Monday, June 1, 2009

Blood Sugar Plateaus

Looking over my number charts for the past few months I just noticed that weight isn't the only thing that seems to jump and fall in steps. As I'm losing a decent amount of weight over the months it seems that my blood sugar numbers, which I have to record in the morning and at night, seem to stay in a "general area" for awhile then start to drop and stay at a new apparent set point. I had numbers that used to be in the 200's until I was medicated a few years ago. I went off my medication after having surgery in April and my numbers were generally decent. I know that I was expecting them last month to be in the 120's or so. Lately they've been dipping into the sub-100 range in the morning, and maybe 110 or so at night. The doctors seem to be pretty happy with these results.

There are occasional spikes. When you're playing with blood sugar I'm not surprised...you can't get a totally consistent number even with two consecutive tests. But you should have a general range in which you expect the test to come out in. I just happened to notice a general pattern in my numbers while looking over the old results.

So while they operate with different mechanisms and chemistry, weight and blood sugar seem to be both susceptible to the stair-step plateau effect.

Any other post-bariatric patients with diabetes notice this in measuring their progress? If so feel free to share...

Sunday, May 31, 2009

Biking is Hard...

Today was a little on the windy and chilly side, but I was determined to do something today that made me feel as if I accomplished something. My wife's bike is "in the shop"...the chain kept flying off the sprockets when she downshifted and the real kicker came yesterday when we tried to go on a biking excursion and her quick-release hub assembly flew apart. We put it back together, but every time you locked it, the lever flew apart from the assembly. Something stripped? We couldn't tell. But the conclusion was a trip back to the store the bike came from, 3 year service plan in hand, telling them it needed repair. They said they'd have their bike mechanic look at it today and call us when it was ready. No phone call today.

So I filled this afternoon first with more weed whacking...quite of bit of that done...then we took my bike and my son's "Hot Wheels" bike (a little bike with training wheels) to a local school to ride around. My son decided to take off without us, and we yelled to him to stop and wait. He stopped, giggled, and took off again. I jumped onto my saddle and took off after him, but I was too late. He failed to brake in time and rode right off the sidewalk, falling onto the pavement.

He seemed okay with a nagging soreness to his arm. We were sure it was a sprain. His grandparents were sure it was a sprain.

A few hours later we took him to the ER. It was a green stick fracture on both bones, mid-forearm. Not a complete snap, but enough to proclaim it a fracture.

Silver lining: he's four. The bones, he said, would heal right up as long as they don't take another hit that would complete the fracture, and they'll heal straight. He should be just fine, although right now he doesn't like the feel of the splint and in a few days he'll have a cast put on.

He'll be fine. Poor little guy.

All of this after scouring the web for information on some sort of a "good" place to try riding. Long story short: good luck finding some. It's hard enough for adults to find a place to ride that wasn't in the road. To ride with a four year old on training wheels? The local school was the closest we could find to being a safe place to try riding. So much for that theory.

Society just doesn't seem to place importance on exercise outside of walking and fitness centers. Biking was a good, practical way to get some more exercise and yet it's relegated to having practitioners roll the dice and take their chances with getting hit by cars or have to use stationary equipment in gyms or basement workout corners.

That. Sucks.

Especially for noobs like me who are too out of shape to really ride on the roads or people, again like me, who have young kids who also want to try riding on a bike. Well, used to. I don't know if my little guy will want to ride for awhile after this incident.

Saturday, May 30, 2009

Biking for Fun

My wife and I went to a park late yesterday to try breaking in the bikes a little. We first stopped at a grocery store and picked up a few items then headed out for a picnic and bike ride. Here's some of what we saw while in Eldridge Park...

I'm not sure how long the path is that circles the park; my wife thought we traveled a mile or mile and a half. Her knee...still injured from when the idiot dog pulled her off the porch many months ago (and she'll probably need surgery to repair it)...was bothering her after the first circuit around the park, so we packed up and headed out.

There was a band playing at the meeting area near the lake. The band wasn't bad, the weather was nice, the park was pleasant; it was a pleasant way to spend the late afternoon.

Thursday, May 28, 2009

Doctors and Medical Myths

Quick article to share with others...

http://www.newsweek.com/id/199679

It explores some of the myths that many doctors apparently believe. A couple of docs as a side project wrote a paper exploring myths that pervade their profession and the results were kind of surprising...including having one guy harassing their office until they had to get a restraining order because, believe it or not, you don't need eight glasses of water a day. Yes, the guy was extremely upset that they would have the audacity to publish that.

Interesting, kind of scary that the people we trust with our health believe some of these myths when most of this information isn't new. But we sometimes need to realize that doctors are humans and it's their jobs, not the essence of their existence, when they're sitting there in the same room where you're only in your Superman underwear and they're examining you. They're fallible. We simply, without question in many cases, expect them to dole out miracles. They can be wrong. We need to remember that.

It's just their job to try not to be wrong and in the process keep you healthier than when you walked in. What do readers think?

Followup to 7 Week Followup: Blood Test Results

I got an email from my doctor this morning about my blood work (holy schnikes that was fast...I rarely hear about blood test results that quickly). She said that I was mildly low on iron, which is common for bariatric patients. I'm supposed to start on an iron supplement of 325 mg twice a day.

Iron can cause constipation so she said if it happens I can go on a fiber supplement as well, but I think I'll wait and see what happens.

Oh, yeah, forgot to mention that when I had my previous appointment the doctor gave me her email address for questions and concerns. So now I have two people on the support team that I can email with concerns if/when I have them! They are both younger medical staff too. Doesn't take much to see a pattern...the generation accustomed to technology are using it to their advantage in working with their patients. Soon they'll be using Twitter as a tool in the medical office.

I hope I can go off some pills soon. I have a rather large number I take every morning now and need to remember to take at night; hopefully I can get off the cholesterol/blood pressure stuff soon!

More On Skin Irritation and Loose Skin

Those dark, sweaty spots on your body from loose skin that people generally don't like to talk about (but, I've noticed, are increasingly used as comedy fodder...even saw it in a cartoon episode of Fairly Oddparents where all meals were comprised of dessert...I have a young son and he likes cartoons, okay?) like to form rashes and skin irritation. I wrote about a problem I was having with this yesterday.

I put Gold Bond Medicated Powder on it last night and again this morning and it feels better. Don't know if it'll solve the problem, but hey...anything to help. I have an appointment with my primary care physician towards the end of the month and will be asking her for some kind of prescription to cure this because it is driving me nuts.

Wednesday, May 27, 2009

Loose Skin and Rashes...

It happened before the surgery a couple times, and this is the first time since the surgery that I've noticed it.

There's some kind of a wet rash under the fold of a section of skin.

It's uncomfortable and annoying. I don't know if it's just a rash or some kind of infection...but I do know it's annoying.

I'm hoping some powder will help with it. Supposedly a few years down the road, if there are infections, I can try getting loose skin removed. As pointed out at weight loss surgery coach once you reach a certain point in weight gain the ability for skin to "snap back" is most likely lost...so exercise will not help this particular problem.

In all likelihood, the sweat and friction will make it worse.

Any other patients out there experience this and try home treatments that seem to work?

Tuesday, May 26, 2009

Milestone: 7 Week Followup, Plateaus in Diet And Some Potential Exercise

Today was my 7-week followup to the surgery. My wife came with me for information and support. There wasn't really much to it...a few question and answer things, primarily, and my doctor put me on vitamin B12 and B-complex pills now. I'm going to pick them up from WalMart soon.

I tried asking some questions about how plateauing works, but I don't know if I sufficiently communicated this idea to the doctor. I'm beginning to wonder if I can't get anyone to understand where my knowledge is insufficient for this. She primarily focused on how we...barry patients...no longer fit the profile of the typical dieter now because we have both smaller stomachs and malabsorption issues. I think I'm asking a very plain question, but either I'm not communicating clearly or I'm not understanding their responses.

I'm trying to ask this...if you view dieting as an engineering problem, the body is reduced to a bag. It's like when I was in school and had to balance equations in chemistry...you put food in, you burn energy and excrete waste. The in-processing matter is what comprises your mass, and on the planet that translates to your weight.

You drink a pound of water, you weigh a pound more. You eat a pound of food, you have a pound of weight added.

As you go through your day you sweat, you go to the bathroom, and you convert some calories into work...movement, heat, etc...and some food/drink is converted into other cells to repair the body while others are shed (hair falling out, skin shedding, internal cells are flushed out as waste...). This is weight lost.

You are a walking chemical equation. Now, if you figure out your basal metabolic rate, you'll find the approximate number of calories you burn if you didn't do jack squat for the day. Lay in bed, this is the number of calories you burn. These calories are used to keep you alive. Your brain activity, your organs functioning, etc. would burn this many calories. It takes calories to maintain your current weight, believe it or not. If you eat less than the BMR, you should lose weight. If you eat more, you gain weight.

If you figure out how many calories you add on to your BMR from exercise you can adjust accordingly.

Now, if you're taking in a very low calorie diet as I once did many moons ago...600 calories, more or less...there is no way I could be going over my BMR. I'm not putting more calories into the bag...my body...than were flowing out. Yet still I hit a plateau. In the current case if you follow the rules my doctor said that we should hit no more than 1200 calories a day; this is still below most people's possible BMR count.

Okay. Body needs...at my weight one time it needed over 3000 calories to maintain it's weight. I'm putting in...1000. Matter does NOT just appear. Matter does NOT become magical. The body needs 2000 more calories here, so something has to give. Normally it means you lose weight. So when you're plateauing...where is the energy coming from? I'm not putting in to the bag the amount it needs to maintain the weight level it is accustomed to. Remember, if you have fewer calories than BMR, you lose weight. Equal BMR, you stay the same weight. Over BMR, you gain. There's a 2000 calorie difference in this example...so how does it stay the same??

The answer I normally get is that the body is adjusting to the changes and lower calories.

That's not quite clicking to me. If I don't put gas in my car it doesn't just adjust. It needs fuel to run. Your body needs calories to run, and if it doesn't get them it will start shedding components...fuel stores in fat, or excess tissue, etc...to survive. The closest I could come to an understanding from my conversation today is that I should feel tired and sluggish as the body "conserves and adapts" by screwing with the rate at which it metabolizes energy stores.

Oh well. Seven weeks in and now I'm adding some vitamin B stuff. AAH! MORE PILLS! My doctor also gave me her email address to address concerns I may have or develop.

My wife and I also went out and she gave me a Father's Day gift from her and my son. A NEW BIKE! YAY ME!

I am not a bike nut. It is something I enjoy periodically, though...I'm not good at riding up hills, I usually rode around buildings on paved and generally flat surfaces, not running through the woods or along roads. It's one of two or three things that both I enjoy and are generally classified as exercise. Unfortuneately when I hit a heavy enough weight I just threw the bike into storage. I took it out over the weekend now that my son is trying to get a bike and found it to be rusty and generally in need of a tuneup.

I lamented to my wife that I was going to save some bucks to get a bike and she took me today to Dick's Sporting Goods just to look around. I ended up really liking a Diamondback Edgewood 09, and she said, "Happy Father's Day!"

She also bought herself a Diamondback Lustre 09, so we can both ride with the little dude. Yay us!

So that was my day for the most part. Not bad. Unfortunately I'll have to return to work tomorrow, but we'll not let that dampen spirits right now...

Monday, May 25, 2009

Adsense activation

I've been curious about this for awhile...I finally activated AdSense on my blog. I have been curious to see what Google would select to show for advertisements now that the search engine is finally showing signs of indexing the content and analyzing information from it; I've been hesitant because normally ads are SO intrusive and annoying. The account is free as in money cost, but there is an annoyance and user-friendliness cost when you're bugging readers to buy buy buy while hoping they'll read and get some information from the content of your words. The default was trying to stick ads in the sidebar and under each posting...I personally find that it interrupts my reading of a blog when it goes post-ad-post-ad, but that's me and I understand the idea that if you're trying to make money from your site you want to try sprinkling as much ad content as you can without annoying your readers.

In the end I opted to stick one hopefully unobtrusive bar just below the title of the blog. Readable, should get some attention, while not being too intrusive.

I hold no illusions that this will make me money. Maybe once a year I could buy a comic book or something.

At any rate if you have any opinions or feedback please feel free to leave comments. I'm still experimenting and with a small readership I'm pretty sure that the void AdSense will fill is my curiosity of what ads Google thinks fits my content rather than any void in my wallet.

Exercise and Dieting...Why I Hate Exercise

After much struggle with my own weight loss issues and a lot of reading on the topic as well as discussions with multiple doctors, the truth about weight loss boils down to a simple short sentence:

Losing weight means taking in fewer calories than you're burning.

In other words, eat less or burn more calories. Adjust as necessary.

Whenever my weight loss stalls or I discuss issues with other people they inevitably start telling me that I need to "Exercise more! You need to exercise!"

Somehow that's the magic cure for everything.

The depressing batwings forming under my arms? "Exercise will tone that up." No, it won't. If I had lost a little weight, yes. When I've lost over a hundred pounds, no. The connective tissue is damaged. It will improve slightly and building muscle will contribute to helping, but dreams of looking like a studmuffin on the beach will not be in the cards. Plus as I established in an earlier post you need to take in more calories than your "maintenance" metabolic rate in order to build muscle...that's kind of against everything we're currently working towards.

I am a person that also needs simple routine and I live in an area that has variable weather. We have snowy Winters, sweaty Summers, and chilly Falls. Perhaps most people can't understand this but I simply cannot stand the thought of getting into a routine of walking along a riverside path for 3 of 4 seasons then get stuck in the house for the Winter months. I'd fall out of habit and never get back on the saddle. It's my nature...look for the asperger label for more.

Of course there is the old standby that I just don't like exercise.

However the real reason is that I am looking for exercise to enhance weight maintenance, not as a necessity. How many people do you know hang up the walking shoes for Winter and gain weight, or stop some activity that's work- or hobby-related and over the next several months gain the pounds? A shift in lifestyle suddenly means they become a lot tubbier? See the kids that went from high school sports stars to college tubbers and write it off as "Freshman Fifteen"?

I need to find a caloric intake that will maintain a more healthy weight. Then exercise can help me while not damaging my mental state. I am not denying the studies that conclude exercise helps in other ways, such as enhancing mood, helping metabolism, etc...simply that I, personally, need to find and maintain a healthy relationship with food before turning to the religion of abs and glutes. Preferably without bandying about terms like carbs, abs, and glutes.

I'm a big believer in The Hacker's Diet; available free online. The author states that he supports exercise for the benefits it offers but not for weight loss.

Maybe it's the psychiatrist effect; it often seems that when a person goes to see a therapist, suddenly everyone needs a therapist. They start to evangelize how their friends and family could use therapy and encourage others because of how it works wonders for them. Perhaps exercise has the same effect on them.

That being said I burrowed into the basement last night and use the air pump to re-fill the completely flat tires on my old bike. My son is getting a Hot Wheels 16-inch training bike for his birthday...we had to order it from Wal-Mart online...and I thought it could be fun to try riding around with him at school playgrounds, plus I used to enjoy riding bikes. My poor old bike has rusted rims and a missing spedometer computer and probably will need a chain replaced and greased, and the brakes are probably not in the best shape after being in storage...I'm really in need of a new bike. I don't even know how to properly work the gears. I'm a total bikenoramus. I'd say ignoramus but I don't count myself as such since I'm aware of how much I don't know about properly maintaining my bike. I managed to ride it around the front yard for a couple circuits...my son chased me on foot giggling the whole way...before putting it into the shed to see if the tires hold the air pressure.

Now I just wait and see.