Status Report

It's Friday, so I figure it would be a good time to give an update on how things are coming along.

Weight...today, I thought I weighed initially at 352. After the little guy went to his grandparents house I decided I felt well enough to have a shower, so I got on the scale and checked sans baggy sweatpants and shoes, and weighed in at 350.5. Amazing how much weight your clothes can add.

So, that means I'm down since January 107.5 pounds.
Since my friend's challenge last Sunday I'm down 12.5 pounds.

Food-wise, I've liked the pudding. Chocolate, vanilla, who cares. It's good. I tried making some cream of wheat, which was more difficult than it should have been just because I was making it with milk to add more nutrition and didn't realize that while I was getting the Cream of Wheat ready to add in and putting utensils away, the milk, which I was keeping an eye on, had some kind of a skin over it that prevented me from seeing that it was bubbling. The moment I touched it with a whisk, FWOOM...it bubbled then foamed over, and I discovered what burned milk on the bottom of the sauce pan looks like.

I cleaned the pan out and tried again, being far more careful to constantly stir it. I added the CoW and stirred on low heat waiting, as the instructions said, for it to thicken. It was supposed to take a minute or two. I stirred and stirred and stirred....nothing. I had what looked like milk. I added more CoW. Stirred and stirred. Still wasn't thickening, although the color changed a little. I kept adding a touch more and stirring until finally I had something that looked like a thinned soup.

CoW is decent, a little bland, but edible. I think I'll add some cinnamon and see what that does for flavor. I'd like to add honey, but I have no idea if a touch of it will cause dumping.

Then there's baby food. I have level 1 and 2, a small variety of different flavors. So far what I've discovered:

The macaroni and cheese? Not bad. Weird thing was the first ingredient is carrot.
The pasta puree sucks.
The chicken and sweet potato? Sucks.
The vanilla custard and banana? Edible.
The corn and sweet potatoes is edible, but the corn flavor comes out more than the sweet potato. It's tolerable but not great.

It's amazing how utterly bland, if not bad, most of these baby foods taste. I was so excited to try something new, some new flavors, and what I get is bleh.

Hungerwise, I'm still not feeling physical hunger (that I can tell), but I think I have a head hunger. Here's what I've identified so far...

Physical hunger: appetite. So far that's pretty much gone still. If I'm not paying attention to the time I don't necessarily know when it's time to eat.

Impulse eating: I still fight the impulse to try some peanut butter or lick a spoon when making something like pumpkinlenta (it smells good...). It's habit. I liked cheese, so I'd grab a slice or three and eat it...I still have the impulse but I make sure to stifle it down.

Emotional eating: food is a comfort. Stressed? Sad? Angry? Food fills that hole in my heart that makes things feel better.

Habit and enjoyment eating: I think this may be tied into emotional eating to some degree. I liked to eat. If a backrub feels good, why stop after only five minutes? So too with food portions. I like eating that ham steak, so why stop at a bite or three or a quarter of the steak? Have two steaks! It's good, I enjoy it, so keep going so you can continue enjoying it! Eat until the stomach can't take any more!

That's part of the goal of this operation. From what I can figure out, my stomach was stretched out and could accomodate a lot more food than most "normals". It doesn't signal that it's full because it took so long to become full. With the new pouch, I am supposed to be able to feel full far sooner. In theory I should be punished for eating more than a moderate portion for a meal because I'll throw the food back up, and eating certain kinds of food can trigger dumping syndrome.

At least, that's what I can figure out.

Personal observations: I met one other barry patient; he was a gentleman that had laparoscopic surgery the day I went in for open RnY. He was in better health in terms of physical recovery...he was driving around and wante dot see if he could drive a mower around, for example, while I was just getting out of my shuffling around with a robe on stage. And, of course, I have this gaping hole in my midsection.

BUT...

He sounded like he was having more trouble with the liquid diet. He didn't have the diarrhea I had; something about the painkillers? But whereas I can drink nearly 20 oz of milk over the course of half an hour, he sounded like he had to take it much more slowly or he had very bad pain which he described as "swallowing a burp". He was even having to ground up pills to a powder before taking them while I'm just splitting or quartering pills and taking them all at one sitting.

Is my pouch faulty? Did something go wrong?

The lady that led the dietary class didn't seem too surprised, saying that it differs by individual how they react to the operation and how things work; some people experience dumping, some don't, some have a "fullness" or get it more slowly than others do, or have different tolerances for different foods. Worse, people can "cheat" the pouch and end up gaining back the weight. But in the previous cases people aren't punished for "breaking the rules" so they don't have the negative reinforcement to help in training new habits.

I've always thought my stomach was iron. I could eat tons of food in a sitting; no negative effects. I was rarely ever bothered by something I've eaten. If it was upset it was because I was usually about to get sicker than a dog.

I'll have to ask next time I go to the hospital what the chances are that I did something wrong or something isn't right with the pouch, I suppose. Maybe I still fall outside the norms.

Until then, though, I'm trying to make sure I stick to 4 oz. servings of food...a pudding cup, or a baby jar filled with cream of wheat or grits, unless I have to actually eat the baby food (or I get the macaroni and cheese again...that wasn't half bad).

Something Arrived!

It's always fun to get deliveries. Unless it's something like a summons or a bill collector. But this wasn't anything like that.

Several people gave me get-well wishes and cards and I've appreciated all of them; I hung up all the cards on a wall while I'm at home recovering. One of my friends sent me a gift certificate to ThinkGeek, an online store geared primarily at selling unusual and geeky toys for scifi and fantasy cubicle dwellers.


I spent a lot of time deliberating on what to get. I wanted to get the Jedi deluxe robe and a ForceFX lightsaber, but the robe and saber were too expensive. Plus the ForceFX doesn't have a detachable blade. What fun is that to walk around a Renaissance Fair in if you can't have just the hilt? I found another blade/hilt combination available but they were going to take time to get in stock and you lost the fun sound effects. Bleh.

There were other fun toys I considered there but decided I wanted something that would be useful, utilitarian, that I would get use out of after the novelty wore off.

And they arrived today.

One neat thing...the packaging is whimsical. Here's a picture of the inflatable cushions put into the box to protect the product...can you read what was used to inflate the pillows?
It's a play on the thing about having your order packed by trained monkeybots. It's fun!

Anyway...here's what I ordered...
Whenever we have family dinners, sometimes we have to take our own silverware. Or if we're going on a picnic, or most common I have to take silverware in to work with me if I pre-made something for lunch. These are "light my fire" sporks, one large utensil and one four-piece multicolor set. It has a fork, spoon, and knife edge all built in!

I know, I know...I'm odd that way. This is the perfect combination of fun and whimsy and utility combined with the irony of the fact that I can't eat "real food" for another week and a half. I loved it! These were also the only things that in my deliberation I consistently returned to while considering the wifi shirt and various games and cube toys I could get. Almost got the keychain multitool but...just not enough need for it...

The big one is a little bigger than I thought it would be, but I don't care.

Speaking of which...I didn't realize the time. I need to get my scheduled lunch in now...I think I'll try one of these babies out!

What Do Yo Do?

What do you do when you realize your mood is just swinging the wrong way?

Last night I was fixing the dressing over my gunshot wound of a clot and I felt as if I was about to panic. I called for my wife to come in...she was busy in the other room...and apparently she didn't hear me despite calling three times. I just sat at the edge of the bed, staring down at this small silver staple and gory dark red opening on my midsection, listening to a rational voice and irrational panic in my head fight for control of the driver's seat.

I wanted someone to come in and see this, to tell me if it was really as bad as I thought it was, tell me that it wasn't taking on a life of its own. I wanted reassurance that this is okay. That I did the right thing. One of the last things I did before being wheeled into the operating room was ask my wife if I was doing the right thing in having this surgery, a change from which there was no going back.

I needed to know that this would be over. Not in years or months. But soon.

I needed to know that I didn't screw up in doing this. So often it's hard to see the points in our lives where we made the right choices and easier to see where we screwed up...worse, there are plenty of times where we made wrong choices and don't understand why we are in the situations we're in.

But staring at that wound last night and fighting the urge to just cry, I began to question myself and my choices.

In the end the more rational side won out. Score another point for my mild Asperger's tipping the scale on the side of rationality. I simply don't have a choice at this point. The surgery can't be reversed. My last moment where I could have opted out of the surgery, to waddle as fast as my pudgy feet could carry me while my bare behind was wagging in the wind (stupid hospital gowns) was in the moments before they gave me the anaesthesia in the operating room, when they asked me to get up from the gurney and hop onto the surgical table.

This wound, according to my doctor, will heal. She does this for a living. She should know, and really, what choice do I have but to trust her? I trusted the doctor that referred me to surgery to start down this path. I trusted the surgeon with playing with my stomach and intestines. I trusted nurses with seeing all my private nubbins while recovering for several days in the hospital, barely able to move.

I made a choice to put my health into the hands of others, and for that there is a tradeoff where I stepped on to the train and can't stop until we reach the next station.

That still scares the bejeesus out of me at times.

I try to be decisive. My wife would laugh at this idea no doubt, but I do try. It's my own small contribution towards building a leadership quality of some kind into my son. I weigh the pros and cons and then make the choice, or make the declaration of what will be done when others abdicate by bickering constantly. I rarely tolerate a group of people hemming and hawing over something as silly as where to go for dinner or what they are going to do next, especially if it affects me; they waste more time going in circles than just making a choice and following through. But that doesn't mean that I don't second-guess myself.

There are times in this recovery where I repeatedly end up questioning myself. I supposed this is all part of the whole "emotional rollercoaster" doctors tried warning me about ahead of time. Just as no one can truly understand what this is like without going through it, no one can be fully prepared for what non-physical effects (or physical effects, really) this may have on the patient that decides to go through with this operation.

So how does one go about dealing with this, especially if food is no longer a comfort that it once was?

Moods and Patience

I have to say that even though I try to keep busy I end up feeling down at times here. Part of my problem, no doubt, is that I dwell on things that I either can't help or am having problems wrapping my head around.

For one, I have a staple sticking out of me. I tried for a few minutes to pull it free, but I'm not sure how it's bent under the skin and it ends up catching as I maneuver it around; it doesn't help that I'm squeamish with the idea of doing this so close to a giant exposed clot. I got frustrated and just re-covered everything with dressings. I didn't sit down specifically to pull the staple out. I sat down to change the dressing because it looked a little bloodier than the past ones were, so I may end up changing dressings three or four times instead of the usual two times. I have a staple sticking out of me and my dressings are bleeding a bit more. I can't help but sigh at the situation. Or cry. I'm trying to choose sigh.

Second, I am planning on returning to work Monday. I will be on light desk duty so there's not much moving around involved and I warned my boss (who seemed to be agreeable to the idea) that I can't come in wearing clothes that I probably should be wearing since I am still kind of "leaking" from my wound so I'm avoiding constricting the site with a belt and dockers. But it marks a return to the grind. I won't even be having solid foods yet so my stamina is on the low side. The very thought of it is stressful. But I don't have infinite sick days, I still have more appointments to go to and will need hours off, and I can't put off going back forever. This job and the environment stresses me out so much...

Third, I tried a programming project, but I'm as green as grass at getting things to work properly or even map out what I'm trying to do. I eventually became frustrated with trying to figure out how to do one seemingly simple function and because this is a niche language, I could not find much in terms of reference material to help in finding a solution. I posted the question to the mailing list specific to that language and closed the development environment. Part of the problem is probably that I'm not a programmer by trade. I really wish I had moved more into that track than system administration sometimes. So now I get ideas, I start working on them, I get frustrated and close the IDE out intending to come back later and finish it, but find excuses not to. Sometimes I wonder if I'm just too stupid to figure these things out.

Fourth...I keep thinking I should try writing a story. I start mapping out a storyline in my head, but then I stall. Should I just try writing and see what happens? Should I wait until I can come up with a complete outline to follow? Mur Lafferty from I Should Be Writing fame often advises new writers to "Write, just write. You can't be a writer if you don't write," as well as, "You're allowed to suck." Okay, those are paraphrases. But basically I think there's a fear in me that if I tried and failed miserably I'll have wasted so much time and effort. Or worse, I'll discover something else I suck at. I'll validate my fear.

So two things I think I'd like to try moving into as a possible career moves...programming and writing...I'll confirm I suck at. On the other hand if I sit here and continue not to do anything I'll end up sitting in my coffin having achieved nothing more than sitting in the rut I'm currently riding along in.

And whenever I start to feel bad about these things, I look down and see that dark red wound in my stomach, or sometimes I catch a whiff of dried blood on my bandages reminding me why I'm sitting home alone with a neurotic dog and growing more frustrated that I'm so obese that my loose skin won't even keep the bandages where I originally placed them; I bandage the area with the blood clot while sitting on the edge of the bed, they're covered. I stand up, and suddenly the wound is half-exposed.

Which, of course, makes me more depressed.

I need to achieve something. I need a feeling of accomplishment. As it stands, I'm sitting here with partial projects that lose their way, alone most of the day with my thoughts. I don't know what kick in the pants I need but I need to find it.

Called the Doctor

I talked to the doctor and she said to just keep changing the dressing and not worry about it. There was just too much tension on the staple.

She'll pull it out next week unless I'm in the area and want it removed sooner.

She didn't sound worried, so I'm just going to do my best to accept the weird gunshot wound in my stomach and hope it'll continue healing. Maybe I'll learn something about how the body heals by watching it. Right now it's just...freaky.

This Could be Bad...

So I wake up and after finally managing to drag myself out of bed I get to work on my morning ritual of changing the bandage on my incision. I remove the bandage and notice what looks like a gunshot wound.

My wife looked at it and said, "I think your staple ripped."

Holy shnikes.

I try not to panic, but when we're talking about holes in my body, I get a little bit antsy. I put another bandage and dressing over the wound and call the doctor's office; their answering service said they're usually available at around a quarter after eight.

I take a deep breath and focus on passing time reading some news stories and, well, writing this.

Soon I'll call back and see if they want me to come up today to check my incision site. I don't know what is going to happen, but when I know more, I'll post an update. I've never really had a surgery like this before so I know nothing about whether this is a serious thing or not...it's not actively squirting blood but it still doesn't look very good.

I'm going back to not panicking now...

Another Surgery Followup

Another milestone reached! I had my two-week dietary followup today.

What does that mean?

It means I am on a "full liquid" diet.

The name is misleading, though. Really it's more like "full slurry diet" or "if it slides easily with little resistance off a spoon you can try putting it down your gullet diet".

I can have creamed or pureed soups without lumps or chunks, smooth yogurts, very very thin hot cereals like cream of wheat and grits, sugar free pudding and sugar free hot cocoa with skim milk, and sugar-free protein powder. I'm supposed to try having things with protein in it as it's important to prevent muscle loss at this point. She also suggested baby food in small jars since it's a good portion size and has good flavor to it. This may be very convenient for meals on the go.

I'm also supposed to have my chewable vitamins now. Two a day. One in the morning, one at night.

A serving size right now is recommended to be 1/4th to 1/3rd of a cup per meal, and she said not to exceed 1/2 a cup. My first "meal" in my newly graduated diet level? A pudding cup! Chocolate pudding! It tastes pretty good so far. I've been picking at it for 26 minutes now (I'm in the middle of doing this entry and a couple other tasks at the desk at the moment too) and it's not even halfway gone. Turns out these snack cups are about 3.5 ounces, which comes to a little over four-tenths of a cup of snack. So one snack pack, if I tolerate it, is a good meal size. Unfortunately the pudding has no protein (well, the chocolate has less than 1 gram). This does have some added energy from carbohydrates and fats, so I'll be a little more energetic. My first meal is an indulgence. Can you blame me?

The person heading the dietary class said there were people in another gathering of people recently who were arguing and complaining about, "Why can't I eat XYZ?" and "I had ABC and it was fine..." and...I'm wondering if this was an exaggeration or example...had someone say they had watermelon in the car they were eating. Are you kidding me?

It floors me to think that this early on people would go through all the hassle I've been going through only to intentionally break the diet guidelines. Maybe doing the surgery laproscopically is really much easier on your system than open RNY...maybe the person or persons doing that had lap-banding instead of RNY, and perhaps that is even kinder on the system than what's happening to me. But still. You go through something rather radical to correct your obesity and at this stage of the game it should be the simplest time to be able to stick to the eating rules. You're healing. You're hopefully not hungry, physically. You just paid (or cost your insurance company) thousands of dollars and probably feel like crap over the first two weeks. Already you're breaking the rules? WHY?!

I kind of wish I had a larger group of people so I could ask them what they are thinking when they do this. I won't even chance a stolen teaspoon of cake or icing for fear of dumping syndrome. Quite frankly I'm not that hungry anyway so it's not too hard to resist, even though I do sometimes miss the flavor and texture. The closest I see myself coming to breaking the rules right now is drinking too soon with the meal.

Not all is totally rainbows and gummy bears. After my dietary class I met with the physician's assistant that in our previous adventures had removed the grenade tube from my gut (don't get me wrong; I stifled a number of not so nice expletives at the time but I really do like her. She's a nice and knowledgable young woman and has treated me wonderfully in spite of the Tube of Death pulling some of my innards out). She removed some more staples but left two in, saying that I'm healing well but it's just not quite ready. I still have two staples in my skin.

She also couldn't get more of the clot out. The result? I go back next week for her to followup on the clot and staples, and the following week I have to have another dietary followup to see if I'm ready to graduate to regular food!

These are my new milestones. Next week I'm returning to work...desk-bound...and in the middle of the week trying to get my staples out. The following week I'm trying to graduate to full food. When I get a chance to go to the supermarket I'll be getting some protein powder to add to my foods and I'll also try getting some of the baby food purees.

Aside from coming home to the dog having chewed up more things she's not supposed to be chewing on, today has been a good day. Yay!

On Verbal Tics

Ever encounter just "one of those things" that once you're aware of it, you can't help but notice it and be perpetually bugged by whatever it is you're now aware of? For example, I have a theater minor from my college days and so I notice certain mistakes whenever I go to a play performed by small theater groups or school ensembles. Things the audience may not see I always end up picking out and being irritated at them for it.

One performance-related peeve is when people use the verbal tic "um" to fill dead air in a speech or conversation. If I had to grade a person giving a speech I'd fail them for doing this. Drives me insane. I'd rather listen to nothing than an "um". I've even deleted podcasts because the guests would keep using "um" every three words. I simply...can't...stop...hearing...it.

Well now there's a new one that seems to be growing in popularity. The "Or whatever".

"He said he'd like to go to the mall or whatever."

"We can take him to the playground and then pick up some dinner or whatever."

...or whatever or whatever or whatever NO NOT OR WHATEVER. Are you stoned?

For the love of $DEITY stop saying "or whatever."

You want me to decide or whatever? You really have absolutely no opinion or preference? Fine. I'll decide. Starting with leaving you behind. Obviously you have no preference since, as you said, "...whatever."

Stop being so sloppy with speech! I hear it on TV, I hear it from some podcasters, I hear it from friends and relatives and family. And now that I noticed it I can't NOT NOTICE it.

I want to dash my brains on rocks after the umpteenth time hearing that verbal crutch. If you don't have any opinions or preferences, don't say a @#$ thing. If you have a suggestion, say it. Break the habit of filling space or backpeddling with sloppy regurgitation of a stock phrase!

Whatever you do don't use "um" and "or whatever" when I'm in a bad mood and have tools in my hands. You may not like the reaction.

...deep breath...deep breath...

The $15 Dinner

Good Morning America (the same one that had the Perez Hilton's non-story) is having a celebrity chef challenge where the hosts are buying groceries in New York for fifteen dollars and then giving what they purchase to a chef to prepare a meal for four. Every day another chef tries their hand at preparing the meal with whatever the host-of-the-day had purchased.

To be clear, the primary reason they're doing this is to bring attention to the needs of food banks around the country. Every day they're making a large donation to a food bank to help those in need. This is a stunt to get people to donate to the food banks.

I found this interesting because I was thinking of doing a posting on poverty and obesity; there are numerous stories out there asking why the poor tend to be so overweight. I touched on this previously but never focused on the cost of nutritional foods versus fatty, not-as-healthy foods, which is pointed to as part of the reason for the disproportionate obesity in lower-income Americans versus higher-income Americans. How timely!

So today Sam Champion gave Emeril Legasse a bag with spinach, red tomatoes from the vine, yellow onions, empire apples, dry black beans, dry pinto beans, and creme fraiche.

I saw the results after an hour of cooking and three notes stuck out in my mind. One, Sam said he didn't get meat (Emeril joked several times about asking fellow GMA guest Jack Hanna if he could borrow some of the furry friends Jack brought to the show that day for protein) because he went to an organic street market for the vegetables and because the cost of the meat would limit how much he could get. This tells me that meat, healthy cuts of meat, can be expensive...although I'm sure in the right place you can get inexpensive packages of hot dogs or some other prepared meat in pound increments.

Second, he went to a street market and haggled for the food. When I wrote about the cost of eating out versus cooking at home, I didn't even mention the possibility of going to a farmer's market environment where you might be able to haggle with the vendors to bring down the price. I concede this is a point in the favor of cooking at home; if you have the skill and time to do this, more power to you. I would also contend that this is an expense of time and effort. These are two of the reasons that Americans don't want to do this. Our society favors the selfish motivation and the quick fix. We don't like sacrificing our time for things we don't like to do. We are a society where people who say they can't afford to pay for their own kids somehow have money for cell phones with GPS tracking, implying they travel enough to justify the added cost of these features and where people with six-figure incomes are "just scraping by," meaning they can't keep up their pre-economic-slump lifestyle so they cry poverty.

Third, the challenge was not fifteen dollars. I don't remember the specifics and the recipes aren't posted to the GMA site yet, but I do know that Emeril used spices from the pantry in making some of the dishes, chicken stock in a soup, and one of his dishes was a corn bread and another had cereal crumbled on it (again from the pantry). It was more like the primary ingredients were fifteen dollars with some stuff "you should already have around the house".

So what does this mean? It means to me that while inexpensive meals are possible, I can get a double cheeseburger off the dollar menu at McD's and a drink for around a buck. I can get their salads for a couple bucks. I can get plenty of calories to survive...unhealthy, yes, but if you're poor, you can survive for the calories count...using their value meals. I can also get canned Chef Boy-R-Dee (or the knockoffs) for a couple bucks a can in bulk; if you were truly in need, that bulk can of canned pasta can last you a day, and it may last longer stored in the fridge than the fresh foods he had made.

But that's not the point they were trying to drive home. They are drawing attention to needs at your local food bank. So for that their little demonstration was nice. I just wish they could have been more realistic in what they used and did.

I did think it was amusing that one of the comments in the feedback section of the website was from someone shaming the hosts and Emeril for mocking the nearly vegetarian composition of the meal. I have been obsessed with cooking shows since the surgery (weird!), and one thing I've found in common with most of the celebrity chefs is that they advocate a meat protein in dishes they prepare. Gordan Ramsay is outrightly hostile towards vegetarians on his shows.

There are plenty of good vegetarian dishes out there and no doubt good chefs who specialized in vegetarian cuisine. But I find it hard to take it seriously when someone is criticising a chef who is NOT known for vegetarian dishes for his good natured ribbing at not purchasing the best source of protein...a meat or fish, instead of beans.

It's good for the commenter that they're in a position to not have to compromise their dietary lifestyle choices in the name of having to buy what is necessary to feed the family.

Progress So Far

A friend of mine, finding a little information about the surgery, said he wanted to lose 30 pounds and wanted incentive. He proposed a competition to lose weight. Whoever loses the weight first gets a $50 gift certificate to Amazon.com.

I told him, "Dude, you really don't want to do that." I explained to him what I was eating and asked him if he thought he could do that.

"No, I guess not...what about I lose 30 pounds, you lose 60?"

I said if he wanted to do that it was up to him, but it still wasn't fair, really. I really don't know what my weight loss will be over time. But if he'd really like to do that I'm not going to turn down a gift certificate to the largest virtual mall in the world (Nor will I fail to pay up if he manages to lose his goal first, of course).

My dietitian appointment is tomorrow and I thought I'd take a quick stock in my progress today.

My weight on January 5th was recorded at 458 (I think that was actually closer to Christmas time, though, but this is when I "officially" began my dieting). I had decided to try in earnest to lose weight by tracking my calories and keeping them closer to 1,500 per day.

My weight just before the surgery on the 7th of April was 376, losing 82 pounds.

Today is April 21st, 14 days post-surgery, and I'm at 356 pounds. This means 20 pounds in 14 days, or overall a loss of 102 pounds.

As I recall he proposed this challenge on Sunday the 19th, when I was 363 pounds according to my handy dandy spreadsheet, meaning from Sunday to today I have lost 7 pounds...still want to wager that $50 gift cert?