Weight loss surgery is officially on hold

Since March I stopped hauling this around.

Since March I stopped hauling this around.

As I write this I am enjoying experiencing the buzz of a carb rush. It came from a combination of one of those apple muffins from Costco that has a Maple frosting on it that makes you wonder how you liked any other flavor. After that I had a slice of pizza left over from last night’s treat for the kids. I didn’t have any with them, so this was my first chance to feel the buzz.

This food intake is according to a healthy diet plan, because today is “cheat day,” or maybe I should call it “treat day,” or “free day.” Whatever I call it, on most weeks Saturday will be the day I can shed all pretense of trying to eat healthy and cheat on the diet, treat myself to everything yummy and feel free to pack on the carbohydrates.

For those of you who saw the last post and didn’t make it down on the Facebook thread to see my decision, I have decided to postpone weight-loss surgery. This comes because I never stopped believing what I believed all along, that if I could lose the weight without surgery I would prefer it. Over the past nearly six weeks I have made tremendous progress in my quest to be at a healthy weight.

In the last post I guessed I would see a 20-pound weight loss when I went to Swedish. I was off by 7 pounds. I shed 27. I’ve lost more since. The dietician at Swedish Medical Center was astounded at the number. Then we got into a conversation, led by me after she asked a question about preparing for surgery, about whether to have the surgery at all. She called in the surgeon. They were supportive. I’m pretty sure they would have preferred I had gone ahead and had the surgery. They laid out the statistics that there is not any data to support the idea that people who go on diets have any long-term success. But the doctor said that if I can be the “one in 20” he would be happy for me. Then he said if I come to a decision later to go ahead and have the surgery to get on track quickly.

Once I hit 370 again, where I bottomed out my last weigh in before deciding to have surgery, I’ll post all the numbers, including how high I climbed. Suffice to say I was heavier than when I started in October 2011. From that start point to the day in August 2012 I hit 370, I lost 34 pounds.

In the past six weeks I’ve already lost more than that. I’m down 36.6 pounds since March 27.

The pace is likely to decrease, but I have yet to have a serious temptation to stray from plan. That is more important than the day-to-day number. I’m also exercising more. The real reason this works, as I said before, is the notion of giving up some foods forever creates tangible fright and stress for me. To turn those things down until Saturday is little problem.

Speaking of Saturday, a Dr Pepper sounds good right about now.

Weighing in on my heavy decision

quandaryThere is one big reason to question whether I will have weight loss surgery. I would love to hear your thoughts on the matter.

There were a lot of reasons to avoid weight loss surgery in the past. The safety of the procedure was unknown, the long-term effectiveness was in doubt. Those two things have been answered to my satisfaction. I could have the surgery and it would be safe and would work. My life would be better.

One of the other big reasons I had for avoiding it before, though, was the idea that since weight loss surgery requires a lifestyle change to work, why couldn’t I just change my lifestyle and get the same result? Surgery is no magic pill.

Then I came to the conclusion that I couldn’t do it without surgery. I made the decision that I wanted it, that the reduced stomach size would help where will power hadn’t been helpful before. In December I went to a seminar at Swedish Medical Center to start the process. The real work began in January.

The biggest issue for me with diets in the past, though, has been the exclusion or drastic reduction in foods that I love. It creates a scarcity mindset. I get stressed and the first thing I turn to is the thing I can’t have. Even on Weight Watchers you can pretty much eat whatever you want, just in reduced portions.

That scarcity mindset attacked as I knew weight loss surgery was coming. My trips to fast food restaurants become dramatically more frequent. I ballooned, exactly the wrong result for the folks at Swedish. To their credit, they want to make sure someone will succeed with surgery. They’re not there to just take my money for their service.

So about a month ago I had another visit with them where my weight had gone up dramatically. Everything was in place for them to submit my surgery to my insurance for final approval, but they wouldn’t do it. They wanted me to show them that I could stick to a plan.

You see the irony, right? To qualify for weight loss surgery I’ve got to demonstrate an ability to do something I’ve never been able to do.

I went home determined to pull it off. Since that visit I’ve been great, for the most part. I’ll get to the exception in a bit. The post surgery diet is essentially a higher protein and lower carb regimen. Bread and rice would be a rarity. Forget soda. I started on that routine the day I left the hospital my last visit and, with a notable exception, have stuck to it.

Here is where the exception comes in. Reading the story of a friend of mine, the second weekend after I started I incorporated a “cheat day.” On Saturday, I decided, I could treat myself. Chips, soda, bread, pizza are all available to me. I tried it one week and it was almost miraculous. I ate what I wanted on Saturday and on Sunday I was perfectly content to go back to the plan. As my friend said in one of his posts, the idea of never having a certain food again is painful, but waiting until Saturday is doable. It’s almost easy. So at work I skip the chips that are so plentiful and the wonderful baked goods fellow workmates bring in. My friend who has done this has lost 78 pounds in six months. I weigh in tomorrow. I’m guessing I’ve lost close to 20 pounds this past month.

I’m day two into another week of waiting until Saturday for goodies and I am content. I feel like I’m in a space where I could live this way the rest of my life. I may have said something like that in the past, but I never felt it this strongly. This is working.

So tomorrow I go back to Swedish, I’ll get weighed in and I’m sure they’ll be pretty encouraged by the results, perhaps enough to submit me for approval. And I might say I don’t want it anymore.

Should that happen, this whole effort with them hasn’t been wasted. The lab work I had to get done revealed some things that we fixed with medication. I feel so much better.

When I first mentioned weight loss surgery in the past I received mixed responses. If you have strong feelings about this, I’d be glad to hear from you again. I make my own call here, but you might know something that is worth sharing. Feel free to tell me here, on Facebook, an email, or call me. I’m not “all” ears, but I am open to ideas.

The preparation nets life changes

This photo is kind of random, but it marks one thing I got to do in between the time I announced my intention to get surgery and today. This was in early December.

This photo is kind of random, but it marks one thing I got to do in between the time I announced my intention to get surgery and today. This was in early December. I think I could double as Chris Christie.

In November when I posted here that I was choosing to have weight loss surgery I certainly thought I would have had it by now. The next day my dad went into the hospital and a week later he was gone. I was scheduled to go to my first informational meeting about the surgery the following Wednesday, but we decided to go to Utah as a family for the funeral, which meant I left a day earlier than scheduled, missing that meeting. It was a month before I could go to another one.

As it turns out that didn’t really matter, because the Swedish Medical Center program is pretty thorough in terms of preparation. Added to that is the fact was with the new year coming it didn’t make sense for the hospital to check on insurance until after New Year’s. I’m pre-approved for the surgery, but in addition to taking the four-six weeks it will take to get final approval, I’ve had to get a long list of tests done.

One of those was a sleep test to see if I have sleep apnea. I do. Severe. So now I sleep with a breathing mask that’s attached to a machine that pumps air into my pie hole so I get a good night’s rest. I can tell it works, because I am wide awake when I get up.

And still I’m fatigued.

I found out why today. My thyroid is slow. Just like finding out I had sleep apnea was a relief, so is the thyroid discovery. The CPAP machine that addresses the sleepiness has made a real difference, but I’m hoping this medicine I began taking today will net the same kind of results for the fatigue.

And there is more. This diagnosis helps me confirm my decision to get the surgery. For many years what has been true is that I have benefited from the hardiness of the Gardner stock. My dad fought a lot and his body would have gone a lot longer, but at 82 his body was made vulnerable by several rounds of antibiotics and an infection eventually knocked him out. My grandfather and my Uncle George, though, lived even longer than my dad, and it was cancer that took my Uncle Darrell. Cancer can knock down the strongest of anything.

The reason this thyroid news confirms my decision is because to me it’s the first real sign that my body can only take so much. I have to change things or my body will give up on me, despite the strength of my genes. When I first looked at weight loss surgery I was looking at lap band, motivated in part by the fact that it’s reversible. The doctor persuaded me that lap band would not be the best for me, not because of the reversible nature, but because of all the follow-up visits I would need to make to adjust the band. So I’ll be getting what’s known as a gastric sleeve, which is more similar to the original gastric bypass surgery, but seems to be the better option for me. It’s permanent, too, which in the nearly four months I’ve had to anticipate my surgery has come to seem like a good idea.

For now the only preparation left for me is taking the medicine to address the thyroid problem and working on eating like I will once the surgery is done. That’s been a hard task, and didn’t accomplish it today either. I will get there, because even though I’m taking a different tack than I had planned, because I’m still fat and still fighting, and not quitting and not hiding.

As of now the hope is that I can have the surgery on April 22. That is probably the earliest.

I don’t want to wait for me anymore

More than a year ago I set out on a public quest to shed 205 pounds. It wasn’t the first time I’d tried to lose weight for Heaven’s sake. I just went blaringly public with this effort. A year later I’m down about 15 pounds from where I started.

That’s not enough.

I hope I’m not disappointing anyone when I tell you that when I had my physical this week my doctor asked if I was willing to consider weight loss surgery, and I answered that I was. But if it is disappointing to you, on some level it was to me, too. I got over it. The prospect of getting my life back is what cinched it.

When I first launched into the public revelation about my weight I had a conversation with a friend who asked why I had nixed the idea of surgery. I told him, “If I believed I needed it to save my life, I would do it.”

At the time when I said “save my life,” I meant it as a choice between living and dying. I still mean “save my life,” but in a different way. I want to go back to Chile for a book project, but won’t consider it at this weight. I used to look forward to flying. My last experience showed me just how challenging it is to be this big and travel on a full airplane. To fly for 24 hours just to get there doesn’t seem worth it. That is just one example of how being this heavy doesn’t necessarily kill me, but removes a part of life I could be living.

So on Nov. 14 I go to a seminar at Swedish Medical Center in Seattle to, I hope, begin the process. And it will be a process. I am well aware that surgery is no magic pill. Typically patients lose about a fourth of the weight they need to during the first year. That is not as far as I want to go. That marathon goal is still real.

I suppose something could influence me between now and then to reconsider. I could continue doing what I have been doing, but the risk is continuing to struggle until real health consequences arise. The other risk is missing out on so many good parts of life while I wait to get a handle on it. I don’t want to wait for me to figure it out. I’m 50 years old and missing out on so much to delay this any longer.

Still fat and still fighting. Not quitting and not hiding

It has been a year since I revealed my weight and it is time to take some stock.

Broadcaster Jennifer Livingston’s response to a listener went viral the past couple of weeks when she considered it “bullying” that a viewer wrote her saying she should think of the children and stop being so fat on the air. I think the viewer was wrong and in later developments exposed himself as even more self-righteous than his original letter revealed, but I don’t think it was the same as bullying. Livingston’s 4 minute, 21 second response was about 4 minutes too long. I don’t necessarily agree with anyone who says she should have just hit the “Delete” key, though that would have been fine, too. I just think if she was going to respond, a brief recognition of the problem and a quick dismissal of the observation would have been in order.

Here is how I would have responded:

“Dear viewer. Yes, I realize I’m fat. I recognize the message that people, children in particular, could get from that message. I also recognize that there would be a different, though less obvious, message if I were to not be on the air because I am fat. That message would be that being fat is the one personal weakness that requires the cessation of every other activity until the fat is gone. I could be a drunk, a sex addict or a chain smoker and all of that would be fine as long as I kept it private. But my weakness for food shows up in obvious ways, therefore I should stay out of the public light. Believe me, I’ve been depressed enough to want to quit, but instead I have decided I’m going to do what I believe I was born to do while continuing to fight the fight against fat. And for anyone who smokes, drinks too much or is bad at relationships, but wants to be better, I’m here to support you, too.”

OK, so that response would take about a minute to read on air. It makes my point. Over the past year I’ve had ups and downs, literal and figurative. I’ve lost lots of weight quickly and put some back on. I’ve been excited and depressed. Some good news is that I weigh less than I did a year ago. I’m not sure how much. The better news is that I have not, and will not, quit.

At times it is easy, but most times it is not. I know in my head that it’s a choice I make, but sometimes that choice doesn’t seem as easy as my head knows it is.

As for Livingston’s contention that the viewer was a bully, the bullying she speaks of does exist. I felt it several weeks ago as I was walking in downtown Bremerton near a Navy shipyard parking garage. Someone within the garage yelled “in a van down by the river.” That’s a line from Chris Farley’s Saturday Night Live Matt Foley motivational speaker character. Farley, you may recall, was fat. I didn’t immediately take it personally when I heard the yell. I can’t even be sure it was aimed at me. But in my most depressed moments I get to thinking it probably was, and that it was shouted by some coward who knew I couldn’t see him in the shadows of the multi-level parking garage. I’ll be honest, sometimes that kind of insult gets to me.

At the same time, I won’t let it stop me. I have a job and a new book, which I’ll announce in a few days. Life goes on in spite of the fact that I’m fat. I can’t hide. And in my best moments I don’t want to.

Thank you all for the support you have offered this year. And here’s to another year of fighting the fight, of making progress, of not defining myself by the number while working to lower it.

When I reach that next new low, I’ll let you know.

A new bottom line — Week 44

Remember that time this fell and, like, hit that coyote on the head? Yeah, that was awesome. This represents what I have lost.

It was more than four months ago that I posted a bottom line, the one you see at the bottom. Coincidence that the bottom line is at the bottom? Now who’s naive?

My strategy was to post the info when there was a new milestone. At last that has happened. And how! Thanks to a concentrated effort over two weeks I’ve reached a new low. I’m now down 34 pounds from where I started, and I think I have found a strategy that can work for the long term. That involves finding something positive and negative to motivate me.

Years ago I heard Tim Harford, an economist and author of The Logic of Life,” on the radio talking about how he motivated himself. He sent a friend $1,000 and committed to some exercise regimen. He said if he met behavior goal over six months, the friend was supposed to return the $1,000. If he didn’t, he’d give it away. That motivated him to keep to his goals.

I thought about that all that time. Since I don’t really have $1,000 to put up for a gamble like that, I found it hard to find something similar.

Then a while back I wrote about rewards and penalties. It’s a strategy used by former Tennessee women’s basketball coach Pat Summit. You basically think of something you’d consider a reward, and another thing you’d hold out as a penalty. I tried it one week not long ago to see if it would work for goals that didn’t really help me lose weight. It worked. So then I set a one-month goals, but neglected to establish the reward and penalty. As a result I buckled on day 10.

After a few days off of the plan, I came up with a two-week behavior commitment, strengthened by the reward: I’d go see The Campaign at the SEEFilm Bremerton Cinema here. The penalty should I fail: I’d give up the Mariners tickets I have for Sept. 1.

The commitment was pretty simple. I set a daily calorie max and exercise goal. Over two weeks I met it. The result is I’m down to 370. I picked Friday as the last day, because on Saturday we planned to go to a family reunion and I wanted to be able to go to that without stressing over food.

The real bottom line is it worked. The key will be repeating it. On to the next low!

Bottom Line:
Beginning weight: 404
Target weight: 199
This week’s weight: 370
Total weight lost: -34
Pounds to go: 171
Percentage body weight goal: 50.5 percent
Percentage body weight lost: 8.4 percent
Percentage of goal lost: 16.6 percent

Rewards and penalties — Week 39

Well. I wondered why I had no feedback on this one. Seems I forgot to publish it. So here it is, only five days late.

There is no quit on this process of shedding half of me, though it may have seemed like it lately. Again I’ve been caught up looking for that magic bullet, only to return to the logic of the 1-degree shift.

This week I am going to a lesson from Pat Summitt, who just retired as women’s basketball coach at the University of Tennessee. I found this once when preparing a podcast episode. Summitt told Success Magazine her teams never began the season with a national championship as a goal, though her teams won eight in the 38 years she was head coach. The problem with that kind of goal, she said, is if there is a problem early on you risk losing “morale, self-discipline and chemistry.”

Frankly I think the term “goal” is best used for short-term accomplishments. Something for the long term takes a more holistic approach.

For the short term, though, a goal is worth pursuing. What helps get there is setting up a system of rewards or penalties, something else Summitt discussed.

“Setting up a system that rewards you for meeting your goals and has penalties for failing to hit your target is just as important as putting your goals down on paper.”

So for this week I have four 1-degree shifts I’ve committed to, with rewards and penalties as part of the operation. I’m keeping all those to myself, but they’re written and visible.

My magic bullet addiction — week 35

The biggest detriment I face in my quest to shed half of me is what happens when I think I’m going to start a new program, or submit to a pretty drastic solution. Those are moments in which I think, “The solution is just a tomorrow away, so today I’m living it up.”

I had it right earlier in this process when I said victory in this comes from the moment-to-moment decisions I make.

And yet, time after time the biggest addiction I have besides food is to the magic bullet that will kill it.

When I began this process I had a long, online conversation with a friend who asked why weight-loss surgery was out of the question. My response then was that it isn’t, but if I could do this without it, then I wanted to. While the surgery does create outstanding results, it is still a tough road to take. My stock answer for years has been that those who get the surgery have to make dramatic lifestyle changes. I’d rather make the changes without the surgery.

It gets tempting, though, and it was this last week. I saw a picture of a friend of ours side by side with one from a year ago. The difference was remarkable. So remarkable, in fact, that I seriously wondered, after 34 weeks of stumbling on a plan I thought would be that magic bullet, whether surgery was my best bet. The second result of that thought process was me tricking my mind into believing a massive change was coming. When that happens I overeat. I did, and I packed on a bunch of pounds. My overall weight loss right now is about 15 pounds, where it had been as much as 27.

The answer came at about 8 p.m. Sunday. I was leaving work and thought about getting a Coke. I considered how it would really make me feel and what impact it would have on my body and decided against it.

That, more than anything I can do, will be what ultimately creates success for me. Making moment by moment decisions on what I have to keep reminding myself is a journey is what will result in one day me jumping on a scale or looking in a mirror or trying on clothing and saying, “I hit my goal.” That’s the truth whether I do it through a structured program, a surgery or by just living better. So right now I’m focusing on living better.

I made progress when I decided against that Coke.