Friday, August 26, 2016

Energize!



As August winds down, the temperature begins dropping as we welcome the winds and rains of the monsoon. Children return to school, and family schedules slowly begin to normalize. Everywhere we go, we can feel the approach of fall in the air - that gentle slowing of movement and metabolism that heralds the oncoming winter season.

Except, of course, in my house. Here we are suddenly bouncing off the walls, getting out of the house more every week than we used to do in any given month. Drive-throughs have been replaced by home-cooked meals, though admittedly very small ones. Long-range planning has suddenly become a concept, where we usually used to only deal with whatever any given day had in store for us.

The schedule around here has certainly changed. I am now getting up around 6 every morning. We head out for a morning bike ride every day, and still walk the dog every evening. Bed time is now closer to 10 - 11 pm, rather than my usual 9 pm. 

It isn't just more time awake, though. Everywhere you look, there are signs of increased energy. Vixen is running around the house, growling and yipping and playing with toys as if she were a puppy again. Lor is pulling out arts and crafts projects that have lain forgotten for years and re-starting work on them. And I am now really writing: instead of hastily writing the blog and then going back to reading or gaming, I am now spending a minimum of 4 hours a day writing, 6 days a week. It is as if someone slipped a permanent vitality potion into our (high protein, low carb) breakfasts each morning.

A dietician will tell you that it is due to the complete shift in the protein:carbohydrate ratio in our diets. A personal trainer will inform you that it is due to the increased amount of exercise we are getting. A doctor might say that it is simply due to losing excess weight and stabilizing our daily nutrients.

I think that these are all at least partially correct answers, but ultimately I think it has more to do with mindset than anything: We are no longer resigned to living with the sedentary lifestyle brought on by my obesity and our other illnesses. Lor and I are suddenly interested in the world outside our front door because we no longer feel ourselves cut off from it. And Vixen is just spastic because, well, Vixen.



It is not all sunshine and roses, of course. Our increased energy expenditure has us now dropping down for naps for a couple of hours every afternoon. We do get to the far side of a long ride or day and look at each other, realizing that we have pushed just a little too hard and now are going to have to struggle to make it home. But this is no different than any other kind of resistance exercise - you push to failure, then next time you are a little bit stronger.

We still have lots of things we want to add - Lor wants to start an aerobics class, I desperately want to get back to the gym. But, I no longer look at those things with a resigned malaise as "may happen some day". I now know, with a little more time investment, we will actually get there.


More Naps May Be Required,

- Hawkwind


Thursday, August 25, 2016

In Transition

(Transition Offense, for those who have no idea what I am referring to here.)

I got to spend some time at ABQ Health Partners Bariatrics yesterday for my 1-month surgical follow-up. My Nurse Practioner, Patricia, laughed at the "oops, I ate bread" story, expressed concern that my blood pressure was too low, and congratulated me on my continued weight loss. She then warned me that a stall might be coming as my diet changed, and then approved me to move to the "regular food" diet - ready to eat any food I wanted, provided I abided by the rules we have been getting hammered into us for the past several weeks. You know: protein first, no liquid before or after meals, less than 20 grams of carbohydrates with any meal in a day.

With that, she released me into the wild. Total time in the office: 19 minutes.

I stood blinking in the sunlight outside the office, my head swimming at how quickly everything took place, and then realized that I was, finally, able to start eating like a normal person again. Admittedly, a normal person who eats 4-ounce meals that take 30 minutes to ingest, but, you know, mostly normal. 

So...now what?

We briefly discussed going out to a restaurant to celebrate, but after the Panera disaster on Saturday I was not really feelin' it. Other than steakhouses and seafood joints, I could not think of any restaurants who specialized in high-protein, low carbohydrate fare, so I decided to just skip it. Instead, we headed to the grocery store.

Where I bought greek yogurt. With fruit in it.

I remember 6 weeks ago, Lor's absolute delight in wandering the aisles of Trader Joe's and buying all these items she had been missing, and felt kind of jealous. I felt no sense of joy, really. No overwhelming relief that the worst was past and now I could start enjoying my new diet. Mainly, I felt panic. How was I going to handle 60 grams of protein a day without using protein shakes? I felt like someone had taken the training wheels off my dietary bicycle, and I was now teetering precariously as I rolled down the street.

So, instead of a celebratory meal, I had a P3 instead:


12 grams of protein, and roasted meats, hard cheese,and nuts - all things that have been denied me for weeks now. That settled me down the way a stiff drink used to. Heck, eat three of these a day, with two yogurts for snacks, and I am already upwards of 50 grams of protein, right? Nothing to this 60 grams a day thing!

Then, for dinner, came Lor's secret weapon. It turns out she had been planning for weeks to make us a pizza to celebrate my return to real food. Not just any kind of pizza, though - a pizza whose crust was made out of baked ground chicken.

Yeah, let that settle in for a bit. It is a real thing: Chicken Crust Pizza.

Except, instead of going all "veggie friendly", Lor piled it with beef marinara, Canadian bacon, regular bacon, and fresh mozzarella. A single slice of this heavenly marvel came in at a whopping 23 Protein, with only 4 Carbs. The best way I can describe the taste of the crust is a deep dish pizza crust cooked in an oven at the same time as a roasting chicken. We (barely) managed a slice each. (Mind you, each slice is about half the size of a standard slice of pizza. So, yeah, pretty nutrient-dense.)

So, yeah, maybe this "real food" thing will work out after all.

Now I Am Ready To Go Back To The Grocery Store,

- Hawkwind


Tuesday, August 23, 2016

Uncomfortable Answers



In the weeks leading up to and following our surgeries, Lor and I have become the friends and family ambassadors representing the nation of bariatric surgery. Sometimes the questions are asked in front of everyone at public gatherings, sometimes whispered as soon as no one is around, but the requests for more information keep on coming. The procedure itself is somewhat mysterious, and people are filled with curiosity.

For the most part, this is excellent - clearing up misconceptions about the procedure and the lifestyle changes that accompany it is probably the best way Lor and I can "pay it forward" for an experience that has had such a positive life-altering affect on us. We have friends and family members who are either considering or going through bariatric surgery and being able to help them along is awesome. Heck, I even write a blog about it, to get the information out there. We want this info to be spread far and wide.

But...there are a few questions that come up (and frequently get repeated) that demonstrate the misunderstandings surrounding bariatric surgery. And the answers admittedly don't feel real good when we know that someone is hoping that our answer will be exactly the opposite of what the truth is. It always makes me sad that someone who is considering bariatric surgery asks me a question that I know will immediately turn them away from looking into it any further. But, in for a penny, in for a pound - here are a few of those uncomfortable answers:

"Aren't you hungry all the time?": No...and yes. Let me explain. If I allow myself to dwell on thinking about food, I will crave it. It is as simple as that. Smells are an especially strong trigger for me - I can't smell pizza without wanting to eat one. Like, a whole pizza, I mean. But if I walk away, and think about something else, within 5 minutes or so I am no longer hungry. The hunger is not being generated by my digestive system at all (which is remarkably quiet if I don't expose myself to pizza), but by my mind. It is pretty weird, admittedly.

"If I have the surgery, when can I get back to eating normally?": By FAR the most common question we get asked. And the short answer is: Never. The surgery does not create a black hole in your abdomen that allows you to eat whatever the heck you want without consequences. The Lap-band, Sleeve, and Pouch all perform varying degrees of the same effect: negative reinforcement. There is less available space in your stomach, so you eat less. I personally find the sleeve superior (for me) because it also removes the majority of your ghrelin-producing stomach from your body completely. No hunger hormones mean no constant craving for food. (Something that plagued me for years before the surgery - I was literally hungry 100% of the time.)

"So, when can I start drinking Cokes/drinking alcohol/eating Krispy Kreme again?": Whatever the trigger food, we all want to know when we can start hitting it again. For some, it is soft drinks, for others ice cream. I, for example, will probably crave beer for the rest of my life. And the probable answer is "Never." Cokes and beer can't be had due to the side effect of carbonation expanding the area in the pouch, creating more room for food. But those Krispy Kremes and McDonald's french fries? They should be avoided as well, because it is so easy to vault off the rails and eat way too many of them at one sitting. They pass through the digestive track so quickly that you will never get full - leaving you eventually with an empty box of donuts and a feeling that you have just done a really bad thing.

"Really? I have to quit drinking?" Alcohol is no longer taking a pleasant 20-30 minutes to work its way into your system. It is no galloping through the stomach straight to your liver and then to your brain. One or two drinks is all it will take to get you very, very inebriated. And here is the real danger - we became obese because of addictive elements in our personality. It is so very easy to switch addictions from food to alcohol. The numbers of alcoholic bariatric patients are extremely high for this very reason.

"Will I have to exercise, like, every day?" Yup, afraid so. There are many stories of failed bariatric surgeries out there, each with their own sad tale about why the patient fell off the wagon and ate themselves back to obesity. Those stories all have one common element - these people stopped moving, and started eating. Exercise is critically important to the success of bariatric surgery - it not only keeps your metabolism up, but it also reminds you on a daily basis that you are doing this for a reason. As soon as you stop exercising, you will start regaining. It is as simple as that.

"Man, it sounds like your life sucks. Why would anyone have this surgery?" The saddest question of all - the questioner has given up on the idea of surgery now that they have been convinced that it is not going to be easy.

And, they are right - it isn't easy. But giving up the foods I loved was not something I could do on my own. It required external intervention to push me over that hump. And now, I may never have a Guinness or a chocolate cream pie again.

Instead, I can touch my toes. I can sit down without waiting for a chair to break. I can (almost) keep up with Lor and Vixen on our daily walks. I have spent more time socializing in the past 6 months than I did in the previous 6 years - once food ceased being the #1 priority in my life, room for a whole lot of other priorities was created.

Now, my life no longer sucks due to obesity. And that is why I had bariatric surgery.

Heck, I Might Even Get To Drink Real Coffee Again,

- Hawkwind

Monday, August 22, 2016

The Revenge of the Carbohydrates

In which I engage the ancient enemy of all bariatric patients.

Today brings us to exactly 4 weeks since I went under the scopes to have my "sleeve" procedure completed. I have not been at all unhappy with my progress. Mainly, I have found that life is now an exercise in patience. I still can not reliably ride the new bike any distance, so I am walking every day instead. I suffer from the problem of not being able to stand for longer than 3 hours at a time, but am informed that this is due to my current loss of muscle mass as well as fat, so I have to sit and rest frequently. My energy reserves are depleting quickly, thanks to my new, higher expenditures of energy, and I am having to nap for an hour or two every day to compensate. All of this still represents progress: while I was morbidly obese, I never stood or moved enough for any of these issues to come up in the first place. (Now, at 235 pounds, I am merely "seriously" obese.)

The area where I have not been very patient is with food - specifically, the kinds of foods that I am experimenting with. I am technically not released to a "normal" diet until two days from today, but that has not stopped me from having a nibble here and a taste there of various non-soft foods to see what type of effect they might have on me. Lor has been filled with dire warnings and ominous predictions, but I have found that just about everything I have tried has worked out fine. I am sure that this has been frustrating to her, since she is still working through re-acclimating to certain foods, but I seemed to be having no such issues.

This all came to a screeching halt on Saturday. For our anniversary, we went to a local event, went shopping at thrift stores, and then decided to cap everything off with lunch somewhere. We selected Panera, thinking that there were several menu selections that were fairly low-carb, or could be made so. Lor selected a chowder and a salad, I picked a turkey and avocado sandwich and chicken noodle soup, with every intention of deconstructing it when it arrived and only eating the shredded turkey and avocado. (I have discovered that shredded turkey is palatable if it is dosed with salad dressing or mayonnaise.) We also ordered large to-go boxes, knowing that we would have to take the majority of our meals home with us for consumption later.

However, once the dishes arrived, something came over me. The fresh bread (something Panera specializes in) looked and smelled delicious. Surely, I thought, I can have a bite or two of the entire sandwich? After all, nothing else I have tried has given me any kind of serious gastric distress, right? Emboldened by my self-justification, I took a small bite.

And chewed. And chewed. And chewed some more. No matter how hard I tried, or how long I chewed, I could not get this bread down to the consistency of "applesauce" that gastric patients are supposed to reduce their food to before swallowing. After a full minute of chewing, I realized I was going to have to make a decision - spit the food out into a napkin, or go ahead and swallow.

I am male - which do you think I did? 

The moment the bite arrived in my pouch, I knew I was in trouble. It landed with what I could have sworn was an audible "thud", and then I could feel it beginning to expand. Within a few seconds, I was sure I had swallowed a bowling ball. I was desperately afraid of throwing up at this point - because I was positive that this mass of food that had suddenly appeared in my stomach would never fit through the esophagus on its way back up. I did my best to sit very still, hoping the mass would settle, and not come erupting out of my chest like an Alien baby.

Lor looked across the table at me, concerned. "Your eyes are watering - are you ok?" she asked. I nodded, afraid to disrupt the delicate balance in my abdomen by speaking. She looked more closely at me, then shook her head. "It was too much for you, wasn't it?" I nodded again, wondering why on Earth I had been so stupid as to try this stunt.

After a few minutes, things did finally settle down, but the feeling that I had swallowed a rock would not leave me for several hours. I sheepishly packed up the remainder of the sandwich in the to-go box and had a few sips of my broth while I waited for Lor to finish her lunch. Graciously, she never said "I told you so" even once.

Needless to say, I later turned the turkey and avocado into something resembling tuna salad, and threw away the bread and lettuce in disgust. When our Nutritionist clears me on Wednesday, I will pay very close attention to my food restrictions, and do my best to not give myself a heart attack in public again by tackling expandable carbs like white bread.

That's what I am telling myself now, anyway.

I May Never Look At A Loaf Of Bread The Same Way Again,

- Hawkwind

Friday, August 19, 2016

3 Decades (And Counting)

Melissa in 1986. Someone should have warned her what she was signing up for.

It has become a regular feature on my blogs to have a little chat about my relationship with my wife (Lor/Melissa) every year on our anniversary. Many people find it charming or romantic, she finds it embarrassing, I find I am simply compelled to do it by the urging of my inner voices.

This year is a little different for a lot of reasons. The last several months have brought us both through bariatric surgery, not because either of us was concerned about our physical appearance, but because we both wanted to extend the potential time we had together. The experience has brought us even closer together than we were, as we have become one another's partners through this process - each acting as a combination of cheerleader and drill instructor for the other. Every member of our surgical team was delighted to hear that we would be going through the process together, because couples enjoy a much higher long-term success rate from bariatric surgery than others. Now, I can see why.

However, this year is also special because it represents a landmark year for our relationship. You see, in 1986, I took a gorgeous 15-year old out on our first date. Within a couple of weeks, we were "going out", as we used to call it back when we were in high school. This year, 2016, actually represents our 30th year together.

When we were married 2 years later, in 1988, I had just turned 18 and she had only been 17 for a few months. We were so young that we spent the next decade or so raising each other. I still can remember the conversation with her mother when Melissa turned 35, when my Mother-in-Law congratulated me on having had her daughter for longer than she did. And, while many couples lament not getting to spend enough time with each other, my illnesses and Melissa's caretaking has placed us in close proximity to each other almost 24/7 for the past 9 years. I can safely state that I have spent more time with Melissa than with any other human being - by a pretty good margin.

Today, we have a very different future to look forward to than we did a year ago. Her diabetes numbers remain very low, and she may be in remission completely. Weight loss has improved my seizure control. We have bought a house. Slowly, we are emerging into what most of the country thinks of as a "normal" life. And none of it would be possible if not for her unflagging patience and self-sacrifice over the past 30 (!) years.

Thank you, Melissa, for everything you are and have done for us over the past 3 decades. I wish I knew what I did to deserve you, because I would do it again in a heartbeat. And here's to the potential of loving you for another 30 years.

Best 30 Years Ever,

- Jeremy

Thursday, August 18, 2016

Wardrobe Malfunction


(Remote Posting Means No Pretty Pictures Today. Imagine Fluffy Kittens or something.)

It was something we were warned about, but I didn't pay a whole lot of attention to. Clothing, that is. All around the bariatric community, there are tips on clothing sales, recommendations for thrift stores, even clothing exchanges - but what the heck did I care about such things? I had a closet full of t-shirts, and a drawer full of "goal" clothes that had been picked up for me by my mother-in-law at garage sales over the years. Surely, I was covered, right?



The first rumbling of potential crisis happened when we met my parents to buy Lor's bike. My mother mentioned that my Dad hadn't recognized me at first, which filled me with pride and accomplishment. Then I was deflated by Mom's next comment - "And that shirt! It looks like a tent on you!"



Meant as a sincere compliment, this dismissal of my favorite t-shirt warned me that trouble was on the horizon. Lor has been telling me for weeks that my existing wardrobe is getting a little too large even for fashion-unconscious me. Later on, at home, I pulled another favorite shirt off a hanger and put it on in front of a mirror. I was startled and depressed to notice it now hit me right above the knees. I looked like I was trying to wear a miniskirt. Clearly, it was time for the wardrobe intervention that Lor had been hinting at.



An hour's worth of trying on clothes later, I was completely disheartened. Fully half my shirts no longer fit me "well". I could hang on to them and accept the "tent" look for now, but I was going to have to start cycling them out. I now had exactly 4 t-shirts that were sized correctly. Dress shirts and sweaters and the like? Not a single one fits me right any longer.



But the really depressing part was the drawer where I keep my jeans. I knew my beloved carpenter jeans would no longer work, because they were 48-inch waistlines. I had cleverly hidden a few 44-inch pants in the bottom of the drawers, planning against today, when I could proudly pull them out and show them to Lor, demonstrating my genius and foresight.



But not a single one of them fit, either. I had missed my window. These brand new jeans I had been waiting to wear for years would have to be worn by someone else - they literally slid right off my hips and onto the floor. I tried on every pair of pants I owned, creating a "donate" pile, and anticipating that I would replace the ones that fit into my drawer.



That drawer now stands completely empty, by the way.



Thank goodness it is summer and I can still wear shorts. We went to the local (bariatric group recommeded) thrift store and were able to find a few pairs of 40-inch waistline shorts. (Bafflingly, 40-inch pants did not fit, but shorts did.) The fact that I was now within 2 inches of my decades-long goal of a 38-inch waistline was not as nearly as exciting as it should have been - it was more than offset by the fact that I was having to go clothes shopping - and I knew that, within a few weeks, I was going to have to do it again. I was not buying these clothes, really. Just sort of renting them.

Thanks to my LootCrate subscription, I can count on one new geek-themed shirt a month, but I can only wear a shirt so many times in a month before it develops holes. The same vanity that used to force me to only wear sweats rather than buy 50-inch waistline pants is now operating in reverse - I refuse to buy sweats to wear instead of shorts or jeans. What is the point of losing weight just so I can wear nothing but track pants?

Or shirts that fit like tents for that matter?

Cursing The Day I Became Fashion-Aware,

- Hawkwind




Tuesday, August 16, 2016

Me vs.The Bike



On Saturday, Lor finally found her bike.

It is really about that simple. She has been looking at Cruiser (or "Beach") Bikes for months now, wanting something simple, without complicated shifters and brakes, that we could use around our neighborhood. I have been...less enthusiastic, as the last bike I owned I ended up having to give to my brother because my ass wouldn't fit on the seat. But, no harm in letting her look, right?

A well-meaning person on one of our bariatric surgery boards posted a picture of a bike that was currently on sale at Sam's Club. It was a single speed cruiser, it had a basket and a luggage rack, and it was on sale for half of its retail price. Oh, and it was the exact color of Lor's new Ford Escape:



I don't need to explain what happened next, do I?

It was a little more complicated than "we went and bought it". Turns out not all Sam's Club's carry bicycles. I spent half an hour checking web sites until I found a local outlet that had this particular bike. Then I had to check store hours - the impulse to buy had overcome Lor at 7 pm. Then came the next problem - we are not Sam's Club members. I called my ever-reliable parents, who gave up their evening of Olympic viewing so they could drive down and meet us at the local Sam's Club to help us procure the bike. My Dad was even gracious enough to load the bike into the back of his truck, reminding me that I was not supposed to be lifting anything over 10 pounds yet, then delivered the box to our home.

Assembly was supposed to take under 15 minutes. 2 hours later, we finally had a bicycle whose seat pointed straight up in the air, and whose front tire rubbed against the fender. Discouraged and prepared to return the bike the next day, we gave up and went to bed.

Daybreak brought some insight - the fender had come out of the box bent. I contacted the manufacturer, and they were happy to send us a new one. In the meantime, the bicycle worked perfectly well without a front fender. A seat adjustment and Lor was ready to go.

But, by now, the fever had overcome me. I now had visions of doubling or tripling the range of our daily walks. Bicycles made everything faster and easier, right? I needed to get one too, so that we could ride together, right? $80 dollars later, I had a Huffy of my very own - cleverly pre-assembled at Wal-Mart. I spent several curse-worthy moments in the parking lot figuring out how to load it into our SUV, then we drove it home.

At last, we each had our own bikes - situated at the top of our downward-sloping driveway. We put on bike helmets, hopped aboard our bikes, and then argued back and forth for a few minutes about who was going to ride first. I finally lost the argument, and shakily pedaled down the driveway into the street.

Now, the problem arose. I have never owned a bike with "coaster brakes" before. I don't know how they work. I frantically grabbed the handlebars looking for my invisible brake handles. They never appeared, and I ran into the curb across from our house at about 5 miles an hour, dumping the bike (and me) into the street.

After Lor coaxed me back to my feet and convinced me not to just throw the bike into our trash can, we decided to take a short ride, just down the road and back. We know from our walking routes that this works out to about a quarter of a mile. Easy peasy, yes?

As it turns out, no. Downhill was great. But once we turned around and came back uphill, things got bad quickly. My legs wobbled. My breath wheezed. I could not see for the red fog engulfing my eyes. And, worst of all, I could now suddenly feel 5 sharp, burning pokers in my abdomen - right at the sites of my incisions from 3 weeks ago.

This was a Cruiser bike - not a ten-speed. There was no way to shift into a lower gear. I proceeded back up the hill at a pace slower than walking, forcing each leg down by gravity, powered only by pride and determination. Lor, of course, was already back at the house waiting for me.

So, it turns out that biking is a great exercise because it engages all your core muscles - not just your legs. Who knew? After staggering back into the house, I immediately took my first pain meds since leaving the hospital, then lay down in front of a fan and waited for the pretty lights to go away. 

So, the bike is now sitting in the garage, plotting nefariously against me and my next ride attempt. I am faced with the reality that I may have to institute an exercise program in order to become strong enough to use the bike that I bought to exercise with. De-pressing.

My Kingdom For Shimano Shifters And Brakes That Work,

- Hawkwind