Seasons

Last week, we suffered the loss of yet another great artist to suicide. Chris Cornell, of Soundgarden and Audioslave, killed himself in his Detroit hotel room at the age of 52.

Chris was one of the great vocalists of the Grunge age. While I was not a big fan of Grunge, I was a fan of Chris Cornell. His voice was a true artist’s instrument, able to communicate effortlessly and emote flawlessly. As a performer, there are two vocalists I have always secretly wished I could sound like. Chris Cornell was one of the two. (Full disclosure: Johnny Cash was the other.)

Which always made it very frustrating that, during my time as a musician, I never worked in a band that could cover a single song by one of Chris’ bands. I had the vocal power, but never the vocal range I needed. The other vocalist I worked with primarily, Brandon, had the vocal range, but at that time was just coming into his own as a singer and didn’t have the power yet. It saddens me to think that Chris is gone, and I never sang one of his songs in front of an audience. It’s a musician thing. You might not understand.

That said, I didn’t know Chris Cornell. I never met him. I never got to see him perform live. But a song he performed on the Singles soundtrack, “Seasons”, remains on my personal “favorite songs ever” list. My only relationship with him is my relationship with the music he created.

Nevertheless, Chris and I share a certain kind of kinship: a pharmacological one.

Ativan is the drug that I get shot full of every time I am admitted to the hospital for a seizure that won’t stop. (Status Epilepticus, the condition is called.) It is apparently also used for the treatment of long-term depression. And it is the drug that Chris Cornell apparently took extra doses of right before hanging himself.

I can tell you from personal experience that Ativan effectively shuts down the ability to reason clearly. The folks wearing lab coats call this “disinhibited and dangerous behavior.” And I can perfectly understand that, under the effects of Ativan, I might make the same decision that Chris did. There is a reason I am never left alone and unsupervised after an Ativan injection.

 

Depression strikes the successful and the despondent alike. Chris apparently had everything going for him. He had seemingly kicked his drug habit. He was widely known as an artist and a philanthropist. He seemed to enjoy a healthy relationship with his wife and kids. His band had entered a renaissance and was headlining a successful tour.

And all it took was one bad night and a handful of pills that are designed to shut down the ability to reason clearly. All I can think, sitting here writing this morning, is “There but for the grace of God, go I.”

 

We never know what lies beneath the surface.

So, good night, sweet prince. I would ask for flights of angels to sing you to your rest. But none could ever sing as sweetly as you did.

With A Heavy Heart,

Jeremy

 

A Week of Bariatric Surgery Misconceptions

Recently, I’ve been seeing a much larger number of negatively themed posts about bariatric surgery. “The Dark Side of Bariatric Surgery.” “Bariatric Surgery: What Your Doctor Isn’t Telling You.” “I Wish I Never Had Bariatric Surgery!” Whether this is a cycle I just happen to be catching up with, or some genuine pushback I don’t know. Whichever it is, there are some genuine questions being raised by these objections to bariatric surgery. So, as a veteran of the bariatric surgery process, I would like to offer a little personal insight. This week I would like to chat about the objections/issues I keep seeing time and again First up: depression.

Does Bariatric Surgery lead to Depression?

The story goes something like this: “I was perfectly happy before I had bariatric surgery. Now I am depressed!” I’ve even seen some major articles by medical journals talking about this issue.

Here’s the problem: depression and obesity are actually linked. If you are obese and not already depressed, you are among the minority. Not only is obesity likely to cause depression, but depression is likely to cause obesity. They share common risk factors.

Now, here is what can happen: a bariatric patient falls prey to “golden ticket syndrome.” They think that since they have had bariatric surgery, their lives will now be stress-free. This pleasant feeling lasts until Real Life Happens. Something goes wrong, and they are suddenly just as stressed out as they were before surgery. Plus, they have a whole bunch of new rules that have to be followed. On top of that, they are cut off from what was likely their #1 way of dealing with stress: eating.

Suddenly, they are thinking “My life was so much better before I had surgery!”

Remember, surgery is a tool – it is not a solution in and of itself. (Though it does act like one for the first few months after surgery.) Life won’t change just because your weight has.

Pushing Back

So, then, how to deal with encroaching depression after you’ve had bariatric surgery?

First, try the post-surgical secret weapon: exercise. According to the Mayo Clinic, exercise can ease the symptoms of depression. If you are feeling a little blue, a bit down in the dumps, strap on your sneakers and hit the gym. Run a mile. Meditate. Remind yourself that you are now healthier than you were before surgery, and you have many more options than you did at the start of this process.

Second, surround yourself with emotionally healthy people. Maybe talk to that one person at work who seems calm in every crisis. Pick up the phone and call a friend or family member who isn’t constantly talking to you about the problems of their personal life. Look for people who will add stability to your life – you already have enough chaos, right?

Lastly, get some help. Clinical depression is every bit as real an illness as obesity is. Get yourself a counselor or other medical professional who can help you through the rough patches. Most insurance plans cover some kind of mental health treatment. Utilize the resources available to you.

Be Good To Yourself

It is worth repeating: you are still you, even after bariatric surgery. The responsibilities, relationships, and stresses you took into the surgical suite are still waiting on the other side. All surgery has done for you is given you a healthier and more stable platform from which to operate. Life was not better when you dealt with stress by sitting in a darkened room eating a whole package of Double-Stuffed Oreos.

Remember, taking care of yourself does not stop with leaving the hospital post-bariatric surgery. It actually only begins there.

Though, as someone diagnosed with clinical depression, I do admit to sometimes missing Double-Stuffed Oreos Therapy.

Protecting Myself From Poor Life Choices,

Jeremy

 

 

 

 

The Psychology of Obesity

Photo Credit: theearlofgrey via Compfight cc

An awfully pretentious title for early on a Friday, right? But today will be my first visit to a psychiatrist in many years, after a couple of very bad patient/doctor relationships – and telling myself to not worry about the visit today has got me thinking about why it is that a person becomes obese in the first place.

The Background of Obesity

Visit any forum or message board dealing with obesity these days and you will find a few trolls – those individuals who have taken time out of their day to drop in and tell us that we are only “fatties” due to a lack of willpower. If we only had some self-control (as, presumably, these individuals believe they do) we would not suffer from this problem. To them, the condition of obesity is a product of nothing more than laziness. Running into an especially obnoxious troll post can infuriate me for hours afterward – which tells me that something inside that post has resonated with me. Apparently, I believe at least in part that if I had just tried a little harder over the past 20+ years, I would not be obese.

And here lies the problem with obesity, in a nutshell. The vast majority of us thinks that we alone are responsible for our condition. But, other than being fat, where is the evidence? The majority of us go to work, we raise families, we practice religious devotions, we do chores around the house – we do a hundred things a day that prove that we are not lazy – and yet we accept that the state of our bodies results from a failure in willpower.

Obesity sits in the same corner with drug addiction, alcoholism, and depression – conditions that a person who has never suffered from will never really understand. These afflictions of the mind are easy to marginalize and make fun of because they are invisible to the naked eye. A person on crutches wearing a cast is accepted as having a broken leg. But, in our culture, obesity is not accepted as a sign of a broken mind.

Rejection by Society

A few years back, Lor and I stopped by a local gym to check into monthly rates, thinking maybe we could get this thing moving on our own. The young and heavily muscled twerp behind the counter took one look at the two of us and suggested that maybe this wasn’t the gym for us. We couldn’t afford it anyway, so I just let it go. But I guarantee you that I went home and ate something afterward. “Healthy” society had just rejected me and made me feel bad. So, I went home and ate, which made me feel good.

Now, which activity do you think I return to most often? It is called a conditioned response – your mind drives you towards those things that feel good. The mind associates things which are good for itself (eating, sexual response) with pleasure, and things which are not good (being cast out of a social group, hitting oneself with a hammer) with pain. This is Mother Nature at work here, trying to secure the continued survival of a species. What Mother Nature did not count on is that we’ve now developed a cycle:

  • There are so many things to eat which cause pleasure.
  • Overeating develops obesity.
  • Obesity causes rejection by social groups, which is painful.
  • One retreats from the pain of rejection, by embracing the pleasure of eating.
  • Back to step one.

This is, of course, a vast over-simplification – and I am no psychiatrist. But the logic is clear: why would I endure rejection and exercise (which is initially painful as well) when I could instead feel good by eating? Eating is a short-term pleasure, of course, but there is always another Quarter Pounder or Snickers bar just around the corner. I am not only eating things which are bad for me, then – I am also eating them more often.

See where this is heading?

The Final Rationale (Rationalization?)

I am not looking forward to bariatric surgery because the smaller stomach size will force me to eat less. I am looking forward to bariatric surgery because I will finally have the chance to look for “pleasure centers” that do not revolve around food. Weight loss will allow me to finally seek endorphin-releasing exercise. It will enable me to live a life where I am not constantly in pain. It will enable me to have a normal sex life. And, yes, it will enable me to interact with other people without the prejudice against obese people working against me. I am willing to have the majority of one of my internal organs removed and THEN go through all the normal work of weight loss, just to reset my association with food as the sole source of pleasure in my life.

It may seem unfair, but there it is. I have to live in the world as it is, not as I wish it to be.  I can only hope that my psychiatrist today agrees with me, and does not instead want to turn me into a multiple-year case study or something. Wish me luck!

Still Looking For Endorphins That Don’t Make Me Fat,

– Hawkwind

 

Keeping It Real

Photo Credit: mikederrico69 via Compfight cc
I find it really interesting that I get so much feedback off of my most depressing posts. Whether because of synergy or empathy, or just because the world is a really depressing place, folks talk about, comment on and send me emails about the really depressing stuff happening as part of the Great WLS Experiment. (My readership even goes up by about 25% for these posts. Odd, that.)
I honestly am not trying to be a downer to everyone here with these less-than-cheerful posts. But, this is the experience as I am living it. To create the impression that I do not have doubts, or bad days, or serious problems with the whole thing would be totally dishonest. And it can be very easy to lose sight of victories for short periods of time when overwhelmed by details and defeats. But writing things down and sharing them with the Misdirected family is my way of identifying my issues and starting to work through them. It is as if I have a pool of talk therapists with several hundred people in it. Thanks for the great hourly rates, by the way!
Speaking of therapy, Lor came up with a solution to the whole psychiatric evaluation problem yesterday afternoon. Since our preferred provider is suddenly no longer accepting my insurance, we’ve just scheduled with an out-of-network provider. Seems simple, right? Cheapskate that I am, it never occurred to me that the problem could be solved by the application of money. But, the cost of a single evaluation when weighed against the total health benefits of the surgery doesn’t work out to a whole lot.
I’ll probably make the money back just in french fries I don’t eat next year.
So, the evaluation is set up for next week, right after my 2nd dietary appointment. Wish me luck – I should have a surgery date by this time next week. I am back today to being excited about the concept – if I can be a little successful without the tools, imagine how much better I will be with the tools, right?
And thanks to everyone who reached out to me, concerned that I was jumping off the surgery train. I am very fortunate in that I am partnered up with someone who wasn’t about to let that happen, and was ready to provide solutions to my issues. I hope I can be as supportive to Lor as she is with me.
Make sure you tune back in next week – we’ve got some exciting stuff coming up right around the corner. I can almost see my surgery date from here!

The Past Is Prologue,

– Hawkwind

Frankie: A Tribute

It has been a dark couple of days here in Frankie’s former household. A kind of malaise has settled over me, reminiscent of some of my worst periods of depression years ago when I was first diagnosed with Epilepsy. Vixen, our other Chihuahua, has taken to lying on top of his blanket and not wanting to move. Only Lor seems to be able to function, speaking confidently about Frankie having moved to a better place and not suffering any longer. I can’t dispute these things. My motivation is entirely selfish: my dog is missing, and I wish him not to be.

The distant voice of logic, somewhere in the back of my mind,  tells me I am being foolish: he was a 21-year-old, 10-pound dog. Get over it. That voice is being firmly ignored right now. I have had relationships with many people that didn’t last as long as the 19 years I had with Frankie. My first marriage didn’t last 19 years.  And though my relationships with people are probably more complex and multi-layered, they are also filled with mistrust and doubt. Nobody likes and accepts me for who and what I am as well as my dog did.

This wasn’t always the case – he and I got off to a rocky start. Back in 1997, I came home from work one night to discover an 8-pound killing machine at the door, full of fire and fury, ready to tear me apart for entering his new domain. After Lor collected him, the truth came out – he had been found abandoned beneath a truck in a friend’s neighborhood. Our friend’s dog was a little too big and too rough to coexist with the refugee. Could we watch him for a couple of days while our friend found his owners?

The original owners were never identified, a “couple of days” turned into 19 years, and Frankie became a part of the household. I resented him because Lor had chosen to take him in without ever talking to me about it. He resented me because he thought of Lor as “his”, and was not happy that I would move into his turf whenever I pleased. But, eventually, we reached a rapprochement and settled into life at opposite ends of the same house.

This all changed several years after his arrival. Unexpectedly, he appeared and crawled into my lap. And then proceeded to urinate all over me. I stood up, furious, and prepared to throw him out into the backyard, until I noticed that his back was bent almost into a bow, with his head twisted off to one side, saliva dripping out of his mouth.

Frankie was having a seizure.

His development of seizures changed the entire characteristic of our relationship. He and I were no longer jealous pack members fighting over the same resources. He and I were now allies in a common cause, struggling together against an implacable enemy who could not be defeated, whose attacks could only be survived, never defended against. Oddly, he and I fell into sync – if I had a seizure, one was coming for him the same day, and vice-versa. I sought him out for comfort just as much as he did me. Though he was never trained as a “therapy dog”, that is precisely what he became.

In 2011, he slowed dramatically. Grey began to appear all through his muzzle, he became listless, and he stopped eating. We took him to the veterinarian, who pronounced that his teeth were all rotting out of his head and would have to be removed. He was delivered back to us after the procedure, tongue hanging out of his toothless mouth (a trait he would have for the rest of his life), and the vet took “the tone” – that special voice a medical professional uses when delivering really bad news. He was old, the vet told us. He would probably not ever fully recover from this. Just take him home, and make his last days comfortable. We solemnly agreed.

Within 48 hours Frankie was bouncing off the walls, running around the house chasing our new dog, and cleaning out his food bowl every night, then begging for more. He put on weight, topping out at a chunky 11 pounds. He acted like a dog half his age.

Thus began the saga of Frankie’s immortality. At least once a year thereafter he would slow down dramatically, show evidence of serious medical problems, be unwilling to eat or move. We would tell the family that he was on his way out. And, every year, within 48 hours he would return to normal, baffling us all. We started referring to him as “Amarante”, after the seemingly immortal old man in John Nichols’ “The Milagro Beanfield War”. My brother once made the comment that the human race really needed to put some thought into what kind of world we would be leaving behind for Frankie and Keith Richards to live in.

Unfortunately, no one can throw sevens forever, and Frankie’s trip to the table stopped on Tuesday. We were allowed to spend some time with him, to tell him how much we loved him and would miss him, and he was able to leave this world sleeping, within our embrace. The vet’s office offered to cremate him for us, to send him home in a box or an urn, but I refused. If I could not be the one to ease my dog’s suffering, then I at least would be the one who laid him to rest. I dug his grave with my own hands, not even letting Lor help me, and I put him beneath the soil where he used to bask in the sun in our backyard. At last, he is at peace, even if his loved ones are not.

Though there is not a shred of teaching in my religious beliefs for the immortal souls of dogs, I have to believe that no one with a personality and soul like Frankie’s would not be granted immediate access to the afterlife. Pam Brown said it best:

“If there is a heaven, it’s certain our animals are to be there. Their lives become so interwoven with our own, it would take more than an archangel to detangle them.”

Pam Brown

 

Sleep well, my friend. We’ll see you when we get there.

– Hawkwind