GU Pics

Shamelessly stolen from my benefactors on the Interwebs.

Top: View of University Chapel on campus
Second: Side view of Foley Center, the Undergraduate Library
Third: The Foley Center
Last: The Admin Building at Gonzaga University

These are pretty pictures, but I wasn't as impressed in person. But then, it's a fairly small Jesuit school, and it is nice. The campus is just outside of downtown Spokane, and the main running/activity trail in town, the Centennial Trail, goes right through campus--I actually ran right by the Law School and the stadium on my run today, and when I was in the library I could see where I had been earlier in the day. It's a fairly ideal location (if you must have your school in Spokane, that is) and is obviously considered a crown jewel of the city. For those who come here as undergraduates, I can see how they develop a lifelong loyalty to GU and a fond memory for their college days. It has that "college town" feel to it, yet Spokane is bigger than a college town. And of course, there's the outstanding basketball program. It's a nice school, but in our program we just don't really feel like we are a part of it. Maybe studying on campus will change that a bit, I don't know.

A Long Overdue Trip...to Gonzaga

I'm back in Spokane, to study and get ready for classes to resume on Monday. It was a nice week in Portland, although the weather was pretty lousy for the last few days, and only warmed up when I left.

I decided to go for a 5 mile run today to wrap up my week. I was already over my past several weeks' mileage before this run--I've been running about 12 miles a week, but by my third run this week was at 15. I've read many places that increasing your weekly mileage too soon is a mistake, but I wanted to run anyway, instead of taking the day off (which I should have done). Long story short, my legs were lead today, and I ended up doing 3.4 miles, about half of which I walked. Lesson learned, I guess. Next week I'll try for about 13 or 14 miles, and try to be more moderate in my increases. On my way back to my car, on the Centennial Trail, I was lapped by a guy who is probably 75 years old--and quite fit. I find that totally inspirational, elderly people who obviously run regularly. I only felt a little bit bad that he passed me--he's probably been running for more years than I've been alive.

We had a crazy weather day today. It started off sort of cool, but the skies cleared and it got up to about 85 by 5pm. Then around 6pm the clouds rolled in and we had a mighty thunderstorm, with lightning and everything. It was pretty cool. It lasted about half an hour, then blew away, but it was cloudy after that until nighttime.

Not much to report with weight loss. Weight hovering around the same -60 lb mark. I am having a very typical bandster problem--eating fine during the day, overeating at night. I know my calories are enough to keep me maintaining this weight, possibly indefinitely, instead of losing another 15 lbs. I don't want to address this with another fill--yet. I have more I can do on my own first. Exercise isn't the issue, I'm doing plenty there. It's clearly the "calories in" half of the equation.

One issue has been where to study. I have a hard time studying at home--too many distractions. I usually go to a bakery to study, because they are pleasant and airy and I can usually concentrate there. If I'm being "good" I go around lunch time and order something on-plan for lunch, so I've ordered something and can justify sitting there for hours. If I'm having a more indulgent moment, I have a baked item, or a coffee, or even both. Not so good for weight loss. We have a little library at the hospital, but it's sort of subterranian. I like some sunlight, as much as I can get actually. So I rarely go there to study. Today I decided to go to Gonzaga and check out the library there. Shocking, I know. It's only the second time I've been on campus, despite being a GU grad student for 5 months now. Everything we do is at Sacred Heart, so you have to have a reason to go to campus. But I decided that I should look into having that as an option for studying, so I can go somewhere that I don't have to buy food to sit and study.

The GU campus is pretty good sized. It's not as scenic as I expected, actually. The UW (main) campus is prettier, I think. But the library is huge, and looks brand new. (Apparently it was built in 1992, though.) It has lots of reading space, desks, study rooms, and everything else you'd expect in a place designed for students. I could definitely go there to study, even if it's further away than any of my other study spots. I'll still probably go to the Rockwood Bakery or the Rocket from time to time. But slowly, I'm building a list of places I can go to study, and the library is very nice. The one drawback is that it seemed pretty warm today--why isn't the AC kicking in? It might not be very pleasant in the deep of the Spokane summer, as it gets much hotter than the mere 85 degrees it was outside when I was there today.

Tomorrow, I'm planning a rest day from exercise--I might ride my bike, but nothing major. I want to go to Manito Park and take some photos--most of the gardens are blooming now. I might go to the Buddhist temple. And I will go back to the library at 1pm to study (on Sunday in the summer, only open 1pm to 5pm). Then, early to bed--I have 2 days of IVs this week, on Monday and Weds. Onward!

Best Things About Having a Lap Band

I may have dwelled a little too much on the potential downsides of the lap band yesterday, so I wanted to put together a list of things that I love about my band.

1. It is adjustable. I can have it "loosened" if I have a pregnancy, go on a long trip, or have plastic surgery. (This is often recommended for PS.) Likewise, when my restriction starts to decrease, I can get a fill and be back on track.
2. I can eat out in restaurants. I never have to make special arrangements or have any strange requests for the servers, because I've always been able to find something on the menu that will work for me. Even if I go "off plan" doing this, I'm not eating a lot, and I usually don't have to "pay for it" later in a weight gain. (And if I do, it comes back off with a couple days of being careful.)
3. Sharing meals. I am blessed with a hubby who doesn't like the huge portions at restaurants, and enjoys sharing an entree with me. We both get the smaller portion that we want, and we save a lot of money.
4. I seem "normal" to everyone else. I'm lucky that I haven't ever had issues with barfing or PB'ing, which sometimes "outs" people to their friends or acquaintences. To anyone I am eating with, I seem normal, just not eating a lot of food. People usually don't pay that much attention to what you're eating, especially if you're having good conversation.
5. My "sagging skin" issues are minimal. I do have them, but I think it would be worse if I lost weight more quickly, and hadn't been working out all along.
6. I'll be more likely to have a normal pregnancy. I can have the band adjusted according to my nutritional needs, and I'm more likely to stay healthy and have a healthy baby if I'm not obese to start with. Also, I hope to be able to control the weight gain to a reasonable amount, and lose it afterward.
7. I'm working, but not suffering. This process takes a lot of work, but it's not like dieting where you're hungry a lot and really feeling the misery. I usually can just forget that I'm losing weight, my eating habits are fairly well ingrained and I can go a good period of time before I get hungry.
8. Thanks to my weight loss, I can run, which I love.
9. If I fall off the wagon at some point, I can always get back on. There's no "window of opportunity" for weight loss like there is for the non-adjustable surgeries. I can go back for a fill, start following the rules again, and start losing weight again. The only real variable is my own commitment.
10. I'm not at risk for all the complications that can happen with malabsorptive surgeries. I absorb my nutrients just like I did before surgery. I do have to watch to make sure that my more limited diet is nutritionally complete, but I don't have to compensate for a variable rate of malabsorption, and I don't have to worry about things like Wernicke's encephalopathy, reactive hypoglycemia, or other problems that patients with malabsorption have had to deal with. There are other complications that can happen with the lap band, but they aren't as scary to me, I guess because they are fairly easily treated and reversible, as the band is itself.
11. I'm not afraid of hunger anymore. I know it will be okay if I do get hungry, and it doesn't take much food to make me satisfied when I do eat.
12. I feel like I'm in control of my body again. I no longer have that panic that I'll just keep gaining weight no matter what I do.

Do you all have any others to add? There are so many I'm forgetting. Feel free to add more!

What To Expect for Potential Bandsters

Yesterday I visited my long-time friend and former roommate, who has been considering having lap band surgery for a while now. We chatted a little bit about my experiences and I tried to convey some of the pros and cons of the surgery, and the fact that it doesn't work for everyone, and it isn't magic. But it made me think more about exactly what I would have wanted to know before having surgery. I'm very glad I had surgery, but knowing a few more things would have made the early stages a little less bumpy.

What to expect: Pre-Op
1. Your insurance might require a pre-op diet. Some people have to have as long as a 6 month medically supervised diet before their insurance approves their band, if they are lucky enough to have insurance that covers it at all. So when planning your time off and when the best time is to have surgery, make sure you find out exactly what the timetable is from your doctor AND your insurer.
2. You'll have a lot of tests. In addition to the standard blood work, physical assessment and history, I had functional testing with a physical therapist, body composition testing, an EKG, a psychiatric evaluation (that I had to pay $400 out-of-pocket for), and then was sent for a sleep study. I ended up with CPAP, which helped my sleep when I was still obese, and helped approve my surgery. Many people also have extensive cardiac and pulmonary testing, and other things as their physical status dictates.
3. You will pay out-of-pocket for a lot of this testing. My insurance covered some of it, but I still ended up paying about $1500 for the pre-op testing. Your mileage may vary.

Surgery:
1. Surgery on morbidly obese patients is technically difficult. You should expect all the staff you encounter to treat you with respect and dignity and never make you feel bad, but if it seems that they are making a lot of special preparations for you in the operating room or before, it is because they want to make sure you are safe. Like it or not, surgeons and anesthesia personnel who treat the morbidly obese expose themselves to a higher complication rate and a higher litigation rate because so many more things can go wrong when treating MO patients. As such, try not to take it personally if you notice a lot of preparations being taken. It is for your safety. Things might not go perfectly in every way, but try to realize that medical treatment is performed by humans who are trying to be as perfect as possible, but still are not perfect.
2. Some people have a lot of pain after surgery, but most report that it is less painful than anticipated. A lot of people have this surgery as an outpatient procedure, meaning they do not spend the night in the hospital. They have as good outcomes as those who stay overnight, although I'm glad I was able to stay just the same.

Post-Op:
1. You will not be eating normal food for at least a month. The post-op diet varies according to surgeon, but usually goes something like this: 2 weeks of liquids only, 2 weeks of pureed food, and 2 weeks of soft foods. The reason for this is that your stomach is sutured around the band, and everything needs time to heal, form scar tissue, and create a "groove" around your stomach for your band to sit in. If you eat regular food too soon, the stomach has to "churn" to digest it, and this can disrupt the healing. This disruption can lead to the band becoming dislodged later. At best, that means your band gets unfilled for a month while the stomach heals, which sucks. But at worst, you have to have the band removed emergently, and your stomach may be at risk for permanent damage. You want to do whatever it takes to make sure your stomach heals properly and your band does not become dislodged. That means following the post-op diet as prescribed.
2. Following the diet isn't easy. The band is not yet filled with fluid when you first have surgery, so it is not really 'working' yet. The band works when it is tight enough to keep food in the upper pouch of your stomach, and for most people that doesn't happen until they have had at least a couple of fills. Even if just the band itself is providing restriction, the liquids and purees go right through, and you will feel hungry. In addition to feeling hungry, your brain will be telling you that you want to eat food. That's what it has done for years, and that's part of how we got to the point of having bariatric surgery. Do whatever it takes to get through this period and stay on your diet. It's not for long, and as long as you take good care of your stomach and your band, you won't have to go through this again.
3. You might not lose any weight in the first few months after surgery. Most people expect the weight to start "falling off" like with gastric bypass patients. Often times we tell all our friends and family that we had this surgery, and then post-op they expect us to be losing tons of weight. This can create a lot of pressure for us. Most people lose some weight when they are on liquids, but gain at least some of it back when we start eating "real" food. They say that any weight lost in the first month, or even first few months until we've had a few good fills, is "bonus" weight. This time is for healing, not weight loss.
4. You probably won't feel any different in the time between healing to the point of no pain post-op and having enough fill to feel satisfied on small meals. During this time, your hunger will be the same as pre-op, and you'll probably be "able" to eat much more than you think you should. You might even wonder ,"What did I have this surgery for anyway?" Be patient. This is a slow process. Use this time to learn the bandster rules for eating, and try to keep the amount of food down to what your doctor prescribes for you.

Weight Loss, and Life with a Band:
1. Weight loss happens more quickly in the beginning (once you've achieved a good fill level and are losing weight for real) and slows down as you get closer to goal. The more you have to lose in the beginning, the faster the weight loss will be, as a general rule. The average weight loss for a band patient is supposed to be about 1-2 lbs per week, but a lot of people who start out with BMIs greater than 45 can lose much more than that in the beginning. Then it starts to slow down and they wonder what they are doing wrong. This happens, and it's a natural response for your body.
2. Plateaus will happen. They are normal. They are the body's way of saying, "Whoa! What's going on? Let's conserve resources before we lose them all!" I don't know any secrets to getting through plateaus. The best suggestions I have are to watch very carefully what you are eating and doing, keep track of calories every day for 3 or 4 days (I use fitday.com, others use sparkpeople or daily plate) to see if you are getting more than you think you are, measure food with measuring cups and/or a food scale, and do something differently. Maybe you've gotten used to a certain breakfast that isn't working for you, or you've been doing the same exercise routine for weeks and your body is used to it now. Some people increase their calories for a few days, then drop them a little lower than before to stimulate weight loss. A lot of people talk about the "starvation mode" that you supposedly go into when your calories are low. I don't know that I really believe in that, personally. Plenty of people are starved against their will, and they lose weight. Not that I am advocating a starvation diet, but I'm just saying that I think this theory is more of a way to justify eating more. Just my opinion.
3. You can "eat around" or outsmart your band. You'll discover that a lot of foods that we liked eating before being banded go down JUST FINE even with very good restriction. Things like ice cream, cookies, chocolate, etc.--go down, no problem. This will sabotage your weight loss. One thing that happens to a lot of people is they get to a very tight restriction very early after surgery, and they have trouble eating solid protein and good, nutritious bandster food. Because they can't eat what they are supposed to eat, they start eating what "goes down" instead--high calorie, non-nutritious junk food. They don't lose any weight, but they are restricted, so much that they frequently barf up food that they are trying to eat. The solution is to have some of the fill taken out, so you can tolerate the foods you should be eating. This is often what has happened when you meet a person who has been banded for over a year but has only lost 30 lbs.
4. The band is on your stomach, not your brain. "Head hunger" is a problem for all of us. You'll be surprised, once you start paying attention to your actual physical hunger, how often we eat when we aren't hungry. You'll have to learn how to deal with this in ways other than eating if you are going to be successful with this.
5. The band won't do all the work. Some people keep getting fills until they are so "tight" that they can only eat a few bites before they vomit something up. This is not healthy--over time, that tight restriction on your stomach will cause problems, either from the band eroding through the stomach, or the stomach slipping through the band, which cuts off blood circulation to your stomach and is a medical emergency. The trick is to learn the proper "sweet spot" for restriction--the level should be at the point where if you eat a proper bandster meal, you stay satisfied for 3-4 hours.
6. "Satisfied" is not the same as "full". You shouldn't be eating to the point of "full" any longer. It takes a while to learn this. Most of the work of weight loss with a band is the mental game--making the right choices, not eating when not hungry, not snacking frequently. The band is just there to keep you from feeling hungry--I think of it as a mechanical appetite suppressant.
7. You must exercise. Science hasn't decided how much exercise really helps weight loss, and it's certainly possible to lose weight without exercising. But exercise will help preserve your muscle mass so that you lose more fat. Exercise will also make you feel 1000% better. Start out by walking, as much as you can tolerate, and work up from there. As you start to notice your workout is getting easier, increase the time or the intensity. Believe me, if you learn to make exercise a daily part of your life, you will reap enormous benefits from it. There are a million ways to do it, incredibly busy people find ways to do it, you can too. You owe it to yourself. I think I owe a lot of my weight loss to my exercise. But even if it didn't help me lose weight at all, it still makes me feel so much better, I can't go without it.
8. Don't listen to the haters. People might ask, "Why don't you just diet and exercise? Why do you need to do something as drastic as surgery?" Or you might meet people who are jealous of your weight loss, or tell you that surgery is "cheating". You can't waste your energy on this. You know why you did it, and you don't have to tell them your reasons if you don't want to. It's good to have a spouse, family member, or good friend on your side from the beginning, but some people have to start out with no support, unfortunately. Usually, the people who really care about you are scared by what they have heard about WLS (usually about gastric bypass) and don't want anything bad to happen to you. To those who are close to you, tell them what you know and why you decided it was best for you. You don't have to discuss it with anyone else. I didn't tell most people I knew about my surgery until after I had it. By then, it was too late for anyone to try changing my mind. People mean well, but they don't understand what it is like to live in your skin, or how long you have been thinking about how to deal with this. That said, make sure you have examined all of your options thoroughly before you decide to have surgery. As fellow blogger Melting Mama says, weight loss surgery is not a cure for life.
9. This surgery is not for everyone. It requires more effort on your part, especially in the first year, than any of the other weight loss surgeries. You have to watch what you eat, and exercise. You might not tolerate certain foods any longer. Many bandsters can't swallow chicken, bread, asparagus, pineapple, popcorn, fruit with skins (like grapes or apples), or any meat that isn't very, very moist. Stuff that gets gummy or doughy might get stuck, and that is painful. If you eat too quickly, don't chew well enough, eat too big a bite, or eat something that doesn't go down well for you, you can barf (some call this a PB, or productive burp, because it's just food, no digestion has occured). A lof of barfing is bad for your band, so you want to avoid this at all costs. It's harder to get your nutritional needs met because you are eating so few calories per day (as low as 800 to as many as 1500 calories a day, usually). And the weight loss can seem slow--but this is also a benefit, since rapid weight loss tends to produce the "cancer look" that some RNY patients have. You have to be willing to make changes in your lifestyle. This is a lifetime thing. But, I think the benefits are absolutely worth it.

Wow, that was much longer than I expected it to be. I hope it's helpful to someone. Some of this stuff you find everywhere, I guess, but some things I never heard before I was banded and had to learn on my own. Good luck to everyone out there.

Return to My Favorite Gym

I'm on semester break this week. It's nice to have this time away...we don't have much time off after this week. We're starting clinical orientation in the OR in a couple of weeks, and after that we start clinicals. The program rolls on...

So, this week I am in Portland again. It was very rainy yesterday and the day before, so instead of braving the rain I got a week pass to March Wellness, my gym of old. I could have gone to the Y for free, but I wanted to run with my own flat screen TV, and I decided it was a splurge that was worth it. I'll be here for a week, and I really wanted the peace and...well, I just missed my old gym. It's better than eating out a lot, or buying clothes like I often do when I'm in Oregon (no sales tax!). Today I think I'll go for a swim (in the saline pool, no chlorine!) before we go see my SIL in Eugene.

I'm back down to 174, woot! This scale in Portland usually weighs me about 0.5 lb higher than the one in Spokane, so I'm probably a little lower than that. My run at MW was really good--I haven't run on a treadmill since I started running outside last month, and I was able to go longer and faster than before. It was great. And, my heart rate didn't get as high as it usually does, so I think my fitness is, in fact, improving. I did my lower body weights as well. I must admit, I feel very good.

Willpower?

Lap Band Talk has revamped their website recently. They rearranged some of the forums, added a few, and started a section of articles written by members of LBT on a variety of topics surrounding lap band and weight loss issues. Frankly, most of them frustrate me. They are good topics, but most of them are written by people who have been banded less than 6 months. Even when I was starting out, I really wanted to hear from the people banded AT LEAST a year, preferably much longer. I want to hear weight loss secrets and experiences from people who have successfully lost their excess weight and kept it of for a period of time.

But today I read a good article about willpower, what it is and what it isn't. It's written by a psychologist in private practice, and it's simple and practical. He basically says that willpower is a myth. When we feel like we have willpower (like in the initial phase of a diet or a weight loss plan) what we really are experiencing is a high degree of emotional motivation. Eventually that starts to fade, and our desires to do the thing we are avoiding overcome our emotional investment in not doing it. We haven't lost willpower, we've just run out of compelling reasons to avoid what we are attached to.

The author then basically advises us to make short- and long-term goals, and analyze what we get out of achieving them--asking ourselves, "What's in it for me?" Then he offers this gem:
This is the real definition of willpower: being able to tolerate frustration or discomfort in the present in exchange for a desirable outcome in the future. Perhaps a better phrase for willpower is discomfort tolerance or frustration tolerance.

Maybe there's something in that idea of "frustration tolerance" in losing the last 20 lbs. What I've been doing for the first 60 doesn't seem to work anymore--I'm more fit, and my body uses fewer calories because it's smaller (and my metabolism is probably lower, exasparatingly, because that happens when formerly obese people lose weight). I don't want to drop my calories more, and I don't know if it would help if I did. I don't want to be uncomfortable--I'm happy with how and what I eat now. It's definitely frustrating, and how have many of us dealt with frustration in the past? Eating. Guilty as charged. It seems the last 20 lbs are a puzzle that a lot of people who set out to lose a significant amount of weight have trouble solving, because it's a setup for old habits to come roaring back.

I'm sure the last 17 (that's how many I have left today) pounds will come off eventually, especially as I'm able to run further and better. My eating is okay, and if I continue like this, I should very gradually continue to lose more weight. For sure, stress is a factor. There are some issues going on right now that I have no control over and that are quite stressful and depressing (and too personal to blog about). And anesthesia school is hard--it's an endurance test not unlike large-scale weight loss. (I don't consider myself quite in the "massive" weight loss arena--I think that's at least 100 lbs to lose.) So is long-distance marriage. So I have to make friends with sloooooowwww weight loss, I think. I'm not willing to tolerate the kind of stress that it would produce to try to speed things up significantly. I'm a realist. And being less than 20 lbs from goal isn't a bad place to be, really. My real "dream" goal is another 10 lbs from my current goal, and I think it's likely that I will get to that point eventually, but I can't kill myself over it. I guess I don't know how much my last 17 have to do with "willpower". When I look at the "what's in it for me" aspect of pushing to lose this weight sooner, I don't see anything attractive enough to tolerate the discomfort and frustration I think it would add to my life at this time. There are worse things than staying a size 8 all summer, for sure.

Article: Huckabee's Weight Loss

Two things I've discovered that are very predictable about me: I like to recycle interesting articles I find on other people's blogs on my own blog, and I like NPR. So when PastaQueen posted this (old now) article about (former presidential candidate Mike) Huckabee's weight loss, I thought, Yahtzee! It's about weight loss, it's NPR, and it's interesting. So there you go. I had no idea he suffered the same humiliations that many morbidly obese people suffer, and while he was governor, no less. I didn't realize it because I didn't think about it--because I personally think he is a scary right-wing wacko. Some don't, whatever. At least it appears unlikely that he will end up our president next year.

Huckabee does kinda make me laugh, though, because of his "Huck and Chuck" ad. He does have a good sense of humor. Our Pharmacology teacher is a big, fairly young (somewhere around my age) Viking-looking guy named Clay, and he likes to start or end classes by reading a few Chuck Norris Facts from his book full of them. He even put one on our last exam. So I think for the rest of my life, Chuck Norris will remind me of my first year of anesthesia school, and will always make me laugh--even though he, too, is a bit of a scary right-wing wacko.

I'm doin it wrong!

Just back from McDonaldland (that's the Valley YMCA, if you haven't been following)--an upper body weights session and 30 minutes of lap swim. Why is it that I can be realistic in most areas of life about my abilities, but when it comes to physical fitness I expect myself to do everything as well as everyone else out there? I have a good idea why: P.E. class.

Don't get me wrong, I am glad that I grew up in an era when they still had P.E. (That's "physical education" for my non-American readers.) I think the demise of P.E. in American public schools must contribute to the obesity problem in our kids. And P.E. does get kids to try activities that they might not otherwise try out, because they have to. I had some achievements in P.E. class, mostly in the last year that I took it, my sophomore year. I became a decent swimmer, because at my high school we were all required to take at least 1 term of swimming. I enjoyed it, so I took 3 quarters that year, and was teaching to other students in my last quarter. Another was the 1 quarter I took of basic P.E. that year, when I was absolutely determined to learn to make a lay-up shot. I never became good at it, but Coach Colleran was impressed by my determination and effort and gave me an A even though I sucked royally as an athlete.

And there's the problem: P.E. taught me that I sucked as an athlete, and when I grew up I just crossed athletic activities off my list of things I could do. I was always the slowest, the least coordinated, the least driven to stay in the game. All of our activities seemed to pit us against each other--whether running around the track, or playing half court basketball, or picking teams for any number of team sports. I didn't enjoy being picked last, or always finishing the race last, or never being passed to because I couldn't make a basket. What I didn't learn was that there were things I actually COULD do well--like sports that required endurance rather than speed. My coordination turned out not to be as bad as it seemed when I was a little kid. And I was a decent enough swimmer that I was asked to join the swim team, although my music activities precluded that.

So now, I'm learning to love becoming fit and being active, but sometimes I still have these scripts playing in my head, about what I "should" be able to do and how I fall short of that. Running is one example: I enjoy the Galloway method, with frequent walk breaks, and it makes sense to me, but I still have the nagging sense that I'm not a "real" runner if I can't run the entire distance without walking, even if it means I barf up a lung. When swimming laps, I have to stop after a few laps and catch my breath, let my heart rate come down a little, and take a swig of water. (Sometimes, I admit, the swig of water is just to make me look like I am not stopped solely to catch my breath.) The guy in the lane next to me was swimming nonstop laps when I got in the pool, and when I got out half an hour later he was STILL swimming lap after lap, like a damn goldfish. Why can't I do that? I'm doing it wrong!

The better question for me at this point is, why am I looking at his lane? Why am I not competing with MYSELF only? It's natural to compare ourselves to others, but often counter-productive. The fact is that most of what I'm doing these days was unthinkable last year. Usually I can keep that in perspective and celebrate that, but I have days, too. I have to remind myself that I'm miles ahead of my former self, who wasn't inactive, but certainly wasn't running, swimming or strength-training 5 days a week. Right?

Head Games--Part 2

My head isn't really staying in the correct mode to do a whole series on sports and concussions. I guess too many other things are going on, and this is a weight-loss blog, so I'm going to wrap it up here. But I do think this is an important issue. So I'm going to share the links that I've had sitting open on my computer for a couple weeks now.

"Iron Mike" Webster is one of the best and saddest examples of the sad consequences of multiple concussions. Here's his Wikipedia entry, which details some but not all of the causes of his eventual homelessness and dementia. There is also a 5 part series on ESPN.com about his career, his mental decline, and the impact on him and his children and wife, as well as the NFL's atrocious handling of veterans and disability.

Another former Steeler, Terry Long, died in 2005 and was one of the four former NFL players who were identifed post mortem as having chronic traumatic encephalopathy. Terry Long's final years were marked by poor business decisions and depression, and he was eventually found to have committed suicide by ingesting antifreeze.

Men's Journal ran an excellent article called Casualties of the NFL. It details some of the ongoing health problems of NFL vets, and the efforts of folks like Mike Ditka and the Gridiron Greats organization to get the NFL and the NFLPA (their players' association) to take care of the men who bring the dollars in for the owners and the top brass.

At the very heart of this whole concussion mess is Dr Elliott Pellman, who was the Jets' team doctor and became the NFL's concussion expert, despite the fact that he is a rheumatologist, not a neurologist or neurosurgeon. Dr Pellman has done a great deal of "research" which has been published, and widely criticized in peer review by experts in head trauma. He has maintained that there is no danger in returning players to play after receiving a concussion, despite the fact that all other literature available on the topic recommends that players be held out of play at least 7 days post concussion. He's even more of a tool than that--it was discovered a few years ago that he claimed on his curriculum vitae that his medical degree was earned at SUNY Stony Brook, when in fact he earned it in Guadalajara, Mexico. After that fact was made public, he resigned from the NFL's Concussion committee, but is still employed by the NFL.

The problem with this deception is that teams, from the kiddie leagues to the NCAA, look to the NFL for guidance in treating concussions. The NFL has a profit motive to keep their players in the game, and forms its recommendations accordingly. This puts players everywhere in danger.

Water Love

I think Spokane doesn't like runners. Either that or she wants to toughen us up by making us carry our own water. (Cities are female, aren't they? That's how we have sister cities.) It doesn't make a lot of sense, with all the sidewalks (jagged and perilous though they are, at least in my neighborhood), parks, and with Bloomsday, the largest timed race in the country, held in Spokane. But on my last 2 runs out in the city (out of my neighborhood) I have found exactly 1 drinking fountain. The first run was downtown, in Riverside Park. I am sure there must be another drinking fountain at least in the park somewhere, but I didn't see any others. Today's was in Manito Park, probably the biggest and most popular park in the city. No drinking fountains, unless you count the broken one covered in duck poo. Unbelievable.

In Portland, they have drinking fountains everywhere. In particular, they have funny things called Benson Bubblers, which are 4-bowl brass fountains that were commissioned by a guy named Simon Benson to give working men in Portland an alternative to drinking in saloons. No runner in Portland has to carry water on a run, provided that he or she runs between the hours of 6am and midnight and isn't put off by drinking from public fountains. There is even a special thumb technique to diverting the vertical water stream into your water bottle without spraying yourself, which I haven't mastered yet.



In Spokane, water is for wusses, I guess. I can get by for now, but in a few weeks it's going to start getting warmer, and I'll either have to start carrying water with me or get up early in the morning to run (horror!). In the end, both may happen. Until then, I hydrate before and after.

I ran up to Manito Park this evening. I ran through the Lilac Garden there and discovered that the lilacs are just starting to bloom. This weekend is the Lilac Festival Parade, so it's just in the nick of time I guess. I was kind of sluggish, actually, but still able to do 3.5 miles. Now that I've read some more of Jeff Galloway's book, I've learned that what I previously thought was his walk-run method of running actually was incorrect--I thought he recommended ratios more like 2 minutes of running and 1 minute of walking. In truth he isn't that regimented at all. In the beginning he recommends as little as 15-20 seconds of running and 60-90 seconds of walking, repeat as able. He says that even at the peak of his season's training he still will run 7-8 minutes and walk for a couple of minutes. The basic gist is to take walk breaks as frequently as you need them to keep running enjoyable and keep yourself able to do it for long periods of time. So now I use a combination of how I'm feeling and what my heart rate is to determine when I need to walk. I run probably about 3 minutes at a time on average, and walk for 60-90 seconds. I use the recovery feature on my HRM to time this--it is a 60 second countdown timer that figures out how much your heart rate recovers in 60 seconds. I walk while that is counting down--the beauty of that is that by the time it finishes, my heart rate is almost always back in the range that I (arbitrarily) set for resuming running, and I am ready to run again by that time. It's a method that's working well for me so far, and I'm able to increase the amount of time I run, while keeping the workout enjoyable for me.

In the PastaQueen annals, I got as far as another milestone date for me in her archives: March 13, 2007, the date I was banded. Interestingly, on that day she wrote about the first day of the year she was able to run outdoors on the trail, and how she now could count herself as someone who loves to run. I've posted something rather similar recently, but on that day when I had surgery I never would have predicted such a thing. I wonder if I had read something like her blog before surgery, would it have affected my decision to have WLS? I think it would have caused me to think even more than I did about it, but in the end I decided to do what I did not because I didn't think I could lose weight, but because I didn't want to regain yet again. It is quite inspiring to see someone who lost 210 lbs without surgery, most definitely. I honestly don't know if I could ever do such a thing, because it takes so much focus for such a long time, and because constant hunger is such a saboteur. But good on her! Truly, it has taken me over a year to lose weight WITH WLS, and the last time I was on a diet it took me this long to lose 35 lbs. I don't know if I could fight hunger and my brain long enough to get it all off--but if I could, keeping it off is the real battle. I'm not a bit sorry I was banded. But hats off to those who are successful long-term without surgery. I'm not going to get all negative and quote statistics about WLS losers vs. dieters. I just admire that there are people who can do it that way, and recognize that most of us can't, or don't, for some reason or another. This is a tough battle, and it's never over for any of us, no matter how we lost the weight.

A Pause to Reflect

Yes, I've been away. Did you miss me? Hubby is in town, so we've been out running together and doing gaggy "are they still newlyweds or what" stuff together. It's been nice.

(I don't know, are we newlyweds still? It's been almost 2 years. I guess we still are, maybe.)

I had an exam on Monday, and since our grades were due for the semester the same day, our teacher just emailed us our grades. I got an A on the exam and an A+ in the class, w00t! But the same day I also got back Jackie's evil Cardiac exam from last week, and did pretty poorly on that. The first poor grade of the year for me, and yes, it stung a bit. Hopefully I can ace the last exam and still get a good grade.

Weight is holding at its hormonally-induced, elevated level. A couple days and it should come back down a few lbs. I hope it's hormonally induced, anyway. I made cupcakes for hubby's birthday and we've been snacking on them, so that can't help much. They are red velvet cupcakes, from a (overpriced) mix I bought at Williams-Sonoma, and thank God I didn't have to answer a doorbell while baking them or I might have been investigated for homicide in my kitchen. Is that much red food coloring really necessary? Anyway, perhaps they don't help me get my weight back down...but whatever, I'm not terribly concerned at this point.

This week--scratch that, this month--has been nice. We had a few classes last week for our official finals-week break, and this week isn't really a break but two of our classes have ended for the semester, so we only have 2 classes anyway. One only meets on Mondays and we don't have an exam for it (physiology) for another month; the other class is Priniciples, which goes on and on, but is probably our most fun class anyway. So now we pretty much have one class per day until the summer term starts in June. It's so weird not having an exam this week and next week to study for. We can use the break.

I have nothing interesting to offer about the current state of weight loss today. I'm still reading PastaQueen's archives. For fun, because I was in the 2006 archive, I looked to see if she blogged on my wedding day, and she did: she posted her ebay auctions that day (August 13). She also posted on my birthday, August 19, when we were on our honeymoon. It took me back a bit, thinking about it. She had lost 160 lbs at that point, with 50 lbs to go to her goal. When I got married, I had been considering WLS for the whole year, but wasn't totally decided on doing it until I got back from our honeymoon and saw our wedding photos. I was devastated at how I looked. Isn't it interesting that our brains don't really register what we really look like until we see pictures?

Our wedding day was wonderful, we had a great time, and I'm glad I didn't obsess over losing weight before the wedding day because I wanted the day to be a fun celebration, not a "perfect" day designed just to have "perfect" photos. And our wedding was about as much fun as a wedding can be, if I do say so myself. Relaxed, intimate, and fun. But when we returned from our honeymoon I was forced to face my weight problem, and I was pretty depressed for weeks afterward. I felt kind of dumb being so down about it, but it was just a matter of facing what I had been in a bit of denial about. My hubby didn't really know what to do about it, actually. But I decided, when I came out of the funk, that I was going to do this lap band thing, and set up my battle plan (which is how I deal with stuff, I make a plan). I attended my seminar in December, and the rest is all documented in my own blog archives.

And here I am. I do feel like a different person in a lot of ways. I'm not "cured" of obesity, and I certainly could gain the weight back if I'm not careful. I have to keep exercising, and trying to make good choices, and working my band so it can work for me. Looking back on wedding pictures is sort of bittersweet in some ways. It's a record of our happiness that day and a celebration of our life. It's also a documented moment in time that I can look back on as the last time I went about my life without considering the health consequences of my lifestyle choices. I've gotten real since then. Sure, I'd love to be able to look back on pictures of myself as a slender bride, but in a lot of ways, I got a lot more out of the wedding that we really did have.

Lazy

I don't have much on my agenda today--go for a run, study pharmacology, make food for hubby's little birthday celebration, which we will have tomorrow. But I have been completely unmotivated all day long to do any of it.

PastaQueen, it's your fault!

No, of course it's not PQ's fault. But reading her entire archive on her blog has been my procrastination/distraction of choice today. Here's why I'm unmotivated today: it's an overcast, yucky day here, I'm hormonal, and perhaps the few drinks at the graduation banquet last night didn't help my energy level today, either. Also, I've been kinda down all week, for various reasons, including being hormonal. Money is tight, I miss my hubby, etc. School is flying by, but still feels like an unending stodgy march toward a distant goal a lot of the time. I know that's a contradiction, but deal with it.

So anyway, Saturday comes and I sleep in, and spend the morning and early afternoon reading PQ's adventures as she went from 372 lbs to 160. (Or so. I don't know how low she got, I'm only up to 2005, and in her recent posts she has stopped weighing herself, although she just ran a half marathon and published a book.)

Anyway, I finally got myself to walk to the store for ingredients to make vegetarian lasagna and cupcakes for my husband's 34th birthday (which was Wednesday, but he was in Oregon then.) I decided the best way to get myself motivated to run would be to have some coffee and cook. Baking the cupcakes would end up with me eating some of the batter, which always makes me feel like I've done something much worse than just eating cupcakes, so I'd definitely want to run that badness off. And Jeff Galloway's book recommends drinking a cup of coffee an hour before a run, for people who drink coffee anyway. I drink so little now (I'm back to my usual, pre-grad school coffee consumption, which is about a cup a week or less) that I don't think it's going to kill me. And if it helps me feel more like getting something done today, all the better.

I had a funny realization when I was preparing the lasagna. I make lasagna on the fly, no recipe--it's pretty easy, and it's always pretty good. But this time I decided to just use the half box of lasagna noodles that I had in the cupboard, because we really don't need that much pasta anyway. Making lasagna nowadays is sort of anxiety-provoking because who needs a big lasagna pan full of delicious lasagna sitting around? Not me, and not anyone else trying to lose weight. But my hubby loves my lasagna, so I make it for him for special occasions. So, now I was getting ready to put the lasagna together, and realized that I only had enough noodles for 2 layers. That didn't really seem good. I have this big fancy lasagna pan that I bought a few years ago just so I could make the perfect lasagna in it, and it's a fantastic pan. But this time it would end up with a sort of shrunk-down skinny little lasagna. I was thinking about how it was probably for the best, that we should have a mostly vegetable (and less pasta) lasagna anyway, but sort of disappointed in myself for not getting more noodles at the store and having a disappointing lasagna for my husband's birthday (hormones, anyone?), when it finally dawned on me that I could just use a smaller pan.

Duh.

It just didn't occur to me, because I was making lasagna, so I have to use the lasagna pan, right? So I got out a 8x8 square dish that I have, and bingo, problem solved. A good lasagna, but less of it, so we don't have to gorge ourselves for days on end or force ourselves to throw away perfectly good food in the hopes of sparing our asses a few unnecessary calories. Sort of scary that it took so much thought to come up with that solution. But there you have it, your future nurse anesthetist, tackling the difficult problems of the autonomic nervous system AND how to make a smaller lasagna. I think I've pretty much tapped my mental resources for the day.

Mystery Fill

Thanks to Lori for her informative blog (Love My Lapband) and the link to the PBS special, FAT: What No One Is Telling You. I watched it tonight (click on the link) and most of the science presented is not new, but the stories provide great perspective on the complexity of the issue, and how being fat affects our lives. I really enjoyed it, and hope you do too. Lori is a filmmaker, and her blog compiles a lot of current information she finds about obesity and weight loss surgery (lap band in particular) in one handy place. She's interviewing bandsters and putting the interviews on her blog. It's a great resource, so go check it out.

Today I studied for my exam, then drove to Idaho for my fill, with my new surgeon's PA, a big, bald, bearded, tattooed man named Brian. He's very nice, very shoot-from-the-hip; he used to be a respiratory therapist before going to PA school, so he's "down" (as the kids used to say). He saw that my surgery was done elsewhere, so he started giving me the spiel about how the band only does part of the work and we have to make diet changes and exercise and all that, but eventually he backed off that when he realized that I'm doing all that stuff, and my original surgeon really did tell me all that stuff, and I do actually need a fill. Once again, he accessed my band, like Dr Pennings did last time, and pulled out only 2.0 ccs of fluid. That's what Pennings pulled out 6 weeks ago (I was supposed to be at 3.2cc from my surgeon in January), and he put a 0.5cc fill in. So we repeated the process, 2.0 there, add 0.5cc. We talked about where the fill went--I've been banded for a while, and researching for a while before that, and I've been online on all the forums with other bandsters, and no one has ever been able to explain where fluid goes from the band. Is there a leak, or does the water move osmotically across the silicone membrane of the band itself, or what exactly? Everyone gives a different answer, but I think the answer is actually "we don't know." It makes sense that if there was actually a leak, since the band is under pressure, it would be EMPTY by the time it gets checked again, even if the leak was tiny. So it's hard to imagine that it's an actual leak if I still have 2ccs in there after 6 weeks. But where does it go? It's a mystery. If I go back for another fill, and it's 2 ccs again, I might ask for a hair more fluid next time. I do NOT want to be tight, but I would like to hang on to the extra "help" from the band a little bit longer.

I have a weird relationship with fills, though. I am of the opinion, through watching others' experiences with bands, that I should work with as little fill as I can and still lose weight, if I want to keep my band forever. I don't want any complications and I don't want more band surgery. It makes sense that the stomach doesn't like any more pressure on it than necessary, so I don't want to clamp the thing down and make it swell and have problems, which is the most common precursor to complications like slips and erosions, from what I've read. A lot of people really rely on "restriction" to keep them eating tiny, tiny amounts and even rely on barfing and "PB"s to force them to stop eating. I think that is asking for trouble, personally. I'd rather have to do a little more work on my end to eat less and keep my stomach healthy. That's my personal belief, though.

Anyway, I went on my run this evening, which looked like it would be rainy but ended up being very nice. I found a cool Google-based site for figuring out the mileage of a route, called (not so creatively) Gmaps-pedometer. Really, they could have come up with something better. But I like the site. It's simple and accurate (based on satellite mapping and all). I got the url off that running wiki that I posted a few weeks ago, which again I say is a great resource for people just starting out like me. I ran/walked 4.5 miles today! W00T! My legs are pleasantly achey now, in a good way. There was also another good site mentioned on the wiki (there are several there for figuring out miles ran) that is widely used and has many posted running routes for Spokane in it, so I'm looking forward to trying some of them out. It's called MapMyRun.com. Didn't seem quite as easy to use, although I didn't spend a lot of time messing with it, but it had more saved routes in my area than Gmaps seems to.

Ugh, the thing I hate about fills: liquids! Both surgeons' offices I have worked with have required 24 hours of liquids after a fill to keep from irritating the stomach and causing swelling. Emma's office also would say to "take it easy" after that, meaning not go eat car parts or chicken bones, I guess, and slowly work back up to regular foods. Brian and Pennings just say the 24 hours of liquids. I am hungry, having only had soup tonight. I don't want to "eat" more, since I'm going to bed soon, but I am hungry still. How did I ever make it through bandster hell? I hate being hungry! But fortunately, it's only until tomorrow afternoon. I may have to have some more soup before going to sleep. Grr.

Progress Pics

Today is a bonus no-class day. I'm on my way to Rocket Bakery to study, then have a fill at 3pm in Idaho. Then this evening I plan another run up the South Hill. The weather is gorgeous this morning--clear skies, about 50 degrees, and it will get warmer later on.

Photos taken today: tulips in back yard, and progress pics at 175ish lbs. I'll put up a pre-op pic too, for comparison. Have a great day.

Suffering vs. Working

Thanks for the great comments on yesterday's post! It does feel good to reach this goal. I did want to clarify a bit--by saying I didn't "suffer" for it, I don't mean to imply that it wasn't hard work to get here. The eating part feels easy after years of diets, and being hungry all the time--I had to learn hard things, like how to resist emotional eating (sometimes it works, sometimes it doesn't) and how to tell real hunger from other little mind tricks, but the band has done what it was supposed to do, which is suppress my feelings of hunger. I went through "bandster hell" in the beginning, and didn't have any real restriction until almost 4 months after my surgery. And my weight loss felt incredibly slow for the first 6 months. Actually, it always felt slow. It WAS slow by many people's standards, which was my problem: I needed to go by my own standards, and compared to how I've lost weight in the past, this was fast. But once I got to a good fill level (after 3 fills) it usually hasn't been hard to eat properly, because it's pretty much how I've always eaten. I used to eat healthy meals, but too much of them, and way too many snacks (mostly sugary) in between. Getting to a more reasonable daily eating plan was not hard with my band, and I'm thankful for that. That's what I had surgery for!

The main work has been my exercise, but it hasn't been suffering, because the more active I've become, the more active I've wanted to be. I've advanced my activity level based on how my body felt--when I felt like I wanted to push more, I changed to something more intense. I've been working out 5-6 days a week for over a year now. It keeps me calm and sane. In February I felt the urge to start running, so I did a little quick reading to make sure I wouldn't hurt myself, and I started running. Now (after some trial and error that I've detailed in these posts) I run 3 days a week, swim one day, and am hoping to resume taking yoga once a week. I also lift weights 2 days a week. This seems like a good balance for me right now, and I feel great. So while I have certainly worked to lose weight, it's become a lifestyle that I enjoy--and the band (and the running) allows me to have treats from time to time without gaining weight back, and eat out without destroying my weight loss efforts. This is what I mean when I say I haven't suffered.

Tonight is a great example of how I am not suffering now. I just got back from a really great run up the South Hill, which took me about 50 minutes. I was wondering a few weeks ago how runners keep from getting bored when they run. Now I know: they leave the treadmill and get outside. I brought my iPod with me "just in case" but wanted to try running without earphones, and it was great. Without a treadmill to punch in my pace and incline, without a timer to watch, or a window to look out onto the same parking lot, I made my own pace according to how I felt--ran whenever I felt like I could, walked when I knew I needed to. I didn't think about time at all--time spent out there, time running versus time walking, nothing. In my 50 minutes, I probably ran about half of it, maybe even a bit more--but that didn't matter. My heart rate was in my training range the whole time, and more importantly, I got to see Spokane by foot. I discovered that the cliff that High Drive sits on, looking over the west valley, is totally blooming in yellow wildflowers--not Scotch broom, or dandylions or California poppies or any other weed, but something that looks like calendulas or black eyed Susans or something. It's really pretty, and there are trails cut into the hillside that I'm going to explore soon. I could even see the restaurant that hubby and I had a great meal at a couple of weeks ago--and it's kind of a distance away. The weather was perfect--dusk, about 60 degrees and clear, very slight breeze. It felt great to be out there, and I realized I was no longer running just because I could, but because it felt great and I loved it. That is a real revelation.

So, yes, I am working, but I repeat: I am NOT suffering.

Head Games

I'm thinking of doing a little series of posts about sports and head injuries, and about the NFL in particular. I'm not committing to it, because of school mainly, but I've had some thoughts kicking around in my head for a while that I think I'll write about. So let's pencil it in for now: Head Injuries and America's Gladiators.

Yes, I am a woman, but I also grew up as the only daughter in my family. My father is a football man, my older brother as well, and especially on Sundays, if I wanted to relate to most of my family, sports were necessary. It took me some years to become a true sports fan in my own right, but as an adult I came to love football, and then baseball, and then all sports.

But along the way, I became a trauma nurse, too. There are trauma nurses who love full-contact sports like football, but a lot of us have a hard time watching them. The first time I was turned off of football was the fall of 2000, when Curtis Williams, a safety for the University of Washington, sustained a spinal cord injury in a helmet-to-helmet collision while playing Stanford. At that time I had recently started working in trauma critical care and had taken care of many high quadriplegics and seen the devastating effects of these injuries. Curtis was a C2 quad and died just 18 months after he was injured, at age 24. Over time I took care of football players while working at Harborview, including a Seahawk who had sustained a career-ending head injury--his third head injury in 3 weeks, actually, which resulted in surgery to evacuate blood from his brain.

Watching 350 lb men flying into each other's heads and spines lost its joy for me. After every field collision I was watching the man at the bottom of the pile to see if he was moving. I understand that professional athletes are paid well for the work that they do, which is often what sports fans told me when I would express my reservations about football. And I accept that injuries and danger are parts of the sports we love. But most sports don't place their players' lives at such risk. Nearly everything that makes a person who he is, exists in the brain. Most people do not understand just how devastating even a mild head injury can be, how long it can take to recover, and what an impact it has on the sufferer's life. As for spinal cord injuries, they aren't as common as head injuries are in football, but they are at least as devastating. Most people don't relish the thought of being completely mentally intact but trapped in a body that no longer works, and at the complete mercy of others to accomplish every activity of daily living, even to breathe. Certainly other sports have their risk of injury, and you can get a head or spinal cord injury doing any sport, doing anything really, but for the most part you don't have nearly as much risk of losing your personality or your ability to care for yourself as a baseball or basketball player. I can watch Ken Griffey Jr. wreck his hamstring again, or any number of NBA players wreck their knees and ankles, but a head injury? That's not what sports are about for me.

Over the past few years, I've been drawn back into football, and the major cases of obvious head trauma and spinal cord injury have seemed to be fewer, which lulled me back into watching the game again. I gradually became less concerned for the massive bodies flying about the field. Let's face it, it's an exciting game, not only the sport and its players, but the pomp and mania that surrounds the football season. But recently I listened to a public radio program called The Infinite Mind. The episode was A Different Kind of Sports Legacy: Head Injuries and Concussions. The show featured Chris Nowinski, a former Harvard football player who became a pro wrestler for WWE (as "Chris Harvard") whose career ended after a series of concussions left him in constant agony. He couldn't figure out why his concussion--which is an injury most athletes learn not to take very seriously, and actually can't even accurately recognize--wasn't seeming to clear up after months. So, being a Harvard-educated guy, and a medical consultant, he hit the stacks and started looking at all the published research about concussion and particularly post-concussive syndrome. He wrote a book called Head Games: Football's Concussion Crisis, which is an excellent handbook for laypeople about concussions and sports, and upon which I'll base a lot of my series of posts on. Chris learned a number of things that really startled him about concussion, but the main things that spurred him to write the book were that it is estimated that only 10% of concussions that occur on the field are ever diagnosed, and the worst thing you can do after getting a concussion is go back out and play, which is almost always what happens, from the pee wee leagues to the NFL.

The worst case scenario for athletes who receive 3 or more concussions is cumulative trauma encephalopathy, or dementia pugilistica. This kind of brain damage causes personality changes, progressive dementia, depression, and has led to suicide in several prominent former NFL players, and probably to the suicide and double homicide committed by Chris Benoit, the former WWE wrestler. Sending young athletes back out on the field too soon after a concussion can also cause a rare but devastating brain condition called Second Impact Syndrome, in which the brain loses its ability to regulate the size of the blood vessels and massive cerebral edema ensues, which can rapidly kill the athlete. SIS is much more rare than CTE, but receives a lot more attention--perhaps this gives the public the impression that the serious sequellae of concussions are very rare, when in fact for a football player, or a wrestler, or boxer, or anyone who receives numerous blows to the head, CTE is not rare but is certainly devastating to the athlete and to his family.

If the NFL took care of its players after they received these injuries, it would be easier to cut them some slack. But Mike Webster, "Iron Mike" to Steelers fans, left the game completely debilitated by the effects of an estimated 25,000 on-field collisions over the course of his 17 year career. Instead of enjoying his retirement and Hall-of-Famer status, Mike ended up homeless, living out of his car, unable to remember where he was at times, incapable of making sound decisions, and begging his children to stun him into unconsciousness with a Taser so he could get some sleep. When he died at 50, his brain was examined by a neuropathologist who studies CTE, and found to have severe, extensive brain damage consistent with CTE. While Mike suffered, he applied to the NFL's retirement plan for active players' disability, but was denied. The owner of 4 Super Bowl rings didn't even have health care insurance. His story is extensive and sad, but also illustrates the lack of regard that the NFL has for the men who put people in the stands and who make money for the owners, and also the lack of knowledge about the "invisible" head injuries, which often aren't as obvious when they happen as a knee in a brace, or a guy on crutches.

In future posts, I'll talk more about the 4 NFL players who were recently diagnosed (post mortem) with CTE, as well as Chris Benoit's case, which the media and public fairly quickly (and inaccurately) dismissed as "roid rage" and forgot about. I'll talk about how athletes are taught to play injured, how coaches pressure trainers and teams pressure doctors to get players back out there, and about other famous athletes whose careers ended with post concussive syndrome. I also might talk about what football could do to reduce concussions and their sequellae (no, it's not better helmets). In the meanwhile, I'd highly recommend picking up a copy of Head Games, if this subject interests you. It's very well written, intended for the public, and particularly athletes at all levels and their families. It's a quick read, check it out.

The big 6-0

I finally made it: 174, 60 lbs gone. 14 to go. Woo hoo! I spent the weekend in Portland, NOT eating like a perfect bandster, but I did go for a couple runs with hubby, which was lots of fun.

This week is a light one at school. We had a big exam today for A&P, which was hard and awful. Now I have IVs in the morning, 0545, then pharm at 0800, then done for the day. Weds we have airway in the morning, Principles in the afternoon, then we are done for the rest of the week. How about that? Of course we have a pharm exam the next Monday, so we'll be studying all weekend. But today was a No Study Day. My classmates and I went for a margarita after the exam, to celebrate Cinco de Mayo. I had an enchilada, and some rice and beans. I didn't eat much, actually, but I'm sure it was about 1000 calories, with the margarita and the food--greasy American-style Mexican food, mmm. The rest of my eating today was pretty slim, so overall I probably came in around 1500 calories, and did a lot of walking. Tomorrow is a run day, after school, and after delivering flowers to our program director, who had spine surgery today.

I can't beleive I made it to 60 lbs lost. It took me 14 months. A lot of people can do that just with dieting, but for me it's a miracle. And I didn't have to suffer for it--just ate less, tried to make good food choices 85% of the time, and lots of exercise. This is something that is sustainable as a lifestyle, not some severely calorie restricted diet with constant hunger pains. I've had no typical Bandster mishaps with barfing or reflux or too-tight fills, my restriction level has been pretty good for about 9 months, and no complications. And I'm almost at goal! Unbelievable.