A Tiresome Intrusion: Epilepsy Follow-up Care

It’s about that time again. Once every 6 months or so I get to head in and have a chat with my neurologist about the disability that isn’t obesity: Epilepsy.

Guess what day tomorrow is?

This Is The Song That Never Ends

I don’t chat much about epilepsy these days. My battle against obesity has so many more facets to it that it just makes a much more compelling story.

Epilepsy, on the other hand, is just sort of there. Like those unattractive freckles, or the paint in that one room you never got around to touching up, it is simply an unwanted part of your life that you learn to work around. There will be no great success story about it like there has been about overcoming obesity. Every step forward is merely an incremental increase in seizure control. The disease then fights back by mutating and developing into new symptomology. Not exactly the stuff of compelling storytelling.

What Does Not Kill Us, We Learn To Live With

But, at the end of the day, epilepsy probably shapes more of my day-to-day life than obesity ever did.

I still can’t drive a car legally. I have to check in multiple times a day with someone to let them know I am still in control of my mental faculties. My memory is filled with gaps – both long-term and short-term. I take a handful of brain-altering drugs twice a day every day to control seizure activity. This on top of the metal implant installed over my heart that tries to regulate electrical activity in my brain.

But, still, every once in a while, an invisible entity takes over control of my brain for a period of time. Afterward, I just wait for the mental lights to come back on. Then, I go about my business as if nothing ever happened.

It is a weird, weird, condition to live with.

Oh Wait, That Wasn’t Me

During seizures I will sometimes stare at my keyboard, unable to remember how to type. I have been known to “remember” things that never happened to me. My latest seizure development is spatial confusion: for short periods of time, I think I am somewhere that I am not. Just a few days ago I was convinced I was in my apartment in Las Cruces, and couldn’t figure out why the front door was in the wrong place.

I haven’t lived in Las Cruces for 10 years.

So, yeah, I prefer talking about weight-loss. Thanks to bariatric surgery I can now control my diet, control my exercise, control my progress in combatting my condition. Control is a really big concept to those of us suffering from a seizure disorder.

So, don’t think for one minute that epilepsy is no longer important to me, or that I have stopped paying attention to it. Far from it. But at my bariatric appointments, I get to see how far I have come. I get to fist-bump Lor and get congratulated by the medical staff on how well I have done.

Tomorrow, I may just get a slight change in medication dosage, in the hopes that a minor change in my seizures might take place.

Which would you rather write about?

Not Super Enthusiastic,

Jeremy

I Can Not Tell A Lie – The Truth About Weight Regain

 

The Truth About Regain

Every so often, you come across a person whose story just breaks your heart. I discovered such a person yesterday, in my travels across the Internet. His struggles with weight gain after bariatric surgery have led him to the conclusion that the whole thing is a hoax. According to his post, he has “done everything right”, but continues to gain weight. Someone must be lying to him.

Suspension Of Belief

The gentleman in question was over a year out from bariatric surgery, and suffering from regain. He wanted to know why “everyone’ lied to him about how surgery would work. He sees all these success stories on various places on the ‘net, why are these people not being honest?

His story is a little depressing, to be honest. But not for the reason you might thnk. If I remember correctly, he started out at around 310 pounds. At his lowest weight after surgery, he was down to 210 or so. Now, regain has hauled him back up into the 240s. In his mind, this proves that the entire thing is a hoax. In his words: “Maybe 20 percent of the people who do this surgery succeed. The rest just gain it all back.”

Number Crunching

First, let’s take a look at the numbers. Any doctor will tell an overweight or obese patient that the best thing they can do for their health is to lose about 10% of their body weight.

240/310 = .774 (in other words, 77%.)

Even after regain, this individual has made a massive improvement in his health. 23% of his total body weight has already been removed.

He is disappointed in his regain, and I totally get that. Heck, I am upset that I put back on a pound and a half. But he is still in a much healthier place than he was when he began the process. His mobility is improved. Previously creaky joints are functioning more smoothly. The heart and lungs don’t need to work nearly as hard as they did previously to supply oxygen to his systems.

Despite his frustration, he is still a success story.

The Grand Conspiracy

As to his belief that we are all lying to him, there is a grain of truth to his paranoia.

Most surgical teams will acknowledge the fact of regain as a potential outcome after bariatric surgery. And, honestly, the numbers are nothing to write home about: somewhere between 10 and 20% of patients will experience a substantial regain.

However, less than 1% of bariatric patients experience a revision: a wholly new surgery designed to repair or replace a previous surgery.  Fewer than 1 out of every 100 patients require a different surgery to straighten things out.

Coming To Confession

So, why do I feel bad for this angry bariatric patient? Because of his assertion that he “has done everything right.”

As gently as I can put it: I don’t believe you.

I have yet to meet the bariatric patient that lives in 100% compliance with their post-surgical requirements. Nobody I have met in person or on the Internet manages to:

  • Always eat 3-6 ounce meals containing less than 20 grams of carbohydrates each
  • Exercise 150 minutes a week, every week
  • Stay completely hydrated every day
  • Completely avoid processed sugar and carbonation

As us gamer geeks like to put it: “Screenshots or it didn’t happen.”

There are always holes in your post-surgical lifestyle. There is always room for improvement. And simple mathematics tells me that an adult male is not ingesting less than 1,200 calories a day, every day, and supporting 240 pounds of mass while exercising 5-6 times a week.

Find out where the holes are in your personal plan, and start working to repair them. Don’t get on Facebook and rage at everyone putting up self-congratulatory “NSV” message and accuse them all of lying to you.

Most of us are too busy trying to lose weight to be conducting a conspiracy.

Not The Illuminati,

Jeremy

Fiction Friday: Last Call

The cover art for Inheritance

The day has just about arrived: by the next episode of “Fiction Friday”, I will be a published fiction author.

Next Tuesday, February 28, the first episode of “Inheritance” will be released on Fiction Vortex. Every Tuesday thereafter will host the release of another serialized novel in the Ash Falls universe: “Felix North”, then “The Perpetuals”, followed by “Reborn”, and capped off by “Fallen”. The cycle will then begin again with Episode #2 of “Inheritance.” At the end of 50 weeks (+/-), we will have released 5 complete novels by 5 different authors.

Still Room At The Bar

I have given up on trying to understand why a site like Misdirected, with several hundred readers a month, has only generated 14 entries into our giveaway. But this weekend will be the last chance to throw your name in the hat. Monday will be the drawing for $10 worth of Fiction Vortex credit. $10 works out to 10 Episodes – enough for an entire serialized novel, actually. Or enough to buy a new episode every week for 10 weeks in Ash Falls. That will get you through Episode #2 in all 5 of our storylines. However, we have several entries now, so someone is going to win it, which makes me feel all warm and fuzzy.

If, however, you have zero interest in reading fiction, you could still do us a solid. Tell someone you know who is an avid reader about our release next Tuesday. I would love to get this thing off the ground with as much momentum as possible.

A Look Down The Road

So, given that we now know the publication schedule for “Inheritance”, what is coming up next?

I currently have two other projects up and running. “Deep Ember” is the title of my next fiction project. “Deep Ember” is also a fantasy serialized novel at Fiction Vortex. It will be releasing in the “Of Metal and Magic” storyverse later this year. And, on the non-fiction side, “Learning to Live in the Dark” is next up. I begin work on moving from outline to chapter creation this weekend.

Plenty of wordsmithing to keep me busy over the next several months. All this on top of keeping Misdirected up and running, of course. I should not lack for things to do in 2017.

We’ll Announce A Winner On Monday,

Jeremy

Stuck in Neutral

Using SMART Goals to break mental stalls

Our unfortunate technical interruption has actually provided me with an opportunity for some introspection. My original plan was to write blog posts for the days that I was unable to access Misdirected – to get ahead, as it were.

Yeah, THAT went about as well as you are guessing.

Unable To Move Forward

I have found myself in a curious position the last couple of weeks. I have been rushing from project to project, but have been unable to make much headway in any of them. My weight loss numbers got a bit sabotaged. I have been stuck on week 4 of my C25K program for 2 weeks, unable to finish the final day. I have written fragments of several fiction and non-fiction pieces, but have been unable to actually finish any of them.

As I told Lor – I feel like I am in a car with the accelerator pressed all the way to the floor, with the transmission stuck in neutral.

Stalls Aren’t Just For Weight Loss

By now, everyone is familiar with the term “stall”. It refers to weight sticking at a certain point, no matter what a person does to try to lose it. I am discovering that stalls apparently apply to personal and emotional life as well as weight loss. Who knew?

There is simply an obstacle of some kind, preventing me from making progress in any significant area in my life. Attempting to overcome it is frustrating, exasperating, and maddening as hell. It does not appear to be a symptom of depression: I have been previously diagnosed with depression, and know what that feels like. I don’t think it is related to my seizures, or my diet, or major life changes. This is nothing more than a rock that I keep banging my head against, waiting for it to move.

The SMART Solution

So, instead of chasing my metaphorical tail, I will attempt to apply some new-found knowledge. My ACE Personal Trainer curriculum suggests that development of workout routines for clients must be based on “SMART” goals. This means that goals must be:

SMART Goals

So, instead of saying “I want to lose more weight,”, I would instead say “I want to exercise 30 minutes a day every day this week.” This goal is specific, it is measurable, it is attainable, it gives both time and results expected.

Mind you, I already exercise 30 minutes (or more) a day, but this seemed like a good example.

In my case, I will stop flitting from project to project, and instead, will make a SMART goal for the week: “I will write 30 minutes a day on Chapter 1 of ‘Learning To Live In The Dark.'”

Specific? Yup, pretty specific.

Measurable? Yeah, I own several stopwatch programs.

Attainable? I could create 30 minutes a day just by not looking at Facebook and Huffington Post every day. 🙂

Results-Focused? I tend to write about 2,000 words an hour. 30 minutes a day, therefore, would work out to about 7,000 words for Chapter 1 of my book: almost an entire chapter.

Time-Focused? Yup, I have committed to doing this for 1 week.

The Proof Will Be In The Pudding

Will I manage it? Only time will tell. But I have to admit that even having a focused goal feels better that the chaos I have been creating recently. I will let everyone know how it goes.

Anyone else out there have any great tips for pushing through these mental stalls?

Ready To Get Moving,

Jeremy

Don’t Judge Me

Don't Judge MeOver this last weekend, I was left unsupervised for the first time since my surgery. Lor was attending a family reunion, so I was left to my own devices for four whole days. I cooked for myself, I wrote, and I played video games. Three days out of four I went to the gym, and I even did some work around the house.

Oh, and I gained 1.5 pounds.

The Shoe On The Other Foot

I must admit that I find it ironically amusing that I am now in the position I find so many other bariatric patients in: “Help! I’ve gained weight and I don’t know why!”

It is a common refrain at support groups and on message boards – something has gone wrong, please tell me how to fix it. Usually, though, there is another component to the plea for help. Something along the lines of “Oh, and don’t tell me anything I don’t want to hear while telling me how to correct this problem. Kthanksbye.”

I, of course, have a pretty good idea what happened to my diet. Hours normally filled with activity were, instead, taken over by sitting immobile in front of a monitor. I probably didn’t push myself as hard as I should have at the gym. I logged meals at the end of the day and discovered that, instead of a single snack during the course of a day, I had 2 or 3. (And this is why logging WHILE EATING is important.) These things all add up. In my case, they added up to a pound and a half.

Many times, though, we as patients don’t want to hear what we have done wrong. We want to know how to fix the problem immediately. A “make it didn’t happen” pill, maybe. The last thing a person wants to hear is “Don’t do what you just did.”

The Danger of Symptomology

We have an unfortunate tendency, in our culture, to focus on symptoms instead of root problems. Your head hurts? Take a pain med. Are you tired? Have some caffeine. Not sleeping well? Drink some Nyquil.

At no time do we stop to consider root causes. Maybe stress is causing headaches. Poor diet may be contributing to your lack of energy. An irregular schedule might be the cause of your sleep problems. But correcting each of those root causes requires work: a commitment of time and energy, usually over a period of days or weeks. And who has time for that? Just gimme something for the symptom, thanks.

I, myself, came very close to that exact “solution” after my unexpected weight gain. After I stepped off the scale I determined I would immediately go on a 3-day protein shake diet, to “reset” myself.

In other words, I wanted to be all better in three days.

Fortunately, I put some extra thought into it. An all protein shake diet is not a good long-term solution. A good long-term solution is to buckle down on gym work, continue to reduce carbs, and pay closer attention to what I am putting in my mouth. The symptom of weight loss is not the problem. The relaxation of dietary and exercise compliance is.

The Benefit of Judgement

See, mostly what I was lacking was accountability. I would love to say “Don’t judge me! I am human and I make mistakes!”

But, what I really needed was someone to smack the cookie out of my hand. (OK, in my case it was almonds, not a cookie. But you get the idea.)

If you are engaging in behavior that makes you want to say “Don’t judge me!”, you probably need to judge that behavior. Find yourself some accountability. Write things down. Tell someone your goals. Make a plan and stick to it.

Or, you know, be embarrassed that apparently you couldn’t be safely left unsupervised for a long weekend.

The choice is yours!

Two Steps Up And One Step Back,

Jeremy