Tag Archives: Health

Revising the plan…

Posted on by

More than a decade ago I finally got around to asking a lawyer to officially draw up a will and do some end of life planning. Having something on file in the event of “what if” felt like the prudent thing to do in my 30s.  Honestly, I packaged it off to the county courthouse and then pretty much didn’t think of it at all for almost 11 years. 

I’ve learned a lot about myself in the intervening years. More specifically, bouncing around between hospitals and specialists since last summer has absolutely focused my mind a bit about what I’d want to happen should things go sideways in a hurry. No one seems to think I’m on the threshold of keeling over, but I am on the precipice of falling over into the back half of my 40s. Dusting things off and giving it all an update felt, once again, like the prudent course of action.

I don’t think anyone ever really enjoys peering through the glass at their own mortality. Going through the bits and bobs certainly wasn’t a laugh riot, but I feel better for having started the process. There is, if nothing else, some small comfort in having the ability to have your intentions known even when you can no longer speak for yourself.

I assume it’ll take a little bit of time for the legal eagles to get things caught up, but overall I feel like I’ve done a good thing. If nothing else, may it was a good way to start drawing a line under my year of medical fuckery and getting on with things. 

Overweight…

Posted on by

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…

Posted on by

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.

What Annoys Jeff this Week?

Posted on by

1. Plant based. I like my GP. I’ve been seeing him since I returned to Maryland and in that time I’ve never felt rushed or blown off. As I’ve started losing weight though, he’s gotten a bit fixated on the “value of a plant based diet.” I’ve had to remind him repeatedly that I’m not in any way on the cusp of going veggie. I like beans and lentils well enough, but not as an absolute substitute for proper meat. Chicken features prominently and I’ve dramatically cut down on red meat and pork, but I need this guy to come to terms with the fact that every so often I’m going to have a cheeseburger or a good slice of roast. I’m willing to compromise and adapt, but I’m not entirely forgoing the best things in life indefinitely. Otherwise we’re not so much prolonging my life as just making it feel longer while every ounce of pleasure is sucked out of it.

2. Egg whites. I like eggs and used to eat a lot of them. A three or four egg omelet wasn’t unusual for breakfast. Because of the seemingly unsettled science of dietary cholesterol I’ve made an effort to cut back to just 3 or 4 eggs a week. But, they say, you can use egg whites and miss the cholesterol completely. Sure. I tried that. It’s hard as hell to turn egg whites into dippy eggs though. Egg whites make the worst egg salad I’ve ever put on a plate. An egg white omelet. Hard pass. I’ve given it the college try but I’m so very much not impressed with cartoned egg whites. They may be “better for you,” but in my estimation they’re not worth needing to clean the damned skillet.

3. Star wars. When I was a kid, one of America’s great presidents stood up and proposed a Strategic Defense Initiative to shield the United States from Soviet nuclear missiles. Never mind that the technology wasn’t there. Never mind the incredible cost to deliver it. Never mind that it would take decades of research to deliver on the promise of securing America from the ballistic missile threat. The very existence of SDI made the Soviets absolutely nutty and helped send them into a spending spiral from which their already questionable economy never recovered. So when, in 2024, I hear vague news reports of Russia wanting to put missiles in orbit, all I hear is history rhyming. I still like our chances of being able to spend this new Red Menace into oblivion if it comes to it.

On normalcy and not hitting the panic button…

Posted on by

For as long as I can remember, every medical professional I’ve encountered told me that I’d feel better if I lost weight. Having lost a not inconsiderable number of pounds, I think they may have sold me a pig in a poke. The fact is, as far as I can tell, I don’t feel any better in February 2024 than I did in February 2023. How much of that is reality versus looking backwards with rose tinted lenses, I couldn’t tell you with any degree of accuracy.

I can say with some confidence that I’m feeling better today than I have since the end of June when all my latest health fuckery kicked off. I’ve worked myself off of being medicated for diabetes. I suspect the next time I see my GP, I’ll be instructed to start back off blood pressure meds. The anxiety, which at times was just about debilitating, has receded into a background hum which mostly crops up when I have the occasional odd ache or pain or when some vital sign pops off with an outlying reading.

Since none of my extremely well credentialed doctors seems to be concerned beyond “continue to monitor,” trying to get my head into a place where I don’t hit the panic button on a daily basis is probably the right thing, but it’s been challenging. Being someone who as a child was perfectly capable of worrying himself sick, this is a bit of a work in progress.

Even if none of that were true, I know I’m feeling better than I was in the summer and fall because my reading pace is picking up. Instead of sitting here in the evening holding a book and idlily flipping pages and being entirely distracted, I’m actually reading, comprehending, and burning through pages. My attention span is coming back. I’m intensely grateful for that… it’s been a long time coming.

What Annoys Jeff this Week?

Posted on by

1. Metrics. One of the things the medicos have had me doing for the last six months is a much more frequent bit of at home tracking. Blood sugar, heart rate, blood pressure, blood oxygen, everything gets tracked. It’s a fine bit of trivia and something that could theoretically be helpful for them, but all it seems to have done for me is generate a new obsession and a lot of fresh anxiety when a rogue value pops up or I see an unanticipated trend develop. While I don’t dispute the value of knowing a more granular level of detail, I can tell you with certainty that even though I was certainly less healthy six months ago than I am now, I absolutely felt better before I knew any of the specifics.

2. Time. By my calculation, it should be December 29th. Somehow, though, the calendar says it’s February 2nd. That can’t possibly be right, can it? I don’t know exactly the age I was when time started to speed up, but I seem to be noticing it speed by at an almost alarming pace these days. Oddly, it doesn’t make the work days seem any shorter, but the pace of moving from one week to the next is getting quite out of hand. I have no idea how one cuts back on the throttle there, but something must be done.

3. Taxes. I switched my Roth IRA from one institution to another this year. During the transition, I managed to add in about $50 more than is allowable by law. The penalty, if left uncorrected, is something like a 6% fine for every year the extra money remains in the account. It was easy enough to fix with a call to the company who holds the account, but the real absurdity is how little our common Uncle Sam will allow you to put away to grow for untaxed future withdrawals. There are articles posted regularly decrying how the Average American will be woefully unprepared for retirement. It seems to me that one way to get after that issue would be to dramatically increase the amount that people can legally shelter from the long arm of the tax man.

Brief Christmas musing…

Posted on by

In the post-plague era, it feels like some of the old traditions have fallen away. In fact, since 2019, I’ve only been home on Christmas Day two out of the last four years – either avoiding the illness of others or not wanting to spread my own across the state. 

I made it home for 2023, though. Still not feeling at the top of my game, but at least I can’t blame this one on the Great Plague. So we muddle through, enjoy some rare true down time, worrying that what the cats are up to in my absence, hoping that the dog doesn’t demolish my childhood home, and hitting most of the usual high points – even if doing it with less vim and vigor than I’d like.

It’s always good to be home, sleeping in my old room, and at least for a few hours not finding myself completely tied to day-to-day normal. That will start again soon with the drive back out of the mountains towards the shore. 

For the moment, though, I’ll soak it in – all the more aware of how fragile and fleeting can be these days.

To those of you reading along, I wish each and every one a very happy Christmas. I hope you got exactly what you wanted.

Simple concept, challenging execution…

Posted on by

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.

A tale about health, both mental and physical…

Posted on by

For years, I listened to every medical professional I met tell me that I’d feel much better if I lost weight. Over the last six months, as you know if you’ve been following along, I’ve finally been following their advice. I’ve been following the very broadly defined advice of “eat less, move more.” In my case, that equated to about 30 minutes of pretty mild exercise – walking or time on the stationary bike – and a pretty fanatical devotion to tracking calories. Since July, I’ve been consistently losing right around 1% of my body weight every week.

Even as I’ve closed in on my initial goal of losing 80 pounds, I can’t say I felt better. Sure, I was a bit more flexible and found that taking the stairs wasn’t hell on my knees, but I felt increasingly awful. In fact, the more I lost, the worse I felt – physically and mentally. 

For the last six weeks, I felt like someone who was definitely not me. My head was in a constant fog, I was struggling to regulate my emotions, and was spending most days in a constant basket of worry and anxiety about everything and nothing. Even my blood pressure, which has been wonderfully controlled for months started to creep up past the “elevated” level towards hypertension. My primary care doctor preliminarily identified the problem as anxiety stemming from my cardiac health scare in June and July. He gave be a very small prescription for Xanax in hopes that would get me over the hump for the worse of the anxiety. I took it, but didn’t notice any difference at all. 

Last week, after a very tough weekend, I finally made an appointment with a behavioral health professional – a therapist – convinced that there had to be something going wrong with my head. My big beautiful brain has always been what I consider the natural gift I got – it certainly wasn’t athletic ability or good looks. Something messing with my brain has always been my nightmare scenario. 

In any case, the therapist I consulted with gave a preliminary diagnosis of generalized anxiety disorder and instructed me to get back with my general practitioner to discuss options for going on anti-depression medication. I wasn’t thrilled, but honestly by this point was pretty desperate to get some relief and get my thinking back under control. Fortunately, I was able to get an appointment the next morning to talk with my doctor. 

We met for almost 45 minutes Friday morning while I described all my symptoms and he asked some probing and uncomfortable questions. A few in office blood tests later, we had ruled out a lot of physical possibilities and we’re closing in on saying yes, my brain was sick… or at least we were until I mentioned how disappointed I was with my weight loss as it seemed the more weight I lost the worse I felt. 

That sentence seemed to hit the doc like someone throwing a light switch. After consulting my chart again and reviewing the bloodwork results, he noted that “You’re still taking metformin…” He went on to explain that in some case, dramatic weight loss can actually send diabetes into a form of “remission,” meaning that it was entirely possible that we were treating for a disease that was no longer trying to kill me on a cellular level. Even though my home testing had never caught any evidence of classically low blood sugar, he speculated that the medication was, in fact, causing my system to mimic the body’s natural response to low blood sugar – releasing stress hormones among other things. It’s possible, he seemed to think, that I was experiencing a form of pseudo-hypoglycemia rather than a true mental health problem. He instructed me to immediately stop taking the metformin and see if that resolved the issues over the next week or so.

Today is my 3rd full day of not taking meds for diabetes in a very long time. I’m keeping a pretty close eye on my numbers, but my head is definitely clearer and I’m feeling much more like myself. I don’t want to call it a comeback just yet, but I’d dearly like to believe the answer to two months of increasingly feeling off kilter is as simple as not taking four little white pills. 

That’s a long way of saying that I have a new appreciation for just how important it is to be your own most forceful health advocate. To our collective detriment there’s still a stigma attached to seeking mental health treatment. There shouldn’t be. The brain is just another organ capable of misfunctioning. Getting help for it is no more problematic than seeking out a cardiologist for heart troubles. Without taking to a therapist, it’s hard to say how long I’d have just stayed mired down in a bad place. If you don’t take anything else from this screed, take this as encouragement that if you need help or need to talk to someone, go do it.

Anyone who thinks less of you for it can fuck directly off.

Feel free to tell them I said it. 

What Annoys Jeff this Week?

Posted on by

1. Decaf. I miss proper coffee. Even though I was reduced to drinking it black, I still miss the periodic jolt of hot caffeine. Decaf and the various herbal teas I’m using as a substitute just don’t get it done. It might be a tolerable sacrifice if giving it up were accomplishing anything towards reducing symptoms. So far, though, the only difference I notice is being more irritable and far more jumpy than usual, which feels like moving directly in the wrong direction.

2. Campaign season. With the Iowa caucuses coming up, we’re deep into campaign season for the 2024 presidential election. As much as I used to revel in it, I wish there was some kind of app that would just block any kind of political add or reporting so I could skip it. There’s not a single thing that any of those blowhards are saying that’s going to fundamentally change my political opinions or influence who I vote for… beyond possibly ensuring that they become someone for whom I’ll never cast a vote even in extrmis. It’s hard to point out any current politician who isn’t just talking for the love of hearing his or her own voice. I have increasingly little tolerance for any of their performances.

3. Snow. Yes, I know it’s December. As I’m sitting here snug in my home office with the curtains pulled aside to give a delightfully peaceful view of my backyard woods, I’m greeted with what is effectively the first snowfall here on the homestead. It’s not going to amount to anything. It makes an objectively pretty scene with the contrast of browns, greens, and birds flitting about the yard… nevertheless, it falls firmly into the category of “do not want.” Snow was once a harbinger of an extra day off, but the convenience of telework mostly made that concept obsolete… so now snow is just confirmation that winter is not just coming, but that it has arrived.