WLS 24 – 8 months in

Ok, ok, I was sucking my gut in. I admit it!

Ok, ok, I was sucking my gut in. I admit it!

Eight months after weight loss surgery. Not a lot new to report.

My weight loss has slowed to a crawl. About 2-3 pounds a month. I don’t get sick eating at all, and I guess I can eat what I want. A couple of times I’ve had a craving for things outside my normal diet, like popcorn, or apple butter toast. Each time I went ahead and had some — after all, if you’re craving it you’re going to eat it sooner or later — and neither time did I explode or turn into a lizard. Disaster did not await.

Of course, with the new stomach I don’t eat as much. So, when I wanted that Apple Butter toast, I made four slices. But I was barely able to eat two. And even then I felt way too full.

Popcorn was fun. I’ve had it twice. The first time I had about a cereal bowl of popped popcorn, then I felt really full. The second time I decided to make it my morning meal, so I nibbled on it throughout the entire morning. No drinks, of course, still sticking to the 30-30 rule. Just popcorn.

Wish there was more to report, but not a lot of drama here lately. Back at work, busy, just doing stuff.

So I guess that’s the good news! I think a couple more of these weight loss entries and it will be time for a wrap-up.

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WLS 23 – Tyranny of the Gumballs

Gained two pounds over the past two weeks. And I’m embarrassed to say why.

Yes, it was the Christmas holiday. Yes, my exercise was off. Yes, I didn’t keep track of what I ate.

But it was all gumballs.

It started off innocently enough. I had gotten into the habit of chewing gum after I ate. It was a long time to wait for that first drink! So sugar free gum and mints helped pass the time.

This worked fine until I ran out of gum during the holidays. Then I looked around — and saw a 20-pound tub of bubble gum I had bought a year ago for my daughter’s gumball business. Just sitting there.

Wow! Was that some crunchy gum! But I found that it tasted good enough, once I got going. In fact, it tasted pretty good! Nothing like a few grams of sugar to get you boosted up.

Turns out that eating sugar was not going to cause me dumping syndrome. Oh well, another barrier to gaining weight shot to shit.

They say that’s what happens: for many folks, you eventually get to where you can eat everything you used to. At that point, it’s like you never had the surgery.

This is not a good thing. In fact, it leads me to believe that those folks who complain the most about their RNY (aside from those with severe complications) are probably getting the most from it. All that sickness, not being able to eat very much, and worrying about certain foods? That’s a great way to get you to 1) reduce what you eat, and 2) pay attention to what’s going in your mouth.

So perhaps complaining about the discomfort of RNY is actually a positive indicator. Go figure.

As for me, inside of two weeks my gumball consumption went berserko. From eating one gumball at a time, I found I could eat two, then three, then four.

Hey, it was Christmas! And it wasn’t like I was eating chocolates or candy. It was just gum.

Before it was all over with, I was sitting down and chewing 20-30 gumballs at a time. Put 2 in, chew them up, then spit them out and put in another two. It was like a day-long sugar rush.

And of course, this did all sorts of nasty things to my metabolism. I would wake up with a headache. My tongue felt like I had been chewing on it, not the gum. I became hungry again quickly after I had ate. Finally I realized I had to quit. Yesterday I made it a point not to have any gum at all.

This resulted in a day-long headache. I can tell you, this was not a fun experience.

So let’s not do that again, okay?

But it goes to prove a point: as you get older, your physiological system becomes less stable. It’s easy to get out of whack, and it’s tougher to stay in whack. Very old people end up taking several different kinds of medications — and they all have side effects. Fat people probably end up with some kind of imbalance earlier on in life. I don’t think there’s any magic cure, and I don’t know if the imbalance is due to sugar consumption, growth hormones, hunger hormones, or too much rock music. But I do feel that this is a natural process of your body system getting skewed.

I also feel like you have to make a decision: how much discomfort are you willing to go through to keep your system in whack? How much of a change in lifestyle? I told the nutritionist the last time I saw her that I had lost most of my initial weight, and I was now considering what kinds of temporary changes I wanted to make permanent.

Sounds pretty obvious to most — do anything to keep the weight off! But it’s not so simple. Do you want to not be able to attend dinner parties without being the only “non-eater” there? Do you want to not socially drink alcohol? How about pre-measuring your food? Happy with pre-measuring your food — for the rest of your life?

These are not easy questions, and over the long term your body is going to go out of whack anyway. That’s just the way bodies are. So it’s always going to be a losing game. The only questions is how much you want to change your life to slow things down before the inevitable.

I don’t know the answers, but I know that I don’t want another day-long headache. Or to gain 2 pounds because of something stupid like bubblegum. If I’m gaining two pounds, dammit, it should at least involve a buffet or a cruise or something! :)

So if you know of anybody that wants 5 pounds of bubble gum? Send them my way.

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Christmas is a Really Weird Holiday

Currier And Ives Christmas Village
The ancient Romans had a problem. A new cult arrived, bringing with it the most distasteful practices. The members all were atheists. They were also incestuous, and they had secret cannibalistic rituals.

The new guys? Some jerks called “Christians”. That’s right: they refused to believe in the Gods, they called each other “brother” and “sister” and greeted with a kiss, and rumor had it that they took part in some kind of ritual that involved eating the flesh and drinking the blood of others. Most folks thought they were killing babies.

New people are always bringing in new ideas and messing things up.

Take Christmas. As far as we know, some kind of holiday around this time has been celebrated forever. Go back ten thousand years, and you’ll find humans dancing around a fire around this day. They just didn’t call it Christmas. Nowadays the best scientific name for this day is the Winter Solstice. It marks the shortest day in the year, and it’s something that any culture that watches the sky would know and wonder about. Would the sun continue retreating? What could be done to bring Spring back? People built bonfires (along with large “yule” logs), used trees in ceremonies, had great gatherings, built huge edifices to properly revere the sun and help bring back much needed warmth to the land.

Then those new guys showed up with this fancy concept called “civilization” (a word which was only invented centuries later!). They wanted everybody to kind of standardize the holiday. Some of them settled on “Saturnalia” It was a pretty fun holiday. Slaves got to play the role of masters, and masters got to be slaves. There was drinking, families visited together, and everybody was thankful to spend time together. Geesh! Did we really need human sacrifices and all of that crazy superstitious stuff this time of year when we had the God Saturn and the proper celebration that should be given to him at this time?

But that didn’t last. And it was those atheist cannibal Christian types that ruined it.

At first, Christians refused to have anything to do with celebrating the birth of Jesus. Why should they? The entire religion was based on the death and resurrection of Jesus, not his birth. The first gospel written, Mark, makes no mention at all of Jesus’ birth. Later gospels went big on the story, though, with wise men, jealous kings, and all sorts of other great themes. But even then, early Christians had little interest in the beginning of the Jesus story. It was the last part that was the important part for them.

“It is only sinners like Pharaoh and Herod who make great rejoicings over the day on which they were born into this world,” said Origen, one of the most notable early church leaders.

People have a hard time believing this today, but early on it was the story of Christianity that was far more important than the historical detail or places. It wasn’t until the Middle Ages that visiting holy sites became much of a big deal. What would be the point of visiting a bunch of old places? Those things were trivial compared to the meaning of the story.

The Gospel of John helped to change that, but it took a long time. John was unlike any of the other three gospels (stories of Jesus’ life) in that it tried to join philosophy and religion together. Many scholars view John as being the product of an early Christian church with a heavy Greek influence. As science and the scientific method has progressed, people took this theme of philosophy and reasoning and started focusing on sourcing and facts. Christians are especially interesting in becoming more interested in “proving” that all these things have historical meaning and validation. Compare this to many other religions which to this day are not concerned with these matters. But I digress.

Because of this joining of philosophy and religion, or in spite of it, Christianity took off in a big way, eventually becoming the state religion of Rome, even though many still kept to the old ways too. Eventually this was a problem: fervent adherents wanted to know: why should we allow folks to keep celebrating this Saturnalia thing? People loved it, but it had nothing to do with Christianity. In fact, it was bad for the brand. It sowed confusion, it diluted the message, it hurt adoption.

So somebody came up with a great idea. “I know,” they said, “let’s keep Saturnalia and all that other stuff, but we’ll also have a celebration at this time for the birth of Jesus! We don’t do anything for that, and that way everybody can have a big party and at the same time be doing it the right way.” (Some scholars consider this the first great ancient marketing ploy)

So the organized, official Christian church used Microsoft’s embrace, extend, and extinguish strategy, but it still didn’t sit well with many of the troops. Why do we need to create some new holiday and do a bunch of pagan stuff? What kind of belief system is that? Indeed, most Christians refused to have anything to do with it. But it was great for converting the unwashed masses. For a long, long time, most Christians would have nothing to do with a mid-winter celebration in honor of Jesus’s birthday. In fact, in the New World, it was outlawed.

But slowly, over the centuries, most all of the Western World adopted this time of year as being appropriate to celebrate the birth of Jesus — if only in a muted way. Even though, of course, Jesus was not born at this time of year. It seems that when he was actually born had little to do with when his birthday should be.

But even all of that compromise wasn’t good enough.

First, people stayed upset about keeping the old traditions around. Geesh! Did we really need yule logs, trees, partying, and all that crazy superstitious stuff this time of year when we had Jesus and the proper celebration of his birth?

Second, for out on the lawn, there arose quite a clatter. Somehow in all of this arguing over when Jesus was born, or if we should actually care about it or do anything about it, one of the obscure Catholic saints, some guy called Saint Nicholas, took on a big role. He had a red coat, a flying miniature sleigh, delivered presents, and…

Wait, what? Where the heck did he come from? And what does he have to do with anything?

And that wasn’t all. The “Santa” story kept growing. He lived at the North Pole. His sleigh was powered by flying reindeer, one of which had a glowing nose.

Those Saturnalia folks have to be spinning in their graves. Would this crazy revisionist nonsense ever stop?

Of course, with modern education people are beginning to realize this silliness. And, just like people do, instead of consolidating something to celebrate, they are digging up all the old Pagan rituals and starting to celebrate them too. Of course, none of them have any idea what they’re doing, and it really doesn’t make a lot of sense, but, frankly, it makes as much sense as singing “Frosty the Snowman” while heading to a yule log ceremony following Christmas Eve church services (which you attended after watching the Macy’s parade, of course)

Meanwhile modern folks are asking if Christmas is a religious holiday after all. Geesh! Do we really need nativities, Christmas Eve Masses, Cantatas, Madigrals, and all that other crazy superstitious stuff this time of year when we have a wonderful inclusive secular holiday with this Santa guy and all this other non-religious stuff in it?

In programming we have a saying: the two hardest things to do are naming things and cache invalidation. What to call things and how long to keep ideas around before discarding them. Seems like programmers aren’t the only ones with this problem!

Our species has gone from animal spirits, to a Sun God, to the God Saturn, to the birthday of Jesus, to this big guy in a red suit, to this mish-mash of magic snowmen, glowing-nosed reindeer, and other nonsense. None of these have a dang thing to do with the other, but historically they all are part of the same thread stretching across the millennia from prehistoric darkness to today.

Like it or not, mankind is determined to have some kind of holiday around the time of the Winter Solstice, although what to call it, why to have it, and how to celebrate it seems up for grabs. Makes you wonder in ten thousand years, if some vestige of mankind still remains in the universe, what kinds of things we’ll be doing this time of year?

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Whatever Happened To Software Engineering?

map-clip-artI’ve been working some on my mailing list to help Agile teams do better and one of the recurring topics from readers has been how to fit “normal” software engineering principles into an Agile framework. How can you do database design, for instance, if every 2 weeks the database is actually being used?

Of course there’s an easy answer: we incrementally do things in Agile. So, for instance, you might use all those database design skills, but a little at a time, instead of all at once. The first sprint you sketch out the tables, maybe add a few fields. Second sprint you change up the tables some, add some more fields. Third sprint you’re working a bit with cardinality. And so on. The concept is that we do the same stuff, only a bit at a time instead of becoming a bottleneck.

This is a good enough answer, and it works for most stuff. But I think it’s also masking a conflict that many people have: software is supposed to be engineering, not just little dips and drabs of stuff added in here or there. To hear many YAGNI pundits and others, you don’t actually do anything until the last minute, and then only in support of the exact thing you’re working on. Most engineering disciplines, however, encourage you to solve the entire problem. If you’re building a bridge, architect the bridge first, dang it. If you’re going to the moon, you’d better have some technical work around the entire trip. You don’t just launch into orbit and figure it out from there. Building incrementally is fine. But there exists fields of inquiry where there’s a long sequential process of refinement over the entire problem domain — one in which you gain execution advantages by working the entire problem at once. We seem to either have tossed this fact away or are purposefully ignoring it.

I began noticing a problem. When we talk about these things, people shut down. I suspect many folks in software engineering, especially Agile coaching, don’t have an engineering background! This can lead to a severe disadvantage when dealing with certain areas:

  • Modeling I don’t see many teams sketch, much less model. That’s a shame, because visual information is a much more effective way to discuss technical matters. Add in a bit of formal training, say 30 minutes, and teams can sketch in UML. Then you can link diagrams. There’s something to be said for lightly sketching problems on the whiteboard. Take a picture if you want to keep it. Start using a modeling tool if you realize that you’re having a group discussion around highly technical stuff. You can sketch, you can use UML, you can use a modeling tool, all without having to become a waterfall BDUF project. Really, you can. It’s the only way to go for complex projects.

  • Process Analysis Does anybody remember structured process analysis? Not to see most teams. The way most people teach Scrum and Agile is that a list of stuff appears — I guess from the sky, brought down by a dove to the Product Owner. The team only works on the stuff in front of it. Don’t spend a minute thinking about the big picture! After all, your project could end at any point in time, and you don’t want to spend one minute on things that you’ll never need.

    Of course, there ARE projects that could end at any moment, but for most of us, we’re brought on to address some kind of system: a website, a business problem, an internal need, and so on. The team, and project, has some cohesion. You’re going to be here in six months, and you’re going to be working on the same thing. For those kinds of projects, spending some time doing process analysis is a no-brainer. You get back much more than you put in. I’m not talking about anything waterfall-like. I’m simply talking about building a process model, over time, of who does what with the system and why. This can help you cut to the chase and decide which stories should be prioritized first. It can help you define and have a common understanding of your stories. It can help the Product Owner make economic decisions about the backlog, and it can help the team interject creativity into the solution, instead of just being a bunch of order-takers. Great stuff for couple hours or so each sprint.

  • Lean Startup Another one of those end-to-end, outside-the-team areas where the team and the Product Owner need to work. What hypotheses is this work supposed to be testing? What are the revenue streams? How are we addressing the gap between market and PO? In a startup world, all these things are critical — and there’s a sequential engineering-type endeavor that can take you from point A to point B. It’s a mistake not to do it.

When we teach things like good architecture or proper database design, many times we view the developer as the center of the universe and the engineering practice as something that’s completed in toto before any other work can occur. This has caused tremendous pushback from Agile teams, rightly so, because it creates handoffs, bottnecks, and unecessary documentation. But are we overreacting the other way? Isn’t there a place for long-format, sequential, detail-oriented work, even in Agile teams in complex domains? Especially in Agile teams dealing in complex domains?

Each of these has a few areas in common: 1) they’re about more than the work directly in font of the team, 2) they’re about having the experts, the team, assist the organization in its work, 3) they’re sequential, 4) they build on themselves as work gets done, 5) they’re not the work itself, and 6) they end up discovering things for the PO and the organization that wouldn’t be discovered otherwise. Because of these attributes, they tend to “fall between the cracks” when teams adopt Agile practices. They are traditionally part of what people employ engineers to do.

How about you? Are there engineering processes you miss seeing in your Agile teams? What are you doing to make up for it?

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WLS 22 – How I haven’t really lost anything in the past month

My last post was about losing 100 pounds in roughly five months. This post is about not losing weight.

Easy come, easy go.

I’m not sure why I’ve plateaued for the last month or so. They told me all along this would happen. “Your body will get used to the surgery” some said. “You have a natural weight that you will gravitate towards” said others.

Meh. What do they know? Don’t they realize I have plans! I’m supposed to lose another 40 pounds, damnit!

So here we are.

What to do now? Looks like there are four options.

1) Do nothing. Continue on with the plan. Exercise, use the 30-30 rule, and pre-measure your food. Even if you don’t lose any more weight, a few months of getting in the habit of eating right for this weight is a big win.

2) Do something radical. Some WLS patients do a “jump start”, where they go back on liquids for a week. This helps their mind reset portion sizes, and gives their body a bit of a shock. Then they add back in the foods, just like the first time around.

3) Measure everything. Write down everything you eat daily for a week. Look up the calories. One of the nice things about the previous six months is that I really haven’t been dieting. Sure, I’ve been severely restricted in what I can eat, but it’s not like I sat around counting points all the time. Do I really want to get back on the dieting and obsessing bandwagon again?

4) Do the same stuff, only different. Stop it with the elliptical everyday — forbid myself from using it — and only run and ride the bike. Move to liquids-only in the mornings, then solid foods the rest of the day. Do stuff that doesn’t change my activity or intake levels, but presents it to my body in a different way. Did I mention I still haven’t started running regularly yet? Sigh.

I probably should do #3 or #4, but for the next week I think I’m sticking to #1. I have a blood test on Wednesday, Thanksgiving on Thursday, and I’m back to the doc for the six-month checkup a couple of weeks after that. That’s probably a good time to go over my options with the doc and nutritionist and make a decision. After all, the “magic” part of my weight loss is over with. I’m going to stay around this weight and clothes size whether I start losing moderately or just stay the same — as long as I don’t go beserko off the program. So there’s no fire we have to put out. Remember, I got into this for the ten-year results. I have time.

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WLS 21 — I lost 100 pounds in 5 months

Weight loss surgery: the good, the bad, and the ugly

Weight loss surgery: the good, the bad, and the ugly

Posting the title today, it makes me feel like I’m part of some late-night infomercial. I lost over 100 pounds in five months! And you can too! Just buy my book, “Eat like a pig and gain all the weight you want, them have them chop your stomach out”

Act now! Supplies are limited! lol

People say that weight loss surgery (WLS) is “taking the easy way out” or “cheating”

Not so sure about that.

First, if you are overweight and killing yourself, what does the word “cheating” even mean? That you’re supposed to die rather than do something to save yourself? Saving yourself doesn’t sound like cheating to me. And what part of undertaking major surgery is “taking the easy way out”? I spent three months at home being sore and eating mushy food. I’m going to be on dietary supplements my entire life. The nutritionist says there are things I will never be able to eat again. I basically have a self-inflicted wound that’s something like most folks used to get in a war. Which was the easy part?

Yet for many it all boils down to 1) how much weight you lost, and 2) how fast you lost it. The first month I lost 45 pounds. That’s freaking incredible. Looking back on it, I’m still not sure I can make sense of what happened. I used to wear a size XXX Large. Now I wear just a Large. I used to worry about breaking chairs when I sat on them. Now I sit on the edge of a table and don’t think too much about it. I used to have sore muscles simply from standing and walking around for an hour. Now I can stand for several hours at a time without problem. Maybe run a mile or two when I’m done.

I’m the incredible disappearing Daniel.

I guess from the outside it does seem like cheating, or like magic, to have such a drastic change in such a short period of time.

It’s weird. Body language is all different now. I went to talk to my youngest son the other day and, joking around, stood arms akimbo and made some silly statement as part of a joke. Then I realized: hey, I can actually pull of the arms akimbo thing seriously without necessarily looking silly. I can maneuver around things much easier than I used to — don’t bump into stuff so much. I also can fit in easily and stand as part of a large group, instead of having to stand back a ways to keep from bumping into people.

At my 1-month checkup, there was a lady in the waiting room getting her 12-month checkup. Several of us started talking about how much weight we had lost. I said I was down 40 pounds. She kind of smiled and said “You know, it slows down. Those first few months you’re losing like gangbusters. But it doesn’t work that way later on”

Now I’m beginning to see what she meant. Over the last 6 weeks or so, I’ve gotten into the pattern of losing one week, then holding steady the next week. So one week I’m all happy and kicking butt and taking names. The next week I’m down in the dumps ready to give the whole thing up. Even though I feel like I’m doing the same thing.

What I’m finding out that I can’t change is this: we focus too much on weight, both as surgery patients and as a country. I was more happy about my weight when I was fat than I am weighing everyday and fretting over whether I’m losing or not. Even though in general I’m extremely more pleased with life in general without all the extra baggage to carry around! Life is about more than a number.

Need to make peace with this issue without either ignoring it or obsessing over it. I think getting out of the house and working with clients is helping a lot. After the holidays I I’m going to move my billable hours back up to 40+ hours per week. Get on the road and away from the scales during the week.

I realize that I’m very lucky that I work for myself and am able to flex my schedule. It also helps that I have disposable income to handle a lot of the money stuff. I didn’t expect that. Even with insurance, weight loss surgery has been expensive. There’s been vitamins, special foods, medicine, gym memberships, and sports drinks. I think you can get by cheaper, but it’s been nice to be able to try to deal with just the WLS stuff, instead of trying to deal with that and pinching pennies too.

Clothes have been an especially painful chore. You’d think it’d be fun to lose weight and have new clothes to wear, right? And it is. But also can be quite a hassle. I’ve kept all of my clothes over the years, so I have big plastic boxes of stuff in a storage building of all sizes. The trick is getting them all out and going through them.

So you dig out six or seven huge boxes and start sorting clothes. A good start is sorting by waist size, but as I’m learning, clothes manufacturers lie about clothes sizes to make people feel more skinny than they actually are. As a guy, this makes no sense at all to me, but that’s the way it works.

Fashions change over time, and what you need to wear changes, so even going through all the old clothes doesn’t necessarily make you have a new wardrobe. I went from size 52 pants to size 48. Then 46s. Then 44s. At the 44-inch waist size, I started running out of good dress pants and jeans. So I ordered new 42s when I reached that size. Some of the 42s were big, some were snug. They were all from the same manufacturer and were the same exact clothes, just different colors. Yet each fit completely different.

Now I’m down to 40s and it’s time to buy more jeans. I think I’m completely out of dress clothes. Hopefully with my weight loss slowing down this latest purchase will last a couple of months or more. But then again, I don’t want them to last too long! I still have a ways to go. Will I make it to 38s? 36s? Who knows? Wouldn’t it be good just to get it over and stabilize?

It was really cool finding stuff I hadn’t worn in 10 or 15 years! Some of those shirts I really missed, perhaps much more than my family did. I had forgotten that I got too big to wear them. And it kinda sucked only having a few weeks to wear some of that stuff. Some of those clothes I went through, sorted, tried out, found, remembered how much I loved them — then never actually had a chance to wear them. Now they’re already too big. Yikes!

Getting into this, I realized that I would be in for a long and bumpy ride over the next year, but it’s been weirder and bumpier in some ways than I have imagined. I’m really glad I did it, but I’ve also found that I’m a fundamentally different person than I used to be. I have a different attitude, I react to stress differently, I do things differently. I miss parts of the old me, and, like a swimmer testing the water with his toes before getting in, I’m cautiously experimenting with bringing back some of the parts I used to like a lot.

Many of the old bad habits are still there too, of course, lurking in the background. I’ve had stomach surgery, not a mind replacement. It remains to be seen whether any of this will last for a long time. I have to keep reminding myself, and others, that it’s normal to lose a lot, then regain some, then lose it back. Many gain it all back. A sizable chunk keep most of it off. Both in weight and lifestyle, I wonder how much of the “old me” will come back — or how much I want it to. But it has been a most enjoyable ride so far, and I’m extremely pleased I took it. Even with all the complaining. Because hey, if you’re not complaining, what fun is doing stuff?

If you've read this far and you're interested in Agile, you should take my No-frills Agile Tune-up Email Course, and follow me on Twitter.

WLS 20 – RNY 20 Weeks out

Been an interesting last couple of weeks.

First, my weight loss has slowed or stalled out. I’m not sure if this is normal or not, but, frankly, it sucks.

I’m getting back into the swing of things in my work. I’m involved more, have more energy, I’m doing more things that are mentally stressful, and I’m traveling, speaking and keeping my schedule off-balance enough that it’s difficult to stay in a routine. Usually when I’m busy and stressed, I just go through a drive-thru, pick up a 2,000 calorie meal, and absentmindedly eat it while watching Oprah or something. That don’t work any more even if I wanted it to. Of course, I’m sure I could always still try to make it work. With enough practice, I could probably end back up where I started.

I have increased my intake. While I don’t get the overpowering physical hunger like I used to, I do feel a kind of emptiness in my pouch that’s like hunger. Enough that it calls me to eat. I believe this is a result of my blood sugar dropping.

The bad news is, without a valve at the bottom of my stomach, I’m basically eating directly into my small intestine. This means, I think, that my blood sugar should be even more sensitive to spikes than it used to be. Kinda seems like a step backwards, eh? So my guess is that watching sugar intake for a RNY patient is very important.

So what I ended up doing last week is eating a protein bar sometime within the 2 hours after I’ve had a meal. I’m not sure whether to count this as another meal or not. Should I use the 30-30 rule? Or is it just a solid version of a protein shake. So I haven’t been paying attention one way or the other. Sometimes I do the 30-30 thing. Sometimes not.

So that adds 600 calories to my daily diet right there. It probably puts me around 1400-1600 calories a day — 600 from protein bars, 360 from protein shakes, and 600-700 from three meals.

I’m just not going to worry about this. If I’m hungry, I need to consume something. Protein or water really are the two choices here. Perhaps I should be drinking more water. Don’t know.

The other piece of bad news is that I have decided I hate my exercise program, which basically consists of getting on the elliptical machine several times a week.

In my life there have been several things that I find I have a hard time hating. These are usually things that people tell me are good for me, that I know I’m supposed to like, that I really want to like, but that I just can’t stand. So I end up doing this thing where I keep telling myself that I “want” to do something, then I half-assed do it, or I put it off, or I quit too easily.

Last week I found myself just not caring about my workout anymore. The week before I had moved my target pulse up a bit, and increased my workout time to 65 minutes. It was enough to get me a bit winded, but it didn’t seem too bad. Then, after a few workouts, I just lost interest. I’d get on, go for 10-15 minutes, then just not feel like doing it anymore. Usually the toughest part is the first 20 minutes, where your body is first adjusting to the intensity, but heck, even after 30 or 40 minutes I’d be ready to get off. I wasn’t feeling like I was getting anything accomplished. Just standing there sweating. It was like being on an endless treadmill that stretched out as far as the eye could see. A lifetime of standing in one place and sweating while I played cards on my iPad.

Not so much.

So I gotta mix it up some. Take a class. Start jogging. I really, really, really need to shift gears. But for now, I’ll probably just go back to the elliptical. Bah.

On the good side, my energy levels are coming back close to normal, and I’m getting to an understanding with my lower bowels. We have had our problems in the past few months, but plenty of liquids and more solid foods seems to make things fine there. Enough said.

So with all of that negative energy, I was pretty down about the whole thing the past couple of days. Five weeks ago I was 220 pounds. The next week? 219. Then I was 217. Then last week 217 again. Then the exercise problems began. My eating increased. It was not looking too good. I was really tempted to start drinking caffeine and alcohol again. Tea in the morning and a few drinks on Friday nights. These things helped me maintain an equilibrium. But they also were highly influential in making me eat too dang much.

Did I mention one of my clients is one of these new high tech companies? They have an open kitchen with all the food you could want to eat provided — free. There’s beer in the fridge. There’s a popcorn machine. I was looking for salt the other day and found an entire cabinet dedicated to fine teas. Yikes!

Not. Helping!


So I resisted the urge to go back to bad habits. At least for now. I made it home, hit the sack, then got up this morning and weighed.

I was down 4 pounds, to 213. That’s a total of 7 pounds over the past four weeks. Not terrific, but about 2 pounds per week. A few months of that and I’ll be at my target weight, plus 2 pounds a week is actually an optimum rate to lose. Perhaps I really should be easier on myself.

I think it’s easier for you, the reader, to consume this. You’re probably reading from the distant future. You already know how it’s all going to work out. “Oh, this is chapter 20 in the book where the guy loses 150 pounds” you might think. Gee, don’t know what the big deal was. He simply had a plateau for a while. Or you could be thinking “This is the blog entry for that guy at work. You know, the one that lost all that weight then gained it all back? Looks like at one point he was almost 210 pounds. Wonder what the heck happened to him? Guess some people just aren’t ever going to get straightened out, huh?”

From the future, this is all fairly simplistic, even trivial. What was this schmuck obsessing over so much, anyway? Doesn’t he know that he gets hit by a bus the following month? All that worrying and fussing isn’t going to change anything.

Living it, however, is a different can of worms. I didn’t know until this morning that I had lost 4 pounds over the past week. Before I got on the scale, looking at all the eating I had been doing, and the lack of exercise, my best guess was that I had gained between 1 and 2 pounds. When I saw the loss, I was as surprised as I could be. Now, of course, I can say “Sure was great losing those four pounds. Sometimes you just have to take a break from exercising and let your body catch up” But 1 hour ago it was a different story.

Things always look different in hindsight, and there are many things we do not understand about weight loss, no matter what the books and TV shows will tell you. So I think it’s always going to be a struggle. I’m just not sure I want to spend my life struggling so much.

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WLS 19 – 18 weeks out from RNY

Daniel Markham

18 Weeks out. Daughter Katrina enjoys grabbing all the skin around my face and making funny faces with it

The last three weeks or so have been pretty much a slog on the weight loss front. I’m losing about 2 pounds per week instead of 3, and I’m eating more sliders. Still sticking to the 30-30 rule, though, and I manage to eat less when I pre-measure everything. Still, I’m not doing as well as I used to.

The temptation is to blame exercise, which I missed quite a bit last week. If only I exercised more! I’ll think, and then plan out some brutal week of hard workouts to make up for things.

But if there’s anything at fault, it’s my eating more, which, I have to say, I like.

It’s great to have more physical food in my digestive system. I don’t think the nutrition value of the food matters much at all. It’s just nice to have volume. So I’m eating about a cup of food three times a day, usually a half-cup of some kind of vegetable/protein, like beans, and then a half cup of fruit or berries. I’ve also upped my protein supplements up to close to 100 grams daily. And I’m shooting for 4 liters of water, although I don’t always get this much.

As disappointed as I might feel at times, I have to remind myself that yes, I am still losing weight. And 2 pounds a week is probably a much more sustainable and healthy loss than that crazy 5 or more pounds a week I was doing there at the start. The trick is keeping things going at this rate.

Weight loss is a crazy thing. You are fighting your natural inclination, which is bad, and you are dealing with a system which you don’t understand, which is also bad. This kind of obsession could make you crazy. If nothing else it will twist your thinking.

I’ve also had to come to some kind of conclusion regarding my opinion on dieting. While I’ve tried a bunch of diets, I came into this thing not wanting just to diet all over again. On the other hand, I definitely don’t want to be one of those guys that gains it all back. So how to reconcile these two feelings?

My decision is twofold: 1) I will get into the habit of putting my food in containers ahead of time and eating only what’s in the container (mostly, aside from the weird social situation like a reception or party), and 2) I will discipline myself to the 30-30 rule. No snacking, and no liquids 30 minutes before or after eating.

Other than that I’m going to follow doctor’s orders, but I’m not going to get too wrapped up around the axle. In other words, I am not going to obsess over small details. Odds are I will stop losing at some point. Hopefully I can go another 30-40 pounds, but who knows? The important thing is to find a new system that can last ten years, not reach some arbitrary goal. I figure learning to package my food ahead of time and eating in a certain way doesn’t constrain me too much. After all, there are plenty of other habits and disciplines I’ve gotten into, like packing for a long trip or shaving every morning. This is just something else like that; something to be learned and practiced.

People might wonder what it’s like to have a stomach the size of an egg. How can I eat a cup of food? Well, it’s a funny thing. If I were eating a dry, chunky food like chicken, I could probably eat just enough to fill my pouch. Then I’d be full. But by eating “sliders”, the food just slides right out of my pouch and into my small intestine, so really there’s not much of a limit. I could sip on chocolate milkshakes all day long, drink gallons of the stuff. Sure, I’d weight 300 pounds again, but it’s possible.

Do I feel hungry and want to eat more? Not really. That’s also a funny thing. No matter how much I eat, it seems to fill me up. Yes, it’s easy to get into the habit of eating the sliders and such, but I know that if I went back to liquids for a few days, I could start right back over at a quarter cup a meal again. I’m not eating due to insatiable hunger. I’m eating more out of comfort and habit.

I had some unplanned eating events in the last few weeks that underscore this. One of the places I’m working with routinely feeds its folks on Fridays. They bring in some kind of buffet. Because I want to be a polite guest, I figure I should eat with the people I’m trying to help. So a couple of weeks ago I line up for a great lunch. There was chicken casserole, beans, and so on. Then I went and sat down outside to mingle.

Now with dry food like that, even a half a cup is pushing it, but I knew to chew my food carefully and listen to my body for signals it was time to stop. What happened, though, was that some really interesting people joined the conversation around lunch. We started talking about all sorts of fascinating stuff like hobbies, political views, and so on. I was engrossed in trying to learn more about their world.

And I found that I could not stop eating.

Somehow I have learned to associate nervousness with eating. So when the conversation lulled, or I had nothing to do with my hands, I wanted to find something, anything, to put into my mouth and chew. Even after I ate as much as I needed (of course my plate was full, one scoop of three items will fill a plate). So I’d pick at my food, pull off a little bit, and chew it. It gave me something to do while listening. It was calming.

And I ate too much. My pouch filled up and started to spasm. Yikes!

But hell, even then I kept going and ate 2-3 more tiny bites over the next 5-10 minutes. I just wanted to be doing something while engaged in conversation.

By the time lunch was over, I was in terrible pain. I spent the rest of the afternoon feeling like I wanted to throw up. If I didn’t consume anything, the pain was manageable, but the minute I swallowed anything the nausea would come over me in a terrible way. The pain kind of subsided for a bit, so I started chewing gum and went to a meeting. Ooops! Not so much. About ten minutes into the meeting I felt like barfing, so I ran to the bathroom. But no luck. Just a lot of spitting.

I waited for an hour. The pain subsided. So I tried sipping water. After a couple of sips, back with the nausea again. My body was not happy! Hello Daniel! We have some serious complaints down here! Are you listening?

Went out to the car, found a whole plastic bag of Papaya Enzyme, and ate all of them — about 30. Still no luck. I drove home feeling like I was going to throw up. It was not a pleasant experience.

Once I got home, I made some hot tea and sat down, prepared to drink all of the tea no matter what. If I threw up, then so be it. Something had to give somewhere. It’s impossible to live if you can’t drink or eat! While I knew in my heart the problem was going to work itself out one way or another, I still had to recognize that if it went on for more than a day I’d need to go to the hospital. That kind of gets your attention.

I sipped about half of the tea and the nausea hit again. I ran to the bathroom and my stomach convulsed, but I didn’t throw up.

That one convulsion must have shaken something loose because that was it. The pain was gone. I was fine after that.

So a week later I’m in the same exact situation. I’m at a dinner party before a conference I’m speaking at. It was a great dinner. All kinds of foofy food. I made a plate again, and again I sat down and started having a great conversation with some folks.

This time, however, I remembered the pain from last time. Once I started feeling full, I covered my plate up with my napkin and physically pushed it away. Even then, that would not be enough. I know myself well enough to know that I’d soon start picking at the food again as the conversation progressed. Fortunately Melissa was there, realized what I was doing, and took my plate to the trash while I continued talking. That’s what having a good wife will help you with!

Yesterday it happened again. Another catered meal at my client site. Another great conversation with one of the folks there. This time it was fried chicken, mashed potatoes, and green beans. (I skipped out on the rolls, pies, macaroni and cheese, and other stuff!) I really enjoyed the flavor! And the conversation was going well also. But sure enough, not five or ten minutes into the chat, I was full. There I was with a plate 90% uneaten, and my pouch was telling me it was time to stop. So I smiled, said “You know, this is extremely good food, but I’m completely stuffed. It was great talking to you!” and excused myself. Crisis averted. I dumped a full plate of food in the trash can. Felt like I was committing a terrible crime doing it.

Interesting thing about that is that 20 minutes later I still felt a little hunger. So I ate a protein bar. Much better to complete my lunch with protein than do a repeat of the eating too much experience.

Writing all of this, it occurs to me that maybe I haven’t been doing so badly after all. I am learning quite a bit — my pouch is helping me out, whether I like it or not. I’m learning why I eat, I’m learning some ways to control things. I’m also learning how easy it is to screw up, even with a modified digestive system. It’s not all stuff I want to know, but it’s stuff I need to know.

But I still feel uneasy about all of it, as if I’m resting on a house of cards that’s bound to crash sooner or later. From reading other folks who have had this surgery, this is a very common feeling.

If you've read this far and you're interested in Agile, you should take my No-frills Agile Tune-up Email Course, and follow me on Twitter.

WLS 18 – Running my Ass Off

Two things happened this week. I ran, and my ass fell off.

First the running. On Saturday I went to the gym with my wife. I am getting tired of the same old machines all the time, so I thought I’d try something different. Ever since I started planning for my surgery, my dream has been to be able to run like I could when I was younger. Running when you’re heavy is a very tricky matter. Sure, I could run for short distances, but long-term running was out of the question. Or, as I told my exercise guy at the surgical group, until I lost some serious weight the only thing I was going to do was blow out a knee. Your joints can only take so much stress.

Now that I’ve been losing, the question is “When do I start running?” If I start too soon, I could end up with injuries. But if I wait too late, I may never start. I kept putting off starting, and I’m the world’s best procrastinator.

Saturday was the day — or at least the day to test the waters.

I started in on jogging, figuring that I’d do a very easy jog as long as I felt comfortable. No trying to run as fast as I could or none of that nonsense. Just loping along. I had a heart rate monitor so I could keep an eye on how I was doing.

Turns out I did pretty well. All that hiking and working out on the elliptical machine, along with this new naturally low heart rate I have, made me able to run for a while without my pulse getting too high. I made it easily over a mile — maybe close to a mile and a third — before I quit. At the end I even tried out a runner’s “kick”, where you sprint the final little bit before the finish line.

Wow! Didn’t see that one coming! I can run!

Still, I’m going to play it cautious. Even with my weight loss, I weigh 30 pounds more than I did when I was a young whipper-snapper, and old bones and muscles aren’t as limber and flexible as young ones. I’m thinking once a week I’ll try running under very controlled conditions — inside, soft track, and so on. After losing another 20 pounds, say in 2 months, I’ll move it up to 2-3 times per week and take it outside. But for now, there’s no rush. Just little baby steps. I’m in no hurry to get laid up for months with a sports-related injury, especially now!

The other big thing that happened this week was I noticed my ass fell off. I found this most disturbing.

One of the things people dread the most when thinking of weight loss surgery is looking like an old bloodhound. You know, they have a really wrinkly face, and these huge flaps that hang off from their arms and belly. Going into the surgery the docs are pretty clear on the fact that you’re there for health reasons, not cosmetic ones. The goal isn’t to get you looking like a superstar model, it’s to allow you to live an extra 20 years that you might not get otherwise. If you live that time looking like you need ironing? Well then that’s just the price you pay.

So I was clear on the terms going in, but I still wondered how it would all play out. Would I look all wrinkly? Would I have these huge skin flaps hanging off of me? Would my face look like a bulldog’s?

Walking around the house last week, my wife said “you know, your butt has fallen off”.

I found this a rather unusual thing to say, so I went to look in the mirror. Sure enough, instead of a large butt that stuck way out and knocked over lamps, it looked like somebody had pulled the plug out and my butt just, well, deflated. Instead of a bunch of cushioning, I had wrinkly skin.

I lost my ass.

I’m also seeing extra skin around my middle section, which isn’t unusual since I’m losing a ton of pants sizes very quickly. My face also looks completely different than it used to. And this jives with what I’m hearing from my online support group: people notice their weight loss first in their faces and then in their butts.

Losing your ass, as you might imagine, can be very uncomfortable. I put a wallet in my back pocket and after driving for an hour my butt hurts. Same goes for sitting on hard wooden chairs. Without that normal rear bumper, it can hurt when you sit.

I still have no idea how this will all turn out. For some folks with serious skin flap issues, more surgery is required to get rid of it. The doctors usually want you to wait a year or two after you’ve stopped losing weight, just to make sure you’re not going to gain a bunch back and that the skin flap is staying. Also there are insurance requirements to consider. Most insurance policies will not cover having skin flaps removed unless you can show several months of recurring rashes and skin problems associated with them. Finally, they say having excess skin removed hurts like the dickens. I’ve heard people say it was worst than the weight loss surgery itself!

I’m hoping that the skin around my waist will get reabsorbed into my body as I continue to exercise. My face should work itself out also. But my butt? I may just have to get used to having a skinny butt (in reality a flat butt), and not worry about it. After all, I’m a guy. I think the last time I looked at my butt was 1980.

Now that I’m busy running my ass off, maybe I can start running my stomach off too!

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Weight Loss Surgery 17 – back to work

This week was “Back to Work” week. I was on-site with a client most everyday. This meant traveling out-of-town, living in an hotel, and trying to make a good impression while meeting a bunch of new people.

In short, a stressful week.

I did well, though. I think because of three things.

1) I planned ahead of time. Before I left, I packed my vitamins AND my meals for the entire time I was there. That’s right, 15 meals, all in a big bag. Good thing I bought those containers earlier, huh? This way I was able to measure out everything. There wasn’t an opportunity for me to go “off the menu” and do something stupid. I simply kept eating the things I was already eating at home.

2) I exercised every day. Every morning I went to the nearby gym and did something, anything. Some days it was the treadmill, some days it was the stepper. I didn’t care about intensity level or anything. I just wanted to spend an hour working up a sweat. I’ve found that when I work out, it increases my ability to handle stress throughout the day, and I was going to need that ability.

3) I found something to do with my time I would normally spend eating in the evening. Usually when I travel, after work is a special time for me. I go back to the hotel, or go out, and I can have whatever I want. Over the years I’ve gotten into the pattern of getting stressed out during the day, then “relaxing” by overeating after work. I didn’t want that option this time, so in the evenings I went for walks on the local trails. (I was lucky to be in a town with lots of pedestrian trails). This kept me busy, got me outside doing something healthy, and was more fun than staring at the hotel walls.

It must have worked fairly well, because when I weighed today I had lost 7 pounds. If you’re keeping track at home, I’ve been averaging a little over 3 pounds per week for several weeks, just like clockwork. Last week, though, I didn’t lose anything. So instead of obsessing over the scales this week, I spent the week helping other folks and doing my thing. I kept on slogging away, and my weight took care of itself.

Today was also a big day because I went to my 3-month post-op follow-up. The nurse practitioner is a nice guy, and he asked some standard questions and looked at my bloodwork to make sure I was getting the appropriate amount of nutrition. My B12 and D levels were high. B12 isn’t much of a problem — a little too much and your kidneys will filter it out. D is more troublesome. Too much D can be damaging. So I’m laying off the D for a while.

In another 3 months I go back with more blood test results, see him, the nutritionist, and the exercise guy. They’re all great folks, but I kind of feel like I’m reaching the end of how much they can help me. It’s really all up to me now. A few more visits over the next year or so and then I’ll probably transition to follow-up work done by my local doctor. I have to admit, if the hard part is reading numbers on a lab test and adjusting my intake to make them normal, I’m not sure why there has to be a doctor involved at all. I should be able to just order my own tests and make my own adjustments. I may look into this.

The NP asked me, “So how does it feel to have lost 80 pounds in just over 3 months?”

I thought for a moment.

“I hear surfers say that the coolest part of surfing is waiting in the water until just the right moment, then hopping up on their board and realizing they’ve caught a great wave. I feel like I’ve caught a great wave, doc. I’m just riding it to see where it takes me”

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