Disability and Bariatric Surgery

Daily Drug Cocktail for epilepsy and bariatric surgery
The daily cocktail of drugs and devices required for an epileptic bariatric surgery patient.

Any morbidly obese person could give you a strongly reasoned argument about how their weight impairs their life. Being over 40 BMI brings problems with moving and breathing, creates heart issues, and can lead to diabetes. However, it is important to know that, as far as the federal government is concerned, being obese is not a disability in and of itself. Currently, the only Federal Court of Appeals to have ruled on the issue of obesity concluded that obesity alone does not count as a disability under the ADA.

Now, as much as many of us may disagree with that, there is a whole subset of those of us suffering from morbid obesity who are still affected by the ADA. What about those of us who are dealing with morbid obesity and a second disability?

From Bad To Worse

When I was diagnosed with Adult-Onset Epilepsy in 2004 I was already heavy. Tipping the scales at around 240 pounds thanks to too much beer and pizza, I fought my weight off by going to the gym and practicing with my band 3 nights a week. I told people I was the “strongest fat man” they knew.

The arrival of epilepsy coincided with two things that were detrimental to my weight. First, I stopped being active. I couldn’t go to the gym any longer, had no interest in music, and just wanted to sit around the house and mope. Secondly, the initial seizure control med I was put on, Depakote, had the side effect of creating weight gain. Those two factors, working together, meant I gained 40 pounds in about 3 months. I was now officially morbidly obese.

Let’s face it: disability sucks. Most of us who are disabled are too busy figuring out how we are going to get through our day-to-day lives to worry about losing weight. For many of us, food is the only real comfort available. We stay home, we avoid the world, and we eat, because that is something we can exercise control over. The thought process is something like this: I may never know true love, or go white-water rafting, or even drive a car, but by God, I can sit here and eat this whole meat-lovers pizza. So we do just that.

I remained in that mindset for 12 years. There is a reason that alcoholism, obesity and drug addiction are rampant among those of us with disabilities: it hurts to go on living, and we reach out for whatever will bring us a little comfort. Those of us born disabled may have been going through this since the day we were old enough to realize our limitations.

Kicked Off The Couch

I’ve written elsewhere about the decision-making process that led me to bariatric surgery. The short version is this: I finally got to the point where my obesity scared me more than my disability did.

Last March, during my first talk with my doctor about bariatric surgery, the subject of my epilepsy was front and center. This surgery had the potential to impact my seizure activity – to make my condition even worse. What did I think about that?

Though I could not have articulated it then, I think I can now. I was already trapped and limited by my disability. I did not want to become even more hemmed in by my obesity as well.

Each of us will have to make this choice. Specialists should be consulted. We should ask our friends for their opinions. Most importantly, we should engage the input of our loved ones, especially those who are our caregivers. They will be the ones to bear the burden if something goes wrong.

I was lucky. Every single person I spoke to about the surgery was almost relieved – as if they had just been waiting for me to bring the subject up. Not everyone will enjoy this kind of support. Many loved ones will object, reacting out of fear. Since you are already limited, they will ask, why would you risk making life even harder for yourself?

Risk vs. Reward

My case is nothing special. Hundreds of thousands of us in this country face the same choices I do every day. Is this really worth it? we wonder. Is what I can gain worth more than what I might lose?

In my case, the answer was a resounding “Yes!” I may have traded my beloved beer and pizza for a cocktail of daily medications and supplements (see picture above) that I will be on forever. But I have also been able to move out from under the shadow of my obesity. My self-esteem, never great since developing epilepsy, has grown by leaps and bounds. For the first time in a long time, I am actually overcoming something, not being victimized by it. I am steadily fighting my way to a place where I am suffering from only one disability, not two.

Because I don’t care what the ADA thinks. I know for a fact that morbid obesity is a disability. I would give whatever it takes to overcome epilepsy. Why would I feel any differently about the other condition that had wrested control of my life away from me?

Yes, I have been lucky: in my medical providers, my wife, and my loved ones. But I also made the choice that enough was enough. Regaining some control of my life started with my decision to go forward with bariatric surgery. Only one person can decide what it will take to get your hands back on the wheel.

Here’s To Fighting Back,

Jeremy

 

(Non-Fiction Friday): Bright Lights, Big Audience

Bright Lights, Big Audience: Getting Misdirected in front of millions of readers

The screenshot above (taken yesterday) is the front page of WellnessNova.com, a highly regarded alternative health website. They receive over 2 million unique views a month from people looking to improve their health and well-being.

Once again, this is the front page. And the article in the top left position (the one most likely to be clicked, according to SEO experts) happens to be under a familiar byline.

Now, being exposed to an audience this large doesn’t mean any immediate financial gains or anything. I was paid for writing this article last year. But it does get my byline out there. And it does expose my author bio at the bottom of the article, referring to Misdirected and my favorite topic, bariatric surgery.

With any luck at all, we could be seeing some new residents here at Misdirected.

The idea of an article I wrote potentially being seen by a couple million people is amazing, to say the least. The initial article I created for Wellness Nova got parked back in the cheap seats, and I think was viewed by a few hundred people before it faded away.

Now the next step – We have a third article coming out in February (all about Creatine, I believe), then I need to start looking for more topics and new forums.

A year ago I was morbidly obese. Today I am writing articles about health and wellness.

Mind. Blown.

In Other News…

I have gathered together all my notes and observations, and have actually begun writing my book on Adult-Onset Epilepsy. It is tentatively titled “Learning To Live In The Dark”. Currently, I have no firm timetable set for publication. However, I have made a commitment to creating new content for it every week. Like, it is on my personal calendar and everything. As the book develops, Patreon subscribers will get excerpts and sneak peeks at what is happening behind the curtain.

Speaking of Patreon, our funding project keeps growing and growing. We are already 3/4 of the way to our second funding goal – starting a podcast! I had better start looking for podcasting gear…Any feedback on topics you would like to hear about on a podcast in the next couple months?

And, keep your eyes here next week for our first “Fiction Friday” – we will have some exciting news and will be announcing a giveaway as well!

Catch you all on Monday!

Trying Not To Let The Idea Of 2 Million Viewers Go To My Head,

Jeremy

The Impact of Low Impact Exercise

The Difference Low-Impact Exercise can make to your workout.

Low impact resistance exercise is a growing trend in our community. Some lack the self-esteem to walk into a gym. Not everyone is a big fan of loading up plates on barbells. And what about those who are just getting started on their weight loss and maybe haven’t exercised in years? There are quite a few reasons to try some resistance exercises that can be done in private. My first several months of resistance exercise were all done at home – so why not yours?

Before you decide that this is the easy way out, consider this: pound for pound, gymnasts are some of the strongest athletes on the planet. Now, consider the routines you see gymnasts performing. They are hanging from rings, whirling around on uneven bars and pommel horses, and catapulting themselves into the air during floor exercises. Not a set of dumbells to be seen, right? These feats are being accomplished mainly with body resistance training.

Locking Down The Core

The term “Core training” gets used quite a bit these days. Disciplines like yoga, pilates, and isometric exercise all promise to strengthen and stabilize the core muscles. Which causes many of us to raise our hands and ask: “What is a core muscle, exactly?”

The core muscles are the muscles of your abdomen and your lower back. These muscles are involved in just about every movement your body makes – from bodyweight bench presses to simply walking down the hallway. Your diaphragm, your glutes, your pelvic muscles, and other core muscles have a unified function. They all work to keep your skull, spine, and tailbone in alignment as you experience resistance anywhere within the body.

Since all muscular activity is going to derive from this central source, strengthening these muscles just makes sense. If you have elected to skip the gym and work out at home, here are a few things you can try:

  • Crunches are used in almost every single workout routine for a simple reason: they work. Focusing on the “6-pack” muscles deep within the abdomen, crunches give great bang for the exercise buck.
  • Planks look like someone taking a break during a set of push-ups. They are anything but that. Supporting yourself only on your toes and forearms not only hits your abs but also strengthens everything from your shoulders down to your calves. Try to do one for 60 seconds, and see what starts wobbling first.
  • The “Superman” may look silly, but that’s why you are doing this at home, right? Lying on your stomach and then elevating your arms and legs as if you were flying through the air does marvelous things for your glutes and your back.

The Rest of the Muscles

Exhausted and ready to move on to something else? I thought you might be. Here are a few starting points for working the rest of your body without using weights:

  • Think you need weights to feel the burn? Squats and wall-sits (pictured above) are really all you need to turn your entire legs into quivering mush. Try working up to holding these leg-killing exercises for 60 seconds at a time.
  • Need tickets to the gun show? You need the push-up. It works your arms, your back, and your shoulders all at the same time. If you can’t manage a “normal” push up yet, try using a wall or counter top as the anchor point for your hands at first.
  • To really focus on those arms, there is another weapon you can add to your arsenal: the triceps dip. All you need is a low couch or bench to sit in front of. Put your palms on the bench, then push yourself up until the arms are straight. Repeat the maneuver without letting your butt touch the floor. Do this to failure. Go throw up. Repeat.
  • Though you will have already been working on your shoulders and back via application of the push-up, you can really blast your shoulders via the handstand push-up. Get a friend to help you the first few times you try this. Put yourself in a headstand against a wall with your hands shoulder-width apart. Push yourself up the wall, then return to starting position. You will fall over the first few times you try it – this is why you require some assistance to get it right initially.

Putting It All Together

Now, remember, these are just ideas – this is not an entire workout. For an entire bodyweight workout, I really recommend that you get some help from an outside source. If you have a Roku attached to your television, you are all set – dive into one of their fitness channels and don’t look back. Though many of them have a monthly subscription fee, it will be much lower than a gym membership.

Other sources of coaching are available on your smartphone. I personally used the FitStar app on my Android phone for months before I moved out of the house and into the local gym. Though I am not a paid endorser of FitStar, I highly recommend it – I loved the initial fitness test it put me through to determine where I should start my workout program. Plus, it had voice-over training work by Tony Gonzalez. Other football nerds will understand why this is important.

No Excuses

Again, the most important thing about an exercise program is to pick one that you will do consistently. There is a big world out there for you to walk or run in. The internet is full of potential workouts you can do at the gym or at home. You can use your Roku, your cell phone, a friend that works out regularly – just make sure you use something. Your dietary changes won’t mean a thing if you don’t add some muscular strengthing and calorie burning to your life. Get off your couch and get moving – every day you sit is another opportunity wasted.

“You Miss 100% Of The Shots You Don’t Take” – Wayne Gretzky

Can’t Top That Exit Line,

Jeremy

Fitness After Bariatric Surgery

Fitness After Bariatric Surgery

(Edit: As of February 19, 2018, I’ve noticed the popularity of this post starting to rise again, due to engagement from Pinterest. I merely wanted to note that, while I am still not a doctor, I am now a licensed and certified Personal Trainer through ACE Fitness – and nothing in this article has been invalidated by my education and training. Take care of yourself, and KEEP MOVING! – Jeremy)

I get it – obesity generally does not happen to those who are maintaining good habits like going to the gym. Now, after years of hanging out on the couch, we are told by our bariatric surgery team that we need to get active. And then we need to stay active.

So, how the heck do we do that?

A Word Of Caution

Now, remember, folks – I am not a doctor, nor do I play one on TV. The most important step you can take here is to coordinate your fitness plan carefully with the professionals in your life. Talk to your bariatric surgeon. Set up an appointment with your family doctor. Chat with your nutritionist. Maybe even make an initial consultation with a physical trainer. Don’t decide that you know everything there is to know about the subject and do it yourself.

Why not? In a word: setbacks. My wife, Lor, decided 3 days after surgery to walk nearly half a mile, despite warnings about taking it slow from her surgical team. The result? She injured herself and was bed-ridden for nearly a week afterward. The most important thing to remember is speed (slow) and consistency (every day.)

Try to keep in mind that physical activity is your friend. (Though it may not feel like it at times.) I have talked to and read about dozens of people who suffered major weight regains in the years after surgery. The common element? Every single one of them had stopped exercising.

Getting Off The Bed

In the days immediately following your surgery, your surgical team will be telling you to walk as much as you can. Great news: you can do this anywhere, with no special equipment. Spend the first days at home from the hospital getting out of bed, walking a few times back and forth around your home, and lie back down. Keep doing this! It may seem pointless, but it really isn’t.

Any kind of exercise (even that slow walking you can do) increases blood flow through your body. It tells the brain that you are using those muscles, creating a caloric deficit. Since you are not getting anything but protein shakes or mush during your first month post-surgery, the calories you need have to come from somewhere. So the body begins tapping into fat reserves, burning off your excess fat.

By being active every day, and steadily increasing your physical activity, you are asking your body to maintain your muscles by burning fat. It is as simple (and as profound) as that.

Getting Into The Gym

At 30 days out, you will hopefully get the green light from your surgery team to add resistance exercise (weights) to your routine. For many of us, this is a daunting task. What the heck am I supposed to do at a gym, anyway?

Relax – it really isn’t that complex. There are literally hundreds of tools out there to get you started if you don’t have a pro available to build a routine for you. I know you have access to the internet – you’re reading this, right? A search of “beginning weightlifting routine” turns up newbie-friendly programs from reputable sites like bodybuilding.com, Muscle and Fitness, and Shape. Spend some time looking around, find one you like, and get started.

I, personally, selected a plan from JeFit, thanks to its integration with my smartphone. My memory is horrible – so bad that I will not remember exercises, weights, and reps from one week to the next. Accordingly, I place my workout on my cell phone. A notebook will work just as well. Lor keeps her entire routine in her head. Not that I am jealous or anything.

My routine is broken up over 3 days: Day #1 is Chest/Triceps, Day #2 is Back/Biceps/Forearms, and Day #3 is Shoulders/Legs. Each routine is only 6 or 7 exercises long. I am not looking to isolate single muscles yet. I am looking for exercises that hit lots of muscle groups all at the same time. Each routine takes me about an hour. On days when I am not lifting weights, I am spending about an hour doing cardio. I include crunches at the end of every workout – weightlifting or cardio.

I do this six days a week. Sunday, I watch football. It sorta feels like exercise, anyway.

Also, remember: your gym workout does not have to be in a gym. A set of resistance bands and a yoga mat can be enough to get you started. It certainly was for me. If you find yourself too short on time to get to a gym, do it at home. Just make sure you do it!

Getting Into It (For Life)

The most important thing you can do is find a workout routine you will stick with. Don’t like weights? Try something like Pilates or Yoga – a routine that uses the body’s weight against itself. Can’t stand running? Put yourself on an elliptical machine or a bike. The most important thing is consistency. The person who simply walks around their neighborhood for half an hour every day will eventually be in better shape than the person with an intensely detailed workout routine who only exercises once a week.  Consistency is key.

After that, don’t allow yourself to get bored! Try new things, and create new challenges for yourself. As many of you know, I started the Couch to 5K  program a couple of weeks back. I did this simply because I have always hated running. It creates a challenge for me – can I really push through all the weeks of the program? This is my motivation – doing better than the week before. Find your own motivations: body measurements, dance lessons, a new outfit. Use whatever it takes to inspire you to get up and get moving.

Though I don’t recommend using things like “ice cream sundae” as a motivation. That way lies madness.

Ready For C25K Week 3,

Jeremy

100 Pounds and Counting

100 Pounds Down!

Quick, what are some things that weigh 100 pounds?

  • A fully grown Labrador Retriever
  • 2 60-inch LED Televisions
  • A baby hippopotamus at birth
  • The amount of weight I have lost since last February

Yesterday I climbed on the scale for my weekly weigh-in. This is what I saw:

202 Pounds on January 15, 2017

I’ll be honest, I’ve been trying to make sense of this number since yesterday morning. It still has a sense of unreality to it. I keep asking myself: “How can I weigh this little?”

I can only contrast this to that day in February last year when I hopped on a scale at my doctor’s office and saw “302” staring back at me.  How on earth could I weigh so much?

To lose 100 pounds – a third of my body weight – is almost beyond words. I feel like my body was previously a prison, and I have finally been released.

And my key was bariatric surgery.

Unlocking The New Me

There are still going to be those that do not understand it, that think that I have “cheated” somehow. I am no longer very concerned about those opinions. After all, the fact remains that, after years of failed “diets”, bariatric surgery worked. I did not use it in place of lifestyle changes. Instead, it allowed me to make lifestyle changes and stick to them. The switch in my brain that was constantly set to “Eat Now” has been turned off. Maybe someone who has never suffered through obesity won’t understand it. But those of us who are obese know exactly what I am talking about.

Losing 100 pounds has meant so many things. My high blood pressure is gone, along with the drugs I needed to control it. My joints work. I am willing to go out in public. More photos have been taken of me in the last 12 months than I had allowed in the previous 10 years. My days of watching wistfully as other people live their lives are over. I feel like, for the first time in a long time, I have a life of my own.

Today, I am going to be able to go to the gym, to lift weights and perform cardio for a couple of hours, not a few minutes. Today, I will be able to eat 3 small meals without being hungry. Today, I will be constantly thinking about writing, about life, and about future plans. I will not be constantly thinking about food.

Today I will weigh 100 pounds less than I used to.

How about that.

Next Stop 199,

Jeremy