TMI -- A Saga of Weight Loss, Exercise, Tummy-Tucks, and Health
This definitely falls into the category of TMI (Too Much Information) but it seems to be the way of the blogosphere so what the hell...
I had been obese basically all my life. I remember being overweight at age 8 and enjoying overeating. I was over 300 pounds since age 30 and it just was a lifestyle of consuming too much food and being good at cracking self-deprecating jokes (some of you may remember me describing my 4XL shirts as "scalable middlewear"). In late 2002 and through 2003, I packed on even more weight. I remember a discussion with my doctor that I should consider one of those surgeries (e.g. gastric bypass) to help you lose the weight... That didn't seem like an appealing idea.
Here I am with with my friend Gurpreet Pall in early January, 2004.
In mid-January, 2004, I went to "Bed, Bath, and Beyond" and bought a digital scale. I brought it home and noticed it had a weight limit of 330 pounds. When I stepped on it, the scale said "Err". This didn't seem right so I took of my clothes and tried again... it still said "Err". This wasn't good! At the time, I was having difficulty getting my 4XL shirts and 48 inch pants on since I was too large for them to fit. I made a decision to change this.
Starting sometime in January, 2004, I started eating less. My rules were:
1) Absolutely no sweets,
2) Absolutely NOTHING between meals except water, coffee, and diet coke, and
3) Two small plates of food served (lunch and dinner) and NEVER return for seconds.
Later, I added a fourth rule: If you are still eating and you are not hungry, stop eating.
Now, as I got started, the size of the two meals was a bit larger... It took a few weeks of adjusting to get down to the meals being close to a salad plate in size. I did not (initially) exercise but I had always enjoyed walking.
It took a bit of time but I soon adapted to life with these rules. I found small portions in the cafeteria. I learned that I could order a chicken salad at a restaurant when out to dinner. Soon, the shirt and pants were a bit looser and I didn't feel the need to buy 5XL shirts and 50 inch pants. I kept this up and was determined to lose the weight. There are MANY social situations that drive people to undermine this effort ("Oh, you've been so good, won't you just have a small piece of cake?"). Fortunately, after a month or two of NO sweets, a simple taste of the sugary stuff was awful.
A bit more on purchasing clothes... America has these places called "Big and Tall Stores" (or what I affectionately referred to as "Seattle Tent and Awning"). You simply can't buy clothes that fit you when you are morbidly obese (which is the technical term for my status for most of my life) unless you drive yourself to these separate stores. I would show up at TechEd and other events and they would have speaker shirts in any size you want up to 2XL... I would joke that two 2XLs still won't work... "We seem to have a problem with scalable middlewear".
As February, March, and April wore on, I gradually got smaller. Every time I stepped on the scale, it said "Err". By March, I was able to fit into 3XL shirts and 46 inch pants. Still, the scale said "Err". These smaller clothes started getting looser... Still, the scale said "Err". I think it was sometime in May that I stepped on the scale and it said "329.8"! I got really excited and leaned forward... the scale then said "Err". I don't really know, but I think my peak weight was 360 pounds.
It was right around this time that my mother who had been very ill passed away. You have to make a decision that your health won't be driven by the emotional challenges in your life and I managed to follow my rules for dietary intake while going through these personal challenges. A few days after the funeral, my wife, Michelle, started having so much nerve pain in her legs ("neuropathy") that she stopped being able to walk... Again, you have to separate the emotions from the reality of your health. Overeating won't help...
As the Summer and Fall progressed, I was dropping 8 to 10 pounds a month simply by portion control (following my four rules). We were all surprised when Michelle passed away at the beginning of September, 2004, and that was very hard on me. Still, I knew in my heart that it was essential that I control my health and future. I had lived a life where I ate for emotional uplifting and (big surprise!) it didn't make me happy. It is a very human thing to look to food for emotional support but it doesn't end up doing anything but make you feel bad about yourself and perpetuate the cycle. Even with major life stresses happening around me, there was no upside to eating for emotions rather than eating for nutrition. In September, I was still right around 300 pounds and that clearly wasn't where I needed to be. So, I kept going with the portion control.
It was around this time (I was down 70 pounds) when I asked a young (and petite) colleague at Microsoft named Maegen how much she weighed. Maegen said "Oh my gosh! I've gained SO much... I weigh 96 pounds!!" My response was that we needed to have a party when "Pat lost a Maegen".
One thing that was a big joy was the downsizing of the clothes... 4XL to 3XL. 3XL to 2XL. 48 to 46 to 44 to 42 inch pants... Each time, I gave away ALL the old clothes to charity and bought new clothes. Being a nerd, I didn't need to buy too many outfits. By now, I knew that a size was only going to last 2 months or so and I didn't need to buy a lot of stuff. Still, I was absolutely determined to give away ANYTHING that became too loose. There was no going back to the old me. I remember the excitement of being able to buy a 2XL leather jacket in October or so. The 4XL leather jacket was swimming on me and I bought a smaller one. This was still at the Big and Tall Store but getting noticeably smaller.
In October, I went with my friend Gurpreet on a business trip to India and we stopped by to see his family home and meet his family. I vividly remember the astonishing food! I was happy to enjoy modest amounts of it and still control what my intake was. It was an important lesson to me to own my health as I was going through so many different emotional changes. Still, I couldn't see how I was going to be happier by burying myself into some dessert! Here I am in India in mid-October, 2004.
I remember Thanksgiving, 2004 at my daughter's house. It was weird to serve all the normal turkey and its fixings but to serve a small single portion. It felt right and it was a good gathering in spite of all the changes and difficulties of 2004.
By December I was under 270 pounds. I remember being down 92 pounds and asking my friend Maegen when we can have a "Pat lost a Maegen" party. She said "Oh, No!! I've gained weight and am now 100 pounds!". My response was "Work with me... Let's meet in the middle!"
By March of 2005, that same old scale that used to say "Err" read in the low 240s. In April, the mid 230s. These few months were when I had decided to try something new, had moved to downtown Seattle, changed jobs to try Amazon, and had just met Lisa. Now, I needed to balance courting this lovely lady with not gaining too much weight. Fortunately, I was living and working in downtown and walked EVERYWHERE. Getting to work was a brisk 15 minute walk and then a ride on the bus in the downtown bus tunnel. Everywhere we went was a walk. Moving around allowed me to increase my food. Honestly, I let myself slip back a bit and allowed the scale to pull back up to around 240. I was able to hold it there. Soon, I was walking the entire 2 miles each way to work at Amazon.
Here I am with Lisa in June of 2005:
By April of 2006, Lisa and I (now married since November, 2005) joined the Washington Athletic Club and had personal trainers. After a few months, we were both seeing Shaine at the WAC (I meet him at 6AM and Lisa at 10 or 11AM). For a long time, it was 45 minutes of weights 3 times a week, now I'm up to an hour. I combine that with a killer (500 calorie) cardio workout and it makes a WORLD of difference in how I feel. My favorite cardio torture is the StepMill (affectionately known at the WAC as the "Gauntlet"). This is a conveyor belt stair that doesn't friggin stop! It is normal for me to do around 140 flights of steps (at 16 steps per flight) over a 30 minute workout. Every single time, I swear I can't finish it but somehow I seem to and, after recovering for a few minutes and showering, I feel fantastic!
So now, let's get to the real TMI part of the story. It turns out when you drop a lot of weight, the skin doesn't get any smaller. You start to look like a shriveled up raisin with lots of skin and not enough inside. As I would talk to my doctor (who was THRILLED with my weigh loss without surgery), he said it is wise to hold your weight for at least a year before cutting off the skin. Simple statistics show that most of us that lose weight go back to old habits and then regain the weight (sometimes even more than originally). It is REALLY bad to cut off the skin and then pack back the weight so you really need to show yourself you have changed your lifestyle.
Anyway, last Fall, Lisa was feeling she wanted to get a tummy-tuck (abdominoplasty) since she was unhappy with how her clothes fit her (and she is a beautiful women who cares about how she looks). We were sitting in the plastic surgeon's office working on her plans and I said "What the heck! I'm never gonna make these shirts fit without help, either!". So we decided to give each other tummy-tucks and liposuction for Christmas. In my case, in addition to my belly, my chest was still misshaped from carrying too much blubber. So, December 5th, was Lisa's surgery day (and I remember pounding away in the waiting room writing the final version of "Life Beyond Distributed Transactions: an Apostate's Opinion" since I was right up against the deadline...) Lisa had a tough time recovering and ended up staying in the hospital for one night but quickly was ecstatic with the results. As we looked forward to my planned December 22nd surgery I asked her what the experience was like. She responded that she counted backwards from 10, 9, 8... and someone had taken a chainsaw to her abdomen... I gulped.
December 22nd, 2006 was my day for surgery. We had pre-arranged that I would stay in the hospital since Lisa, three weeks out of surgery, was concerned (legitimately) about caring for someone significantly larger than she is. Lisa is a registered nurse and knows that you need to be careful about healing. I went into surgery at 7AM and remember awakening at around noon. For me, it was different, though. For some reason, I wasn't too annoyed by the pain in either my abdomen or my chest (which had received liposuction). Indeed, I got quite high energy moving around and saying I didn't hurt. I didn't find the need for any of the pain medications. Apparently, I get this from my father who has experienced major surgery (aorta repair) and not wanted pain medication... I could mostly feel pain when I was moving and pulling but had no problem when lying still. Being a high-energy nutcase, I did a lot of moving (more than was good for me). This opened up the wounds a bit and Lisa had to work hard to get me to calm my butt down and let the wounds close... She ordered me to stay FLAT for the first night to let the bleeding stop (which I reluctantly did). Our friend, Charlie (a VP at Amazon and a dear friend), came and drove me home from the hospital (since Lisa was so recently out of surgery).
We live in downtown Seattle in a condo on top of a very nice hotel with a wonderful restaurant. My aspirations for recovery included having the special Christmas dinner sent to our home (via room service) three days after surgery. I then hoped to be downstairs for the special New Year's Eve dinner nine days after surgery. I met both goals.
After the December 22nd surgery, I was off the exercise program for almost a month. They had tightened up the muscles in the abdominal wall and removed over 10 vertical inches of skin (relocating the belly button). Before surgery, you could grab fists full of skin on my belly. The incision went on the belt line from pelvic bone to pelvic bone. Of my 38 inch waste, about 40% of it was horizontally cut. The front of my abdomen was now straight up and down and that was AWESOME. It was a huge and noticeable change. My chest was smaller but still looked weird. Also, by pulling so much skin straight down my sides (right above the belt line) stuck out in a goofy way. While it was a LOT better (and well worth the difficulties of the process), it wasn't looking good enough for me to feel happy wearing a tight shirt. I kept wearing the loose Extra-Large Tall shirts to hide the distortions. Still, it was a LOT better.
So, after much discussion and healing, I decided to go for "Tummy-Tuck 2.0". On May 18th, 2007, I went back under the knife. This time the surgeon removed skin from my chest and reshaped it (also moving the nipple upwards). The scars are shaped like a comma with the tail of the comma moving away from the midline of the body. For my belly, the belt line incision was extended to be about 65% of the circumference of my 38 inch waist (maybe 24-25 inches) and wraps quite a ways around my back on both sides.
The second surgery was a lot easier. Surgery was Friday morning and I went home at around 3PM that day with Lisa driving and me walking just fine (if gingerly). Charlie called Saturday morning to see if I was in the hospital still and was surprised to find out I was home. We agreed he would come by and have dinner with us. When our friends Mike and Barb called to say they wanted to drop off the case of wine they scored for us, we asked them to stay for dinner. 30 hours after waking up from surgery, I was downstairs at our restaurant having dinner in a party of five. I ate light but had a great time... we visited for about 3 hours and I was tired. Again, I moved around too much... Seems like I'm always wanting to move. I was working at home starting Sunday, had the drains removed Monday, worked a half day at MSFT on Thursday and then had the staples (yup, they stapled my incision -- all 24-25 inches of it) removed on Thursday afternoon and was back at work all day Friday a week after surgery. Now, my excessive moving did come back to bite me as I opened up about a two inch gap on my left side... Consultation with the surgeon revealed that this will just close up over a 1-2 week period and, indeed, it mostly has.
So, I am a bit more than 3 weeks after surgery and have resumed weight lifting and cardio... Shaine, our trainer, keeps telling me "NO!" as I want to try something that may put pressure on my abdomen. He also rats me out to Lisa when I overdo... ;-) I climbed 115 flights of steps in 30 minutes last Friday (exactly 3 weeks after being under the knife) and the hole in my side is closed up and on its way to healing. I wanted to push harder but think I can ramp up over the next week or so back to my normal 140 flights in 30 minutes.
Here's some photos from the last week. I have been accused of joining the witness protection program as no one can recognize me! It is a LOT of fun when dear friends can't recognize me... I shock the crap out of them.
Turns out my office at Microsoft was moved on May 18th, as I am now working for Jason Zander on the .NET Frameworks (more on that soon). I have an INSANE office with lots of paraphernalia which takes HOURS to set up. It has been killing me to leave the stuff packed and not get settled in. I will be working on that this weekend since I am now feeling strong enough. More blog entries soon on the office.
Anyway, I am not proud of what I had let myself become. Neither for the health aspects nor for how I presented myself. At 240 pounds, I am still at least 30 pounds overweight and want to gradually work that down (and build muscle) to be healthier. I am not panicked about the remaining weight loss but rather determined to have a lifestyle which leads to more health and happiness. While I am not proud of where I was most of my life, I am proud of the changes.
I remember spending over 30 years feeling like I couldn't do anything about my weight. When people ask me how I accomplished it I have a number of quips I frequently respond with. The most honest and direct answer is "I changed my mind". When you realize you own your body and you own your decisions then you make things change. For me, I had to decide that I needed to eat for nutrition and not emotion. Now, I must say that I am enjoying myself now and eating like a normal person does... Sometimes too much and frequently with wonderful food. I'm going to have to either cut back on food and/or increase the exercise to move down from that 240 pound plateau. For me and at this stage in my life, I want to make that be an enjoyable journey but I want to move forward gradually and in a way that is a permanent lifestyle.
Lisa and I gave away all my Extra-Large shirts this week.
All my best,