Sunday, November 15, 2009

Hump.

I mentioned my October funk last time, and one of the things that shook me up and made me so down I think was this story in the L.A. Times. The man in it is someone who had gotten just a little bit further than me down the bad road. He was 700, I was 525, he was really crippled by his problem, I was merely housebound and desperately unhappy. But one feature of his story really stood out to me. He had the leg thing even worse than I do.

I have something I call my leg thing. Sometimes I call it my "hump." The name's not important, although some of the names I've heard for it have terrified me. My doctor called it a "fatty tumor." The physical therapist I'm working with forwarded me an e-mail she wrote to my insurance company in which she called it "one of the worst cases of lymphostatic elephantiasis I've ever seen." It's a big bulb of fatty tissue and fluid that hangs from my left thigh. It's dense and heavy. The skin has stretched and gotten thick like a rhino's hide. It makes it hard to walk, to get in and out of a car, or to sit comfortably in one. It's the thing that makes people stare at me, and it makes me feel like a freak even worse than I'm used to. I hate it. I hate it so much. I live with it every day, and the hate simmers, and I forget about it sometimes, but it's there.

A while back, I was sitting with H and a friend at a yogurt shop and this lady came up to me. She said I had to go to physical therapy, that she was the head of some lymphedema group and that's what I had, and that PT would help. So I talked to my doctor, and he got a referral for a place down in El Segundo, and after much back and forth, they said they couldn't do anything for me, that I was too heavy for their equipment and that was that.

I had been through this once before - a client had recommended a doctor in Santa Monica that dealt with edema and had helped her mother. I called the clinic and they said the same thing, I was too heavy and they wouldn't be able to help me, and they weren't particularly nice about it. I was so put off I left it there.

But this time, with the El Segundo people, I didn't. I said, "Look if you can't help me, you know the industry and the people, can you help me find someone?" And they did, they found a place in Hollywood where the therapist had experience with bariatric issues and had a system and way to execute it. So I got in touch with them, and it's taken three months to get them approved by the HMO and then see what insurance will and won't cover. Finally last week I said to hell with it and let's get started. I don't care what it costs, this thing needs to change and you can help me do that. So next week I am beginning a course of treatment finally to deal with the leg thing. I hope it will help.

I don't think I could have done that without the progress I've described in my previous post. Action begets action, and momentum is an important thing. But there's another thing, and that's that I can't let my self-hate (hating the hump is hating myself - it's part of me) and self-pity keep me wallowing in my little mire. One of the things I love the most in this world is the scene at the end of "Two Cathedrals," an episode of "The West Wing," where Bartlet is confronted by the ghost of Mrs. Landingham, a fiction of his mind. She says to him:

"Are you in a tough spot? Yes. Do I feel sorry for you? I do not. Why? Because there are people way worse off than you. You know, if you don't want to run again, I respect that. But if you don't run because because you think it's going to be too hard or you think you're going to lose, well, God Jed, I don't even want to know you."

I'm in a tough spot. I got myself here. I'm going to get myself out. I'll need help. I have help. I have people who love me, who care for me, and who want to help. But ultimately, I have to love me, to care for me, and to want to help myself. I need to make those decisions, to recognize and forgive my mistakes, and keep myself looking forward, down the good road.

Songs I can't stop listening to:
Cannibal Resource by Dirty Projectors
Percussion Gun by White Rabbits

back on track?

So I haven't posted on this for a while. I spent most of October in a funk, doing what I thought I should be doing food-wise and kind of half-assing it on the exercise, but with no real progress, just kind of bouncing around between 442 and 448. Up a little here, down a little there, it was motion without advancement. I was letting myself eat some drive-through - a Chicken Fajita Pita here, an Egg McMuffin there, but of course that's never all it was. I was using beef jerky as a protein snack, and that meant going into 7-11 sometimes and facing down the taquitos, sometimes unsuccessfully. So I had the occasional fast-food freakout, culminating in a binge where I ate about 2500 calories in 2 hours from three different restaurants. Not good, eh?

When H went out of town 10 days ago, it seemed like it was time to do something different. I stayed in most of that time, and ate about 1200 cals a day, down from the 1600-1700 I was trying for and the 2000 or so I was actually eating. It's settled in to a nice little routine now.

1 Wheat "Alternative" Bagel from Western Bagel - 110 cals
4 oz 2% cottage cheese - 100 cals
1 medium banana - 100 cals

6 oz Low Sodium Turkey Breast - 210 cals
2-3 carrots - 40 cals
1 Tbsp. Fat Free Ranch - 30 cals
1 apple - 70 cals

7 oz boiled chicken breast - 200 cals
4 oz brown rice - 150 cals
4 oz broccoli - 40 cals
4 oz grapes - 80 cals
sugar-free popsicle - 20 cals

All that's about 1150 cals. It's not easy, but it's doable. And it's working - I've lost 14 lbs and am down to 434 now.

I've learned a few valuable things. One, I can do this. Two, as far as fast food goes, no chipping. A Chicken Fajita Pita from Jack in the Box is 300 cals and not terrible as far as it goes, but it opens a door that needs to stay closed. Same for beef jerky and other so-called "reasonable" snacks - it's shitty food and even if the numbers look good, it's not good for me. Three, progress on one front begets progress on others, which I'll explain in my next post.

Friday, September 25, 2009

The Biggest Loser?

I'm not a fan of reality shows in general, and I have studiously avoided watching even a minute of "The Biggest Loser." Since beginning my little experiment here, I saw an ad for the new season and in a moment of weakness added it to the TiVo season pass list. I thought it might be inspirational, I guess.

I'm not sure if I was right. The contestants, most of them, I adore and identify with so strongly. These are heavy people, and their stories feel real and genuine to me - the woman who lost her husband and children in a car accident, that she even gets out of bed in the face of that pain, never mind deciding to go on TV and lose weight in front of millions of people, that is a powerful reminder that no matter what, you have to go on and make good decisions for yourself. The 475 pound woman, who survived a very traumatic and difficult childhood to go on and get herself through college and into grad school for her M.S.W., who speaks from the heart about her anger and shame at having let her life slip into this abyss, I feel her anger, I understand it. The young man who's been through the show once, lost 125 lbs and come back to keep going, his energy and determination are in fact, inspiring, a reminder that you can build the ladder out of this hole, one rung at a time, and slowly find your way back above ground. Each of these people has a story, and I hear and acknowledge them and their power - their successes lift me, too; their pain as they share it reminds me that we are all brothers and sisters in this effort and gives me a place to put my pain, to see it in perspective.

But the reality show tropes intrude, the hard sell for sponsors, the strangely robotic trainer lady and her hard-eyed disgust for the people she's trying to help, the "look what you've done now" tone of the oily doctor telling the young pastor that he unknowingly does have Type II diabetes, the false exhortations of the show being everyone's last chance at a normal life, the unnecessary obstacles put in place by the shows designers that seem designed to set the contestants against each other and tear at each other's failings instead of supporting their successes, these things and all the other things the producers do to make it a "reality" show instead of the incredibly powerful story it already is, they undercut and erode the true capability of a show like this to really connect and inspire - that it does at all is in spite of this artifice, not because of it.

I'm watching the second episode as I write this, and the hard sell for the branded products and affiliated organizations is still as forced and awkward as before. The opportunities to actually provide information are edited and made into ellipses. But the people still have a lot of power in them, and I'm still watching. I guess that's your answer there.

Wednesday, September 16, 2009

More Days on the Path

Day's 4 and 5 uneventful I guess, a little more speed, a little more time, a little more distance. I guess the distance follows from the speed and time, eh? A little x=vt for the phine physics pholks, I tell you what. I added some Crystal Method and Art of Noise to the mix, but I always end it with the fine fine Alabama 3 telling me the glories of R.E.H.A.B. You may know the A3 (as they are known in the US to avoid confusion with the country act Alabama) for their wonderful Woke Up This Morning, etched into the zeitgeist as the theme for "The Sopranos," but my one regret in having that song so completely tied to that show is that the version used for TV cuts the opening spoken word part that explicitly puts out the themes of artistry and mortality hinted at in the lyrics. In any case, R.E.H.A.B. is set in a cynical context of snake oil salesmen hustling fake recovery and celebrity wellness, but it has greater depth than that for me - if I can't believe that I am redeemable, that this thing I've done to myself is fixable, well then, I might as well go back to the cheeseburgers and wait for my untimely end. I don't think it's for nothing that my new mechanical friend is called the Path, with all the Zen that implies. That's what it is, a Path to enlightenment, to acceptance, ultimately to de-emphasize my intellect and achieve a wholeness and integration with my physical being. Nothing to do now but keep putting one foot in front of the other.


Monday, September 14, 2009

day 3 with the Path

Got onboard for day 3, 15 mins, 0.53 miles, 136 cals. I really like this machine. Added the Buckpet's "Living is the Biggest Thing", Mooney Suzuki's "Alive and Amplified" and Ned's Atomic Dustbin "All I Ask of Myself..." to the playlist, and lost the Adam Lambert and the Hombres.

I'm dealing with the scale numbers now. I was 449.5 last Tuesday, but a few days of birthday celebrations finishing up with a great meal at Bazaar left me at 456 yesterday and today, despite getting back on the horse on Saturday. It's a little disheartening when then numbers were really with me up til now. Not much I can do except work my meal plan and exercise, and wait for the numbers to catch up. I hope they do.

Sunday, September 13, 2009

One Step at a time...

Day 2 with the Path. 15 mins, .45 miles, 124 cals. Same playlist. It's a sturdy beast, the Path is.

Saturday, September 12, 2009

Day 1 on the Path!

First walk on the Path - 11 minutes, .35 miles, 94 calories.

playlist:
The Hombres\Let It Out (Vinyl Rip)\01 Let It All Hang Out.mp3
Adam Lambert\Adam Lambert - 11 - A Change Is Gonna Come (Studio).mp3
Alabama 3\Power in the Blood (UK)\08 R.E.H.A.B.mp3
Cage The Elephant\Cage The Elephant\03 Ain't No Rest For The Wicked.mp3

It's not bad really - more fun than I thought it would be. It's a good machine.

Friday, September 11, 2009

Episode 4: A New Hope

Hello my imaginary readers.

In a nutshell:

I am 43 years old and 450 lbs. I have thus far avoided the major complications of obesity. I am not diabetic, my blood pressure is normal, my cholesterol is under 200. My major health issues aside from the obesity itself are a ventral hernia since being attacked in July 2004 that gives me a lot of problems, but that my doctors feel is too dangerous to repair now, and a large fat deposit on the inside of my left thigh that is a huge impediment in my daily life. I take once daily a baby aspirin, a 75/50mg dose of triamterene/hydrochlorothiazide to combat edema in my legs, and 4000 I.U. of vitamin D to bring my levels to a normal range.

More specifically regarding the obesity, I started gaining weight above the normal range early in my teens, reaching 300lbs by the time I was 21. I did OptiFast at 21, was 200 lbs for about 10 or 15 seconds, then gained to 380lbs by 26 or so. At that point I worked with Dr Wayne Callaway in Washington DC, and with diet, exercise, therapy, and OA got to about 230lbs over 18 months. After that, a long slide up to about 440 by age 35 or so. At that point I went to Lindora in L.A., and over about a year got down to 320 or so, then back up to around 460 by 39. I then went to the R.F.O. program at UCLA for several months and lost down to 360 or so, but by about 6 months ago was at my peak of 525. Since then I went down to about 490 by July. Since July 20 I have lost 40 lbs largely through diet to the 450lbs I find myself at now. I have consulted with UCLA regarding bariatric surgery, and they have recommended a sleeve gastrectomy over the traditional gastric bypass operation because I am so heavy. I am deeply ambivalent about surgery, as I feel that what's broken about me and food has so little to do with my stomach and so much more to do with my mind and brain.

I feel that I am an addict. That food stimulates the addictive pathways of my brain, offering reward, sedation, and solace. I was a heavy (no pun intended) consumer of fast food - sometimes eating drive through twice a day, and usually at least 5-7 times a week. It fit my busy schedule, and also satisfied my penuriousness, being cheap, satisfying, and quick.

Currently, I have taken the following steps. I keep track of all my eating in a computer program, and find that creates a moment of mindfulness that's very helpful. I try to stick to 2000 calories a day, spread over 4-5 meals. I stick with lean meats and protein, fruits and vegetables, and use starches sparingly. I weigh myself once daily on waking up. I have been seeing a therapist for about 3-4 months, and am trying to develop an understanding of what I refer to as my "lizard brain," the part of me that wants the unhealthy foods, that lives only in the present, understanding neither history nor consequences. I am trying to separate its impulses and desires from my actions, accepting that it will always need, but that I do not have to act on that need. I am also trying not to let the perfect be the enemy of the good. My compulsive nature punishes me when I am not absolutely perfect, and in this effort, I am trying to "let the arc of history bend towards justice" to borrow a phrase, to accept and continue a trend to the positive and not slam the door shut when I am imperfect or flawed in my execution.

My next step is exercise, and to that end I have committed a great deal of money and a large portion of my living room to a Woodway Path treadmill, delivered yesterday. My intention is to wake up and walk before the pressures of the day begin.

Perhaps more than you asked for, imaginary readers? I am sorry for it's length, I know you're busy imaginary people, but I hope it's helpful. I'm sure my story isn't unique, nor that it's the first time you've heard it, but I'm hopeful that this time, this time the change is settling deeper in me. We'll see how it goes.