Sleep
Created by: Medical Billing and Coding Certification

Sore and Sorry for Myself

I'm feeling very sorry for myself today.

I saw the doctor this morning and had my flu shot. The doctor decided I was due for a blood test, so I did that as well while I was out. Then I remembered we were out of milk, and thought I may as well get a few things from the supermarket.

After either a needle or a blood test, I ought to have come straight home for a nap.  Waiting at the check-out, I found I was using the supermarket trolley to prop me up, as my ankles, hips and knees all announced they were going on strike. I started to get the shakes putting my shopping on the checkout counter, my shoulders, wrists, elbows and fingers all saying they were done for the day, and stop trying to force them to do overtime.

Fortunately, my son was at home and brought the groceries in for me.

Since then, I've been lying in bed in pain, crying.

These are the days I wish I wasn't single, that there was someone to lie beside me and hold me until the hurt stops. (They're also the days when I know I no longer have the energy or anything else left to put into starting or maintaining a relationship.)

I was asked once why I don't say "Why me?" But I've seen so many really bad things happen to so many people, that I can't see that what happens to me is really any worse. But it is my pain, and some days I do feel a bit sorry for myself.

When dinnertime came around, I went to get my tablets, and discovered I hadn't taken my lunchtime ones - I'd been without pain relief since breakfast.  Pills helped a lot. I'm still a bit sore, but nothing like the afternoon I've had!

Wednesday, 21 March 2012

Getting Behinder and Behinderer

Sorry, you don't know the words "behinder" or "behinderer"?  That's probably because I just invented them.
I had to come up with words to describe what's going on.

I've been going through a reduction in my steroids over the past few weeks, thanks to my sadistic rheumatologist.  OK, I know Dr K has is reasons, and at least theoretically, they're good reasons: to help me get control of my weight, and to stop the risk of steroids damaging my bones and other parts of my body.

I'm now down to the final point - what he says should be my highest level, but the lowest I have been at for many months: 5mg of prednisolone per day. This means I've gone from something resembling almost normal life, to being almost back where I was when I couldn't work at all.

I still have some energy to get things done in the morning, but I have a fair amount of joint pain with it, and I run out of oomph at about 10 am. (Given that I get up at 7am, that doesn't give me a very long day to achieve things in.) I just barely manage to keep going until about 10.30 when I have a coffee and sit and rest until lunchtime, when I eat and go for a nap.  This nap often lasts until dinner time, unless I absolutely have to get up for something like hydrotherapy.

In terms of work for work, and work around the house, well I'm getting behinder and behinderer on where I need to be in getting things done. My "to do" list just keeps growing and growing, and I keep reorganising and rescheduling.

Eventually, what I am going to have to do is simply start eliminating things from the "to do" list - to decide what I can live without doing, as I've already put a lot of work into finding easier ways of doing the little bit I do.

Not everyone with lupus spends so much of their day in bed. I look at the incredible Brynn Hultquist's blog Lupus Interrupted, and am constantly awed by all that she manages to do. She's getting married (doing everything herself), is a mum of five, and does daycare. When I can't drag myself out of bed after my afternoon nap, I can't imagine how she does it. Which means that some lupies out there are getting on with their lives and getting things done.

Me, I'm getting next to nothing done. I'm just getting behinder and behinderer.

Friday, 16 March 2012

Hair Today, Gone Tomorrow

I'm having a hair fall. It's one of those things that goes with lupus, but I haven't had one for quite a while.

I cut my hair, so it doesn't seem as bad
when it falls out.
Since my steroids have been cut back, I've had extra pain and fatigue, and now the hair issue.

(Of course steroids caused their own hair issues as well - I had to wax my moustache and sideburns often. Before steroids I'd never thought I'd be doing that.)

I found it quite distressing, having handfuls of hair fall out. Other lupies on Twitter gave me some suggestions: B-group vitamins, Hair, Skin and Nails tablets, and pre-natal tablets.  (This last one I found amusing, imagining what the staff at the chemist would think if I bought pre-natals along with my regular truckload of pills. I can already hear all the well-meaning advice against becoming pregnant while constantly pouring this toxic cocktail into my body!)

So, next time I'm at the chemist's, and I'm there at least once a week, I'm going to look at B-group vitamins, and at Hair, Skin and Nails, and see which will work out the most cost-effective for me to try first. I'll give the pre-natals a miss, at least for now.

In the meantime, I've had the chop.  I decided that if my hair were half the length, there would only be half as much in the handfuls that fall out - and that would look far less disturbing. So yesterday morning, when I got up, I took my domperidone, and in the time I have to allow between that and eating breakfast, I went to the bathroom with a pair of scissors, and cut most of the length off my hair.

Cutting my hair has an extra benefit, in that it's actually easier to wash and brush than long hair. That's really important on the days when my shoulders hurt and make reaching my head difficult!

For a brief moment, I considered getting out the clippers and taking all my hair off - having the problem completely solved, at least for a short while. It wouldn't be the first time I was bald - in May 2006, on my 40th birthday, I had all of my hair shaved off to raise money for the cancer society's "Shave for a Cure". That was less than six years ago, when I didn't know I had my own horrible disease.

Thursday, 15 March 2012

Weight Loss Group: Triggers

My weight: last week 90kg; this week 90.6kg.

Firstly, I was going to get back to you with the group's response to the question posed last week: "What is the procedure for losing weight?"

What the group came up with was: "It's twofold. Find a supportive and educative group; and get a resource like the Calorie King website that we use to help you track your energy in and out."

All of group members agreed that the group support was the most important tool in weight loss. When I specifically asked: "What would be the first chapter in your best-selling weight loss book?" I was told they would all say don't read a book, go to a support group.

Now, on to tonight's topic: triggers.

Everyone who has ever had a problem with binge eating, will have trigger factors: those things that lead to the start of a binge. For many people it's stress, but it also be boredom, happiness, watching TV, almost anything you can think of.

I think I've overcome my big trigger: stress. I'd realised that I was over that when Mr Wonderful and I broke up, and I was able to look at a block of chocolate and decide I was not going to eat it.

I still have two other triggers: physical pain and fatigue.  Those explain my weight gain this week. Reducing my steroids has increased both my pain and my fatigue.  Why do both of these things have some sort of link in my mind with eating? Fatigue I guess makes some kind of sense - I get energy from food, I have no energy, therefore eating should help (but it doesn't.) Pain? My father had a cure-all for all kinds of pain when I was a kid - it was a Cherry Ripe. (If you're outside Australia, a Cherry Ripe is a heart attack wrapped in red foil - glace cherries and dessicated coconut in what I think is a condensed milk base, wrapped in a ton of rich dark chocolate.) I can't eat Cherry Ripes anymore, because they have lactose in them. But I still eat when I'm in pain.

I know why my triggers are triggers - what I still have to do is master the art of saying "no" and closing the fridge, just as I have done with stress.

As for the rest of the group? We did one session on stress not long ago.  This week, we're going to look at identifying what still may be triggers for all of us, and why they affect us.  And we're going to look at the art of saying "no".

Part of the art of saying "no" to trigger factors is to realise that there is no logical reason that food could help the situation. If I my shoulder, or my big toe, is hurting, no amount of food is going to stop it hurting. If I'm worried because a kid is late home, no amount of food will get them home any faster.

Another part of the art of saying "no" is to look at the situation we're in. Do you know it is possible to go to a movie theatre and not have popcorn and softdrink? I do it regularly now - but the first few times it felt very strange.

Sometimes our trigger is just habit. And habits can be changed - either just stopped, or substituted for something else. If you always have a big snack to relax when you get home from work, but are not actually hungry then, a piece of fruit or even a glass of mineral water will do just the same for you. The point isn't what you eat, it's that you sit down and relax at the end of the day. Alternately, you could go for a walk.

If you have a binge eating problem, what are your triggers? Perhaps there are creative ways you could defuse them.

Wednesday, 14 March 2012

Gadgets in the Kitchen

When I was really sick before, I started collecting gadgets that helped me do daily tasks with a little less effort.

At the time my daughter said I was becoming too gadget-dependent, and I pointed out that if she ever hoped to leave home I should be dependent on gadgets and not on the kids. Then she started looking out for gadgets with me.

I thought I'd like to share with you some of my favourite kitchen gadgets. Because I love cooking (and I love cooking because I love eating) these get a lot of use.

The big plastic hook..
.I can't remember its real name.
I tend to lurk around the kitchen shops looking for those great finds that cost very little, but make a huge difference to my life.

One of these is a big plastic hook. I'm sure it had a "proper" name, but I can't remember what that is.  It opens those ring-pull cans. You know the ones. They're supposed to be easier to open because you don't need a can opener.

If you're like me, you find those cans a problem, because you have to be able to lift the little ring in the first place, and then have hands strong enough to pull it forward and then peel the can lid back.

The hook can be pushed under the ring with less effort than trying to get fingers under it. Then it's a matter of rocking the hook forwards to break the seal and back to peel off the lid.

The handle is easy to grip with my whole hand, so I'm not relying on just a couple of fingers, and the hook shape means that I don't need to use a lot of force to peel the lid back from the can. This bit of plastic can save a lot of frustration in the kitchen.

Jar key.
Another great gadget is the "Jar Key". This helps to loosen the lids on jars.

Most things to help open jars, work on turning the lid. This one works by helping to break the initial seal. It hooks under the edge of the lid, then it's a matter of gently lifting enough to allow some air into the jar. The safety button on the lid pops up and the jar is suddenly easy to open.

Again, it has a nice long and flat handle, easy to hold, and is designed so it takes the minimum of effort to use - something absolutely essential on days when my hands are not working properly.

As for cost, I bought this about three years ago, so I'm not entirely sure, but I think I paid less than $5 at my local Robin's Kitchen.

Sometimes, just holding a piece of equipment differently
makes a difference.
Some days, simple things like holding a vegetable peeler or a vegetable brush can hurt.

Here's an alternative - instead of the traditional small handle, these have a loop to go over the finger. I hold my peeler or my vege brush in the palm of my hand.

The technique takes a little bit of getting used to - but I find that even my daughter now prefers these to the traditional ones that are left lying unused at the back of the drawer now.

From memory, they were slightly more expensive than the "normal" versions - but not by much at all,   and they have proved their value for several years.

Staysharp scissors, a can opener with an easy grip.
and a gadget to help turn lids.
One of my most used gadgets is my pair of staysharp kitchen scissors.  I now use scissors for a lot of things I used to use a knife for. Scissors cut up herbs, meat and vegetables, provided they are thin enough. They have a really good grip, so are easy to use, and the case/sharpener means that they're always ready to use and perform well.

Another useful gadget to have is the kind of can opener that has big handles. It's easy to hold and easy to use.

The other object in this picture, I'm sure has a name, but I don't know what it is. The idea is that it helps grip the lids of bottles and jars to make them easier to turn. I have needed to use this for small bottle lids once or twice, but find for jars, the Jar Key is far easier.

The ultimate gadget: Kenwood Chef.

Of all my kitchen gadgets, my favourite is not something I picked up for a couple of dollars at the kitchen shop.

For my birthday last year, Mr Wonderful gave me a Kenwood Chef. (Yes, he was very good to me.)

There's lots of attachments that I want to save up for to go with this, but even the ones that came with it have made an amazing difference to my life. The standard equipment included a hook for kneading dough. Gluten-free bread that tastes good is hard to find, and the best is home-made. The dough hook does the kneading my hands and wrists no longer can do - meaning I can still have my home-made breads. The whisk attachment does what I used to be able to do with a hand whisk - only much faster and better. The other attachments also make a world of difference to the basic tasks of cooking.  And the plastic splash guard means that I don't have a mess in my kitchen from the ultra fine gluten free flour being spread around.

Monday, 12 March 2012

I Want My Steroids Back!

Yes, I know I look tired.
It's midday, and I'm still in my nightie. But then, I went to bed at midday yesterday, and didn't wake up until 9am today. I got home from church, ate lunch and went to bed. I'm still tired.

I'm in the process of weaning off steroids - not completely, just down to about a third of what I was on. At the moment I'm on 7.5mg per day - and will eventually be down to 5mg per day.

As my steroids go down, my pain and fatigue levels go up - I'm getting behinder and behinderer in all the things that I need to get done around the house, for work, for my blogs, and for my self-care.

The reduction in steroids has meant I've had to give up Curves as much as I loved the workout there.  Instead I'm doing hydrotherapy - very basic and gentle - and it still feels like too much!

Another effect is that my hair is starting to fall out. (Not the excess hair on my face that steroids caused, but the hair on my head is coming out by the handful.) A long conversation on twitter with other lupies this morning has led to the suggestions I increase B group vitamins, or take "hair, skin and nails" supplement, or a pre-natal supplement. (I could imagine the amusement at the chemist's if I add a pre-natal supplement to my truckload of pills - so I might go with one of the other options first.) As my wrists and shoulders are hurting so much, maybe having my hair fall out is a good thing - if I lose it all, I won't have to brush it.

There is a plus side to reduce my steroids - my weight has been slowly, but steadily, decreasing as the steroids have decreased. Since weight was one of my rheumatologist's major concerns with my steroid dosage, that's a good outcome, I guess.

Thursday, 8 March 2012

Weight Loss Group: What's the Procedure for Losing Weight?

My weight last week 90.4kg; this week 90kg.

A friend asked me an interesting question last week when I was preparing for Weight Loss Group. He asked what the actual procedure for losing weight is. (This is a person who will probably never need to lose weight.)

It was such a good question, I set it for homework for the group. Think about what the actual procedure is for losing weight.

Tonight we're going to have a big sheet of paper, and we're going to list our procedure.

Some elements that it will need to include are:

  • Diet and nutrition: it's not enough to just reduce calories, we need to make sure what we're eating is actually good for our bodies. A treat once in a while is OK - it will help us feel we're not being deprived - but most of what we eat has to actually contribute some nutritional value to our bodies.
  • Exercise: it's possible to lose weight without exercise, but exercise helps to keep us healthy, and helps us to build lean muscle which boosts our metabolism.
  • Psychological issues: we all need to look at the habits that made us overweight - if we don't intentionally do something to change them, there is a real risk of just going back to the same habits. 
Tomorrow, I'll post the full procedure the group comes up with tonight.

Friday, 2 March 2012

Overdoing Things

I've overdone things a bit today - and I did so intentionally.  It's not that I'm a masochist, or anything like that. I don't enjoy being miserable and in pain and over-tired.  It's just that stuff needs to be done and it's better now than later.

Since my last visit to my rheumatologist, my prednisolone had dropped from 12.5mg per day to 10mg per day. Next week it drops to 7.5mg per day and a fortnight after that to 5mg per day.

There's things I will need to do to adapt to the change. So far, it's not been too bad. That's partly because I've been here before.  It didn't take much for me to fall back into the habit of frequent naps and long soaks in the bath for aches and pains. I prefer to be out of pain and not suffering from fatigue - but that kind of requires the dose of steroid I was on, along with the risks the rheumatologist was concerned about. Of course, the other reason it's not too bad yet, is that I've only taken one step in the reduction process - I have to learn to live with half the amount I'm on now.

If I'm getting sore and tired on a 10mg dose, I'm going to be very sore and tired on a 5mg dose.  So I've looked around the house and decided it's time to do one big spring clean, and re-organise.  In the past couple of months, I've become lazy about where I keep things. It's been easy to pick things up from floor level, to reach into the back of the bottom cupboard, to empty some towels out of the linen cupboard to find that tablecloth.

It's starting to get harder to do those things now.  In a month's time, it will be very hard indeed. So now, while I still have a little energy left, I'm using it to rearrange things - get the things I use most in the house back to where I can access them the easiest, and get the house thoroughly clean and tidy so it is easier to keep clean and tidy.

I've overdone things a bit today - and will do a bit more over the next few days. Hopefully, the pain and fatigue will pay off, when this transition the lower dose of steroid is complete, and I need to conserve all of the energy I possibly can.

Thursday, 1 March 2012

Weight Loss Group: Making Your Recipes Healthier

My weight: last week 90.6kg; this week 90.4kg.

Weight loss group this week is looking at modifying recipes so they are healthier.

So let's just use a simple example.  Here's a basic recipe for a fast-food meal you could cook at home. (Note, even if you just stick with the recipe as written, you'll probably have a healthier meal than if you ate it at a take-away restaurant.)

Basic Recipe: Hamburger and Chips
(Serves 4)

4 x hamburger buns
4 lettuce leaves
1 sliced tomato
Tomato sauce

4 large potatoes

Oil (for frying)

500g minced beef
1 diced onion
1 egg
1 cup bread crumbs

To make rissoles: knead all ingredients together, shape into four large (or eight small) patties. Refrigerate at least an hour. Shallow-fry in hot oil.

For chips: peel potatoes. Cut into chips. Wash, and dry thoroughly. Deep fry in hot oil. Drain on paper towel.

Split and toast buns. Butter them. Fill with lettuce, tomato, rissole and sauce. Serve with hot chips on the side.

Yum! Huh?  Actually, I'm feeling quite nauseas looking at this - yet it's how I used to eat.

Healthier Variations

  • Start with low-fat mince, the leaner the better. (Reduces kilojoules, and saturated fat.)
  • Substitute half of the mince for cooked lentils. (Still good protein, reduces saturated fat, adds fibre, and adds flavour, lowers the GI of the meal.) 
  • Or You could substitute all of the meat for half and half lentils and mashed chick peas and add herbs for extra flavour - my personal preference. (No fat. Low GI carb and still good quality protein.) 
  • Use wholegrain breadcrumbs. (lower GI) Gluten-free variation: half rice crumbs half psyllium fibre.
  • Grill the rissoles or cook them in a pan sprayed with oil - there is no need to have them swimming in oil.
  • Use whole grain bread roll or sour dough roll. (Lower GI) Gluten-free variation: skip the bread roll all together - you've got plenty of carbs in this meal anyway.
  • Don't butter your bread. (Why add unnecessary fat?)
  • Add more salad. Try some cucumber, grated carrot, beetroot. 
  • For the chips. Substitute half the potato for sweet potato.  Peel and cut as usual. Half-cook in microwave. Place in a single layer on oven trays, spray lightly with oil, and sprinkle with your favourite herbs.  Cook in a hot oven until lightly browned. (Lower GI, dramatically less fat.  Want to increase the fibre? Leave skins on your potatoes.)

The reason most people have fast-food meals is that it is fast. (Even if the definition of "food" is a little fungible in this context.)  Cooking your fast-food meal at home isn't necessarily slower than going to the restaurant, ordering, picking up your meal and coming home. Cooking the healthier variation is no more difficult or time-consuming than cooking the original version.

Basic Rules for Varying Recipes

  • Reduce fat.  In many recipes, oil/butter/margarine can be reduced even by half without changing the taste or texture of the final dish. Substituting leaner meats cuts the amount of saturated fat in a dish. Dairy products can be substituted for lower-fat varieties. Don’t deep-fry or shallow-fry anything in oil – grill, cook in a non-stick pan with just a spray of oil,
  • Lower GI. Changing from white bread to multigrain bread, from another rice to basmati rice, etc can lower the overall GI of the meal without changing the overall experience of eating the meal.
  • Increase Fibre. Add extra vegetables where possible. Add whole grains, and legumes.  Add fresh fruit. Lots of plants as close as possible to the way they naturally grew. 
  • Add herbs for flavour. Don’t add oils, salt, etc.