Category Archives: Health

The good and the bad…

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Last week I had my standard cardiology follow up. The good news is that we continue to observe nothing abnormal. The bad news is that we’re no closer to identifying why my heart went wonky a few times nearly 18 months ago. I’m beginning to think this could be one of those unfortunate unknown unknowns that I’m just supposed to learn to accept. 

Acceptance of “what is” has never been a particularly strong suit for me, but since we’ve basically run out of non-invasive tests, options are a bit limited. It was made very clear to me that a consult is only a phone call away, but unless old symptoms reemerge or new ones develop, I’m to check in year hence for a follow up. 

I know I should absolutely treat this as a no news is good news situation… maybe I will eventually. At the moment I’m still trying very hard just to wrap my arms around the idea that I am, in fact, a mere mortal after all. One thing at a time, I suppose. 

In more important news, doc cleared me to start easing back into the world of caffeinated beverages. It turns out I can take or leave getting a morning jolt of fully caffeinated coffee, but I’m really, truly appreciating the return of a proper cup of mid-afternoon tea. My days of burning through two pots of coffee a day are probably over for good, but it’s an awfully nice option to have back on the table. 

Feeling salty…

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Other people go over the moon for chocolate or other sweets, but it’s always been the bag of potato chips or bowl of pretzels that’s been my weakness.  Being on this damned diet hasn’t changed that in the least. If I’m having a craving, 99 times out of 100 it’s for something salty rather than sweet. That has been a unique challenge while trying to keep my daily sodium intake somewhere close to the AHA’s recommended daily allowance. You don’t realize how sodium heavy everything is until you really start tracking it relentlessly. 

I find I’m just now arriving at a place where I can have a bag of Doritos or salt and vinegar chips in the house and reliably hold myself to a one ounce “serving.” Some days – yesterday, for example – all the counting in the world doesn’t make much difference. Between my morning bagel, 100 grams of ham salad at lunch, and a cup and a half of beef stew, my sodium content for the day was shot to hell. Believe me when I tell you it doesn’t take much for the day’s allowance of salt to slip entirely off the rails.

Fortunately, I don’t seem to be one of the people whose blood pressure responds absurdly out of proportion to sodium so my reading this morning didn’t go stupid. I have, however, noticed that weighing in after a high sodium day easily packs on 1% or more of my previous day’s body weight. That’s an absurd increase while still being in a nominal calorie deficit. Sure, I know in the next day or two I’ll literally piss that water weight away, but goddamn if I’m not feeling just a little salty about it.

Anyway, I’ve been doing this for almost a year and a half now and there’s honestly none of it where I would look back fondly and say, “yes, I was having a good time.” As long as the status quo holds, I continue to be willing to trade flavor for a promised increase in yardage. Should the status quo change, rest assured, all bets are off. 

Shit in a box…

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I’m not going to lie, one of the things that has changed unexpectedly since I turned 45 has been how often I’m required to shit in a box… for science. Admittedly, the total number of times that’s happened in the last 15 months is twice, but that is exactly two times more often than it happened in the previous 45 years, so it feels like a significant deviation from the norm. 

The first of these experiences was to check for any underlying gastrointestinal issues causing my acid reflux. The second was as a screening tool for early detection of colon cancer. Both are worthy objectives and I support the goal entirely. That doesn’t make it any less weird when you have to spend some part of your morning packaging up your own shit and then driving it over to the nearest UPS store. There’s something intensely surreal about the whole process.

Despite the warnings that “things change after you hit 40,” I’ll admit I was entirely unprepared for some of what that was going to entail. In some ways, regularly shitting in a box and then posting it off for someone else to analyze is, perhaps, not even the strangest part of this brave new phase of life. I’m equal parts curious and terrified of whatever comes next.

Again with the Great Plague…

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Last week, I suffered through my second round of the Great Plague. This iteration of COVID wasn’t as awful as the one that knocked me on my ass last fall, but all the same it’s still not something I’d recommend for someone looking to have a good time.

The butchers bill for this round of sickness seems to have been the loss of two weekends and lots of hacking and wheezing and generally stuffiness. I did have an easier time getting my hands on antiviral meds, which means I got to start them on day 2 of symptoms instead of day 5. I assume that has something to do with how quickly the worst of the symptoms dissipated. 

I’m still a touch congested and I certainly get played out a lot faster than I did before getting sick (again). I’m happily testing negative now and otherwise seem to be on the mend. I can’t help but reflect that these bugs were a whole lot easier to avoid when I was allowed to embrace my inner hermit and everyone was legally required to stay at least six feet away from me. In my heart of hearts, I’ll always kind of miss those halcyon days of the early pandemic before we knew what we were up against and staying home was the order of the day. 

One thirty down and I have some thoughts…

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It’s been just about a year since I made the conscious decision to get my weight down towards something that wouldn’t trigger such a serious lecture every time I walked into a doctor’s office. Realizing that I was, in fact, both destructible and well past the demographic definition of middle-age gave me a level of motivation I’d never had before. Score one for the motivating power of fear and self-preservation. 

In any case, dropping 130 pounds over the last year hasn’t exactly been an adventure. I’m agitated every day about the foods – and lifestyle – I had to give up in order to achieve what would be easy to assume was purely a vanity exercise. I won’t pretend I don’t have my vanities, but none of them have ever been tied to my appearance, which is probably for the best.

I’m sure when I wander back to my doctor for my next scheduled checkup, he’ll make all the appropriate approving noises. My most recent bloodwork came back with significantly marked improvements over its historic baseline. Even if we haven’t gotten to the root causes of what was causing my heart to ramp up to a sprint of its own accord, it’s hard to argue against my innards being healthier than they were a year ago. 

What no one mentioned as they encouraged me through this process, though, was all the minor annoyances that would accompany this process. I just did my second cull of the clothes hanging in my closet and came to the unhappy realization that I only have eight shirts and two pair of pants that fit now. The rest – some of my favorite shirts mind you – are now comically oversized on my new frame. 

I’m going to have to take some time during this little Independence Week vacation for clothes shopping. I spent time doing that already this spring. This means I’ve spent more time shopping for clothes in the last three months than I have in the last three years. In fact, it will probably account for more time than I’ve spent shopping in the last decade.

I used to know the brands I liked and the appropriate sizes. It was easy enough finding them online and reordering as needed. Now, every damned shirt is a roll of the dice. It’s an enormous pain in the ass and feels a little bit like adding insult to injury. Sure, I’ll do it because wandering around naked is frowned upon by western civilization (and winter is coming), but there’s no power in heaven or earth than can make me enjoy the process. 

It’s been a very strange year…

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It’s just a few days shy of the one-year anniversary of experiencing the still unexplained tachycardia that started me down what feels like a very long and often unfulfilling series of medical appointments and major life changes. As June 28th looms larger on the horizon, I’m still not sure what to make of the experience. Maybe it’s not surprising to anyone else but learning that I am not actually indestructible came as something of an unwelcome surprise. 

I won’t say that I ever considered myself particularly healthy, but I always felt robust and strong as a bull moose. I rarely gave much thought to my physical limits. This experience has forced me to confront both human fragility and the illusion of invincibility I once held. Every medical appointment since has been a reminder of my body’s unpredictability, and despite numerous tests and consultations, the cause of my tachycardia remains elusive. This uncertainty has become a constant background noise in my life.

Each day carries a mix of hope and frustration, as I swing between optimism that the next appointment might bring answers and the annoyance of another inconclusive result. It’s a challenge to remain patient and positive when the path to wellness feels never-ending. Often, the struggle between my own ears is as or more problematic than the physical one.

As June 28th approaches, marking a year since this parade of fuckery, I find myself reflecting on the life changes that have accompanied it. Adjusting my lifestyle to accommodate both the knowns and the unknows has meant altering routines that felt as natural as breathing. From dietary changes and new exercise regimes to prioritizing rest and stress management, the shifts have been both major and minor but always impactful. The experience has reshaped my understanding of health and well-being and the surprisingly delicate balance required to maintain it. 

A year later I wish I had better answers than, “well, as long as the incidents aren’t recurring, keep doing what you’re doing.” Patience in the face of uncertainty has never been one of my strengths. This experience hasn’t improved that at all. As I gain some distance from the events that launched this ridiculousness, pondering on what it all means and what’s going to happen has receded to manageable proportions rather than filling a dominate place in my daily thoughts. That has gone a long way to letting me make the mental leap to getting back to what now passes for normal.

The post in which I don’t bitch about health insurance…

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I know the hip thing to do is bitch about health insurance and the American medical system on social media. There seems to be an entire cottage industry dedicated to telling us how awful everything this. My experience over the last year has been the polar opposite of the narrative I’ve seen being pushed across the internet. 

About a month ago, I got a notice that BlueCross didn’t want to pay for my 30-day heart monitor. Frankly, with the $10,000 bill associated with it, I didn’t exactly want to pay it either. But, as it was “not medically necessary,” according to their note, they weren’t going to pay. That’s despite two cardiologists deciding that that level of monitoring was, in fact, medically necessary. 

After several long conversation with me – and presumably even longer discussions with people representing the hospital system and the test provider, it looks like BlueCross ended up paying out about $3,000 as the “insurance rate.” I just paid $36 as my portion, and everyone now appears to be satisfied that they’ve done their due diligence and has gotten a fair shake. 

I honestly was expecting more of a fist fight on that. Who really knows? It may yet come back to rear its ugly head, but for now I’m considering it a win.

Look, I’ve learned a lot about health insurance in the last year. It’s not an ideal system. It requires you to keep a very close eye on your treatment plan and everyone involved in it. Even more so, it means staying on top of your insurance provider, knowing their terms of service and the ins and outs of your policy, and questioning everything that doesn’t pass the common sense test. That’s just the baseline starting point to participate in the system. I don’t know that it would be any less complex under single payer. Under any universe of care, I expect that I would want to be very aware of what was happening and the services that were being provided on my behalf. 

Overweight…

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As far back as elementary school, I remember various “tests” aimed at assessing basic health. Is the President’s Physical Fitness program still a thing anyone does? I have some vague recollection of calipers and some kind of devious box we dutifully stretched our hands over to determine how flexible we were. Those and the damned timed mile run were the only tests I never really did well on in school. Gym classes are not among my cherished childhood memories in any case.

I assume the calipers were there to make some measurement of our body mass index. As the years have screamed past, even the AMA has admitted that BMI is not a particularly unproblematic measure of health. The fact remains, however, that it is still what’s used by most of the American medical establishment to apply some statistical analysis to body composition. Like it or not, there is a correlation between high BMI and adverse health outcomes, so it endures.

Here we get to a bit of surprising news. Apparently when I stepped on the scale Saturday morning, I magically qualified to be simply overweight instead of obese. Now, that’s still not medically ideal, but feels like it should be a reasonably significant improvement from ranging into the morbidly obese category. At least in terms of where I fall on someone’s wall chart, there has been demonstrated progress. I’d probably be more impressed if I the net result to date was, “well, I don’t feel any worse.”

The helpful BMI charts online still say I should be somewhere down around 185 to be “normal weight.” I’m still not convinced that is in any way a reasonable target. The fact is, I remain a little sore at the doc for his latest bait and switch, so as far as I’m concerned 200 is the new “final” number. If I can manage to do that without chewing off my own arm, the saw bones just might have to learn to accept a final form of me being slightly overweight and devise his treatment strategy from there.

At some point, likely sooner than later, I’m just going to decide I’ve had enough of this and get on with things on a maintenance level instead of giving a damn about whether I’m losing weight or not.

Bait and switch…

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Back in July of last year, when the medical appointments were coming fast and furious, the doc advised me to, among other things, drop 100 pounds. I weighed in at 330 that morning. I can’t argue that I hadn’t been carrying around too much weight for too long. 

At last week’s follow up, I tucked in about 8 pounds short of the goal. I was feeling reasonably proud of myself for not immediately reverting to old habits the moment I started feeling a bit better. 

That’s when the old boy did a bait and switch on me. 

I know we talked about an even hundred, he said, but I want you to take it down another 30 from there. 

Two hundred pounds flat is where they want me now. I’ve been trying to play along with all this like a good little trooper, but fuck me. 

I was close enough to taste a meal that didn’t have to have every ounce of joy sucked out of in an effort to stay under an 1800 calorie daily limit while not being ravenous enough to ponder gnawing off my own arm. And then they moved the fucking goalposts. 

I woke up this morning with 33 pounds left to drop instead of the 3 I was expecting. Bet I’m not just a little bit salty about that.

Simple concept, challenging execution…

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On June 28th I had an epiphany. Maybe a lot of people do when they find themselves laying on a gurney in their local emergency department waiting for tests to reveal if they’ve had a heart attack. The tests, fortunately, didn’t reveal anything immediately catastrophic, but that didn’t do much to change the simple fact that I felt awful and it was categorically impossible to keep plodding along as usual with all the warning lights that were being flashed for me. 

So, I did what any reasonable person would do… I slashed salt, downloaded apps, poured over internet discussion boards, and scheduled appointments with any doctor I could think of that might help get to the root cause of why I was feeling so badly… and more importantly why my heart occasionally decided to make a big show of trying to thunder out of my chest. Months of tests, scans, consultations still haven’t definitively what was going on with me through the summer of 2023. They keep poking at it, though, so maybe we’ll find out at some point… though as my symptoms have diminished, I’m less optimistic that will happen unless they reemerge and can be captured on one of their fancy tests or scans. If I’m honest, the part of me that things better out of sight and out of mind is winning out over the part of me that wants conclusive answers.

One of the deals I made with myself laying in the ED back in June was that I would finally head the medical advice I’d been getting for as long as I could remember. I couldn’t control the test results or the lack of official diagnosis of what was happening, but I could, in theory, control my weight. It had to come off and it had to happen in a significant way. As someone who’s life is almost defined by being a dedicated creature of habit, it would be arguably one of the hardest goals I’ve ever set for myself… and one I was being drug too unwillingly by my own traitorous body. 

July 1st I weighed in at 330 pounds. Not knowing a damned thing about weigh loss, I set an arbitrary goal of making it down to 250 by the end of the year. Eighty pounds. Six months. I had no idea if it was doable, or even if my own brain would let me stick with something I hated with a passion for that long. 

I downloaded the LoseIt app, plugged in my vital statistics, and told it I wanted to lose 1.5 pounds a week. It spit out how many calories I should be eating each day… and that’s when I realized I had no idea how to effectively measure food. After that it’s been all weights and measures before anything gets on my plate. If you ever want to take the romance out of food, definitely weigh it all up first.

If June 28th was my epiphany, buying that damned kitchen scale was a light bulb moment. I’d been protesting for years that I wasn’t eating absurd amounts of food. That’s objectively true. What I was eating, however, was incredibly calorically dense. A proper 400 calorie “serving” of lasagna is preposterously small. Same with anything involving cheese, really. Once I accepted the scale, though, things started happening. Yes, I was ravenously hungry all day every day, but the weight came off at a rate closer to 2.5 pounds a week than my planned 1.5. Chalk that up to the limited additional exercise I was willing to program into the day’s limited hours. 

Two months along, I discovered I wasn’t ravenous anymore. I was hungry for sure, but felt decidedly less likely to chew my own hand off. That’s about the time the anxiety I mentioned in last week’s post started to make its presence known. After that it was pretty much a war between my own stubborn determination to lose weight and my brain screaming that something was wrong. We seem, for the moment at least, to have concluded that particular war. I’m particularly grateful to that particulate respite.

What have I learned? Well, for me, losing the first tranche of weight was simple – radically decrease the number of calories going in while moderately increasing the number of calories burned. Calories in, Calories out as the people in the forums are fond of saying. The catch is, although the theory is simple, not a single part of it is easy. Learning about calories, how to measure them, abandoning long cherished menu items, learning to cook new recipes in an entirely different style, and sometimes being hungry all day no matter how well planned your meals are is hard. It’s damned hard. Every step of it is a goddamned fist fight with yourself. 

This how I sum up my experience so far… it’s an incredibly simple concept, but wildly challenging in execution.

I don’t think this process have given me any special insight. I still don’t know dick about losing weight. I don’t know much about macros or the fancy concepts of nutrition. I’m just a guy over here using an app and a scale to try to keep everything the experts say you need in between the lower and upper limits. Some days that works better than others. 

Anyway, I hit my mark of losing 80 pounds two weeks early. I’m still losing – down to 248.6 as of this morning. All the charts say at my height, I should “ideally” weigh in at 185 pounds. Frankly that sounds unreasonable. The chance of me hitting a weight I haven’t seen since high school at the latest doesn’t feel like something that’s achievable. Now 220 or 225, something that puts me in the range of being merely overweight instead of obese, does seem that could be within reach.

I’m plugging in my next goal as hitting 225 before June.

We’ll see how it goes.