93,280

I never knew there was no such thing as an overweight New Yorker.  A couple weeks ago I was in New York City for a few days as a chaperon of sorts for a Central Methodist University mission trip experience designed as a discernment opportunity for college-age participants to ponder what might be the Christian community's response to immigration.  Each day brought a new venue, a new opportunity, a new sight to visit, a new day trip to take, a new conversation to participate within.  It was a fabulous experience, envisioned and flawlessly executed by my friend Lucas, the CMU chaplain.  And the experience involved lots and lots of walking -- to and from our home base in Greenwich Village, to any number of the church-related institutions we visited each day, through Central Park, to Times Square and a Broadway Show (The Lion King -- awesome!), to Ground Zero and back, around Liberty and Ellis Islands, to and from seemingly a thousand different restaurants and hot dog carts and the famed Magnolia Bakery just up the street.  All in all, according to the trusty pedometer I kept in my pants pocket, I walked 93,280 steps in about 100 hours spent in New York.

When I uploaded the rather sophisticated pedometer to the laptop when I got home, taking into account my height and weight, the program calculated that I had walked 43 miles!  My mother put it in best perspective:  I had walked a marathon and a half!  PLEASE hear me say I don't see that as terribly heroic.  There are surely New Yorkers who walk further than that weekly; indeed, many of our college student participants' late-night city wanderings probably resulted in twice the steps I walked.  But it was a monumental achievement for me.  No way could I have done that three and a half months ago when this journey began.

Generally speaking, I am starting to feel like I'm adjusting to this new normal.  Food is staying down better, and I've been green-lighted to start weening off the prescription (Reglan) that has helped reawaken my stomach post-surgery.  I still find myself staring at the stranger I see in the mirror, and get a chuckle out of the fact that at a recent encounter with a few old friends I hadn't seen in a while, I had to reintroduce myself to some.  Neither the surgeon or excellent family practice physician have gotten to the bottom of the sometimes serious pain I'm experiencing under my right shoulder blade -- I had an ultrasound of my gallbladder just prior to the NYC trip and will undergo another test next week to determine whether the gallbladder is even functioning at all.  If it's not, well ... at least thanks to the insurance out-of-pocket having been met, the next surgery is a freebie.

Still, there are a few hopes not fully realized, yet.  I try not to get overly wrapped up in how much weight loss to go, although I'd be lying if I said I didn't stand on the scales more mornings than not -- I have goals no matter how much I pretend I don't.  I tried on suit coats (off the rack!) this morning and discovered that I'm six sizes down from where I was, and yet my new-found vanity kept from seriously considering a purchase -- that suit will look a lot better in one more size smaller!  Yet, I still haven't had to take a diabetes pill since the night before surgery, and the doctor just told me I needed to eat more salt due to my now too-low blood pressure. 

It's just that I never had the goal of walking a marathon and a half.

The Man in the Mirror

Recently I was hanging out at church with a few of my favorite folks.  As is often the case in these past few weeks, the conversation somehow turned to my surgery and my current place in recovery.  One of the fellows mentioned his own specific current weight.  It jarred me.  I looked up from what I was doing and noticed for the first time that he and I seem the same height -- and apparently we weigh exactly the same.

He would say he wants to lose a few pounds, but I look at my church friend as entirely a size "normal".  If he's normal, maybe I'm "normal".  What?!  I've never been "normal" with regard to my size (or anything else) -- never.  Growing up, Mom hung one of those collages on the wall that held each year's school picture from kindergarten through high school and the visual evidence of my heaviness became noticeable about second grade.  For as long as I can remember, I've never been normal.

A good friend of mine had a bariatric surgery many months before I did, and I've leaned heavily upon him for guidance and encouragement.  I took him to lunch when I started pondering having the surgery, in part because I wanted to pick his brain, and in part because I wanted to see him eat.  That lunch was encouraging in many ways, the least of which was I saw him eat a regular meal like a normal person (he just put half of it in a to-go box nearly immediately!).  But he said something I found even more intriguing:  to paraphrase, he said his body and his brain were adjusting at two different paces -- and while folks around him might see him as a normal-sized person, he still saw himself in the same old light.

Now I get that.  Eleven weeks after surgery, my body is transforming into someone "normal", yet I don't feel normal.  This has been exciting and disquieting all at the same time.  I've never considered myself anything close to a vain person, yet I never pass a mirror by without staring at my reflection.  Yes, I've become our oldest when she was a toddler -- anytime she was cranky, we could place her in front of a mirror and she'd stare at herself seemingly for hours.  I look in the mirror and don't yet recognize the man I see.  Hopefully someday, my body and brain will catch up with one another.

Happy New Year!

Yesterday was my birthday.  The day began with dozens of virtual greetings from friends on Facebook, and the girls showering me with presents before everyone headed off to school and work.  I actually love that birthdays in our family are largely episodes in practicality:  From Molly and the girls I got the wallet I've desperately needed (along with a couple movies I wanted but certainly didn't "need") AND a new Mickey Mouse/baseball antenna ball in honor of my beloved Cardinals' Opening Day.  From my mothers I received cash and a gift card.  But practicality really won the day when it came to birthday dessert.  Instead of birthday cake leftovers remaining (and being eaten) over several days, we dipped bites of banana, strawberries, marshmallow, and pound cake into chocolate fondue.  A few bites and I was plenty full, and filled with joy in seeing our girls' happy, messy faces.  Here's a clip of Norah with a chocolate-covered marshmallow and the hilarious "Chubby Bunny" routine:

But the real birthday surprise came yesterday before I logged into Facebook or opened presents.  Sometime shortly after surgery, I set a series of audacious weight-loss goals of targets I hoped to achieve by my birthday (roughly two months post-op), Annual Conference (four months post-op), and family vacation time (six months post-op).  Perhaps calling them goals is a bit of a misnomer; "goals" somehow implies I believe I have full control over the outcome, when in reality there's an awful lot of all the change my body is going through that feels beyond my power.  Well, I hopped on the scale Tuesday and I discovered I had met my initial goal!  I'm not yet ready to share with the world the specifics, not so much because I'm embarrassed where I started (which, honestly, I am), but because I'm still in-process.  Like Kenny Rogers says, you're not supposed to count your money when you're sittin' at the table....  Nevertheless, supposedly I'll lose most of my extra weight within six months of surgery.

Of course, I may have gained it all back today.  Today is the first day I have been consistently hungry at predictable times.  Unlike too many days in the past few weeks, I ate well (a quarter cup of cereal for breakfast, a few bites of soup for lunch, a smoothie in the afternoon, and an ounce of leftover steak for supper) and kept everything down.  Not coincidentally, I've felt more joyous and energetic today since this journey began.  I'm hoping that on this, the first day of my 38th year, the proverbial corner has been turned.  We shall see.  Happy New Year.

Off the Rack

Off-the-rack is defined as "clothing made in standard sizes and readily available from merchandise in stock".

I'll be 38 years old in a few days and never have I been an off-the-rack kind of guy.  Ever.  Rather, I've always been on the low-end of the big-and-tall section, and a shopping experience for me typically involved choosing between the least unpalatable options. 

Tonight, I bought off-the-rack.  Wow!  I found a sale and figured out my size and there were literally dozens of options!  Color choices.  Plaid, stripes, or solids aplenty.  Polo or button-down.  I was overwhelmed ... in a good way.

I don't know exactly how much weight I'll lose, and nor do I have a particular goal in sight.  I expect eventually my body will settle into a natural weight, and then begins the real challenge to maintain.  But while I'm still losing weight, it doesn't make much sense to buy too much of anything -- where I am today may not be where I am tomorrow.  I've dabbled a bit in the Goodwill racks but so far have given a whole lot better than I've gotten.  As they say, it's a good problem to have ... but make no mistake, it's still a problem.

Second Verse, Same as the First

It's back to the liquid diet again.  At least for an indeterminant "few days".  That's the plan.  At least the plan today.  <<insert expletive here>>

This morning I had an esophagogastroduodenoscopy.  I prefer to write that simply because I can't pronounce it, and frankly neither could the terrific nurse at the surgery center.  But to make the whole consent-signing moment kosher, apparently she had to at least go through the motions.  I offered her five bucks to say it a second time, to which she chuckled and reminded me that she was the one with the IV needles.  She also gave me the same look my wife often gives me, one that says I'm not as charming as I think I am.  So, we'll just call this morning's events an endoscopy, or EGD if you'd prefer. 

The procedure was easy and I don't think lasted ten minutes before they started rousing me.  My surgeon and I fully expected they'd discover some sort of esophageal stricture that they'd knock out with some dilation.  Instead, what they discovered was a more nebulous problem:  apparently bile from the small intestine is backing up through the stomach and up the esophagus, caused by the stomach not contracting as it should in digestion.  I left with a script for Reglan, which I am to take before each meal and before bedtime, supposedly will facilitate better digestion.  In addition to a digestive aid, Reglan is also a treatment for migraines; maybe I'm due for a double benefit.  I'll go back to the clinic in six weeks or so to reevaluate, and we'll regroup earlier if need be -- what the docs think today is truly a best guess at the moment.

All in all, I'd call the day frustrating:  frustrating that this isn't something that could have been solved while I was under anesthesia ... frustrating that we spent the better part of the afternoon back at the clinic to be only told nothing definitive by the surgeon ... frustrating that the wisest course is to go back onto liquids for several days before slowly reintroducing food once more.  The day wasn't a total loss, however, as Molly has the singularly unique ability to make even the crappiest of days a good time -- she has entertained me before by quite literally reading aloud from the phone book and she was a delightful companion today.  And, of course, I provided great fodder for her post-anesthesia with my walking and talking like a drunk.  She lets me get away with nothing.

Minor Setbacks

I guess it comes as no surprise to say I'd rather just post the good news.  And there has been plenty of that.  But my intention in blogging has been to document the journey for family and friends, but also for someone who might be on his or her own journey with bariatric surgery.  And so, I must be honest.

It's been a tough go of late.  I've had two chief complaints -- the first of which being overwhelming fatigue, and which I understand via the excellent clinic nutritionist that is not unusual at this point in the journey.  The other complaint has ebbed and flowed -- the general struggle, most days, to keep down what little food has been consumed.

I started struggling with this about the one-month point post-surgery, where the doctor expressed appropriate concern and warned that an endoscopy may be warranted.  Perhaps all it took was that gentle threat -- things started getting better.  But early last week, the struggles resumed.  I spent three days throwing up, and then have had problems intermittently since.  My surgery clinic responded very quickly, first sending me to the hospital for an upper-GI, and then a follow-up with the surgeon.  While the radiologist determined the test "normal," the surgeon read it and pronounced himself suspicious.  His hunch is that my esophagus, post-surgery, is behaving a little like a clogged drain -- there is likely a stricture, one that allows some food to pass through, although not consistently.  He is sending me on for an endoscopy, likely involving dilating the esophagus to allow food to pass through.  Of all the possible bariatric surgery complications, this is the most common.

So, tomorrow is the day.  Molly -- bless her heart -- gets to haul me to the surgery center in the morning where they'll make me snooze and hopefully get to the bottom of whatever is going on.  Then we go back and see the surgeon later that afternoon to assess success.  I'm hoping by Tuesday I'm a new man, continuing my progression back into normal routines.  Stay tuned....

Utterly Random

Lots of random thougths cross my mind each day ... usually the thoughts aren't worthy of a blog post in and of themselves.  The jury is still out whether they're worthy of a blog post all lumped together, but let's give it a try.

• It always catches me off guard when folks ask me how much weight I've lost.  I say that because I've not ceased to be humbled by the many expressions of genuine care and interest in my life -- it means more than I can adequately express.  However, while I don't mind talking about my weight -- and I say this with all possible due respect -- asking about what size pants I wear is a little odd!  :)
• A week ago, perhaps in a moment of sheer dilerious longing for spring, I bought a fleece vest.  I imagined wearing it on those brisk mornings where an extra layer would be nice, and easy enough to shed in the warmer afternoon.  Once upon a time, a 40 degree day would not feel cold to me.  Now, I wear the vest indoors all day.  It adds a bit of bulk underneath the old winter coat that's far too big, in order to keep the wind from whipping up from underneath.  Having been warm-natured my whole life, this sudden change in my internal thermostat may be the oddest discovery to date.  I'm grateful for the drawstring of all my way-too-big old flannel pajama pants -- my default wardrobe choice at home.
• Ridding my closet of shirts, slacks, and suits that are far too big to ever consider wearing was more difficult than I ever imagined.  I'm grateful Molly and my mother-in-law were able to see around a corner I hadn't -- ridding the closets of summerwear, and from a conversation they had my mother-in-law came up with a plan to transform my short-sleeve Hawaiian shirt collection into a quilt.  I'm curious what my new style will become this summer -- because unlike a few leftover long-sleeve shirts I found in the back of the closet from years gone by, I don't own a single work-appropriate short-sleeve shirt that fits. 
• Old patterns are tough to break.  My whole life, my stomach has deceived my eyes into eating too-big portions.  And now, my eyes deceive my stomach:  no matter how small the portion I put on my plate, it's too much.  You'd think I'd learn, but each time I make the same mistake.  On a related note:  I'm ready for some creative farmer to figure out how to market half an egg.
• I had surgery six weeks ago.  Reality is, I had more energy six days after surgery than I do now.  The first week after surgery, I walked 80,000 in six days as part of an employer/health insurance health challenge.  That seems insurmountable now.  I'm not certain why that is.  The nutritionist at the bariatric center says this fatigue isn't unusual, that this is the body's reaction to this "medically-induced starvation".  She also says typically surgery patients experience a surge of energy at three months post-op.  I'm praying she's right.  I can't wait. 
• As my body adjusts to carrying less weight, regular visits with the chiropractor have been essential.  The chiropractor strongly urges me to consider massage -- something I've never pursued mostly because of my self-consciousness caused by several fatty tumor-like deposits on my back that I've had as long as I can remember.  After an adjustment a couple weeks ago, he noticed that all the lypomas are gone!  Our best guess is this is an added benefit of the liquid diet-purge of fat stored in the liver.  Now all I have to do is compete with Molly for the next splurge on a massage!
• I continue to progress through the reintroduction of food.  This next week is the biggest and most varied week so far -- reintroducing chicken, pasta, tomato sauce, bread, raw veggies, beans, rice, and nuts.  It's weird what I've missed food-wise and what I have not.  My greatest cravings have consistently been for tortilla chips (and queso dip), blueberry muffins, and cucumber -- not necessarily hoping to remedy this craving in the same sitting.  Oh, and popcorn.  Good grief, I miss ordinary air-popped popcorn.  I get it back in a couple weeks.  Can't wait.

Every day it gets better, a little easier, and more familiar.  I can't wait for summertime fresh foods and opportunities to be more active.  While I have no particular ultimate destination in mind nor a timeline of when I expect to get there, I have reason to hope I will have lost most of my excess weight by the end of the summer.  No, this hasn't stopped feeling surreal.