Wednesday, July 8, 2009

Insurance Politics Are A Racket

I toyed with the idea of putting this in the feed several days from now, but you know, this story is so outrageous that I decided to just plop it into the present time in the list.

Here's the story about one woman for whom a trip to the hairdresser was the first step on a road to ruination, financially and emotionally. I couldn't imagine going through what she went through and coming out on the other side a sane person.

It highlights so much of what is wrong with healthcare in the U.S.; the politics, the playing of the system, the bureaucracy, and the black mark that you end up having tattooed to your name for having the audacity to get sick.

What's really sick is the system.

Read the story. It's truly a terrible state that we're in when this is what can happen to any American and underscores the need for medical reform more than ever.

How Dumb be Americans?

I picked up a book at a Barnes and Noble that is still sitting on my shelf (unfortunately) waiting to be read called The Dumbest Generation: How the Digital Age Stupefies Young Americans and Jeopardizes Our Future (Or, Don't Trust Anyone Under 30). It's another in a series of works coming out discussing how stupid today's population in America is.

I found another post dated for the Fourth of July at the Junkfood Science blog that highlights yet again just how dumb we are. It's very disheartening and highlights the lack of critical thinking skills in our student population.

Some points from reading the article:

I agree...an uneducated population is easier to control. We are a population that cares more about toys and ourselves than intellectual pursuits. It's a boon for groups with selfish interests, though, since stupid people are too dumb to understand they're being manipulated.

The article implies that immigrants are more intelligent than Americans since a huge percentage of them pass the test with all the answers correct. I think they study the topic ahead of time. I mean, I took the amateur radio test to get a technician license many many many years ago; I read the practice books so much that I literally memorized the the test. When the time came to take the test I knew what the answer was from the multiple choice exam by reading the first few words of the question, since the questions were taken from a pool of questions. It's not so hard when the immigrants had just studied to come here (although there may be some difficulty involved with the language barrier).

The article brings up a state exam where the majority of high schoolers couldn't pass (and thus not graduate). Since most of them weren't passing, the legislature simply got rid of the requirement. Not surprising. I've seen it happen in similar cases several times before; the Enrichment Program, when I was in school, was our school district's gifted program (for kids tested and found to have a higher than average IQ). Not enough kids were getting into the program for their spending so the requirement for the minimum IQ was lowered and thus created a full classroom; the program was dumbed down but it made the administrators happier. Eventually I think they eliminated the program because the smart kids (in the age of No Child Left Behind) is already "proficient" so they don't deserve additional attention. That's a different problem though.

The post also mentions that there's a problem with teachers in Massachusetts where new elementary level teachers couldn't pass the basic teacher's exam, so the state allowed a huge percentage of them to get certified anyway with the requirement that they pass the exam within 5 years. After having spoken and observed many teachers in my time I have come to the conclusion that teachers are not some different animal from the rest of the population; they aren't necessarily more intelligent or reasonable compared to anyone else. On average they're probably higher up than non-skilled workers, but I was shocked to find one teacher in a school district that believed the moon landing was a hoax. I was floored to discover that an educated person would actually believe this, but in retrospect I shouldn't be. Teachers are people that specialize in their sub-field and aren't necessarily Renaissance Men. I've met some very knowledgeable teachers and I've met some that I'm surprised manage to dress themselves. But there always seems to be one universal...bureacracy from higher ups always seem to be disconnected from their employees' needs and work. I guess politics will always be a detriment no matter the organization.

Overall the article probably is a bit of a simplification of what the founding fathers were really like, but still the post was worth checking out. It was some fascinating food for thought.

Tuesday, July 7, 2009

Another Day at the Gym

This post is going in rather late. My day was busier than it has been. After work I came home and started changing and getting things around to head to the gym when I got a call from a friend asking me to help out because one of his clients couldn't get their server to start up after turning it off during a storm. He was out of town and wondered if I could act as remote hands since the system was blue-screening at startup; he couldn't remotely access their system to help them.

I headed there first to scope out the problem. After evaluating the system I found it had filesystem corruption; silly Windows wouldn't even boot into safe mode command prompt only so I couldn't run a chkdsk. Another pet peeve of mine...Windows clearly had in the error message the instruction to run chkdsk to see if that would fix any problems Windows was having, yet it won't set the flag for the filesystem to be checked at boot, and I couldn't get to a prompt to fix it from the system. Of course Microsoft doesn't pack in enough tools for it to repair or bootstrap itself in cases like this, and they make it a real pain in the arse to create boot discs from which to fix it. You're expected to use the install disc. Which most of the big vendors don't include install media anymore.

But I digress.

I packed the system in my car and went to the gym, then joined my wife to take trash to burn at my parents burning pit before coming home and having dinner and working on that system again. Looks like everything has been fixed thanks to bootable CD tools. Once again the tag-team of RIP Linux and BartPE worked their magic. The client's server should be back in place tomorrow morning.

Anyway, I managed to get to the gym and put in about an hour of sweating profusely. I started with a 3/4 mile on the treadmill, then did:
compound row: 15 @ 125 lbs
lat pulldown: 15 @ 125 lbs
pec fly: 12 @ 120 lbs
lateral raise: 15 @ 80 lbs
overhead press: 15 @ 50 lbs
bicep curl: 15 @ 50 lbs
tricep extension: 10 @ 65 lbs
lower back: 15 @ 155 lbs
abdominal: 15 @ 100 lbs
leg press: 15 @ 300 lbs
leg extension: 15 @ 95 lbs
seated leg curl: 15 @ 115 lbs
abd/adduction: 15 @ 100 lbs

Then I finished off with a half mile on the treadmill again at about 2 or 2.5 inclination in 10 minutes' time.

I'm still trying to find the right numbers, balance my reps and weight to challenge me without killing me. Some obviously need to be altered; see the whoopsies where my arms gave out in the pec fly and vertical chest, for example.

But it's not like I've done this a lot. I'm still experimenting. I'm just hoping I'm putting in proper form when doing the exercises.

It's been a long day. I need to get to sleep now...night everyone!

Monday, July 6, 2009

Bariatric Followup for July

I just had my followup with the bariatric team this morning. It was a cursory thing...it seemed that the office was running late, since my appointment was scheduled for 9:30 and I didn't get in until about a quarter till or ten til ten.

The doctor said that I'm doing well. Went over medications, some of what I'm eating for meals, etc. and commented on the weight loss.

I told her about the pain in my waist and she said that it is probably scar tissue; she didn't seem to worried about it so I won't be worried. Just have to wait and see if the pain improves. Not that it's much of a burden, since the pain only seems to happen when I sneeze. Weird. Must be just right to trigger the stretching of whatever is scarred.

I need to get bloodwork done to test my vitamin and mineral levels in my blood since last time I was iron deficient. Other than that...progressing nicely, according to her. I still think I'm not changing fast enough. But that's an issue for the psychiatrist, I guess.

This isn't just me though. Notice that people in society just sort of treat fat people as if they're supposed to be able to remove fat like a shirt? It's as if you just woke up and did something stupid, deciding to be fat for the day, then normals turn around and are shocked that you'd choose something so stupid. It's not like your daughter dressing like a whore and being told to go change before leaving the house...look at all that fat! You know you should be skinny! Go change right this minute! What will the neighbors think!?

In our society impatience is valued over patience, and immediate gratification is almost expected as the norm. So when it's taken from January until now to lose 151 pounds. That's not what is in the doctor's records, but I tracked without my clothing on to reduce variables...so on my records I lost 151 pounds since the beginning of January.

So that's the progress for the day. Or month. I have to go back in October to talk to the surgeon...and before taht I'll probably hear back from the doctor about my blood test results.

Your Bariatric Team

I had an email last week from the dietitian working with me on my "bariatric team" asking how I was coming along with my food choices and if I would like any recipes or had questions. She said she had been reading my blog and commented on one of the other posting as well.

This emphasizes a point that really I didn't give as much thought to as I should have before the surgery, and that is making sure that your entire medical support group is one that fits your needs as well as possible if you're going to go through with this kind of surgery.

I'm very online-oriented; I usually don't feel as comfortable in group settings and prefer that one-on-one type sessions be limited. I had second thoughts about my doctor for the surgery because he was described to me as being more "old-school", doing only open RNY surgeries instead of laproscopic and meaning I'd have a longer healing time and more scarring, but I went with him because he had a proven track record and really the open surgery is easier and less likely to have complications on the table. He was a straightforward no-nonsense guy and I've rarely seen him afterwards.

I realize that I now have a dietitian who is willing to periodically check in on my blog and will communicate with me over email as well as a physician assistant who will answer questions via email. When you have professionals willing to take the time to keep tabs on you over email, one of the biggest time sinks you can possibly have during the workday, you know you have a support team that is going out of their way to accomodate the patient instead of making it harder for the patient to fit their lives into the professional's schedule and I for one really appreciate it.

I'd also like to think that by keeping this blog and putting in the occasional "here's my status" entries that my doctor and dietitian can keep tabs on me without having to sacrifice a lot of time from their day. To be honest I don't know if the doctor checks it or not, but I was very glad when the dietitician let me know she still does since I suppose if I really had a concern of some sort and had it on the blog she might know if I should have it forwarded to the doctor.

I doubt the insurance-required psychiatrist checks the blog...I already give him half-reams of journal information periodically for sessions. I don't really know. I probably don't pay him enough to be a personal Dr Phil (then again, would I want a personal Dr. Phil? Probably not), and he doesn't strike me as the type of person who is really a technologist (but he's not a luddite either, since while in session he uses a bluetooth keyboard on his lap to type notes while we're talking. It's kind of neat. I like the blinky blue light on the USB dongle from his monitor when he's hitting the keys). I really don't know him well though because I think this type of doctor is supposed to keep a distance between his life and yours; he's here for therapy, not to be your friend. Paying for friends is legal in Nevada if that's what you think you're looking for.

Anyway, it's important that you find a team of people that will fit your needs. It's not easy. I've reached the point with hospitals and doctors and insurance where I feel mentally whipped; I'm happy that I can even get medications without having to jump through thirteen hoops ("My pharmacy will call the doctor's office to authorize the refill for me?? THAT'S GREAT!" - isn't it sad when that actually was a relief because it was one less thing I had to schedule to do? True story). When I was doing the hoopty-hoos to get the bariatric surgery done I more or less was a pinball, going from one post to the next as I was told to fall in line on a checklist of tasks and items. Whatever doctor I got, I went with. The only thing I actually stopped and changed was the psychiatrist because the one I first went to for the initial head test really really peeved me off with the handling of notification of results.

So if you can, make sure you sit and figure out what you need to make the surgery and post-surgery time a success then try finding people to make that a reality. I sort of lucked out with the group that helps me. I more or less stumbled onto a really capable team of people that seem to be working to help me. Other people may not be so lucky.

Sunday, July 5, 2009

Workout for July 5th

I went back to the gym today. The gym I belong to is only open a few hours on Sundays...noon to three. Probably a reflection of the dedication to exercise in the area...or they don't have a lot of members around on Sundays. Doesn't matter. I went down around 12:30ish and got home around 2:00.

I've been slowly reading the Weight Training for Dummies book; one of the things it pointed out that I didn't know before was the relationship of reps and sets to strength training. From what I understand so far, the goal is to work the muscle to failure, meaning to the point where you can't do another set in proper form. Then you rest that muscle group for a bit.

Anyway, I tried pushing a little more to find some limits. For some exercises, I think I found some failure points. As I type this a few hours after the fact I'm still feeling pretty good, so I am hoping that I'm still moving around tomorrow.

compound row: 15 reps at 110 lbs
lat pulldown: 10 reps at 125 pounds
pec fly: 15 reps at 110 pounds
vertical chest: 10 reps at 95 pounds
lateral raise: 15 reps at 80 pounds
overhead press: 5 reps at 80 pounds, then 5 reps at 65 pounds (ouch!)
bicep curl: 9 reps at 65 pounds
tricep extension: 11 reps at 65 pounds
lower back: 15 reps at 155 pounds
abdominal: 20 reps at 95 pounds
leg press: 15 reps at 300 pounds
leg extension: 15 reps at 95 pounds
seated leg curl: 15 reps at 115 pounds
abd/adduction: 15 reps each at 70 pounds

As you can tell, some of the funny numbers came from reaching a point where I wasn't going to move much more, so I cut it short. All these numbers were significantly higher than last time when I was tentatively trying things.

Some I really need to adjust higher, like the abd/adduction. Others I guess I just need to keep repeating until they become easier.

Because of the need to rest muscles (the book discusses that) I will probably not be going back to play with the weight machines until Tuesday. Whee!

Why Do I Blog? And How Offensive Do I Get?

I don't know if I ever actually said why I'm blogging.

I had toyed with the idea of keeping a blog for awhile, but what really pushed me into doing it was the surgery. At the time I had to absorb a lot of information and sort through a lot of thoughts and issues pertaining to bariatric surgery.

So I suppose the push to actually do it was the surgery. I wanted to keep an account of what happened in case other people might search for anecdotal evidence of what it was like for me.

I decided early on not to keep it just about bariatric surgery, though. I knew that I'd run out of information. It would get repetitive very early on, I thought, and besides that, the information I passed on would have a bias from my life. My life is affected by other things; my technology obsessions, my Asperger's, even facing the possibility of my death in the surgery brought into question my religous views. As a result I decided to open the blog to being bariatric surgery with commentary from my point of view of my life.

I didn't want to define my life by the surgery. But at the same time I cannot escape that I have largely defined my life by my weight, my obesity; after more than a few decades the obesity had come to define too much of who I was and shape much of what I had become. Hence my blog name and strong obesity/diet/WLS bias.

But at the same time I do put items in that are somewhat controversial. I'm not out to poke sticks into wasp nests; I don't aim the offensive guns just to generate controversy or offend people.

Besides, if I wanted to do that, I could. It would be way to simple. But pointless

I figure my audience is far too small for my posts to cause ripples. But I do on occasion post things that some would find offensive.

It's nothing personal.

Posts regarding religion are showing my viewpoint of the world; it's part of what shapes my worldview. It's supposed to help illustrate part of why I believe what I do, why I understand the world the way I understand it.

I haven't had any complaints, so if anyone has read something they took offense to he or she hasn't voiced it.

But I thought I'd put this in just to clarify things a little. I wanted to do a blog for awhile. But I actually did it because of the surgery, and since then I've used it to act as a sounding board for who I am. It's a way to send my little voice into the big wide ether; I don't pretend that others will pay attention or even that it would make a difference to others, but there's always the chance that this can help create a legacy in part for my children to have after I'm gone, or get some insight into who I was long ago.

My father is still alive, but I have almost zilch knowledge of what he was like growing up. He's simply not an open person. I don't think he's ever even going to read this blog...I know only bits and pieces of his childhood history. I'm hoping that this is a record for my kids to go back to and find out more about where I came from, my beliefs, my worldview, and to a degree the problems I encountered in this period of my life.

I suppose this blog, potentially offensive bits and all, are just a way of staking a little corner for my voice among a chorus of millions out there. It's not much. But it's something.

Saturday, July 4, 2009

It's So Easy to Overeat

My wife and son had some fast food for dinner. It wasn't today necessarily; this particular post refers to a dinner they had awhile ago from McDonalds. My wife tried the Angus Mushroom and Swiss Burger; it's a 1/3 of a pound of meat with mushrooms and swiss cheese (surprise!), onion, pickles, and tomato with a large sesame seed bun.

Seeing as I'm obsessed with nutrition information from restaurants, one of the things I love about McDonalds is that they are very forthright with their nutrition information. By going to their nutrition site, you can easily look up info on particular items or even create a "McMeal" that will compile nutrition information for your meal in total.

My wife's burger and medium fries came to a tad over 1100 calories. She had unsweetened tea, so she had a non-diet soda...scary.

That was for a burger and fries! It's a meal order...you can get this by a number at the menu! Many people who think they need to cut back or are overweight may justify their meal choices in part by comparing it to what other people are having. My assumption used to be that if you can get it by a menu number at the restaurant, how bad can it be? Other people must be getting it too.

But when you stop to think that your nutrition information is based on a 2000 calorie diet, and that most people should be getting somewhere between 1600 to 2500 calories a day (depending on your activity levels)...1100 calories is a significant portion of the caloric intake for the day.

Once in awhile this probably isn't bad. But when it's a habit, you can see how one sandwich with an average side apparently can easily push your calorie intake numbers.

It's not necessarily a "fast food" thing. Going to the nutrition side and getting a cheeseburger and medium fries (and tea or water to drink for 0 calories) comes to only 680 calories. For a meal, looking solely at calories, that's not too bad. I say looking solely at calories because it's not a panacea of nutrition, but if we ate a perfectly balanced meal for every meal every day of our lives then our lives would probably feel pretty boring.

In my little world that is a major problem for overeating in America. Our portions and calorie densities we fit into those portions are so easy to overdo. If you're careful it's not so bad. I gradually had cut back my once-a-week McD's breakfast to just having a McMuffin; that was a 4 ounce sandwich (believe it or not, it's really about 4 ounces despite its size) that came to 300 calories.

But if you have a yummy sausage, egg and cheese McGriddle? 560 calories. The McSkillet Burrito with sausage? 610 calories. The Sausage burrito isn't bad...300 calories. Unfortunately the meal option for breakfast is 2 burritos and a hash brown for a total of 740 calories and 41 grams of fat. If I told the dietitian working with me that I was having that kind of breakfast she's probably shake her head and wonder what was wrong with me. Pre-op, of course. Trying to down that much fat and quantity of food at one sitting would mean that I probably have something off-kilter in my head (the meal in total has 26 grams of protein, though!)

In other words, it's very very easy to eat too much, and relying on restaurants or other people in those restaurants as rulers by which to measure your adherence to being "average" in your eating habits is going to lead you down a road of obesity.

If you want to lose weight you have to be proactive to some degree and start monitoring your intake. So far the best tool I've found for me (aside from the surgery) is to monitor your caloric intake through a journal. It means being organized, it means sticking to your routines of recording things. It's a pain. But for many people it would probably be a real eye opener to what their habits really translate to.

Since having the surgery I now monitor the quantity, not calories, in food. I keep meals to 6 ounces or less. I avoid sugared foods, chocolates, etc, and I have some peanuts during the day when I'm feeling woozed or heading out to do something of some exertion like riding bike or exercising. Just keeping your meal sizes reasonable (especially with the requirement that I try focusing on getting calcium and protein in each meal) can really help keep your calorie count down as a side effect.

But it means having to keep your kitchen scale handy. Seeing as I can't take my particular scale with me, it means prepping most of my meals at home and taking them with me, although I've found that having something like half a Panera sandwich is enough for an entire meal now (even those calorie counts can get rediculous if you have what they sell as a basic meal...the pick two's soup and 1/2 sandwich? Check out the calorie info on their site...)

Restaurants are trying to turn a profit. They do it by giving the public what the public wants. The public wants to feel good about overindulging...the public doesn't word it that way, but that's what they want. So relying on the fast food joints and sit-down restaurants to validate your eating habits? Probably not the best idea.

Anyone else have thoughts or ideas to share?

Thursday, July 2, 2009

Being Overweight is a Good Thing?

Science Daily has an article with the results of a study from Obesity from Statistics Canada, Kaiser Permanente Center for Health Research, Portland State University, Oregon Health & Science University, and McGill University.

Apparently the risk of death from highest to lowest runs:
Underweight
Extremely obese
Obese
Normal weight
Overweight

That's right...being overweight carries the lowest risk of death.

There is a caveat in the article that "Our study only looked at mortality, not at quality of life, and there are many negative consequences associated with obesity, including high blood pressure, high cholesterol, and diabetes."

This is the first (Canadian) study to show that overweight people may live longer than normals.

I knew there were claims that extremely low calorie diets extend lifespans, but this is the first time I've run across someone saying that being fat is good for you too. Then again, correlation does not imply causation.

Wednesday, July 1, 2009

The Nation's Obesity Report Card is Out! We FAIL!

Let's take a poll. Should I feel sad or bemused at the results of the recently released results of the "Obesity Report Card"?

We have more attention than ever on obesity.

Schools are adopting these cranial-rectal inversion policies enforcing limited snacks and beverages that are not "healthy".

PE programs are getting more (but probably not enough) emphasis in school-age kids.

Diet books are a multi-billion dollar industry.

Almost every tabloid has at least one story poking at weight issues with celebrities.

Every year there's a new buffet of diet hoaxes, pills, herbs, quick fixes, and fads from which to choose.

New bariatric patients continue to surge into the ranks.

And yet the rates of obesity rose in 23 states.

Granted, this is based on a study following BMI, which may not be an accurate overall assessment of your actual health level. But still it's troubling that there are so many steps being taken to do what in my view amounts to legislating health (how cooperative are most people when they have to do something "just because"?) while apparently the effect isn't quite as successful as hoped. People won't want to be fit unless they come to decide they need to do it on their own, and quite frankly our society is one that values excess and indulgence.

On top of that there's stress from our economy. Uncertainty on whether you'll have a job or a home next week.

Foods that are healthy are expensive compared to the unhealthy stuff. Some people who dedicate a good bit of time to learning about healthy living and frugality can proclaim this to be false, that it is possible to eat well and in a healthy way without spending a huge amount of money. Unfortunately it still takes effort to reach that point, to learn the techniques, and quite frankly, there's an investment to be made in changing lifestyle.

It's not easy. Ergo, we reach for snacky foods and cheaper foods and fast foods instead of the vegetables and healthier choices.

One of my favorite lines from the article is "research suggests that overeating is a key reason kids are overweight." I love it when they find the obvious, as if people are actually overweight because of exposure to some kind of floor wax; were they actually expecting to find something to justify the idea that it's not our own fault we're overweight? Apparently there are still people holding out hope that fat actually is caught by inhaling bad air or some kind of angry sky wizard waves a wand and somehow makes that small three-slices-of-pizza lunch multiple in the gut; it's not because that tiny three slices of pizza should have been one slice, yeah? Something is causing me to simply make calories multiply after I swallow the food. That must be it.

Anyway, there's the link to the article. Take a gander. Let me know if the whole situation is amusing or sad.