VNS: Very uNexpected Surgery

Welcome to this special Wednesday edition of Misdirected!

I know – two days late, right? But I have been busy. Like busy, busy. Like the kind of busy a bee would aspire to if it aspired to be a busy bee.

Holy smoke, how can someone fit that many uses of the letter “b” in three sentences?

Anyway, to draw back the curtain a bit, here is what has been happening since the last time we visited…

A Little Background Music

As most of you know, I suffered from massive, life-changing clusters of seizures from 2004 until 2009. These seizures were so debilitating that I required 24-hour care. Like, diaper-changing kind of care. My parents actually both took early retirement from their professions so they could commit themselves to being my full-time caretakers – presumably for the rest of their lives.

Thanks to a very forward-thinking neurologist, we discovered a potential treatment – the Vagus Nerve Stimulator. It is an implant that is surgically inserted into the chest, with two leads attaching to the vagus nerve in the neck. Every 5 minutes (or so) an electrical impulse gets fired off from the VNS, up the vagus nerve, and into the brain. This impulse somehow regulates the electrical activity of the brain, bringing over-excited neurons back down to a normal state.

It sounded like science fiction to me. At that time, fewer than 10,000 people had this procedure performed on them. But further research performed by my mother seemed to support my neurologist: this thing worked. Especially in cases of “temporal lobe epilepsy with intractable clusters of seizures.”

I will give you three guesses what my official epilepsy diagnosis is.

In March of 2009, I had the implant installed. By the end of the year, I was already no longer suffering from clusters of seizures. I still have seizures, but they are no longer day- or week-long events. I have a seizure, I recover, I move on. And I have an almost normal life.

Almost.

The Price of Loose Skin

Now, the VNS is installed at the top of the left breast, almost directly above the heart. This gives the implant a steady shelf to operate from and gives the leads emerging from it an almost straight shot up into the neck to attach to the vagus nerve.

So, the human breast is a muscle (the pectoralis major) covered by a sheath of fat and skin. (This is true even for men, boys.) A pocket is carved into the tissue on top of pectoralis, the implant is installed on top of the muscle, and the whole thing is sewn back up. Within a year you have a lump on your chest underneath a fairly impressive looking scar. 8 years later, the scar isn’t even that noticeable.

Now, you did notice what I said the covering of your breast is, right? Skin and fat.

You know, the kind of fat I just lost about 120 pounds of thanks to my bariatric surgery last year?

So, what happens when you remove the material making up the majority of the pocket that your VNS sits in?

This:

VNS Sideways
No, the VNS is NOT supposed to be able to do that.

When I woke up one morning a couple months ago to find that my VNS had turned completely sideways and was popped up under my skin like a circus tent, my immediate thought was “Maybe I should see a doctor about that.”

So, I demonstrated the problem to my neurologist last month. He turned a very unusual color, swallowed hard, and immediately started making phone calls.

And, so, here we are – with me scheduled for VNS replacement on Friday. This week has been spent getting blood tests, meeting anesthesiologists, etc. All the normal precursors to surgery.

A Week On My Back

Now, it isn’t as bad as all that. A VNS is a battery-powered device, which means I was going to have to get it replaced sooner or later anyway. Usually at around the 10-year mark, which is only 2 years from now. So, in one respect, I am just advancing the timeline by a couple of years.

On the other hand, this is happening right in the middle of one of the busiest periods of my life. My novel is getting ready to be published. I am scheduled for my Personal Trainer certification exam next month. I have my 1-year bariatric follow-up appointment in 12 days!

Just at the time I am wanting to spend every day at the gym to make sure I am in the best shape possible, I am going to have to spend about a week on my back.

This does give me a chance to really sit around and study for the exam, so that is good. I also have a lot of Fiction Vortex correspondence and reading to catch up on. But, seriously, I am faced with the possibility that I may go in for my one-year follow-up no longer at my lowest weight.

I am torn between irony and embarrassment, really.

Someone (probably me) will let everyone know how the surgery turns out, either on Friday or Saturday. I expect no issues or complications – the procedure itself takes less than an hour. We should be back to our normal publication schedule on Monday.

After all, I will have nothing else to do, right?

I Am Spending My Life In Waiting Rooms,

Jeremy

“Skinny Is A Side Effect” Redux

Happy Independence Day to all our American readers. If you are celebrating the 4th of July, hug or shake the hand of a veteran. Your preference.

I have been reviewing my publication history for Misdirected while outlining my next book. In doing so, I have discovered some…changes in my outlook from last year to this year. My former annoyance with my obesity still rings true. The combined fear and hopefulness regarding the potential outcome of the surgery still feels real to me.

But what is different is my absolute conviction, a year ago, that my physical appearance wasn’t going to matter at the end of the process. Looking at my recent posts, I can see that turned out to not be true at all. Which makes me wonder:

Exactly when did I get so vain?

Mirror, Mirror

Now, understand what vanity means here.

I do not gaze in the mirror every morning and think “Damn, I’m hot.”

No, actually, exactly the opposite.

I look at sagging skin. I fixate on scrawny arms and legs. I stare jealously at big, muscular guys at the gym and can only think that I won’t ever look like them.

I have become a body nazi, sitting in judgment upon a population of one: me.

This after I swore up and down that all I cared about was Non-Scale Victories. That I was “Not Waiting To Turn Into Brad Pitt.”

Sigh.

Taking A Step Back

So, let’s take a look at what has happened instead.

For years I suffered from sleep apnea.

Today I can’t remember the last time I used a C-PAP.

A year ago my resting blood pressure was about 140/100 with medication.

Today it is sitting at 112/75, and I haven’t taken a blood pressure med for literally a year.

Once upon a time, I could barely walk to the end of my block and back.

Last week I walked 6 miles in one day and could have done more.

So, why the sudden concern about my looks, for goodness sake?

You Can’t Miss What You Never Had

So, here’s where things get weird. Being obese never bothered me from the perspective of my self-esteem. I have always looked at myself as being…umm…less than attractive. So, being overweight didn’t really impact me very much, in that regard.

But nowadays I keep seeing these amazing before and after photos of my fellow bariatric patients. And the “after” shots seem to always look like supermodels.

Hell, I am living with a supermodel nowadays.

And I am…well, I am back to looking normal. Just with a whole lot of extra skin.

I know it shouldn’t be important to me. I ran a 5K. I will be climbing Sandia Peak later this summer. I am out being active almost every single day – doing things I couldn’t do while I was obese. The way I look while I am doing these things should not matter.

But, somehow, it suddenly does.

Pushing Beyond The External

If I was advising someone in my position, I would tell them that they were already beautiful. I would say that true beauty comes from within. That the world should not judge a person on the basis of their physical appearance.

I now know that person would be thinking that I was full of shit.

Despite that, I need to make the effort to get over my sudden onset of self-esteem anxiety.

A few months back I made the commitment that I would stop using the term “fat” here on Misdirected. I have been largely successful, and I think that Misdirected is better because of it.

So, I will start doing the same thing with myself.

Every time I have a negative thought about my appearance, I resolve to match it with a positive self-affirmation.

I may look in the mirror and think “my arms look terrible.” I will match that with “Yes, but my hands now write a blog that speaks to hundreds of people.”

The thought may cross my mind that I am covered in loose skin. I must learn to match that with something like “The skin is empty because I have extended my lifespan by losing the fat that used to fill it.”

Every time I wish I looked different, I should immediately go do something that I used to wish I could do, but could not due to my obesity. I should still make personal wishes come true. Just different ones.

I will have to teach myself to start being focused on being healthy, and stop being obsessed with being skinny.

After all, skinny is (only) a side effect.

Glad I Can Air This Out,

Jeremy

 

 

 

 

Split Personality

Split Personality - The Dual Existence of Misdirected

They say each day brings new opportunities.

“They” forget to mention that a new day also brings new problems.

As my schedule has filled up with writing, family visits, and prep for my Personal Trainer exam, a few other details have been sort of left unattended to. Ignored, even. One of those little details has been the current identity of my website.

Not a week goes by that I don’t have some version of the following conversation: “Man, I went looking for info on your new fiction books, and all I found was some blog for fat people.”

Or, alternately, “I was trying to find your books on bariatric surgery, and some dude with your name is writing stuff about vampires.”

Welcome to the world of a multi-platform writer.

The Surgical Solution

The problem, of course, is that my website, jeremycschofield.com, currently exists only as a platform for Misdirected. This is where people come to find info on our surgical journey(s), life experiences, and ups and downs. Anyone looking for info on my fiction works finds…nothing.

On the other hand, anytime I talk about my fiction writing, I get a certain amount of push-back. “I don’t care about your novels, when is your book on bariatric surgery coming out? Stop wasting time with that other stuff and write about important things.”

My supporters on Patreon are even more confused: “Am I supporting your health and wellness blog, or your fiction writing?” (The answer is “Yes”, by the way.)

So, yeah, I would say that the time has come for a bit of an overhaul. Time to get things straightened out in the world of personal marketing.

Which is going to mean some revisions to the website that I have been putting off for fear of the project taking over my life.

The Literary Truth

So, here’s the skinny: Misdirected remains my main project for plugging into people who are going through or interested in bariatric surgery. There is also going to be a book talking about my experiences with bariatric surgery.

That book has just not been written yet.

See, my other project, the episodic Urban Paranormal novel Inheritance, has been taking up all my writing time. I have finally completed the storyline, and the first four episodes have already been released into the wild at Fiction Vortex.

What clearly needs to happen is that I need a home for each of these projects. I have even flirted with the idea of writing two entirely separate blogs, but that way lies madness. Instead, I will have to re-engineer the current website so that a new visitor gets deposited at a front page where they can choose between wanting info on my fiction writings and my health/wellness writings.

Given that I have completed the entire storyline for Inheritance, this is probably the time to start working on that project. Then I can write the first of my bariatric surgery books. Following which I can begin work on the sequel to Inheritance.

My head hurts just thinking about it.

Strap Yourself In

So, be prepared! Changes will be made. Things will probably break. Web pages will look funky. The days when I actually created websites as a programmer are decades behind me. I am bound to screw things up.

But, at the end of the project, we should have a lovely landing page where people can head safely to choose between my offerings. Fiction readers to the left, Misdirected subscribers to the right. Something like that.

As my fiction begins releasing as complete novels, they will be available on the website. Once the health/wellness books start releasing we should have access to those as well.

I hope.

I have some minor surgery coming up in July (battery replacement on my VNS implant), so maybe I can sketch out my changes while I am lying around recovering.

While I am not studying for the PT exam, that is.

And not editing my fellow Ash Falls authors.

And not outlining the sequel to Inheritance.

Sigh. See what I mean?

First World Problems,

Jeremy

The Saga Of The Stones (Not a Story About Iceland)

After you go through bariatric surgery, you are warned about a few things. “Take your multivitamins” your nutritionist will tell you. “Otherwise you will suffer from malnutrition.”

“Make sure you exercise 150 minutes a week” you surgeon will prod you. “Lack of physical activity is the #1 leading cause of regain.”

And your whole medical team will tell you “Stay hydrated!” They will give you a long list of things that can go wrong if you don’t drink enough, including this one: “Lack of hydration can lead to kidney stones.”

Turns out your medical team actually knows a thing or two about this.

The Path Paved With Good Intentions

I had thought I was doing pretty well on the whole “hydration” thing. I drink about 40 ounces of (decaffeinated, sigh) coffee over a couple hours every morning. After that, I try to down another couple of 20-ounce bottles of water during the course of the day. 80 ounces of hydration a day, right?

Except…well, a few things have come up in the past few weeks. We’ve started a pretty intense new exercise routine at our gym called “BodyPump”. It involves high-rep (like 70+reps) low-weight exercises for the entire body. Though we only do it a couple of times a week, it is a major drain. And I can’t say that I leave the class feeling like I am fresh and hydrated. More like I am a squeezed-out dishrag, really.

And, then, we have our semi-annual visitor. Our nephew has come to stay with us for a few weeks, which throws our entire schedule into disarray. We spend all our time hanging around with him (we like him), and tend to ignore our regular routine. Between the new exercise program and our break in routine, my hydration habits have probably been less than optimal.

And down that path lies madness.

Eruption

It began one night late last week. At about 9 pm, I stood up to head to bed. Suddenly, I was aware of what felt like a cramp, deep in the right side of my abdomen. It felt as though someone had inserted a metal bar into me. No matter what I did to stretch, nothing worked to release the pressure.

Finally, I shrugged it off and went off to complete my nighttime routine, hoping the pain would simply go away on its own. However, during my ritual nightly visit to the bathroom, something unusual happened.

Nothing.

No matter how I strained and pushed, I could not pee no matter how hard I tried. I knew I needed to. I just couldn’t manage to get the job done, as it were.

Now, I am a man in his late 40s. I have been through some of the more…exotic…issues that accompany my aging physiology, including prostatitis. But this just didn’t feel the same. I finally gave up and went to complain to Lor. She immediately questioned my hydration for the day.

Now, as it turns out, my fluid intake for the day had consisted of…one cup of coffee. All day. No more. She suggested I down some fluids. I spent ten minutes taking in 20 ounces of water, hoping to get things moving.

Then all hell broke loose.

Suddenly, I was no longer suffering from a sore spot in my abdomen. Now, I suddenly felt as if someone had inserted a red-hot poker into my abdomen and shoved it all the way through my lower back.

The Night That Would Not End

Chatting later with others that have suffered from kidney stones, I was able to determine that this was a pretty normal set of symptoms. At the time, I was positive that no one had ever experienced pain on this level. From 11 PM till 1 AM, I kept up an ongoing argument with myself about whether or not I needed to go to the emergency room. I was quite certain that my appendix had burst, or something equally dire.

However, at around 1 in the morning, I was suddenly able to produce about an eyedropper’s amount of urine. Some of the painful internal burning subsided.

I immediately drank a little more, hoping to flush out whatever was causing this ailment.

The pain returned.

I kept this cycle up, also taking a shower four different times, hoping the heat would help with the muscular pressure. (It did, a bit.) Finally, at 4:30, my exhaustion overcame my pain and I fell asleep on the couch.

At 7:00 AM Lor came and woke me up, ready to take me to the urgent care center. I made one last attempt to go to the bathroom…

And succeeded, producing a bowl filled with an evil-looking orange fluid. I spent the next two days seated on the couch, trying not to move due to how sore I was.

Except, of course, during my frequent trips to the bathroom.

Hydrate Or Die

So, did all this occur due to a week’s worth of bad habits?

Almost certainly not. I have probably been failing in my hydration goals for weeks now. Certain people have suggested to me that downing 40 ounces of fluid first thing in the morning should probably not be counted toward my 80-ounce a day goal. It apparently needs to be spread out over the day, not all done at once.

If I wasn’t a believer in hydration before, by God, I am now. I may never leave the house without a Camelbak again, just to avoid another night like that.

My PSA for the day: Avoid Kidney Stones.

I tried it, and you won’t dig it.

Still Sore, Four Days Later,

Jeremy

The Week That Got Away

The Week That Got Away

A few of you sent tentative questions wanting to know what happened last Friday. Was I on vacation? Had Misdirected switched to a weekly publication schedule when you weren’t looking? Had some other mysterious event befallen me?

In truth, it was a series of events…strap in and I will bring you up to speed.

Puppy Gymnastics

First, meet our new exercise program:

The ghosts of Samson and Frankie watching over her little doggie bed…

Her name is Delilah. She is a 6-month old Chi-Weenie, and no I didn’t come up with that breed name. On the 9th through the 11th of June, our local Albuquerque Humane Society ran an event where they were attempting to “empty the city shelters” by adopting pets for only $5. We visited, and Delilah was the result.

At six months old, she came to us very confused about life in general, and about house rules like potty-training in particular. So she has completely destroyed our daily schedules, including gym attendance.

However, she herself is a profound exercise generator. A few weeks ago I was speculating about how to get over 10,000 steps a day consistently. We have found the answer. Socializing and playing with a new puppy has kept us above our daily step goal every day, with one marathon of a day putting us at nearly 14,000 steps. She hasn’t been great for our weight-lifting routines, but boy is she good for the heart. In more ways than one.

The Inheritance Marathon

Inheritance Book Cover

Speaking of long-term exercise, my longest-ever writing exercise is over. I finished writing Inheritance last week. It has now been handed off to my editorial review team. Who will undoubtedly find so many issues with it that I will effectively have to re-write it. I couldn’t care less.

This is a big one for me, folks. When I started writing Misdirected all those years ago, it was a daily journal of my gaming activities. I had no idea that it would begin a chain of events that would lead to me completing an entire novel. But, it has done just that, and I couldn’t be happier. Even if I never sell more than two copies (I have two parents, remember), I will be able to go through the rest of my life knowing that I actually sat down and wrote an entire novel. This is huge for someone who couldn’t put a sentence together ten years ago.

Once again, if you too are suffering from a disability, keep pushing those boundaries. You never know how far you will get until you try.

The ACE Fitness Iron-Man

I also finished my course of study for the ACE Fitness Personal Trainer course last week. I got myself revved up, sat down for the practice exam…

And flunked it.

I even got a consolation note from the ACE Fitness on-line study system: “That’s why we call it a practice exam!”

So, yeah. I now have just over 30 days to get my real exam scheduled and to take another practice exam, this time (hopefully) passing.

Needless to say, I am glad I already finished Inheritance. I won’t be doing any fiction writing of any kind in the next month. I am going to be busy.

Studying for this certification may be the hardest thing I have ever done. I have never been an athlete. I have never had any aptitude for biology. I always watched bodyworkers like Lor with a certain mixture of awe and jealousy.

Becoming professionally certified as a personal trainer could not be further out of my comfort zone.

But, if Misdirected has taught me anything, it is that there are a bunch of people out there looking for support and advice. And the ACE PT certification is my first step toward feeling comfortable providing advice from a professional background, rather than just shooting from the hip. Personal experience and internet research can only take you so far.

So, yeah. Here we are. Wish me luck as I study constantly for the next month. I have a feeling I am going to need all the luck I can get.

Hitting The Books Like I Used To Hit The Girl Scout Cookies,

Jeremy