New Directions or What the heck am I doing?

This is going to be a long post. I considered breaking it up in several sections, but there never seemed to be a logical place to say “to be continued.” So you're getting it all in one dreary post.

It's been just over a week since I restarted the hospital weight loss program. I thought I'd write a bit about the program itself in more detail. I foresee that some of my future posts will include writing about my personal journey in this program. I wanted to give you all a glimpse as to what it is I'm actually doing and the support I get from the hospital as I go forward so you all have an idea of just what the heck it is that I'm talking about.

The New Directions program is designed, first and foremost, for the morbidly obese. It is not for those who have 10-20 pounds to lose. It is for those patients whose weight is seriously affecting their health.  There are risks, real risks, but those risks must be balanced against the risk of staying overweight. For me, there is the risk of becoming diabetic.  There is also damage being done to my heart because of my blood pressure right now, so getting the weight off is a very key component in stopping and possibly repairing that damage.

It is a low carb program. A patient starts off with 3 protein shakes a day, plus a lean meat and low carb vegetable for a meal (most choose supper). The goal is to stay below about 50 g of carbs a day. That is ridiculously low. But the goal is to get the body into ketosis.

Now, I don't claim to understand exactly what ketosis is, but I know diabetics avoid it like the plague It's when your body has used up most of the glucose in the muscles, the body starts burning the fat. It also starts burning muscle as part of the process, which is why protein is very important on this diet. The process also puts several different products in the bloodstream which, if unchecked, can damage the liver and kidneys.

(At this point, I am probably worrying my readers. Hang on...hear me out.)


It is important to drink 64 to 108 oz of water a day to flush the waste from the blood and keep the kidneys functioning. That, plus 2/3 of the glucose molecule is water, it means you're in the restroom a lot. The program makes use of the body's own process of using the fat stores but turning it up to eleven.

That's how I understand the process as it happens in the body. And I'm sure I have greatly simplified it.

Now, the program is done in the hospital. There is a health screening before one is accepted. It is directed by a nurse practitioner, overseen by a cardiologist/internist, and has a staff of registered dieticians (I prefer that spelling), personal trainers and two other nurse practitioners. Once a month the patient meets with a NP for essentially a health check up, just as one might see a doctor for a health and wellness checkup. Labs are drawn every month for 6 months to keep an eye on the kidney and liver. After 6 months, if there no indications of problems, labs are drawn every other month.

Now, to the meat and potatoes of it all, so to speak. Once a week the patient checks in. Weight and blood pressure is measured. This is when the patient purchases the shakes. The patient then meets with someone on the staff, usually the dietician, to go over the week prior. We review what we did for exercise and how often. We talk about problems encountered, feelings of success and failure, answer questions the patient might have and so on. It is also the time the staff asks questions geared to elicit information about the patient's general health and the director is notified if there is any change in health.

After the review, the patient attends class. These are real, in-depth classes covering nutrition, exercise, general health and emotional health. The last was always difficult because I feel the emotional connection to food is soooooo deep, it really can't be addressed in a group setting. Plus, the speaker has some woo woo ideas that I just couldn't always buy into, but more often than not was extremely helpful. Participation in the classes are mandatory if the patient wants to continue. However, some patients, like me, have been through the curriculum several times. These patients get excused from class if the director is comfortable that we “get it.”

Once the patient reaches his or her goal, maintenance begins. The patient works with a dietician to ween off the shakes and on to real food, using the lessons learned in class and specific work to the situations that arise. This goes for at least 6 months minimum. After that, the patient comes in for a checkup once a month for 6 months. If the patient is still maintaining the loss, he or she comes in once a quarter for a year. Then the patient is asked to come in twice a year after that.

Once you're in the program, you're in for life (or so long as the hospital funds the program). One can visit any class after the weight loss, purchase the products, meet with a dietician or nurse practitioner as needed or just simply call in if one needs a little encouragement.

I know some of you are skeptical of shake based programs. I was too. But the medical supervision, the educational component and the accountability has removed a lot of that skepticism for me. Eighty percent of their patients have maintained their weight-loss a year after meeting their goal. That was a statistic I couldn't ignore. If it hadn't been necessary for me to quit midstream last fall, I have no doubt that the transition to maintenance would have happened.

I'm NOT sure it would have been successful though.

I had a lot of work to do in self acceptance, self love and accepting & understanding emotional connections to food. In many ways I look at the last year as a time to work on these aspects without the stress of weight-loss I am much more confident restarting the program because of this work. And I have my readers and fellow bloggers to thank for that. I would not be at this point to begin anew if it hadn't been for your encouragement and understanding.

That's it in a nutshell.  Later I'll write about my personal adaptation to this program.  It isn't quite a severe as the description above sounds.

Ask me any questions you might have. I'm going to add a link to my email somewhere on the blog if you don't want to ask via a comment.  I believe in this program.  That in itself will take me a long way towards success.

Interweb Finds

500 Before and After Weight Loss Pictures

(Thanks to Janice over at Fitness Cheerleader for sharing this on her blog.  Check her out!)

Turning Corners and Looking Back

Way back in September ’10, I had written a post that could arguably be my rock bottom.  We were about two months into my wife’s illness and life was just grinding me down and crushing my spirit.  I had happened across a blog by Jack Sh*t and, instead of immediately inspiring me, his blog…well…in many ways his blog took away what little wind that was left in my sails.  That post was probably the first, honest assessment of myself.  I remember the words crawling through my chest and down the underside of my arms, ripping themselves free and falling into the keyboard.  It was a painful post.

Jack picked up on it, to my surprise, and left a very encouraging comment.  He even went so far as to make our exchange a post of his own, for which I will always be grateful.  Suddenly I had so many readers—so many people visiting the stable.  I wasn’t really sure what to do with all the encouragement.

So I kept writing, making TJC something into my own personal journey rather than the exercise blog I had envisioned (where weight loss was a minor subject).  I’ve mostly shared, I think, the emotional side of my struggle which is at the heart of my growth.  Not everyone who came over from Jack’s blog stayed.  And that’s ok.  I have been quite content with the readership I have found.  And I’ve said it before, to those who have walked with me down this path for the long haul, and for the recent readers I seem to have picked up along the way, thank you.

I ran across that post while reviewing my blog and it got me thinking about where I had been and where I've gone.  

I’m back, in a significant way. Well, significant to me at least.  I’ve spent the last two weeks catching up on several blogs including Jack’s and many others who I used to follow until my depression had really taken hold and left me apathetic (It’s true.  I’m sorry. I wasn’t able to follow several of my fellow bloggers) I’ve found a few new ones too.  And I am getting inspired. And excited. Yet, I’ve also noted with some sadness that some authors have closed up shop.  

In that post, I said I wouldn’t know what I’d send to Jack for his W.I.D.T.H. program.  I think I know now.  I just recently came to this conclusion.  Since learning of my wife’s recent diagnosis, I thought it would be because of my realization that if I don’t get healthy, my kids have a slight chance of not having parents in 10-15 years.  But, as true as that insight is, it isn't the answer I finally discovered.

The real reason Why I Do This Here is much simpler than that.  And it’s something I’ve said for a long time but didn’t realize how important it had become: 

Why I Do This Here: Because I have to take care of myself before I can take care of anyone else.

Last Saturday I wrote that I feel like I’m going to turn the corner sometime soon.  I realize now that I’ve turned that corner a long time ago.

This is my real life

When I awoke today
Suddenly nothing happened
But in my dreams
I slew the dragon
And down this beaten path
And up this cobbled lane
I'm walking in my own footsteps once again


And you say,
"Just be here now
Forget about the past
Your mask is wearing thin"
Let me throw one more dice
I know that I can win
I'm waiting for my real life to begin

~Colin Hay "Waiting for my real life to begin"

I have long enjoyed this song by Colin Hay.  Essentially it's a story of a man (I assume) who continually waits for that one thing to happen that will turn everything around for him--winning the lottery, get rich quick schemes, etc.  Meanwhile another person in his life (a wife? certainly someone who loves him) implores him to start living now.  It's a story I'm guessing many relate to.  This week it resonated with me like a church bell up close.

I'm not a guy who is waiting for many of his dreams to come true.  I have a good job and a mostly successful career.  I am happily married and am thoroughly enjoying the dad thing.  I have a roof over my head.  I have worked very hard to understand my life and to love those around me.  Sure I daydream of being financially independent and incredibly handsome.  What I'm saying is, my life is pretty much what I've wanted and I am slowly becoming the man I had always hoped to be.  I've not waited for my life to begin.

 Except...

It struck me last week just how much I've been planning all my married life that my wife would be the healthy one.  She is the nurse who knows about healthy living and stuff.  She knows nutrition.  She was an athlete in high school and is much more active than me.  She was the one that was going to stay healthy and be there with my kids and grandkids should anything happen to me.  I took comfort in that.  Too much comfort.  

It's another nugget in this whole weightloss, healthy living, emotional eating thing I got going on here.  It was the assurance that if anything happened to me, my wife would be there for my family.  And I wasn't fully aware of this nugget, just as I am unaware of so much about why I am the way I am and do the things I do.  I didn't need to take my health as serious as my conscious mind told me.  My unconscious mind believed this secret knowledge.

Two weeks ago we received the news I've shared previously about my wife's diagnosis of Lupus.  We've since learned that the doctor's diagnosis is quite preliminary; that she doesn't have the expertise to diagnose it correctly.  It is still very likely to be Lupus, though it may be any of a number of auto-immune and connective tissue disorders.

Whether or not it is Lupus and whether or not it is terminal in the long or short term, I became painfully aware that there is every possibility that it will be me surviving.  I hope that with the grace of the universe that she and I will spend the next 50 years together, but I can't count on it as I once did.  And that is probably the hardest thing I have ever forced myself to write on this journal.

I realize now that there are parts of my life that I've been waiting to begin.

"Just be here now, forget about the past, the mask is wearing thin."

I have a whole life to look forward to.  With my wife.  With my children.  And if the universe is gracious enough, with my grandchildren.  How selfish of me to put all that unconscious pressure on my wife to be the healthy one.  I have not been a true partner in this regard. But I am learning. The past is past.  I've said that often in this blog.  It's time to move forward.

 

(Lest anyone think that this post is moribund and I am melancholy and despondent, the truth is I am thankful for this insight.  How wonderful is it that I still have a chance to regain my health?!? I have been searching for a reason to live a healthy life beyond the vague feeling that I should want to.  I have found it.  I have already lost 10 pounds in the last month. I am experiencing what I believe many people call Joy.)

So tired.

Me

Do I really want to lose this weight? Do I really want to be healthy; do the work it takes to be healthy? I'm been hemming and hawing, coming up with some striking insight, learning about my triggers, my fragile self image.  And I've been sharing it, here, online, for the world to see.

But, that is only an illusion of transparency.  I share what I want.  I reveal what is safe.  I write words that offer a shell of understanding.  Do I really believe whatever the hell it is I am saying?

Here's where I stand right now.

I am so large that even a Super Walmart did not have clothes to fit.  Despite changing my tone of The Jogging Clydesdale from a runner's blog to an introspective journal of weightloss nearly a year ago, I am at my heaviest and my largest. Ever.

And that's the truth.

I have a wife recovering from a serious health issue; one that prevents her even now from a completely normal life and the possibility of employment. I have children to care for.  I have bills to pay.  I have a job to perform.  I have issues of my own to deal with.  I am stressed beyond anything I ever imagined I could go.  And I eat to deal with stress.

I have a history with food as a great comforter, as a conveyance of love, as a link to a childhood.  And I eat to remember those time I felt loved.

I have discovered that there is some part of me that fears never having food again.  I don't know where that comes from.  I cannot remember a time when food was scarce; either in my parent's home or in my adult life.  I don't understand this one.  And yet, I eat to make sure I'll have enough.


I have bad habits.  I don't know where they all come from.  I know Sundays were always popcorn days.  Mom rarely left a gas station without a candy bar for us.  I have triggers simply because it's what I've always done.  I eat because it's what I do.

I eat when I'm bored.

I eat when I want to celebrate.

I eat when my stomach is upset and I think a little something will settle it down.  A box of granola bars is a little something, apparently.


I don't like myself.  I don't love myself.  I have grown a lot in this area and have taken great strides toward acceptance.  But I'm not there yet.  And I eat because I believe all the things I tell myself: you are weak. you are ugly.  you have no control. go on, feed your fat fucking face, you deserve no better.  I eat because I hate myself.

I eat not because it nourishes my body, but because food has meaning.  Food has emotions.  Food has histories. Food is a weapon and a reward.

And here's the thing.  I'm dying.  I am one glucose tolerance test away from diabetes.  The way I carry my fat on my belly and apron shows that I am statistically higher risk for a heart attack.  I am afraid of learning that my high blood pressure is back.  I am in very poor health.  I should care about this.  This should scare the hell out of me and prompt me to do something about it.  But the immediate reward of a binge has more immediate meaning than a long, hard path to recover that health does.

I am tired of this.  So tired.  I am tired of hitting this bottom time after time after time.

I don't know what I'm going to do this time, but something has to change.

I am too important to give up.

Quick Thoughts

What Works:

• --Planing the day.  Deciding either what I will have for each meal or have a plan on how to approach the day's nourishment.  Could be an actual menu, could be an understanding of what will and will not be acceptable.
• --Exercise.  Feels great when I'm done.  Gives me a sense of accomplishment.  I find it motivating to occasionally tweet or put a status on FB saying I plan to run/bike/walk etc and ask for someone to volunteer to follow up the next day and inquire if I accomplished it.  Need to do that more often.
• --Talking to family and friends.  Not necessarily about health and nutrition.  Just being engaged.  Need to try to stay on the positive, but it's nice to know there are those I can unload on if need be.
• --Meditate.  Or prayer.  Or what have you.  I succeed more when I stay in what I've learned to call Wise Mind, as opposed to Emotional Mind.  It is a hard balance and Emotional Mind is very powerful.  It cannot be ignored nor can Wise Mind solve every problem.  But Wise Mind can give direction to Emotional Mind's potential.

What Doesn't Work:

• --Grazing.  I keep thinking just one more snack will satisfy, but it never does.
• --Eating to settle the stomach.  This one really doesn't make sense, but I often eat because I feel nauseous and think that a little something will settle things down.
• --Broad Accountability.  I find myself to still be a paper tiger.  What I pour out here is shaded and not the complete truth, though I continue to strive to be more honest with myself and, thus, with you.  That said, I have tried to hold myself accountable to groups of friends, but ultimately I am missing being accountable to myself.  Narrow accountability, like I described above in the exercise bullet, works very well.
• --Mind games.  I can justify everything I eat even though I know I am killing myself.
• --Couch Potato.  I don't feel as good as I do when I am regularly exercising.

These are today's thoughts.  Who knows what my list would look like next week, next month or next year.  Anyone else have suggestions of what does or doesn't work for you?

Paper Cuts

I've been poking around at other blogs and discovering many wonderful people struggling with the same things I struggle with.  It has been a thrill to know I am not alone and I have enjoyed the comments and support I receive here on The Jogging Clydesdale.  Recently I came across The Anti-Jared and I just stopped in my tracks.  In particular, his post I am a food addict has had me thinking for many days.

He says many of us are paper tigers when it comes to facing our unhealthy ways.  I admit it.  I touched upon it in my post This is Bullsh*t (though I didn't know it had a name).  And it was that post that got JackSh*t's attention, put me in touch so many other wonderful people and started me on this resurgence of blogging and getting geared up to fit my health battles again.

But...I am still a paper tiger.  I bluster a lot, both here and in real life, about my diet and my running.  I know what needs to be done but I often believe I lack the skill, the will, the drive or the knowledge to really kick it into gear.

I admit that I am still unwilling to really believe I can do this.

I am a food addict.  I wish food were just fuel that sometimes tastes good.  No, food is comfort.  Food is love.  Food is satisfaction.  Food is distraction.  Food is shame.  Food is joy.  Food is a reflection of emotions.  Food is celebration.  Food is family.  Food is a gift that you share with yourself and with others to show that you care.

Food takes away the pain and the emptiness.  But only for a moment.  And then that moment is gone.

And I write these things knowing full well that it is lies.  Food is none of these things, but it is how I experience food everyday.  Each and every day I eat because of one of these things I list or several dozen equally false reasons I haven't listed.  Rarely do I eat because I am hungry.  Rarely is it because I need fuel.

Currently my wife is very sick and in a lot of anguish.  She lost her job after exhausting her medical leave of absence.  The stress is intense and having to take care of the family, the house, keep my own job and all the other things normal life throws at you is difficult enough.  Having to drop out of a structured weight loss program I believed in (though haven't faithfully followed for quite awhile) was a blow.  My structure is gone.  Food has become again all the things I was convinced I had put behind me.

I am a paper tiger.  I am a food addict.  I am feeling lost.

But I am not alone.

In addition to all the new friends I have met through this blog, I have many IRL friends and family who have said they are willing to walk this journey with me.  Not just the food, but the journey of life that has been gifted to me.  I have family, both from my side and my wife's, willing and able to help out in the house.  My MIL is here and plans to stay for another 6 weeks or longer to help us and to take care of her daughter so I can keep everything else together.  I have friends I can talk to, in person, on the phone and in the internets.

I still don't know how to answer Jack's challenge to answer "why I do this here."  But with every post here at TJC and with every day's meditation, I hope to get closer to that answer.

I really am a paper tiger and I am addicted to food and all the lies it has become.  That said, paper tigers can grow teeth and lies can be countered with truth.  And addictions can be overcome.

Tomorrow Tonight is as good as any to start the teething pain.

The Expanding Clydesdale

So, we've all been there.  Stress so overwhelming and food so comforting.  It has not been an easy week.  My stress eating has been rather controlled, but today I am losing it. 

Because of a reduction of income, I've needed to drop out of my medically supervised "rapid" weight loss program at the hospital.  I just can't afford the $80/week in supplements and classwork or the $65/mo medical check in any more.  And I really miss the weekly encouragement and having someone to talk to.  So I guess Clydesdale Jog will be evolving into my place to check in and talk about wellness far beyond just running.

So here are the stats.  In August 2008 I started the program at 310 lbs and did no exercise.  By May 2009, I had lost 50 pounds and started running on the Couch to 5K program.  By August I had lost another 15 pounds, but in September I started a medication garunteed to put on the weight.  20 pounds in that month.  It was during that time that events around me started exploding and the stress has been continuous since then.  I am now back to 285.  But I run and I am more mindful of what I eat.  Having met this online group of bloggers, I feel a certain accountability to MYSELF that I haven't felt in over a year.

Thanks to all of you who have dropped by and left comments.  It has been more helpful than you know.