Exercise and Weight Loss

I got into a rather animated conversation over the weekend about exercise and how it relates to weight loss.

My position is that exercise isn't a feasible weight loss tool for most people.

I say this for a couple of reasons. First, I've crunched numbers, and in the lifestyle led by most people it just isn't realistic to use exercise to offset eating habits.

Let's first get some numbers so we have some idea what I'm talking about. This alone is a chore; I'm big on numbers adding up to results. The human body is funny about things regarding solid numbers; you can only get rough estimates, and I've resigned myself to that, but you can normally get those numbers to fit with a plus-or-minus that is reasonable. Want to lose a pound of weight? Drop 3500 calories from your average diet in that timeframe. A pound of fat is 3500 calories. Simple.

Most foods give (rough) calories on the label when purchased pre-packaged. My 2% cheese was fifty calories per slice. Egg Beaters were 30 calories per quarter-cup. Multiply your servings by the calories.

There were rough formulas figuring out my basal metabolic rate, the calories burned if I just sat on the couch all day and breathed. Without more sophisticated techniques, this should give some idea of "if I ate this much, I stay the same weight; eat 3500 less over a week/month/whatever, I lose a pound; eat 3500 more, I gain a pound." It wasn't precisely accurate but it was close enough.

I also already blogged about the body acting like a rubber bag; calories don't magically appear or disappear. You gain or lose weight based on what you put into the body and what is excreted from the body. It's like balancing a chemistry equation.

Combine these bits of information...your body can only gain or lose based on what you put into the body and excrete from the body, 3500 calories equal a pound of weight, and you can figure out your BMR to find and estimate your "maintenance calories" and from there figure out how to lose weight to get to a goal, and you should be able to come up with a pretty simple guideline of how many calories to eat per day to achieve your goal. A routine. Routines, especially for people like me, are good. And considering my aversion to hassles then this is a pretty simple way to lose weight.

Now exercise. I can't count it as part of a routine for a variety of reasons.

First, it's terribly difficult to get numbers to plug in to a chart for tracking your net caloric intake for a day. How many calories does walking burn per hour? One of my two favorite diet books, The Hacker's Diet, states that the average person burns 300 calories per hour. The Nutristrategy.com website gives three numbers for someone walking 2 miles per hour "slow pace": a 130 pound person burns 148 calories, a 155 pound person burns 176, and a 190 pound person burns 216. The Mayo Clinic's website lists that a person weighing 160 pounds walking 2 miles per hour burns 183 calories per hour, 200 pounds burns 228, and 240 pounds burns 273 calories per hour. So what number do I use? Plus I'd have to figure it out on a sliding scale as weight changes. Why is this? Because the calories you burn depend on your metabolism, the activity level (what is the definition of walking? The intensity, the technique you use while doing it, etc. all affect the calories you burn...), the weight you're moving around on your body...this is as close to calculating magic as figuring out a mortgage schedule. There are websites where you can get a rough number by entering your weight and how long you walked.

Okay, so now you have a rough set of numbers that seem about as accurate as what you'd get throwing darts at a chart. Let's just say you walked slowly and burned 200 calories. The numbers on the charts are for walking *an hour*. No change. You need to dedicate an hour to exercise. Plus the time it takes to get changed and go where you're going to exercise (if you're doing this at a track or gym, for example). So let's just throw another rediculous estimate and say it was an hour and a half total and you burned 200 calories. Come to think of it this probably isn't all that off base for a beginning exerciser in poor physical shape. What did you burn off for an hour of work? Let's look at some common fast foods.

The Fast Food Calorie Counter, available for the iPhone and iPod Touch, tells us that the McDonald's Egg McMuffin is 300 calories. A 6 piece Chicken McNugget is 250 calories. Even a Fruit N' Yogurt Parfait without the granola is 130 calories. Ever been to a Chevy's tex-mex restaurant? Their grilled steak tacos are 972 calories. Their Portobello Mushroom and Asparagus Fajitas without tortillas are 618 calories. Red Lobster's Honey BBQ Grilled Chicken and Shrimp is 710 calories; and if you go there, you need to remember to factor in your salad (plus dressing) and your cheddar bay biscuits are 150 calories each.

So you spent an hour sweating your cajones off and you managed to lose a part of an Egg McMuffin, or a little more than a cheddar bay biscuit. You just spent an hour working off what you enjoyed for three minutes, if even that long.

For weight loss, that's a lot of work to offset something that you enjoyed for a very short period of time. This brings up the next reason exercise isn't a good method to lose weight.

You have to keep doing it.

You need to schedule a regular time to do it and keep with it. For people like me, most comfortable with routine, this limits what can be done. I couldn't exercise outdoors; if weather interrupts me, it will be a reason to stop the routine, or at least feel like dirt because I didn't do it that day. So I'd have to figure out a way to exercise in a gym or my basement on a treadmill or bike. But what of other events that interrupt my schedule? Unless you are an athlete or can be dedicated to constant exercise it just doesn't seem feasible that this is something that will be reliably followed over a long period of time.

The hassle to get rid of those couple hundred calories just isn't enough compared to just cutting out the calories in the first place. After the third set of clothes end up with stains that I just can't get out from the arm pits I start to question why I just didn't eat the @#$ burger in the first place.

So, if I'm doing this solely to eliminate calories and lose weight, I'd gain back an hour and a half (or more) of time and a clean set of clothes if I just don't eat a burger. That's a huge savings in the hassle department.

Now I'm not saying that exercise is bad or that I'd refuse to do it, especially if I lose enough weight that I could actually move for an hour without wishing my legs would just shrivel up and die if that would reduce my pain. I found, after going through numbers and information, that exercise is simply too difficult and too much hassle to use solely for calorie reduction. Exercise is good because it helps your lifespan. It tones the body, increases metabolism, and will make you just feel better. So if I do exercise, it's for the extra effects and it's on my own schedule so I don't feel like I've yet again failed myself because I went to the movies instead of the gym. The calorie reduction is a side effect and not the primary effect I'm looking for out of it.

The book The Hacker's Diet approaches the problem of weight loss as an engineering problem. For someone with Asperger's tendencies, this is an excellent book for spelling out the mechanics of weight loss. That book also recommended that exercise not be used for weight loss but instead be done for health reasons:

Clearly, even an hour a day of exercise doesn't account for much food. And what's the likelihood you'll find the time to spend a full hour, every day, month after month, year after year, doing those exercises?

So, don't exercise to try to burn off calories and lose weight. Unless you're a professional athlete or obsessed with sports, you're not likely to spend enough time exercising strenuously enough to make much of a difference. Exercise will help you lose weight in more subtle ways. Regular exercise increases your rate of metabolism: the number of calories you burn all the time. Plus, for many people, exercise actually reduces appetite.

So in my philosophy, exercise simply isn't sustainable for weight loss. Reducing your food intake is far easier and more reliable and is less hassle. If I lose enough weight that basic exercise isn't as painful as recovery from surgery has been then I can do recreational exercise for the benefits exercise offers; I may burn calories but I wouldn't have to fret about integrating it into my calorie burning charts.

Maybe someone else would be willing to do it and put it into their own weight loss tracking routine. I just happen to think that if it were that simple then gyms wouldn't have so many people show up for a month and then disappear into their old eating and exercising habits. Not that "eating less" has a higher success rate, but at least the effort of not shoving as much into your mouth is less than dragging your butt to an exercise session for a couple hours every other day...

Another Appointment

Troi: "How do you feel?"
Picard: "Almost human...with just a bit of a headache."
*********
That exchange was from the Star Trek: The Next Generation episode The Best of Both Worlds, part 2, after Jean-Luc Picard was assimilated into the Borg collective and then was rescued and his crew had started the operations necessary to remove all the cybernetic implants. I am often reminded of that scene since I think of waking in the hospital with all those wires and tubes melded to my flesh.

I've mentioned that I can't seem to track time the way I used to anymore...breakfast, lunch, dinner, an snacky time...so I've taken to measuring my short-term medical progress by removal of various items implanted on my person.

Today was another milestone day. I had an appointment to see Angie at the clinic. She examined my progress and...drumroll!...removed my drainage grenade AND most of my staples! Most of the staples, not all, but I'll take what I can get.

No grenade and 90% fewer staples! Yay me!

I've been bleeding since I got home last Friday. Not a torrent, but enough that the gauze is pretty red by changing time in the morning and at night. Angie clarified that this was normal; I basically have a clot under the skin near the incision. As the clot breaks down and is re-absorbed into the skin it will, she said, ooze blood. Perfectly normal. I just have to keep it clean, take a preventative antibiotic she prescribed, and change the gauze every day. If something goes very wrong, I am to call them or go to the ER (depending on the severity).

How did the drain get removed? She first had cut the sutures securing it to my skin. It kind of reminded me of the Thanksgiving turducken the father-in-law and I had twined a season or two back...snip! Then she started prepping for pulling staples and in mid-conversation, when I was concentrating on some Percocet-inspired shiny on the wall, waited until I wasn't paying attention and deftly plucked the grenade right from my abdominal cavity without skipping a beat.

No warning. No pause.

There was a wet hissing bubble noise as the grenade sucked air in and exited the fleshy hole in my chest. I felt a weird sensation of something moving inside of me accompanied by a slightly dull pain. Then done.

I was wearing my Simpson's pajamas. It has a bright yellow shirt with Homer's face on it, stuck in a perpetual yell, mouth open, tongue wagging. My wife said I had a look on my face that closely resembled that face on the shirt for several minutes after the tube had wriggled free from my body.

I was still stifling the colorful metaphors for describing the young lady who pulled the tube free as she began plucking the staples from my incision with her perky disposition and a little metal tool.

I'm very glad the appointment showed progress. The doctor seemed to think I was progressing well too. She felt that my incision was doing very well, not "splitting" as much as she thought it would as the staples were removed.

I bet it's all the milk I've been drinking.

She said she'd remove the remaining staples next week when I see the dietitian group (yes, a group of us from the operation time I was at the hospital are all coming in for a group session, apparently) and then...we "graduate" to a full liquid diet!

I don't know how much it will matter since as I type this sentence it's 4:10 PM and I don't remember lunchtime going by. Whoops.

Progress, progress, progress. Still hurts as I move around, but I resemble something more human. I can't wait for my little dude to come home and see me...he was asking me last night, "How's your boo-boo, Daddy?"

Now I can show him the incision, bandaged instead of stapled, and reply, "A little better, dude. Daddy is feeling a little better."

Supersize Me!

My father-in-law, wife, and I watched the Morgan Spurlock movie "Supersize Me" last night. It is a documentary that took on the issue of obesity in America and basically blamed McDonald's (and the fast food industry in general) by having the documentarian (Spurlock) going on a "McDonald's-only" diet for a month and documenting the effects on his health. The end is not very surprising; he gained twenty-some pounds, his blood chemistry was wacky, he had mood swings and overall generally felt ill.

I believe that fast food is but one component in the obesity puzzle. The portions Americans eat, in fast food joints or sit-down restaurants or at home, have spiraled out of control. This documentary could easily have highlighted the effects and could have been an effective tool in educating people about this aspect of the problem.

But it doesn't.

Why? Because unless you have absolutely no ability to think critically, you have to see right off the bat that he set the diet to "prove" that McDonald's is a selfish evil corporation peddling poison to citizens. He had very simple rules for his experiment:

• The only foods he ate would be from McD's.
• If they asked him to supersize it, he would.
• He was going to have at least once each item on the menu
• He would have three meals a day, breakfast lunch and dinner.

Doesn't sound like much except for the supersizing part. Most fast food joints upsell their product to increase profit. No one is forcing the customer to take that option; they often do, but he set it up as a rule that he'd accept the large portions when asked.

His diet ended up being approximately 5,000 calories a day. The fact that this was fast food meant that a larger proportion of the calories were comprised of fat than other more nutritious components of what would have been a healthy diet, but most people who consume 5,000 calories a day will gain weight. I'd like to know what would happen if you took an average American and gave them a diet of 5,000 calories for a month what would happen to them; on top of that, the person must not exercise. Morgan Spurlock did not do additional exercise and even documented with a pedometer how much walking he did in his day while walking down the sidewalk to a nearby McD's for his meals.

Instead of highlighting the evils of fast food, what he actually highlighted were the evils of overeating. Is ice cream evil and horrible? Would I prove it by going on a diet of Breyer's for a month, breakfast, lunch, and dinner? Or would it be just highlighting that overindulging for a long length of time is bad for you, period?

The documentary had a large amount of good information regarding obesity in America and statistics on the fast food industry. I felt the driving publicity stunt of following his "McDiet" detracted from what could have been a good message for your health; stop overeating and eat more healthy foods. The fortunate part of the experience was that Morgan didn't give large amounts of screen time to his "vegan chef" wife who tried to convince him of how abominable his experiment was and how he was killing himself on meats. And McDonald's food. But mostly the meat was bad.

The movie was also a little dated but that isn't necessarily the movie's fault. The epilogue pointed out that supersize is no longer offered; it was removed from menus shortly after the movie premiered. They took a little pride in believing it was because of the movie (maybe it was, I wouldn't be surprised). But the movie had other information that portrayed a kind of conspiracy that isn't there; McDonalds claimed to have their nutrition information online, but as of the time near the filming of the movie less than half of households have access to the Internet. He visits multiple restaurants and most of them can't produce a pamphlet of the nutrition information.

Internet access continues to grow; it's virtually assumed that the average citizen in America has Internet access, if not at home then at schools and libraries.

The nutrition information issue; I could believe that it's hard to find information in most restaurants, but McDonald's is the wrong one to pick on. I find a nutrition table now on the papers covering the serving trays. The wrappers have information on the items they contain. The part that confused me a bit was that I could have sworn that in some of the scenes portrayed in the movie had McDonald's workers holding containers with the nutrition label on them. I was pretty sure it was in there because I remember thinking that the movie wasn't that old if it had that information printed on the boxes and wrappers...I could be wrong but haven't verified this with a re-watching of the documentary. The facts to me point out that McDonald's and many other fast food restaurants make health information available and Americans simply don't care and ignore the information. The food isn't bad until you overeat and overindulge for your lifestyle.

Another mystery in the movie was Don Gorske. I admired fact that they had him in the movie despite the fact that I thought he was actually a case against Morgan's hypothesis. Don Gorske has eaten over 23,000 Big Mac's in his life. Despite eating 2 Big Mac's a day, this six-foot-two average guy is 185 pounds and has a cholesterol of 140. While he was a topic in the movie, there was never an explanation or exploration to why this guy wasn't four hundred pounds with a waxy drip of cholesterol sliding from his earholes as was implied was in Morgan's future if he stayed on this diet for another two months.

Overall the movie was food for thought and I recommend watching it not for the commentary on fast food as much as for being a good example of how to undermine your message with an elaborate staging of a situation that amounts to a rediculous publicity stunt. Had he not spent a month force-feeding himself a diet that he said, as he was putting the burgers and fries into his mouth, made him feel ill then his conclusions might have held more weight. As it stands I thought that his otherwise good message only gained any attention because it made a popular and wealthy corporation bristle at some bad publicity.

Easter Dinner

I said yesterday that my father-in-law had made Jell-O "deviled eggs" for me. Here are pictures of them at dinner. Some explanations...the deviled filling on some of them slid off when the picture was taken, and the white part is ice. Yes, ice. It was in the fridge for the day and something goofy happened with the airflow in the fridge and all the other items in there for Easter dinner that somehow ice formed on the "eggs" and just my Jell-O eggs. Nothing else had this happen to them. It didn't hurt them, I just broke off the thin ice armor before eating them.

My first holiday dinner since the operation: deviled Jell-O eggs, vegetable broth, milk, and water. I enjoyed eating with the family, and I did appreciate everyone's efforts to include me despite not eating what they had worked so hard on (referring to the meal they had...I ate most of the eggs and the broth and of course my milk. What they were eating my wife and father-in-law had spent most of the day working on and looked and smelled fantastic, but of course I couldn't have any. The ice on the eggs make them look unusual but I assure you they were just fine.)

Customer Service and Attention to Detail?

Whatever happened to customer service? Or a business that pays attention to detail when serving customers? When a business that ignores one or both of these ideas continues to stumble on, and I'm assuming they're still turning a profit, the only explanation I can come up with is that the customer base is comprised of people with very low standards or have the brains of minnows.

Ideally in capitalism if a business screws the customer over they go bust. Yet it astounds me how many businesses in our area (or national companies in some cases) give the impression that they're run by incompetent boobs but continue to keep their doors open (and I assume are turning a profit).

We have a local Burger King that fits this description. Out of the last ten times we've gone there to pick up a burger or meal, I think we've had maybe two or three orders that weren't missing something or wrong. How can they stay in business? Are they catering to high schoolers and elderly people from the nearby "Home" that don't really care about things like, I don't know, actually getting the order they paid for?

I like to think that we are fairly easygoing when mistakes normally happen. Mistakes happen. Things get overlooked. We go...or went...to McDonald's fairly regularly. Once in awhile they would forget something or a drink would be wrong. Sometimes we overlook it. Sometimes we've gone in and asked to switch with what we actually had ordered. Mistakes at our local McD's seems to happen to us maybe once every ten orders or so.

So what's different? Burger King, McD's...both hire bored highschool kids who often carry responsibility issues. They have turnover. They don't pay very well. But the McD's, in our experiences, have a 90 percent "correct" rate while the BK has an 85 percent screwup rate? And BK is one of maybe two companies in my lifetime that I've complained to the corporate office about. And BK never replied and nothing apparently changed. I actually don't go there anymore, which is a shame because I would have liked some of their menu items more than McD's if they weren't so incompentent (Cheese Sticks!!)

Other businesses just scare me because I wonder about the education level of the people in charge. A local office supply store spent decent cash on an electronic sign outside the store that can be programmed with messages and information. I don't think I've ever driven past the place where there weren't typos or grammar errors. For personal things like blogs, typos are one thing. For a business where it affects how people perceive your business and presumably how careful you are with running your business sloppy signs are a definite no-no.

National companies aren't immune to this. I've known two people who used Vonage. They had legitimate reasons to drop the service; in once case, he moved and simply didn't use their broadband service any more, in the other, his broadband provider wasn't stable enough to provide reliable voice-over-IP. It wasn't a problem with Vonage. But Vonage made it a problem with Vonage. They called to cancel the service and for both of them the company reps argued with them and hassled them to keep them from cancelling. They had to jump through so many hoops to cancel a service for legitimate reasons that I swore I'd never try Vonage and anyone I saw that was considering it I would warn them what a crap company they are to deal with. Another quick lesson for douche companies: if a customer wants to leave you and you hassle the hell out of them, you may end up losing more than that customer...I was a potential customer until I saw how you treated my friends. And I will do what I can to cost you other customers.

Same thing happened with me and Discover. While refinancing a loan I discovered I had a Discover card. News to me. I gathered information from my credit report and called them to close out the card since I didn't even have the plastic in my wallet. The rep argued with me repeatedly about how it was a mistake to close it, how it hurts my credit score, and convince me that I wanted to just request a new card and not close it out. I'm the type of person that just wants no hassle. I probably would have become a customer later on if my experiences with them were associated with fond memories. Instead I utterly refuse to have anything to do with Discover. I don't care if Sam's Club is trying to bully me into their wonderful incentive programs with the Discover/Sam's card. If Discover was such a pain to deal with before why would I want to risk having to deal with them again?

Contrast this with a local auto repair shop. I had a minor collision problem with a bear. I took the car to the owner to have it looked at; he wasn't their "body guy", but he gave an estimate of time and cost and I okayed it. Instead of a couple of hours on the frame bender, it took the entire day. The body guy did an utterly fantastic job...he not only bent the frame back to a condition better than before the collision, but he replaced missing bolts, missing body screws, he repaired rust spots on the frame, and overall simply improved the car beyond my expectations.

I saw the bill and thought I'd crap the bed. "I'm sorry dude...but this is nowhere near your estimate." He said, understandably, that the car had taken a lot of time, and he couldn't possibly only charge the estimate. So he split the difference. No hassle. He dealt with the issue in a fair manner, and he bit the bullet for his mistake. I respected that.

And I have taken my vehicles back to him ever since. He took a loss and took responsibility for it. In return he's made a huge profit from me over time since I'm a loyal customer and I'm confident he won't screw me over.

Funny how a little attention to detail can have a big impact on your customers.

Who's The Joker?

I checked my weight this morning. After five days living on milk, water, broth, and Jell-O, I gained three pounds.

I'm having trouble understanding that one myself...

Psychological Changes I've Noticed So Far

This has been a rough weekend. Not only am I recovering from the surgery, but my wife's family...an additional 9 people...are staying at our home for Easter. It's a cramped fit, but surprisingly enough, it seems that a few Percoset makes the house seem a lot more spacey. Or maybe it just makes me seem more spacey. Either way while many others out there would just scoff and counter with stories about their own family having thirty brothers and sisters, my situation of having my two kids, wife, and her 9 family members, plus my own family that aren't staying with us but will be coming up for the dinner itself, is a large number number of people for this single-child with a problem socializing.

On the plus side it does help me in that it offers some introspection on my relationship with food as it now stands. My wife speculated that food was an emotional crutch. It was a comfort. My friend. I wouldn't disagree, but I didn't think that was the reason I loved eating so much; it may have been part of the reason but not necessarily the primary reason. I couldn't really verify it to any degree because I couldn't separate the urges of eating from the mental reflex of eating at my habitual mealtimes and the actual hunger signaling when it's time to eat, and how these interact (or didn't interact) to tell me when it's time to stop eating.

After the operation, almost immediately after the surgery, I no longer had the urge to eat. I was told many post-ops have that happen to them, but it's one of those things that you can't understand without experiencing it.

My entire day revolved around food schedules. Usually it was dinner, breakfast, lunch, snack, maybe even close to bedtime snack meals. After moving to a schedule of tracking all my calories shoveled into me, I was even more focused on mealtimes. I would schedule out what I was going to eat and when when I woke up...I knew what I was going to fix, what I needed, whether we had it in the fridge, and approximate calorie counts before getting the exact numbers from entering it into the website.

Since the operation I have lost my sense of time. I feel like I could eat, but I don't really have the urge to do so...I look at the clock and am surprised to see it's one or two in the afternoon. Or it's pitch black outside and I haven't thought of making a dinner. If you have experienced losing time, you may be able to relate...only now I have it happen 24 hours a day. I am only mostly aware of night and morning because I'm either very tired or not tired enough to go back to sleep.

My wife's family is far more traditional with meals than we are. They tend to use dishes that require washing instead of our paper plate meals. They sit down for meals at a table. We use trays. You can get the picture. Tonight, they had some sort of pizza dinner. It smelled fantastic, and I enjoyed the smell of barbecue sauce and chicken and the pizza dough. But I didn't have an urge to share some of their meal. Maybe it was the Percoset but it didn't bother me in the least that my dinner was a cup of milk and some painkillers with a jug of water while they were feasting on various pizzas.

What does this mean? I wondered how much of my eating was habitual...it's dinner time, I need it. It's lunch time, I need lunch. Apparently this isn't a driving force any more.

I can smell delicious food and I enjoy the smell, but it isn't triggering an urge to eat it.

I apparently had some impulse-eating issues; I have had thoughts about eating a couple goldfish crackers or stealing a quick piece of popcorn from my wife's bowl, but so far immediately catch myself when the thought occurs to me; I can't eat that now or I'll risk intense pain and vomiting as my stomach is healing. And there's no "gosh darnit this is unfair" thoughts when I tell myself I can't have the items in question.

I sat here thinking maybe I could have a snack tonight of milk or broth. I eventually decided it was more effort to get it than to just wait until tomorrow to have something. I was happy with my water.

At this point two things occur to me. First is that this has future ramifications emotionally. The second is that this could all be part of the bariatric surgery honeymoon, a period of time where there are specific changes involving feelings and adjustment during the period of time where the patient loses the vast majority of the excess weight.

Only time will tell about the effects of the second one. This could be temporary. It might be permanent. Every person has different reactions to surgery like this and it'll entirely depend on my physiology to find out how I'm going to react.

The first one, emotional effects...this is only one aspect of my "new self" that I will explore as time goes on. But I have heard of post-ops encountering social issues due to no longer feeling the urges to eat as most others do. People...normals and overweight alike...use meals as a time to commune with each other. It's a time of sharing. And during this mealtime with the family I was very much aware that I wasn't part of the group. I watched a TV show ( Deadliest Catch I believe) while they ate several slices of pizza and foodstuffs from bowls. I could smell it (I need to ask if smell becomes more acute or if it's imagined) and I liked the smell, but really didn't need to go sneak a bite. This can lead to feelings of isolation and not fitting in...not that this is necessarily an alien feeling to someone who is overweight, but in this case getting my own bag of Reese's Pieces or plate of pizza stacked high to snarf down isn't an emotionally satisfying alternative.

This is but one small part of the emotional changes I'm told I may get to experience. It will contribute to the emotional roller coasters...as the body adjusts to not having the food and dealing with the loss of my friend food as an emotional crutch and reacting to how people react to me if and when things start to change physically. I read that there are days where the post-op patient will just suddenly start breaking down in tears like a bipolar sufferer. I haven't had this happen yet; I told my wife that there are times where I may be very grouchy or emotional and she being the supportive nurturing person she is replied, "So, no different from usual?"

Again, only time will tell of the effects all this will have on me, but so far this is what I've noticed. I thought that the scheduling of the surgery was extremely unfortunate..."I am going home for recovery over Easter? Easter with peanut butter filled white chocolate eggs? And the gluttonous ham dinner? And rolls with tasty tasty butter? Oh man!" As it stands I don't really care about the dinner.

I am touched, though, that my father in law made jello eggs split in half with what appears to be lemon or orange jello scrambled and placed carefully on the halves, saying "I made you some deviled eggs for Easter Dinner!" I'm looking forward to having one or two of them. But I think the plate of them will be lasting awhile unless other people take them as well.

It'll be interesting to find out how Thanksgiving will change for me.

Two Items: Blog Focus Note, and Not for the Queasy

I'm aware that most of the posts here have focused on the recent surgery and my emotional journey through those waters. This is a relatively large thing for me...no pun intended...and so I kind of expect that it will be a topic of blogging for awhile, with the occasional sprinkling of other life events of note as we go along. Not that there are complaints or anything yet...I don't even know if there are more than three or four people that check in on the blog. I am simply afraid that sooner or later this surgery and my dieting efforts will come to define me as a person, and I don't want that. There are other facets to my life that better help define me as a person whether I like them or not and "the fat guy" is just one part that happens to be taking center stage for awhile.

In summary...while the next month will be heavy on the weight loss surgery stuff (again, no pun intended) there will be other topics put in here and gradually there will be a shift in focus if for no other reason than I don't want the blog to transform into a daily affirmation of "Yep, this hurts" or "Here's another lowfat recipe I've discovered!" Right now I want this blog to reflect what is currently prominent in my life...the weight loss surgery and its effects...and provide useful information for other people about to have the surgery or are considering the surgery or know someone who is in that position. I want to provide some food for thought.

Now that that is out of the way, one of the things I was...okay, am...freaked out about was the prospect of the tubes and devices that would be hanging out of me. When I first woke up I had:

• a tube in my back (epidural)
• a "grenade" tube on my left side of the abdomen
• a "grenade" tube on my right side of the abdomen
• 2 IV tubes in my right hand
• a virtual diaper of gauze and pads taped to my chest covering a vertical line of Frankensteinian staples in my midsection
• a sensor taped to my finger for heartrate monitoring (I might tell you some time about my "friend," Beepy the Annoying Alarm)
• A plastic tube that was attached to my favorite piece of anatomy (technically it was anchored to my bladder but for all intents and purposes it meant the nurses all got to have a glance or three at my giblets. I was glad they were professional enough to stifle giggles. And horrified looks. I don't know how nurses and clinical assistants can do the job they do.)

That was quite a bit of poking and doesn't even count the stabs by staff as they had to test blood sugar and take periodic blood panels and administer an occasional insulin shot.

Over the next several day most of that was removed and I now have only a few items stuck in me now. I had read some warnings of things that patients may have on (um...in) them when they leave the hospital, but if you were wondering what it looked like, here's some quick photos. I still pause when I see these wounds on me and shudder when I think about the fact that I have two holes where tubes are coming out of my tummy, but slowly I'm acclimating to the sight. If you are considering open Roux-En-Y surgery then you should be prepared to see something like this when you have your shirt up at home. Hopefully these things will be removed on Tuesday (these were taken on Friday).

Home At Last

This has been one H*#@ of a journey.

I'm home now. Sitting on the couch. My own couch in the living room. I left this room Monday afternoon to trek to the nearby town where my wife and I stayed in a hotel, and now I'm finally back the following Friday.

I hurt quite a bit. Right now I have a small arsenal of staples in my gut and a rubbery plastic "grenade" sticking out of me. Every time I try to move I feel the staples pulling on my abdomen. These pains have been...challenging.

I managed to use the bathroom twice; once I needed help standing, once I managed to do it on my own. I can't get up from the couch without help yet. I have managed to stand from my chair on my own.

So...it's extremely frustrating. But it's getting better. A caregiver told me that this will be the hardest month of this change, and this first week will be the hardest of that month. I believe it...I'm already looking forwards quite anxiously to Tuesday, when I expect to have the staples and drain removed. I can't even think of what is going to go on this weekend...I just hear the word "Tuesday" echoing in my head.

I've come a long way. Tuesday I had the surgery, so early in the morning; I woke up in extreme pain in the Recovery area of the hospital, bleeding and crying for something to alleviate the pain coursing through my stomach. They gave me more drugs and slowly, slowly, slowly, the pain faded. but then I wasn't breathing properly. A side effect of the epidural, I was told. I'd start to doze or nod off slightly and then an alarm would sound...that alarm became quite the close buddy over the next few nights...telling the nurse that I wasn't breathing. They'd feed more oxygen to me and it just didn't seem to be helping enough. I was in Recovery for eight hours. The nurse assigned to me...there is one on one nursing in Recovery...became somewhat attached to me in our limited exchanges. She said that normally a patient would be in recovery for much less than an hour; wake up, ship off to ICU or another ward. I was an exception that day. I was to be closely watched because of these complications for, well, eight hours. We'd talk a little then I'd be jolted back to a fully awake status by her voice telling me to breathe.

Then I'd bleed. A doctor was consulted; he come into the curtain for a cursory examination and then proceeded to add three more staples to stem the bleeding. Not much pain, but thank the deities that I had the epidural in my system.

My wife was already debriefed by the surgeons about my breathing issues and that I was in Recovery, despite the operation being a rousing success. She was the first one in the Day-Surgery waiting room and the last one to leave while waiting for me to leave Recovery; I can't imagine how she felt waiting for an update when she was supposed to see me after just a couple hours.

Finally I was moved to the second floor and into my single-occupancy room. I was so glad to see her and relieved at my luck at having a single room. Unfortunately, while I was mostly stabilized on the breathing issue after reducing my pain killers and increasing O2, the bleeding wasn't stopping.

All night, about every hour and a half to two hours, I'd be woken up from my pained, fitful sleep by the trickle of blood that was overflowing the mounds of sponges and gauze taped to my midsection and had begun pooling around my hips on the bed. Every time the nurses would change my dressings and again change the sheets and mats, forcing painful shifting of my position or standing in order to make the alterations. I had earlier been taken on my promised walk of the hallway for recovery, but it was cut short when the nurse realized I had a trail of blood on the floor following me.

Early in the morning...I don't remember if it was near four or five...I became aware that I was starting to lose it. I remember asking the nurses what was wrong with me. I wanted to cry. I felt weak, I was tired, and I had watched handfuls of clot-covered gauze by the fistful being pulled off my sleep-addled body. I was becoming miserable, wondering what the hell I'd gotten myself into.

A doctor came in that morning. I successfully stemmed the bleeding problem by applying (painful) pressure to the specific point where I was bleeding from the incision. He had me hold that point for ten minutes after he packed on some specific chemical-laced gauze from the surgical wing and it just stopped bleeding. He "milked" the clot-stuck drain, one which was removed before I came home, and since then I began making progress in recovering.

Every day things have become a little easier to do. I'm pulling muscles because I'm straining to get up using my side instead of my abdomen; I even strained my neck muscles and I'm not sure how I did that.

Now I need to adjust to recovery here. I have a constant fear that either the dog...an 80 pound doberman with the brain of a sponge...or my four year old boy will hit or leap on me. My little guy already forgot once in and leaned on my, hand outstretched, to crawl on to the couch with me, forgetting completely that daddy has a gaping wound on his tummy. Fortunately I bit back the yelp that would have scared him half to death. He also was playing with a toy that went wild from his hand and, of course, bounced off my stomach. Of course I add to my own stress by having to bite back sudden emotional frustration when the children or the dogs or just anything in life is making me want to scream. Quite frankly, the recovery process itself has shortened that tolerance considerably, and my wife will tell you it wasn't that long to begin with.

I just need to hang on a little while longer. And the first SOB that says this was the "easy way out" for losing weight is going to get a bat to the face, because so far I'm not finding the easy part in all this.

TV Cravings?

My surgery was done on Tuesday. I've made definite progress towards healing up...moving better, most wires and tubes removed, etc. Best of all, I don't feel hungry. Meals in total have been 12 oz of skim milk, a little jello, and maybe half a bowl of beef broth and a bowl and a half of chicken broth. Most of it I made a point of consuming because the body needs material to repair itself.

But the funny part is that despite this I just finished watching Hell's Kitchen and for two nights the TV has been set on the food channel, watching cake competitions and souffles and such. I can't get enough of those shows.

Weird?