One-Seventy-Nine

Regain. It is a word that strikes terror into the hearts of bariatric patients. An admission that things have not gone as planned, regain means that the changes after surgery have gone off the rails. Regain feels like a failure, and it carries the bitter taste of defeat.

Oh, How Dramatic

All this introduction to explain what flashed through my mind yesterday morning, when I stepped on my scale for my weekly weigh-in, and saw the numbers “179.4” flash up at me. Alarmed, I stepped off the scale. I moved the scale, made sure it was level. Gingerly, I tried again. “179.6.” Yikes! Maybe I wasn’t stepping on the scale exactly in the center. I tried a third time, carefully placing my feet this time. “179.3.”

Thank goodness I wasn’t using the logging feature built into the scale. It would have thought I had weighed in for 3 separate weeks in less than 60 seconds.

Then again…there was a reason I wasn’t using the logging feature, wasn’t there? All week long I had been feeling the malaise. I knew I didn’t feel right. All my shiny new clothes were just a bit too snug.  My suspicion was that I was moving backwards, and now here was proof, glaring at me from the bathroom floor.

Drama. I am making a mountain out of a molehill here, right? Compared to my all-time low a few weeks back of 174 pounds, 179 isn’t that bad, is it?

Yes…and no. The problem is that last week I was at 177, a gain of two pounds from the previous weigh-in. That number I wrote off as statistical variance – you can gain and lose a couple pounds over the course of a day easily. (And this is why it is important to do weekly weigh-ins at the same time every day. Preferably immediately after you wake up.)

But two weeks in a row, both edging upward by a couple pounds? This isn’t statistical variance. This, my friends, is the beginning of a trend.

The Cold Equations

By now, we all know the numbers, right? It all comes back to Resting Metabolic Rate, the number of calories your body burns while sitting around doing not much of anything. If you ingest less than the amount your body needs, you lose weight. If you take in more than your body needs, it gleefully stores the excess as fat.

Diet and exercise, then, are two sides of a balancing act: the weight loss teeter-totter if you will. We eat all day, every day, to provide our bodies with enough energy to keep the vital organs working, to stay upright and moving. But any extra whatsoever will be taken by our treacherous metabolism and stored as fat.

So, we try to go to the gym, to walk, to keep moving somehow to place our bodies into a caloric deficit so that more of that stubborn fat will come off. The body eventually gives up and adjusts, raising the metabolic rate to reflect all this activity.

But, what happens when you slack off at the gym for a couple of weeks because your schedule goes crazy? Without changing your diet to reflect the drop in physical activity?

One-seventy-nine. That’s what happens.

The Non-Alarmist Solution

I freely admit I am being paranoid about this. But I’ve worked pretty darn hard to get here. I’ve had 80% of one of my major organs lopped off, for goodness sake. From walking to running to jumping to lifting heavy objects and putting them down, I have pushed pretty darn hard to get from 302 to 174.

I am not interested in moving backwards.

Now, the last two weeks have been insane, I grant you. My PT certification exam. The publication of my first book. The weekend-long science fiction conference I just attended. I skipped maybe half my gym days. I took some shortcuts in my diet, especially during the Con.

So, now, I get to repair the damage.

This is the point where many of us panic. We freak out over our regain and hit the Big Red Button of diet and exercise changes. We switch to an all protein shake diet. Maybe we try a juice cleanse. We commit to stupid amounts of work at the gym, hoping to undo weeks or months worth of neglect in a few days.

Sadly, it doesn’t work that way. In my case the numbers here are pretty small: I’ve gained about 2.5 pounds a week for two weeks in a row. Happily, I can work on safely losing that amount every week. I can repair the damage in two weeks or so.

Not in a day via a marathon session at the gym. Not in a week by a juice fast. But by taking a safe, methodical approach.

I already know how to exercise every day – I just haven’t done it for two weeks or so. I already know the secret to a healthy diet: buy non-processed foods at a grocery store and prepare them at home. For the next two weeks, if it doesn’t come out of my fridge or my pantry, I don’t eat it. As simple as that.

Resuming The Journey

Success tends to be followed by a downturn of some kind. This is because success requires effort, and effort is tiring. There is nothing wrong with the fact that I have “rested” for a couple of weeks after one of the most stressful periods of my life.

However, I am reminded of a man I know who went through bariatric surgery, trained for a year or so, then ran his first marathon. Six months after the marathon he had regained 30 pounds.

Why? Simple. He took some time off after the marathon (which was fine) and then never started running again (which was NOT fine.)

All backsliding starts with a single step backwards.

Bad habits and lifestyle choices are always waiting for us, at every turn. This is just as true for those who have never had bariatric surgery as for those who have. What you choose to do every morning will determine your success for the weeks and months to come.

And I have another conference coming in only 3 weeks. I’ve got only that long to get my head back in the game. I need to re-develop my discipline, and make sure that the next time I am away from my normal routine for several days that I find ways to incorporate healthy choices.

After all, I don’t want to come back in a month and write an article titled “One-Eighty-Nine.”

I Shudder At The Thought,

Jeremy

What Does Fitness Mean To You?

 

What Does Fitness Mean To You? We talk quite a bit about obesity here on Misdirected. It is a blog with a slant towards bariatric surgery, after all. But the point behind bariatric surgery is not actually mitigating or minimizing obesity. The point is about taking pretty drastic measures in order to restore fitness.

But…what does that mean, exactly?

A Little Less Fat

I remember the years before I even considered surgery as an option.  I would tell myself things like “If I could get down to 240, I would feel pretty good.” Or, maybe, “I think my ideal weight is actually 225 pounds. That BMI chart is ridiculous.”

The point is that I was so heavy and so uncomfortable that I didn’t fantasize about being functional again. I just dreamed about being a little less fat.

I didn’t dare dream about returning to something close to a normal weight, you see. The idea was too big, too overwhelming. What I really wanted was to have a normal life again. And how can a person who is 150 pounds (or more) overweight think that is an achievable goal?

Sure, we all see the wonderful testimonials of the person who looks in the mirror and says “No more!” Then they change their diet, then start walking, then start jogging, and next thing you know they are running the Boston Marathon.

Just between you and me, those stories didn’t use to inspire me. Mainly, they made me tired just thinking about the work involved. And, in a nation where over 60% of us are overweight, and over 30% are obese, I don’t get the impression that these success stories are thick on the ground.

So, instead, I settled on the dream of being “less fat.” And, as it turned out, I couldn’t even do that on my own.

The Post-Surgical Solution

I have previously documented here what I thought about Dr. Tyner when I first met him. I thought he was out of his mind. His off-hand suggestion to me that I would be under 200 pounds when he was done with me was the stuff of science fiction. Bad science fiction. The kind not based on science at all.

And it turned out he was right and I was wrong. Big surprise – he has a medical degree and thousands of surgeries to his credit. But I literally could not wrap my head around the idea that surgery could almost cut my weight in half.

To this day I am still surprised when I look in the mirror.

So, a person that gets a year out from surgery (as I am), and embraces their new lifestyle (as I have) is left looking in the mirror, scratching their head and wondering “Now what?”

Once the weight is gone, what should I do now? I want to make sure that I become “fit”, right? So, what does that mean, exactly?

So, I went in search of the answer to that question.

The Fitness Gauge

From a certain perspective, I have already arrived at “fit.”

My blood pressure now regularly sits below 120/80. I used to be hypertensive.

My standing pulse rate is around 55 beats per minute. It used to be 80+. So that is a win as well.

My BMI (28.2) claims that I am still overweight, but BMI is a cruel and capricious deity at best. To get to what BMI considers “normal” I would have to weigh in at 154 pounds. I am not sure where another 21 pounds of weight loss would come from at this point.

According to the American Heart Association’s waist circumference test, I pass as well. At my BMI, I need a waistline of 40 inches or less. Earlier this morning I was at 33 inches and some change. (For the record, the passing grade used to be 38 inches.)

So, I am fit, right? Pat myself on the back and have a seat on the couch! Surely I feel fit now, right?

Well, no. Not really.

Functional Fitness

Here’s where things get funky. Is fitness about what your measurements are, or about what you can do?

Here’s an example. Who is more fit: a nominally “overweight” person who just ran a 10K, or Bob from Accounting who only weighs 130 pounds despite the fact that he mainlines Doritos and Mountain Dew and never moves except to go to the bathroom and back?

I know what my answer to that question is.

My journey has given me the belief that size means nothing unless it is combined with motion. You will never convince me that a sedentary person with a BMI in the “normal” range is fit. The University of Cambridge agrees, with a recent study suggesting that twice as many deaths every year were due to inactivity than to obesity.

If you’ve just gone through bariatric surgery and are wondering “what’s next?”, the answer is clear: start moving.

And, if you are apparently healthy but spend your days in front of the monitor at work and your nights in front of the television, you aren’t as healthy as you believe you are. Start moving.

30 minutes a day, every day. It is as simple as that. Surely you can just cross your least favorite TV show off your list every day and spend that time walking around the neighborhood. Maybe doing yoga. Or even going to the gym, if you are that motivated.

But, for heaven’s sake, do something.  Trust me. You’ll thank me later.

An Idle Body Is Entropy’s Workshop,

Jeremy

 

Mission: Accomplished

Well, now, THAT was exciting. In a “drop at the beginning of a roller coaster” kind of way.

It has dominated my days and interrupted my sleep for nearly seven months now. I have missed deadlines, dropped projects, and skipped family gatherings because of it. The voice of Misdirected has grown fainter with every week as it approached, an inexorable monster that threatened to swallow me whole.

I am referring, of course, to the final exam for the ACE Fitness Personal Trainer certification.

Which happened yesterday.

We Don’t Need No Education

My relationship with education has been weird throughout my life. I didn’t go to college out of high school. I got married and started waiting tables instead. Who needs that education stuff, right?

My professional career as a database developer and project manager all came from books and week-long seminars. My success derived from an unusual talent: I was the person who was willing to Read The Flipping Manual. But I also had the ability to remember what I read. This didn’t seem unusual to me. I just thought everyone else was lazy.

Then my disability struck, and suddenly I was unable to remember my own name for long stretches of time. By the time my treatment stabilized, I could do a pretty good impression of a thinking person, but the memory was gone. I literally can forget what I am doing in the midst of doing it nowadays. I made a couple of abortive attempts at college in my thirties, but couldn’t ever keep up.

And that is where I thought my relationship with education would end.

Where Obesity and Literacy Meet

Fast forward a decade or so.  My upcoming bariatric surgery met my gaming blog, and the current version of Misdirected was born.

Suddenly, I was fielding questions I didn’t know the answers to. I went to various sources for information: my nutritionist, WebMD, my wife the massage therapist, my brother the personal trainer. The deeper into the process I got, the further down the rabbit hole I fell. In January of this year, I was suddenly 100 pounds lighter and writing a book about bariatric surgery, for goodness sake.

Then, in February, I happened to mention to my family that I was looking into getting some education about muscular retraining, weight loss, and lifestyle changes. Maybe, I said, at some point in the distant future, I would look into getting my personal training certification.

Later that week I was presented with a gift: my family had sprung for the ACE course materials for their personal trainer certification. Just one little detail: I only had 180 days from the time they ordered the course to take my certification exam.

Opening The Box of Pandoras

I suspected I was in trouble when the box of course materials arrived. Inside were anatomy charts, nutritional guides, exercise CD-ROMs, and over 1,000 pages of textbooks.

I confirmed I was in trouble after I completed the first “class”, took the final exam, and was presented with a grade of 40%.

Oh, man. What did I just get myself into?

I remember confessing to Lor that I would never be able to do this. There were twenty-two individual course segments I had to pass, for goodness sake! By the time I got to the end of a chapter, I had already forgotten everything I just read. And I had no previous experience with any of this: no frame of reference. What the heck was adenosine triphosphate? I never took chemistry! What was a muscular attachment point? I flunked biology in high school!

Twice, in fact.

I had apparently thrown myself off the deep end of reality, into the swampy morass of human physiology.

The Struggle Is Real

For months I studied, and quizzed, and attempted to memorize. My fiction writing slowed to a crawl. My posts to Misdirected became ever more sporadic, the closer I got to the date of my final exam. I stopped sleeping normally, waking up in the middle of the night to go study.

Everyone in my family was tremendously supportive, all patting me on the back with various versions of “You can do it!” I remained unconvinced. The time pressure was the real killer here. I was sure I could do this, given enough time. Say, 2 or 3 years. But not 6 months.

I finished the course materials, then threw myself back in again from the beginning. Then a third time. Each time revealed new weaknesses. Finally, after my 3rd time through, I took the practice exams with a week left before my final.

I managed a 76%.

I was crushed. Yes, it was a passing grade, but…a “C”? That was the best I could do?

Lor disagreed. “You worked harder for that C than I ever saw you work for anything in your life” was her take on it.

I would have to settle for it: I was out of time.

Test Day

Yesterday morning dawned early. Real early in my case. I was up at 2 AM, in a complete panic about the exam coming up at 8:30.

There was nothing else I could do. I resolved that I would not rush, that I would go through the exam multiple times, that I would read each question several times before answering. Breakfast was out of the question. My stomach dipped and rolled frantically as Lor drove me to the testing center.

150 questions. 3 hours. This is what the last 6 months of work had finally come down to.

After my meticulous progress through the exam, it was time to press the “Submit” button to have the test graded. I probably sat there for 5 minutes, willing myself to click the button. Only the fact that I was convinced I would throw up if I waited any longer forced me to move.

The spinning wheel rolled for a moment as the PC thought, then I was presented with a “You Passed!” message.

My final score? 77%

I have never been prouder of a C in my life.

Jeremy Schofield, ACE Certified Personal Trainer