Happy 100: The Post-Game Analysis on Bariatric Weight Loss

Salutations, friends!

I love it when the universe aligns for a fortuitous coincidence, and how’s this for kismet: yesterday was the six-month anniversary of my sleeve gastrectomy, and when I stepped on the scale in the morning it read: “168.0” One hundred pounds lighter than I was about a year ago.

I’ve been carefully monitoring my progress throughout the procedure, all the way back to the first pre-op appointment in 2014. The total process from an initial seminar at Hartford Hospital to the surgery proper on January 19 took roughly one and a half years. That time was spent in close consultation with a dietitian, pulmonologist, and cardiologist in addition to my surgeon, the rock-star and pioneer in his field, Dr. Pavlos Papasavas. A psychiatric examination, sleep study, and support group attendance were also part of the preparation.

Considering the significance of a centenary drop in body weight (and, incidentally, a drop in BMI from 39.0 to 24.5), I think a recapitulation on the journey is needed. If you’re thinking about surgical weight loss, or you’ve had it, or you’re just curious, you’ll enjoy my look back at what I’ve lost and gained from having my stomach removed.

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January 19, 2016 – three hours after surgery. 

The replay on…the value of surgical weight loss.

The question I’m most often asked is, “Why have surgery?” Some folks want to know if I tried it “the old fashioned way” first (I did, many times) and others wonder why I took the risk of going under the knife for a serious elective procedure. In medicine, everything is about odds. Treatment for an illness, whether with drugs or surgery, is always a risk. The health care team calculates the dangers of treatment against the risk of not treating an illness at all. I approached my surgery with the same mathematical rationale: was the risk of complications and even death from surgery greater or smaller than the long-term damage of morbid obesity? I already had a very high BMI, hypertension, hyperlipidemia, sleep apnea, and a pre-diabetic fasting blood sugar (my A1C was 6.5). The research showed that each of these symptoms related to weight would be dramatically reduced or eliminated by surgery. Overall, life expectancy for someone who has a gastric bypass or sleeve is increased by 85% compared to obese persons who do not have surgery.

So it was, logically speaking, a no-brainer. Of course I was nervous ahead of surgery – who wouldn’t be? But after the procedure, the payoff became immediately evident. Within a few months, my hypertension, hyperlipidemia, and blood sugar levels were resolved. Sleep apnea was gone by May, and I felt incredible – more energetic, focused, and grateful than I had been in decades. At six months out, my doctors concur: I’m in outstanding health.

The next step: At my last consultation with the surgery team, in May, we set a weight goal of 170-175lbs. I’ve exceeded that, so technically my weight loss target has been met. I still continue to lose weight, however, at a considerable more modest rate of one to two pounds biweekly. I would be happy to settle in at around 155-160, providing a comfortable buffer for any weight gain after the so-called “honeymoon” phase is over. But with all of my health issues resolved, any surplus weight loss is really just icing on the low-carb, sugar-free cake.

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In 2010 (258 lbs) and again in 2016 (185 lbs). 

The replay on…diet and exercise.

Of course, surgery is the catalyst for a weight-loss journey, not the panacea for obesity. I used the initial “boost” of losing 40 pounds in the first month to exercise constantly. Sticking rigidly to the nutrition guidelines prescribed by dietitian have also made this process a success. I have a “rule of five” to which I adhere fanatically; these five foods are strictly verboten, never to be eaten: rice, pasta, bread, refined sugars, and ANY kind of corn or potato-based fried or baked snacks (chips and their like).

For proteins, I stick to non-fat dairy (Greek yogurt), 1-2 ounces of nuts per day, fish, beans, and lean meats. About 70% of my daily diet is vegetables, greens like kale and spinach, and low-glycemic load fruits like cherries, raspberries, and strawberries. Never before in my life have I eaten so many salads, nor did I ever think I could relish a good salad as the old me did a fat pork chop or bowl of Chee-tos. River and I counted the number of salad dressings (no more than 5 grams of fat per two tablespoons) in our fridge the other day, and there were nine!

I am obligated to take in a minimum of 64 ounces of water per day, and since I can’t “chug” 32 ounces of that in a go, I need to sip constantly throughout the day. I still take my morning coffee – with skim milk and Stevia. Soda is a never, ever – I have not had a single drop since the start of this year, and never will again.

Eating out has been a bit of a challenge. Not only is it hard to ascertain what you’re eating when someone else prepares it, but I’m budget-minded and dislike paying too much for a meal I can’t possibly finish. I get creative and order side dishes, salads of course, or just plan to take my meal home to finish over a few days. On the bright side, I have a much greater appreciation for the quality of food. Like many of us, I used to go for quantity – line me up at the buffet so I can pack in as much crap as possible. Now, I can afford to eat small portions of excellent-quality foods.

The next step: Despite the protests of my dietitian, I’m considering going pescetarian (a vegetarian who still consumes fish). The goal for someone post-surgery is 70 grams a day, and I’ve calculated out how to take in that amount through beans, dairy, nuts, and fish. It isn’t very difficult at all. Relying more on these foods for protein would cut out some of the very unhealthy and hard to avoid saturated fats in meat. In terms of fluids, I grew tired of plain water about a month ago and have been adding those dreadful aspartame/sucralose based sweeteners to it. Not only are the sweeteners problematic for health, but the dyes are nasty as well. I’m challenging myself to return to plain water, or sweeten my drinks with fruit.

In terms of fitness, I have a lot of sagging skin around my lower abdominal region, and I need to strengthen and tone my core. Time to use my gym membership and left those weights.

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One week ago, at Mount Misery.

The replay on…emotional and spiritual benefits.

You’ve already read about my renewed sense of gratitude and joy. To some extent, I’m sure, these are products of improved biology, but it’s also how different I perceive myself…and how others treat me. I must say, I have not been complemented on my physical appearance this much since, well, ever. It comes so constantly that I’ve become quite unsure of how to respond, anymore. It’s flattering and I am always humbled. My dating options have improved; apparently I’m now in a different “league.” Even strangers seem warmer and more appreciative of me. It’s bizarre, too, being one of the lightest people in certain places, or realizing in a room of people who’ve never met me before that I’m not “fat” to them. A guy at work even asked if I’d been on a wrestling team before…it blew my mind.

Next step: Interestingly, the surgery has completely eliminated my libido (and I didn’t have much of one to begin with). I don’t know if this is a result of the surgery itself or just a facet of my new perspective on life or understanding of myself. I now struggle with dating, even though I have more options in that arena. Do I really want a partner? Have I become a sapiosexual or even an asexual person, now? Has my sexual identity changed? I’m still trying mostly because I feel obligated to not “give up” on romantic life, and the superficial perks (a readily available babysitter, second income, someone to go out with for fun) are compelling. But most of the time, I’m rather frustrated and even feel some antipathy for becoming romantically attached to someone. Maybe I just haven’t given it enough time.

I also want to keep up with mindfulness practices like yoga and meditation. As work in nursing is very stressing and frantic, I need to cultivate more pose and calm in my life.

So there you have it! I’d really love to hear from YOU, readers, so do feel free to post in the comments below.

Stay positive!

How Heartbreak Is Like Getting the Flu

(A work in regress.)

How Heartbreak Is Like Getting the Flu

The cold, it rips you unobserved.
The flu, oh, it may pass after a few days
But you want a vaccine for it; care of

someone brighter, an expert in chemistry.
Bodies have a memory, you see
and you keep the little injuries for life;
going out gets that much harder.

The coffee is inert on your sick room table;
it cannot mend, today. It shivers a bit,
(the world is chilly which makes the flu and heartbreak)
under the shadow of that rising wall,
atop a pathway crumbling, un-counseled, far off.

Damask in the silt
Little mice tense in skin
Making nothing from something
A little flu, a little sadness
It will pass in a few days – I aver.

I know nothing of chemistry.

Getting It All By Giving It Away (Free Photo!)

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Free photo of day! (Attribution: “Photo by Jace Paul, 2016.”)

Hello friends,

Whenever we lose a patient on my unit, I try to take a second to whisper, “Thank you.” No, not “thank you that it wasn’t me,” but rather for that person’s life, witness, gifts, and all they gave to the ones they loved.

Maybe it was the sun shower that hit just as I left work, maybe it was the date I went on last night with a girl that made my heart sing, but today, as I came to a field bursting with black-eyed-susies on my hike, I decided to shout my gratitude out loud. I spread my hands wide, let the wind and butterflies twist around me, and just let my voice speak for the mass of my soul: “Thank you!”

Working in healthcare, I see death often enough that it’s honed my sense of urgency about the whole “carpe diem” thing. Perhaps it’s a shuffling of priorities. So much of my life has been spent in the pursuit of Truth that I have often forgot that other aims are more important. Life presents opportunities for us to be right and kind – but sometimes it gives us a choice to only one or the other. Insecure, unhappy, and overly-educated, I have all too often chosen to be Right and not kind. I’m glad that, in recent years, I have learned to be kind more often.

At an in-service for work today, we took the new hires on a tour of the building. Our wonderful Infection Control/Safety Compliance Officer, Jane, stopped to talk about responding to a combative patient. The question was when it’s right to argue with an angry patient, and when it’s better to avoid an argument. When safety or health is at risk, she said, it’s important to be right. But if these concerns aren’t present, it’s better to be kind. If a dementia patient thinks it’s 1945, let them think it. What good will come of trying to convince otherwise?

“As often as possible, choose to be kind over right,” Jane said to cap the conversation.

A patient in a wheelchair, on leave from long-term care (the unit for people who won’t, most likely, ever be going home) suddenly spoke up.

“That’s very good advice,” she said. “I’ve seen people who spent their lives trying to be right and not kind, and let me tell you…they don’t get many visitors.”

We touch down on this earth and barely find our feet before the ground disappears below us. The sliver of time we occupy in the greater lifetime of our cosmos is such a small space within which to move, to learn, to create. How do we want to use that time?

It’s a question that is never fully answered; or one that dips below the horizon of our awareness as we become focused on the immediate, the logistical, and the mundane. I try to bring it forward each day and use it to stay focused on the things that really matter – those virtues and choices that will mean more meaning, more love, and – yes – more friends and loved ones at our side when time runs out. 

My friends, don’t listen to the pragmatists or cynics. Give away the “stuff” you think you need and become rich with freedom and peace. Love wildly and impulsively. Believe in gods or good people or fields stuffed with flowers.

Say it with me: “Thank you.” 

When Yes Meets The Flower Kings, Positivity Rules

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Anderson/Stolt: Invention of Knowledge, Inside Out Records. Available now on iTunes, Spotify, on CD, and vinyl on June 24 (EU) and July 8 US)

“It’s like adding maple syrup to caramel.” So said a friend upon learning that former Yes front man and solo artist Jon Anderson had teamed up with “the magic genie,” Roine Stolt of the Flower Kings, for a brand new recording entitled Invention of Knowledge. Both men have established themselves as the gurus of spiritually-minded, positivity-promoting prog, and a collaboration was sure to bring the mystical meditations right up to eleven.

I have always considered The Flower Kings to be the logical heirs to Yes’ legacy in the twenty-first century. Though straying often toward jazz-fusion and sonic dissonance, thematically and lyrically the band is a near facsimile of their 1970’s forebear, and when they’ve done symphonic prog (The World of Adventures, Stardust We Are), The Flower Kings compel the same soaring sense of wonder and grandeur as Yes did with outings like Tales from Topographic Oceans. Stolt’s lyrics consistently remind the listener to love, to embrace peace, and seek deeper understanding in spiritual practice. Consider the final segment of Adam & Eve‘s grand opener, “Love Supreme”:

See life reinventing itself, starting over, time and time again
A new time of understanding begins, see yourself as a link in the chain reaction
This world couldn’t do without you, this world couldn’t be without you
It’s perfect because you are, it’s perfect because you are.

So it’s a natural and – for me – much welcome pairing to have the masterminds of these two bands produce a work together.

Before I delve into Invention properly, let me make the obvious caveat: if you find Yes a bit twee, bloated, and pompous you might as well get your hat now. If, on the other hand, you like long-form symphonic rock with an uplifting angle, read on.

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The disc kicks off with “Knowing,” an 18-minute suite that begins as slowly rising chants and distant guitar harmonics, then launches into a near-martial beat set to Anderson’s unmistakable sky-high tenor. “Some may say the positive in life is always, always growing,” he sings, accented by a chorus of counterpoints and harmonies (ably provided by a beautiful backing vocal section that includes Daniel Gildenlöw of Pain of Salvation). The song really takes flight, however, in its second movement, “We Are Truth,” a ballad with strong similarity to Yes’ “And You And I.” Stolt carries the initial verses with playful acoustic guitar as Anderson avers: “We will not break down and let/the darkness call our names.” The song closes with “Knowledge,” and here the potential and payoff of the collaboration comes into clear focus: Stolt has always displayed a genius for powerful finales that send his listeners soaring into the heavens, and with appropriate gravity added by a mighty pipe organ and angelic choir, “Knowing” comes to a trademark glorious Flower Kings conclusion.

European reviews of the CD have remarked on the Yes-like character of the music, with some saying this is the music Yes should have been making for the past few decades. (Let’s be honest: Heaven and Earth was, ahem, Hell.) I think that to a Yes fan unfamiliar with The Flower Kings, that’s true: this music is far more like Yes than most of what the band itself has released since possibly Keys to Ascension in ’96. To my ears, however, the music is distinctly in Roine Stolt’s style. So steeped in The Flower King’s music am I that I knew, in most cases, what chord was next in the progression and when the guitar solo would begin. (Flower Kings bassist Jonas Reingold and former bassist Michael Stolt also play on the CD, adding their fretless bass and funk-inspired rhythm lines to the music, which adds to the Flower Kings sound.) On the other hand, The Flower Kings are very much the progeny of seventies-era Yes, and so perhaps it’s equally fair to say that this is “YesMusic.” The bands are so similar, it may be hard to say where one ends and the other begins.

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The Flower Kings.

Track two, “Knowing,” is lighter fare, largely comprised of impressionistic lyrics that work like poetry rather than realism. The second movement, however, features some tastefully restrained Roland piano from Tom Brislin, who provided keys on the Yes Symphonic tour. The song’s final minutes are reminiscent of “The Truth Shall Set You Free,” the marvelous opening track to The Flower King’s 2003 double CD Unfold the Future.

 

In the third track,”Everybody Heals,” Yes fans will hear echoes of both “The Remembering: High the Memory” and “Ritual: Nous Sommes du Soleil.” The piece makes several key and tempo changes, and on first listen it can appear indistinct, almost uniform in composition. Careful attention brings out the changes between light and shadow, as once again majesty is exchanged with contemplative passages which allow the headier content to settle a bit.

The last track, “Know…,” begins with a gentle shuffle and some Rhodes, vocal scat, and vibes – all in lovely major seventh/ninth chords that, as always, evoke wistfulness and longing. As the bass and percussion take a bit of a backseat, the feeling here is more acoustic and intimate; appropriately doting on Anderson’s voice and soft-spoken words of love. About halfway through the track, we return to some of the earlier themes and melodies from the album,  and once again leap from earth to sky. The repetition of themes is nice, but seems tacked on and unnecessary. A shuffle of the tracks to end on a more majestic note would have been nice – perhaps this would have made a nice third movement, with “Invention of Knowledge” being a stronger and more memorable close to the disc.

But that’s picayune when the music itself is so rich and textured, and brilliantly executed by all of the artists involved. Sure, there are no long instrumental passages or curry-worthy keyboard solos, and the rhythm section is virtuoso but not flamboyant about it (a real shock if you’ve seen Reingold play live). But Invention of Knowledge radiates enthusiasm and joy, and I can’t recommend it strongly enough. By Anderson’s own admission, this is the music he’s been longing to play for many years. Here is a fortuitous union of two exceptional talents, and fans of both Yes and The Flower King will find this a glut of ear candy – though I’m certain that listeners who know and enjoy both groups well will be doubly rewarded. It’s not daring, but it’s sublime, and for fans of symphonic progressive rock like me, that’s all we need to know.