Tuesday, August 25, 2015

It must be time for the triennial blog post

Yah, I don't use this blog much these days.  I don't use my twitter or tumbler a lot either; I'm mostly on Facebook, which is where I'd put this post if it weren't probably going to be a longish one.

tl;dr: I had sleeve gastrectomy in early July of 2015, and I have lost over 80 pounds from my pre-surgery high weight, and as far as I can tell, I no longer have type II diabetes, nor high blood pressure, nor high cholesterol.  I have about 90 more pounds to go to hit my ideal goal, and about 50 to go before I'll be mostly happy if the weight loss stops.  So, if you've been wondering about the cryptic (or not so cryptic) Facebook posts of late, that's what the deal is.

Longer version, with some history, and probably some anger and disappointment I've kept mostly bottled up, but I'm ready to let it out.  This is really raw, straight out of my brain into this blog post:

I have come close to weighing 350 pounds several times in the last 10-15 years, and while I've never gone over that (that I know of), I've also not really been able to get down below about 310 pounds in that time, either.  I have been bombarded with the message that because I weigh so much that I'm somehow worth less than those folks with willpower and control who can manage not to weigh 350 pounds, and I have to admit, I mostly believed it myself (with occasional and short-lived backlash forays into "fat acceptance").  But, really, this is nothing new.

I imagine that this will be a familiar story; I'm certainly no special unique snowflake, but it's my story, and I'm going to tell it.  I remember being made aware by the adults around me that I was chubby.  Some were genuinely concerned (mostly with the surname "Dyson"), I'm sure, but I got the impression from others that their "concern" was borne more out of embarrassment than anything else (mostly with the surname "Martin").  I definitely internalized all this pretty quickly, and it wasn't long before middle school hit, and I was pretty certain I was fat, and that everybody at school thought I was disgustingly fat, and thus began my lifelong feeling of inferiority to most of the people in my life at the time, and by the time I hit high school, it was just an established fact that Greg Martin was that fat kid who was kind of funny and kind of smart, but mostly just fat.   That was my life.

Things didn't get better in college; there came a point where I stopped being constantly worried about being fat and trying to do things to be not fat and I just gave up and dove into my studies and my activities and tried hard not to think about it much.  Much to my surprise, I did end up getting married, and I got a career, had a daughter and found another love, too, and life seemed to go by and most things seemed to be pretty great.

Except, I was fat.

What's worse, there comes a point where carrying too much weight starts to have consequences beyond my self-esteem:  the blood pressure started to creep up, my fasting blood sugars were starting to be over 100, and the doctor started saying words like "pre-diabetic".  This was in my early 30s, and I weighed around 275 pounds.

So, I did lots of things.  I started taking a couple of medications "just to give me some runway to get the weight off".  I bought a bicycle and started riding it all over the place.  I rode the bus into downtown and walked a mile to and from the office every day.  I counted calories.  I did the Zone.

Even though I tried to do the right things, it never really got better.

Time marched on, I got older and heavier, and the medications seemed to have the worst of it under control, so I gave up.  Again.  It turns out that a wreck that I had back when I was riding my bike damaged something in my abdomen enough to weaken it so that I developed a hernia over a time period of a few years, and it got to the point that it hurt all the time.  So, I stopped riding the bike, and I stopped walking, and I worried about it.  This went on until 2008, when I finally was in a spot where I could afford to get it fixed, so I did.  It turns out that I had two, though, so I had to get the other one fixed in 2009.

At this point, Laura had started taking taekwondo at a local school, and since I was fixed, and had just taken my first trip to Europe, I was feeling extra ambitious and ready to try again.  So, I also started taking TKD, which I did for quite a while.

The whole time, though, I was still that fat guy at TKD.  I couldn't get a uniform that fit properly, so I had to wear a white t-shirt so my giant man-boobs didn't hang out of the uniform.  I did my best to have a good attitude, though, and I really did get into it.  There were periods where I would do 4-5 classes a week, plus this bonus workout class called WAR a couple of times, plus I'd practice forms and work out at home.  I was logging 8+ hours of hard workout per week.

Still fat.  308 pounds.  That's the lowest I could get.

I now understand why, but at the time I couldn't figure it out.  I mean, figure calories in, calories out, 3500 calories a week deficit means 1 pound of weight lost, right?  Wrong.  While I can't describe the physics behind it, I can tell you that none of the basal metabolic rate calculators out there work for me.   I have years of data showing that even using a conservative calculation, and running a 7000 deficit weekly just between calories taken in via food and my BMR, never mind exercise, produces weight loss that stops at 308 pounds.

Anyway, I did all that, it stopped working, and then my hernia recurred, and the depression started in again, and I fled the taekwondo school, because it was all just too much to bear.

After a couple of years of feeling pretty awful, emotionally and physically, I found a new family doctor (the old one retired, so I had to), and we ended up with a pretty good rapport, and he said something to me that no doctor had ever said to me before.  He said "You know, this isn't really your fault".

Really?

I was pretty sure it was; all the fitness programs out there say if I just do this, and do that, the weight will come off, I just have to be patient.  I just need to have willpower, right?

He told me that I probably could lose weight the hard way by calorie restriction, but that without help, I would need concentration-camp-like conditions.  An 1800 or 1500 or even 1200 calorie diet wasn't going to do it because for whatever reason, my body was just super-efficient.  Silver lining: if the big famine ever does hit, I'll be one of the last ones to go because it'll take me a long time to starve to death.

Anyway, he wasn't the first to mention weight loss surgery to me, but he was the first one to mention it to me in a way that wasn't a judgement on my character.

So, after all this time, and all this anguish, I finally decided to stop flogging myself for failure to be a normal human and look into it, because the self-image aside, I needed to do something about all this other shit that was wrong with me.  My A1c was 7.9 (that's way too high), I was on two different blood pressure medications, and my joints hurt all the time, my feet hurt all the time, and nobody would fix my hernia until I lost weight.

So, I did it.  I did the six months of nutritionist appointments and supervised diet and exercise plans to prove to the insurance company that I actually needed this surgery (and I did lose some weight during that time; down to about 325 pounds before I stalled out for the last 2 or 3 months).  I did the two week pre-op diet, except I did it for 3 weeks just to make sure that I shrunk my liver enough to have the surgery.  I did the goddamn camera down my throat so they could check out my esophagus and stomach (retching the entire time; that was damn unpleasant).  And then I went and let them take most of my stomach out and give me a new teeny tiny one.  And the pain and the recovery and the pitiful laps around the living room all so I would be able to go and walk for real in a couple of weeks.  I did all of it, it was a giant pain in the ass, it sucked up all of my vacation for the year.

And now, I'm happier than I've been in years, because I'm in control again.  The pre-op stuff, the trauma and the recovery were enough for me to make a mental shift in the way I think about food, and the tiny stomach provides an actual full signal and immediate negative feedback if I screw up.  And, I've lost more than 80 pounds and I'm still going.

Almost the saddest thing about it all:  if I'd known that I just needed to eat around 600 calories a day, I might have tried that, and it might have worked, but nobody ever recommended that I do that, because conventional wisdom is that's crazy talk.  Even now, myfitnesspal bitches at me every day because I didn't eat 1200-1500 calories.  But now, I just ignore it, because it's working.

One of the reasons I waited so long to do this was the judgement I see out there every day about how the surgery is "the easy way out". I actually bought into the idea that I was fat because I was a bad person and deserved the consequences and if I wanted to be normal and good-looking and all that, all I needed to do was have some willpower and control, so I avoided thinking about the surgery because I wanted to "do it right".  Both Barbara and Cheryl can attest that it was pretty much an act of God to get me to even consider this.

And you know what?  It wasn't easy.  Nothing about this was easy.  And, anybody talking about this surgery being the easy way out in front of me will earn a punch in the nose.

And now the saddest thing about it all: I look in the mirror and I still see a disgusting fat guy.  I think once I hit my 3-month follow-up, I may ask for a referral to talk to somebody about that, because that's all wrong.


Friday, June 29, 2012

More Lessons Learned

I've been monitoring my blood glucose levels for a while now, and a few things have become apparent to me.

  • Carbohydrates are trying to kill me.
  • Dawn phenomenon sucks.
  • Exercise can do some wacky non-intuitive stuff.
  • It is going to take me a while to get a handle on this whole thing.

So, to recap, this class I went to that was supposed to teach me how to manage my type II diabetes was almost entirely useless, and most of the advice was counterproductive. At this point, I see only two good things to have come out of going to the class: a) I'm now monitoring my BG on a regular basis (I have test 14 times thus far today, with at least another test before I go to bed), and b) I have become extremely curious about this disease (condition?).

Here are some of the things I "learned":

  • Diabetes is a progressive disease and as time goes by, I can expect it to get worse and for additional complications to come up.
  • If I can make sure I'm between 70 and 120 before a meal and be less than 180 after meals, I will be in good control.
  • I need lots of of carbohydrates (to the tune of 275 grams per day) including lots of starch because they contain essential nutrients.
  • I need to make sure to eat low-fat foods, because dietary fat causes heart disease.
  • I need to make sure to keep my dietary cholesterol low, because dietary cholesterol causes heart disease.
  • Sulfonylureas are super awesome because they cause your pancreas to excrete insulin, which will lower your blood glucose.

That's not all, but it's enough. Here's the deal, though: every one of those things is just wrong.

Fact: constant high blood glucose levels is the cause of every diabetic complication. Normalize the blood glucose, and there are no further complications, and in a lot of cases, existing complications can be reversed. Normalizing isn't a _cure_ for diabetes, but it can certainly cause one to become asymptomatic.

So, how do you normalize blood glucose levels? It's actually pretty simple, and the answer isn't a high-carbohydrate low-fat diet.

Fact: there's no such thing as an "essential carbohydrate". That's right, you don't need them at all. Your body can run entirely on protein and fats. Here's another fact: carbohydrates cause blood glucose levels to rise rapidly; proteins and fat do not do this. I know this because I've verified it with my glucose meter.

So, what is "normalized"? Well, regular non-diabetic people generally have a blood glucose level of about 83. So, if I want normal blood sugars, 83 seems like a pretty good target, and the ideal is for it to just stay at 83 all the time; upon waking, before meals, after meals and so forth. If my pancreas, liver and muscles all acted normally, this would not be a problem. But, my endocrine system is messed up, so I have to give it some help in the form of a low-carbohydrate high-fat diet, lots of anaerobic exercise and oral medications.

How does one normalize their blood sugar? It's actually pretty easy (to understand, at least):

  • Eat a low-carbohydrate diet.
  • Exercise regularly
  • If necessary, take metformin (aka Glucophage)

The purpose of the low-carbohydrate diet is pretty straightforward. If I take most of the carbs the ADA would like me to eat and replace those calories with fat calories, my blood sugar simply cannot have those high spikes (at least not from eating; the "dawn phenomenon" is another thing). The reason you replace the carbs with fat is because you still need a particular number of calories to fuel your various activities each day; if you just cut the carbs down and do nothing else, your body is not going to be very happy with you and other nasty metabolic things will happen, which you do not want.

Exercise does a couple of things. First, it burns blood glucose, which lowers the levels; second, and probably more importantly, it helps reduce my insulin resistance, which means that what insulin I do produce is much more effective at getting my muscles to accept the glucose running around in my blood. This is good, because the other choice is for fat cells to accept it, and that will just make me fatter, which is not at all what I want.

I have to be careful with the exercise, though. Super-vigorous exercise can cause you to release "fight-or-flight" hormones, and these hormones signal the liver to create some glucose posthaste so you can outrun the bear that's after you. I've seen a rise of over 40 points just from going too hard at class. Interestingly, my daily walks to and from work from the bus are probably the most helpful right now in controlling my BG.

Metformin is one of the oldest and most useful drugs for treating diabetics that still produce insulin, which means most type IIs, and a few Type Is. It does two things:

  • Lowers insulin resistance, causing muscles to allow the insulin to let the glucose in
  • Signals the kidney to slow down or stop gluconeogenesis (creating glucose from proteins stored in the form of glucagon)
This is very helpful, because many Type IIs (including me) actually produce insulin, they're just insulin resistant which means that the insulin cannot do its job. The other major class of oral drugs (sulfonylureas) instead cause your pancreas to crank out more insulin, which can also work, but also causes accelerated beta cell death (those are the ones that make insulin) which is not something I'm interested in.

But, what about all that fat? Well, it's fine, if I'm exercising regularly, it gets turned into fuel as I go about my daily routine. It has the added bonus of making me feel satisfied after meals, and also, calorie-for-calorie, it takes up less room in my stomach, and if I can feel full without being stuffed with food, that helps keep my blood glucose levels from spiking, too. Contrary to popular belief, dietary fat doesn't get turned into fat, and dietary cholesterol doesn't get turned into that stuff that clogs your arteries. So, yay, eggs! (Eggs are an awesome source of protein, yolks and all).

I've been using an application called "SugarStats" to track my vital diabetes statistics, and I can tell you that, for me at least, the low-carb diet really is the thing. From the week ending June 10th, 2012, my morning average BG was 136, and my daily average was 128, with a high of 168 and a low of 100. I've been low-carbing since then, and this last week, my morning average BG was 119 and my daily average was 114 with a high of 138 and a low of 79.

I've also learned a couple of interesting things:

  • I have "dawn phenomenon", meaning that my liver likes to make glucose in the early morning hours (starting around 4am, it looks like), which is also the time during which I am most insulin-resistant; overnight, I can generally expect it to rise 30 points between bedtime and waking up at 5am. This bites, because it's pretty consistent, and there doesn't seem to do anything diet-wise that can change it, at least in the short term.
  • My morning walk of 1.2 miles from the bus to the work will lower me around 15-20 points. This is awesome, because I can get to a decent number before breakfast. However, it looks like the liver doesn't finish up dumping glucose until around 8:30am or so, because when I'm done walking, I see a low, then I continue to see a rise from that point, even if I eat no carbohydrates, and even if I eat nothing.
  • It matters greatly what my BG level is when I go to bed. With the dawn phenomenon, if I start at 100 at bedtime, I'm going to be 130 when I wake up. so, I need to actively try to lower it at night to something like 80, so I can wake up at 110 or so.
My next visit to the doctor is going to be interesting; I'm expecting to see a drop in my HgA1C (the "3-month blood sugar" test).

You're probably wondering just what it is I eat now. It's actually not too bad, and pretty normal.

For breakfast (on work days), I have 2 eggs over hard, and 2 slices of bacon. Oh, and coffee, lots of coffee. On the weekend, it's still a little weird, but I'm going to find something similar.

For lunch (again, work days), I have 4-6 oz. of some kind of protein, and vegetables. Today, I had some grilled pork chops, and a nice salad. I use olives and nuts to add most of the fat, but sometimes I'll have bratwursts and sauerkraut instead. In any case, I do not eat until I'm full any more, I just eat the pre-calculated amount, and stop. And, I'm not hungry.

For dinner, it's usually a lot like lunch, except I'll probably have a couple of kinds of vegetables, and I'll probably have one of those Wasa styrofoam crackers with some cream cheese. It's still not a lot, because I've got this taekwondo stuff I need to do without yarfing all over Ms. Murphy's floor. :)

On most nights, I have a small snack before bedtime, just to keep the BG from falling too far in the night. If I let it fall too far, I'll get the old double-cross: dawn phenomenon + rebound high, where I'll end up going up 60 or more points overnight, which is not what I want.

There are things I just cannot eat any more, at all. No pasta, no rice, no bread, at least not in any portion which would be useful. I can get away with one spaghetti noodle, but who wants just one spaghetti noodle? When we go for sushi, I get sashimi now; just as good, and I never really cared about the rice that much anyway. Generally, I have to be very careful at restaurants because even if I eat the right things, I can still easily eat too much, which causes another thing called "chinese restaurant syndrome". It turns out that if you eat too much of anything, it causes a chain reaction that ends up dumping a lot of extra glucose into your system. As in, you could fill your stomach with sawdust, which is not digestible (and I don't recommend it for any purpose), your BG will rise, and if you're insulin resistant like me, it'l stay risen for quite a while, which is not good.

For treats, I eat the occasional tiny ice cream, and dark chocolate in small quantities doesn't seem to hurt much. So, all in all, it's just not that bad.

Oh, and by the way, I've also lost almost 30 pounds with the new low-carb diet. So, personal victory for me.

Wednesday, April 18, 2012

The One With TMI

It's time for my somewhat-yearly post, I guess.

Apparently, I've had type II diabetes for about 6 years. Not "pre-diabetes", not "borderline diabetes", not "a minor blood sugar issue", and my "sugar" wasn't "a little high." It was a few weeks ago that I came to this realization and I've been facing facts since then. I got myself enrolled in a "How to manage your diabetes" class, and I've been learning (and re-learning) some things. It turns out, if you don't actually have diabetes, probably everything you "know" about it is wrong, including the basic "well, your blood sugar is high all the time, right?".

This post is just me organizing my thoughts around what I thought I knew, what I've learned, what life is going to be like from now on, and some numbers from the last couple of weeks, and whatever else I feel like.

Here's what I thought I knew:

  • I have blood sugar issues because I'm fat.
  • If I lose weight, it'll go away.
  • If I exercise a lot, I'll lose weight.
  • I don't actually have diabetes, but I could get it if I don't straighten up and fly right.
  • I got myself into this, I'm going to have to get myself out of it.

It seems that none of that was actually true.

It's not at all clear that the causation arrow goes that direction on the first one. Really, I have blood sugar issues because I have type II diabetes and I have type II diabetes because I chose my ancestors poorly. Seriously, it's genetic. It's possible that had I taken better care of myself in my 30s, that I might not have become symptomatic until later, but this was set in motion before I was born. So, I guess it isn't really my fault, and maybe I should put that aside and worry about what I'm going to do going forward, right?

I was actually told that if I lose weight, it'll go away. By an M.D. (or D.O., I don't remember for sure). Sadly, that's not the case. I will have this for the rest of my life. If I lose weight, it will become easier to manage, but I have a pretty well-mapped-out progression to look forward to which will eventually lead to me having to administer insulin in some manner. I can put that off, though, by managing my BG (blood glucose) levels correctly now.

I've been exercising for the last year. A lot. For the entire year, the scale did not move. There's a reason for this: my BG has been out of whack and nothing's working right. It's pretty discouraging to work as hard as I've been working and not see any results on the scale. It's good to know there's a reason.

I really wish the doctor had just told me "You have diabetes, dude. If you don't control it, you're going to go blind and I'm going to have to cut your leg off." Seriously, that is scary and I might have actually read about the disease and taken it more seriously. But, instead, it was "Well, your blood sugar is a little high". I definitely could have been more curious, but she never used the D-word.

The last point is the hard one. I don't like to ask for help. I never have. "I DO IT!" has been my motto since I was a little kid. However, I am not an endocrinologist, and a lot of this stuff is really counter-intuitive (e.g. "My BG is high in the morning" is frequently solved by "eat more right before bed". Wha?). In a nutshell, I needed help. Fortunately, they have people for that. Actual scientists who can impart the actual science behind what's going on. I dig actual science as practiced by actual scientists, so there's a bit of synergy.

Anyway, back to the story. My doctor retired. I had to get a new doctor, which I didn't do until I absolutely had to, which means I got injured while sparring and ended up at the emergency room with an infection on my left shin, and orders to follow up with my family doctor. So, I made an appointment with a doctor recommended by my old doctor, and when I went in, she gave the leg a cursory look, said to follow the directions from the ER doctor, and then proceeded to do a full history and work-up, and demanded that I get myself to a diabetes education class immediately. (The leg ended up being a problem, but for unrelated reasons; I broke a largish blood vessel without knowing it and it was still bleeding. She fixed that and it's healed and I'm back at taekwondo as of today).

So, I've been attending this class, and learning all kinds of things:

  • I definitely have type II diabetes.
  • I'm probably fat because of that and the complications that uncontrolled BG cause.
  • Diabetes isn't just about high BG. Lows are also a major problem, and can be more acute.
  • When I eat and what I eat are just as important as how much I eat and maybe even more important.
  • Getting my BG checked once every 3 months is almost useless.
  • Losing weight is not a good primary goal for a diabetic.

I've never seen my glucose under 100 mg/dL. I've rarely seen it under 110. Now that I'm monitoring, I regularly see it in the 170s. That's diabetic.

In type II diabetes, several things are at play. Not everybody has all of these things, but most have some combination. 1) my pancreas is bad at creating insulin. 2) my liver really likes generating glucose. 3) My muscles only grudgingly allow insulin to do its thing. 4) Fat cells are happy to let insulin do its thing. Insulin is the "key" that unlocks the cell and allows glucose to enter the cell. If I don't have enough insulin, and what insulin I do have is rejected by my muscles, any glucose I have that's not used by my brain is going to one of two places. It can get flushed out in the urine, or it can go into fat cells. I have both. This is not conducive to losing weight. The result is that even though the exercise is good and all, I'm not going to see any appreciable weight loss.

This was something I misunderstood for a long time. While the most prevalent symptom of diabetes is high blood glucose, and indeed that's how a diagnosis is made, it's not that the glucose is always high, it's that the swings in levels are quite wide. A normal person will stay around 85-90 most of the time, and be at most 139 two hours after a meal. A diabetic is shooting for between 70 and 120 before meals and lower than 180 after meals. That's the target range. 70 is pretty low, and 180 is pretty high. Most people don't feel any different at 180, but lots of people feel not great at 70, and with a low, one can get quite confused, get the shakes, get irritable on top of a whole litany of other symptoms. People don't die from their BG being at 180, but a severe low can cause death because of increasing confusion and inability do treat the low. Like I said, I didn't know this.

Managing one's blood glucose levels means managing how fast glucose enters the blood stream. Lots of things contribute to this, and how much one eats is a, but not the, primary contributor. The most important thing is to carefully craft meals to have the right ratio of carbohydrates, proteins and fats. The second most important thing is to break up and schedule food intake throughout the day such that BG spikes and falls within a narrow range. After all that, how much you eat just determines how long the food is going to cause glucose to enter the system. There are also medications to help regulate this, but without getting the food right, nothing else really matters.

In order to manage my blood glucose, I need to know what it is at fairly frequent intervals. Once a day is really not enough, because that doesn't give me my curve throughout the day. Once every 3 months is certainly of no use. I mean, the HgA1C test can give an estimate of what my average BG was over the last three months, but even that doesn't tell me what the curve looks like. If I have a low of 120 and a high of 180 on a particular day, and a low of 50 and a high of 250 on another day, those both have the same average, but the first day is a pretty good day, and the second day is an unmitigated disaster (at least for me). I specifically asked "Should I be checking my blood sugar regularly at home?" and was told that I didn't need to do that. So wrong.

Goal one is to get the blood glucose under control. I need to concentrate on that. If I do that right, the weight will start regulating itself, especially if I'm getting regular exercise, which I do. If I focus on the weight loss, I'm going to be disappointed, because the uncontrolled blood glucose is going to sabotage anything I do. I have anecdata to support this, too: I've lost 10 pounds since I started the class, and this is without even really trying. I've been laid up, so I haven't been to taekwondo for quite some time, yet I'm losing weight just by managing my blood glucose level. This is an awesome thing.

So, where am I now?

Well, on the one hand, I'm pretty excited because I've gone from "what? I actually have diabetes?" to "okay, I can do this" in a pretty short time. So, the class was definitely worth it. Now that I'm testing all the time, I know what my current glucose curve looks like, and mostly, it's good now. Mostly. I've got this new thing, called the "dawn phenomenon" where my levels are consistently high in the morning before I eat. The last three days, it's been 156, 161 and 168 right before breakfast. This is not what I want to see (remember between 70 and 120 back there?). So, I need to tinker with my food, and I also need to tinker with the timing of my medication. On the advice of the diabetes educator, I started taking my metformin with breakfast and dinner instead of at bed and when I wake up. I have a sneaking suspicion that the bedtime dose of metformin was keeping my liver from dumping all the glucose in the middle of the night, and now it's not, so my levels are high in the morning. So, I'm going to have to tinker.

All in all, though, things are looking up. I get to go do taekwondo tonight, and my lunch was perfect (111 before lunch, 152 two hours later). I'll be interested to see how the TKD class affects all of this.

For my records these, are the last 3 days of readings:

4/168:00am156fasting
4/1610:00am1502-hr post
4/16noon108pre-lunch
4/162:00pm1692-hr post
4/168:30pm122pre-dinner
4/177:00am161fasting
4/179:00am1722-hr post
4/1711:45am116pre-lunch
4/171:45pm1482-hr post
4/176:00pm153pre-dinner
4/178:20pm1682-hr post
4/1710:30pm114before bed
4/186:00am141fasting
4/187:30am168still fasting (!)
4/189:30am1682-hr post
4/18noon111pre-lunch
4/182:15pm1522-hr post

Thursday, June 02, 2011

Let's get some things straight

It's been a while since I've posted. At one point, I had planned on posting something daily. Then, when that didn't work out, I thought I'd post weekly. Of course, that didn't work out, either, and here it is June of 2011, and I haven't posted since January of 2010. Oh, well, what ya gonna do?

Today is the day I post some truths. If you're squeamish about that stuff, you might not want to read on. But if you want to know who I really am, and what I think about stuff, and you think you can deal, please, do read on. Some of this may not be news to you, but I guarantee you that at least some of what you think you know about me is probably not what actually is.

I'm in two long-term committed relationships. Actually, that's kind of inaccurate; I'm in a single long-term committed relationship. My committed relationship just happens to have more than one person at each end. So, let's meet my immediate family. There's Barb, to whom I'm married (legally, even, in most states). She and I met way back when we were both in college. We met on a internet BBS (bulletin board system) the likes of which almost don't really exist any more. We had the usual long-distance courtship, and got married in 1994. It was a lovely wedding, many of our dear friends were in attendance, and aside from running out of the sparkling wine before we got any, all was well. Of course it was, because we fit nicely into the mold most people are comfortable with.

We had a pretty normal life as married students, and when the time came to be done with school, we moved to where there were high-tech jobs, which at the time was Dallas, Texas. This was also the time when we really got to know our dear friends, Chuck and Cheryl, who also lived in Dallas. It was actually Chuck who convinced me that moving to Dallas was a good idea, and in hindsight, he was right for many reasons.

In Dallas, we got to live the young dual-income-no-kids life, and it was good, even if the job I moved there for tried to kill me eventually, at which time I got another better one. And, we spent a lot of time with Chuck and Cheryl, both because we didn't really know anybody else down there, and also because they are delightful people.

At some point, Barb and I fell for Chuck and Cheryl. It's the only way I can describe it.

What do you do when that happens? We had both read Heinlein, and had been exposed to the concept of plural marriage, but only academically. This was for real, and it was happening to us. The two of us talked about it on many occasions, but figured it would pass as many things do.

It didn't pass.

But, time did pass, and situations changed, and I ended up taking a great opportunity in Abilene, Texas in 1998. Barb was happy to quit her awful job in Dallas, and we moved, thinking "Abilene's not that far from Dallas." Well, it turns out that Abilene really was far from Dallas after all, and we were pretty bummed because we didn't get to see Chuck and Cheryl very much any more. And, pretty soon, they pulled up stakes and moved up to Seattle, which is where Cheryl is from.

We tried to live the quiet suburban life, mostly successfully, but as happens, plans changed again when Barb called me up at work one day to tell me she was pregnant. So, we rented a house with a yard, and started setting up a home with a place for a new baby.

Most of 1999 was a blur; we went to lots of OB/GYN appointments, and in addition to the regular job I was working, I worked on my first start-up with Chuck and a high school friend of his. When it was almost time for baby Laura to arrive, Cheryl dropped everything and flew down and stayed with us and helped with, well, everything. It was really awesome, and she and I tag-teamed running interference for Barb while she labored and we were both right there when Laura was delivered. It was really the sweetest thing. Chuck was able to fly down and join us shortly thereafter, and it was like old times again.

I really can't stress enough how wonderful the two of them were and are.

Eventually, the time came for them to go back to their jobs and lives in Seattle, and we were sad to see them go, but we got on with life, but our relationship would never be the same after that.

Our hands were full with a new baby; neither of us knew anything about what you were supposed to do with a baby, but we muddled through, and life was good, and I took a bunch of photographs and wrote a lot of stuff, and worked like mad for most of the first half of 2000. Sadly, the start-up didn't work out, and we it up sometime in 2000. Things were afoot at my regular job, too, with lots of talk about closing the Abilene office, and I started looking around for what my next gig was going to be. I knew one thing for sure: Abilene was a one-horse town, and if my office closed down, there wasn't going to be anything for me to do there. So I started looking for jobs in the Kansas City area, but really without much luck. There is a small high-tech industry there, but it's a really small market, and at the time, was on the decline.

At this point Chuck pinged me and let me know that his company was hiring software architects. We had never even considered moving to Seattle before, but we thought I should at least check this opportunity out. Working with Chuck again was definitely a plus, too. For reasons I don't even remember, the two of them traveled to KC in June of 2000 and attended my sister's wedding (I was the photographer, and shrewdly predicted I'd need an assistant, a role Chuck filled well). Unfortunately, Laura was not having a good day and was being really fussy. So, while Chuck and I were photographing the wedding and Barb was standing up with Wendy, Cheryl sat in the car with Laura, who cried and fussed the whole time.

We got to spend a lot of quality time with Chuck and Cheryl that weekend, and I think it cemented in our minds what we had only kind of figured out in the previous two months; we didn't ever want to be away from these two again.

Well, word came down from my job that the office was indeed going away, and soon. So, we made arrangements to go visit Seattle in July, and we went up and stayed for a week or so and I interviewed with Chuck's (and Cheryl's, by that time) company. It was a really good visit and we fell in love with Seattle and even more with the two of them. The company made me an offer, and after talking it over, Barb and I decided that it was the right thing. So, we packed everything up, and tied up our loose ends and moved up to Seattle. Aside from some bumps in the road, it was a lovely drive up from Abilene to Seattle and we got to see a lot of the country we hadn't seen before, and it was all really cool.

At first, everything was really great. We had an awesome apartment in Bellevue, and I had a great job, and Barb and Laura had everything they needed, and our relationship with Chuck and Cheryl blossomed, and it was just wonderful.

And then, on the same day, all three of us got laid off. It was a freakin' nightmare.

A bunch of really bad stuff happened in the December 2000 - April 2001 timeframe, which I'm not going to go into here, because it's all water under the bridge, and there's no reason to open up old wounds, but at the end of it all, Cheryl was in her own apartment in West Seattle, and Chuck was living by himself in Kirkland, and I was unemployed again. That was a pretty stressful time, but we got through it all, and after a long wait, I found another job, and we were back on our feet enough that we bought a house in Des Moines in September.

Time passed, Chuck moved from Kirkland to Seattle, Cheryl moved from her apartment into her house in Shorewood, and through a fraternal organization we all belong to, we met Joe, and it became pretty obvious that Barb and Joe had some kind of mutual attraction going on.

More time passed, and the relationship between Barb, Cheryl and me settled out into something resembling comfortable, and I could tell how awesome Joe was for Barb and vice versa, and at some point everything just fell into a nice comfortable happiness.

It's been 17 years since Barb and I married, and 11 years since Cheryl joined our family, and 9 since Joe joined the family, and things have stabilized nicely. We're all pretty happy with everything. I love them all, and they all love me and each other. We all support each other, we all annoy each other, but we all know we're in it together, and we're in it for the long haul.

Laura Grace has never known anything different, and doesn't think it's out of the ordinary. I know this because she told me so today.

So, what's the point of all of this? Well, it's high time people understand that Cheryl and Joe are Very Important People to Barb and me. It's not legal to be married to more than one person in the state of Washington, but for all practical purposes, we are all married to each other. And, it's not a passing fad. I can't think of a better arrangement for my family.

I'm happy to answer any sincere questions anybody might have, but know this: this is for real and it's not immoral or evil just because it's not your cup of tea.



Postscript: You might be wondering what happened to Chuck. Chuck is still very much around, and we love him, too. He's had some things to deal with, but he's dealing with them, and he knows that we're all here for him whenever he needs us. Even Cheryl. Hell, especially Cheryl. :)

Saturday, January 30, 2010

Fitness, Health, Taekwondo and Me

Laura started taking taekwondo in November of 2008 at a school in Burien and it she seemed to really take to it. As I watched her in class and then watched her test for higher rank, it started looking kind of fun to me, too, and last April, I started taking classes. The first few classes were pretty hard and at the time I wasn't entirely sure that I'd be able to survive, but here it is, 9 months later, and I'm still going and progressing in rank (I'm a green belt and will be testing for purple in about 3 weeks).

When I started it was all I could do to do the three 45-minute classes a week, but eventually I joined the "master club" and stepped up to four one-hour classes per week, and started doing the W.A.R. workouts as well (W.A.R. == Warriors Achieving Results, a general workout/circuit training class that does a hard workout for 45 minutes). At my peak, I was working out before lunch 6 days a week for about 1/2 hour, 4 hour-long taekwondo classes, and 2 45 minute W.A.R. classes. I say, "at my peak", because of late, I haven't been doing the lunch workouts, and life keeps intervening, and I'm lucky if I can make two or three classes, and because of a bit of awesomeness (not) I pulled the other day, I ended up going to class and not to W.A.R. (note to self: don't forget to take your meds, forget to hydrate and then eat poorly on class/W.A.R. day or you will experience dizzyness and tunnel vision and have to stop).

I've discovered some unfortunate truths along the way. I remember at one point, long before I ever thought of doing taekwondo, learning "eating right is not enough". I.e., Eat the right number of calories in the right proportions of protein/carbohydrates/fat all you want, and that's great, you might even lose weight, but you won't be healthy. Now, I've learned "exercising lots is not enough". It helps with some of the numbers (cholesterol, blood sugar, blood pressure), but not enough. I guess I can't eat like "normal" (whatever that means) and exercise 6-8 hours a week and expect any real results; I am in better shape than I've been in a long time, and I do have more endurance and more wind, and it's important to look back at what I was like when I first started. But, it's not enough, because I have to lose weight, and I'm not really losing weight. I've lost a little, but my joints tell me that I need to lose a lot more. So, exercising lots is not enough either.

So, where to go from here? Well, it is fortuitous that next Monday is not just a Monday but also the 1st of February. I like beginnings and this one seems to be shouting at me "time for a new beginning!". I've found a tool that combines the utility of all the fitness/diet trackers out there with the annoying social aspects of Facebook and this combination may give me a bit of accountability, which I also need. If I put my food and exercise diary where my friends and family can see it, I'll at the very least be embarrassed when I eat a pizza (yah, a whole pizza) and either enter it where they can see it, or don't enter it out of shame. That will help in the short term, and maybe get me going towards forming more good habits for the long term. So, going back to the "new beginnings" theme, I'm going to start this plan on 2/1, and see how it goes.

Now, I've still got to get my head on straight, and that's the hardest part. If I don't do that, then it doesn't really matter what I do in the long run, because I'll just run back to my bad habits in times of stress like I always do. Gastric bypass, LAP band surgery, this new plan, none of it will matter unless I figure out why I have to eat like i do. Anyway, one thing at a time, I guess.

Sunday, March 15, 2009

It all started when I wrecked my bike...

So, about 5 or 6 years ago, when I was gung ho about cycling (not "riding bikes"), I was out riding the Interurban Trail, towing Laura behind me in a Burley. Joe and Cheryl were along. We went out about 5 miles and then turned around and headed back and decided to stop and rest and have some water, etc. I glided up, feathered the brakes, and ever-so-gently came to a stop. And then, realized my cleats were still stuck to the pedals because I had forgotten to click out at which time I panicked and instead of either a) clicking out and leaning over or b) PEDALING, I just fell over.

If there's a feeling sicker than that just before you hit the pavement because you forgot to click out of your pedals, I don't know what it would be. If you cycle, you know exactly what I'm talking about. If you don't, just trust me. It's the inevitability of the pavement meeting parts of one's body mixed together with the thought of "wow, I could have avoided this pain I'm about to feel if only I weren't a complete idiot" added to "sure are a lot of people around who are going to see this embarrassing spectacle". It's all bad is what I'm saying.

So, I hit the pavement. Hard. I also took a handlebar to the gut. Hard. Hard enough that the handlebar was all bent up and pretty much unusable in its newly current state. Laura, back in the Burly, was fine because the makers of the Burley are very aware that idiots like me exist and designed the burly so that if the cyclist goes Tango Uniform, the Burley remains upright and its passenger is spared the ugliness of being unceremoniously dumped out onto the pavement.

Laura, not knowing the agony I was in, thought it was pretty funny, which, in retrospect, it was, especially to a 3 year old. I, on the other hand, did not think it was funny. Actually, I didn't think about much of anything as I was concentrating on breathing; that handlebar knocked the wind out of me completely. I believe Cheryl and Joe were both concerned for my well-being because the next thing I remember is them asking if I was okay.

Well, I was okay enough at the time. It hurt a lot, but we still had 3-4 miles to go to get back to the cars, so I hauled this way and that on the handlebars to get them bent back into some kind of usable shape, and we headed back, and all was mostly well. Kind of. At the time, I was pretty sure that I had cracked a rib or two, but I didn't go to the doctor because I figured "what's a doctor going to do with cracked ribs anyway? tell me to take it easy and don't do that again?". In any case, I didn't bother with it and it wasn't long and all was well and normal again, and I replaced the handlebars and didn't think about the incident much.

Gross stuff coming; stop reading if you don't like gross stuff. On the other hand, if you are interested in why I would want to write the above stuff, read on.

Flash forward to about a year and half ago where I had this thing on my belly that was weird, but I didn't know what it was. All I knew was it poked out, and I could push it back in, and then later it would poke out again. I just figured it was part of a) being fat, or b) getting older or some combination thereof.

Well, I had this thing for a while, and didn't think much about it until it started hurting when I took my walks or played Dance Dance Revolution (a valuable part of my weight loss plan at the time, which was working, by the way). Still, I didn't really worry about it, although I did slow down, and eventually stop, the walking and DDR. After a while, though, I was starting to be irritated by this thing, and so was my family, and I had also figured out that it was probably a hernia.

So, I went to see Dr. Laura, our family doctor, and asked her about it and she confirmed that I had a hernia. About this time was when everything started the downhill slide, but I did not know it yet. She referred me to a surgeon and he looked at it, and we scheduled a surgery for early December. I angsted about the surgery, but did everything I was supposed to do: a bunch of blood tests, an EKG and show up at the outpatient surgery center early early in the morning. The surgery went pretty well, and I went home and did the recuperating thing, which also went okay. When I was "all better", though, I still had this frickin' pokin' out thing. So, when I went back to the surgeon for my follow-up, he said "Yah, I found exactly what I expected, an umbilical hernia and that's what I repaired. However, this other thing you have is not from that, and I really couldn't just do exploratory surgery while you were out (no consent), so we're going to have to go again."

Now we reach the point where I tie the bike stuff in with the hernia stuff. It turns out that most likely, this 2nd hernia (or the 1st one, from my point of view) got started the day I wrecked my bike and took the handlebar to the gut. To be fair, I do not think that had I rushed to the doctor that day, she would have found this and been able to give me a pill that would spare me future surgery. In any case, if you wear cleats and use clipless pedals, always remember to click a foot out before you stop and you can avoid this whole nightmare.

Back to the first surgery. Right before I went in, the anesthesiologist came to see me and confirm what I was getting done and so forth, and he mentioned in passing that I have a "funky EKG" and did I know anything about it? I, of course, did not know about it, but he didn't seem concerned and we went ahead with the surgery. I did, however, ask Dr. Laura what a "funky EKG" was and she got a copy of it and looked at it and had her husband look at it and concluded that I had Premature Ventricular Compressions (or PVCs), and referred me to a cardiologist to get checked out "Just In Case". As will become clear, this is the first and last "Just In Case" anything I'm doing because it all went sideways from here.

I had my first appointment with the cardiologist, and he ordered up a bunch of tests: another blood test, another EKG, an echocardiogram, a "Nuclear Stress Test" and I had to wear a monitor for 24 hours. I went and did all that stuff, which was a pain, and when it was all done, everything looked good except the results of the something-grams they took as part of the nuclear stress test were "inconclusive".

So, the cardiologist says "you need an angiogram." I had had enough of the testing, and really didn't want an angiogram. My surgery for hernia #2 (or #1, from my point of view) was scheduled for the end of the week and I just wanted to get it over with. Well, except, now I couldn't have my surgery; I was informed that no anesthesiologist would put me under with what was currently dictated into my file. So, I had to cancel the surgery and do an angiogram that day instead.

Let me tell you this: you do not want an angiogram. Not ever. They take a garden hose, and they shove it up into your femoral artery via your groing and use this to get a catheter into your heart so they can put a contrast dye in there and take picutres of your circulatory system. He told me I wouldn't feel anything other than a little pressure. What bullshit that was. In getting into the artery, they hit that big nerve that goes down the inside of my leg not once, not twice, but 3 times, and that utterly sucked.

The funny thing about all this is, about 30 seconds after they started actually taking the pictures he said I was "all clear, everything looked great", at which point I was wondering "Then why in the hell did I need this stupid angiogram in the first place?". He finished up, and they took me back out where I started and the nurses removed the garden hose, and I bled all over everything, and they applied pressure for 10 minutes and then I had to lay flat on my back for 3 hours and then I had to do laps of the recovery room and then they let me go home and I was sore for days. The cardiologist suggested that I could have the angiogram on Thursday and then the surgery on Friday, which in retrospect would have ended up working out logistically, but would have been a very bad idea for other reasons, chief among them that I would have been groin-sore and gut-sore and that would have been to much, I think.

I got my 2nd hernia surgery for the 2nd (1st) hernia a couple weeks later and here I sit, recuperating and healing up, and, truly, all's well that ends well, I guess. I'd just as soon have skipped the whole thing, which I could have done had just remembered that I needed to put a foot down a little bit earlier.

Also, medical care is expensive and I'm way glad I have health insurance. Oh, and the "funky EKG"? Perfectly normal, lots of people have PVCs.

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Monday, November 24, 2008

A Very Astute Take on Gay Marriage

song chart memes

Seriously, people, get over yourselves.