Test Results Are In!

Today is the day, my return visit to the doctor to get the results of my blood work. I was very nervous going in for my first visit and way more nervous going in this time. Am I going to be showing signs of diabetes, is there anything else I don’t know? Plus, my appointment is right in the middle of the afternoon before my PMO team meeting, so I need to get there and back quickly.

First 2 things that weren’t good in the appointment were weight & blood pressure. When the nurse asked me to step on the scale, my impressive weight loss wasn’t as impressive. It was the afternoon, 2 meals consumed, lots of fluids and fully dressed unlike the morning. Still lost weight, but only 5 pounds and not as much as I saw in the morning. Oh well, I know I am doing well. Then, my blood pressure was pretty elevated when the nurse took it. I assumed this was just stress about my results so I didn’t think too much about it.

Then, the doctor came in and shared my results. So, the good news first, nothing is bad, nothing super-negative and nothing to be overly concerned about. However, there are some things that I need to work on. I had some elevated liver enzymes, nothing horrible, but need to work on through reduced alcohol consumption. Both sides of the cholesterol need some attention, exercise will help as will diet. I need to start taking a vitamin D supplement, but this is very normal in Ohio. Plus, I need to go get an x-ray on my knee to make sure everything is ok.

Then, after getting the results, my doctor asked me to take a couple of deep breaths and to relax. Then, he took another blood pressure reading and it was still very high – 158/110. This is way too high and needs attention. When I come back for the x-ray results, we will test again and I may need to go on blood pressure medication for a while. My doctor’s opinion is that the blood pressure is related to weight and stress with a heavy influence from the stress. He even asked whether my “measure everything” approach to getting healthy is helping or hurting on the stress level.

I scheduled my follow up appointment, left the office and immediately ordered a smart blood pressure cuff to start monitoring at home.

Week 1: my plan is working

After one week, I am happy to say the I have stuck to my plan and it is working for me. For seven straight days, I have tracked my food and drink intake and have exercised through walking. I really only walked for six days and skipped Saturday morning to sleep late, but I did choose to walk instead of drive to a hair appointment, so that’s some exercise.

My new wifi-enabled scale also arrived this week. So, now I am weighing myself every morning before going out or consuming any food or drink. I discovered that I need to weigh myself multiple consecutive times so I can get a solid reading, so that’s what I do. At the end of week 1, my weight is down to 316.4 but I was as low as 315.2 during the week. I never realized how much my weight can vary from day to day.

From a nutrition perspective, as of the start of the week the Lose It app defines my daily calorie target as 3,017 calories based on my current weight. By the end of the week, the daily target had dropped to 2,981. Fortunately, I have been able to keep my calorie consumption below my target for 6 of 7 days. The one day I missed was Friday and that was only by 125 calories including a trip to the movies. Craft beer and movie popcorn really add up in calories.

I also managed to reduce my drinking this week. Monday and Tuesday were completely alcohol free days and the rest of the week was pretty well throttled.

The week wasn’t all good though. Stress from work is still pretty severe and I haven’t managed to find a good way to reduce it yet. I have reduced my hours a bit, but this seems to have increased stress a bit – same work and expectations compressed into fewer hours. I have also not increased or improved my sleep. I am hopeful that all of this will get to a better point over time. Finally, I have developed some ankle pain that has pretty much subsided and some annoying recurring knee pain in the mornings. That will need to be a discussion topic at my follow-up appointment with my doctor.

I have also done lots of research on fitness trackers and plan to buy a Fitbit Charge 2 at some point over the next couple of weeks.

Early this week, the Lose It app sent an email suggesting an exercise that was really beneficial. The exercise was called “what’s your why”. Essentially, to write down why I am pursuing weight loss and improved health. So, here goes…

I am focusing on losing weight, eating better, exercising more and de-stressing because I am tired of being so overweight. It has annoyed me for years and I just have to address it. The time is now because I hit an embarrassing level at 325 pounds. Plus, I am over 40 now and need to get into some healthier habits or face terrible consequences – my dad died at 59 after a really rough 10+ years of suffering, my grandmother died at 63 after years of suffering. I don’t want this to be me.

My parting words from week 1 are that I know I won’t always be able to lose weight at this rate. But, it is just good to start out with a win and helps keep me motivated.

Let’s do this my way (with some help from Lord Kelvin)

I have a plan!

1. First off, I am going to start taking action now. It won’t be perfect, it may not be the successful approach, but I am going to start today and I am not going to stop.

2. I am an operations guy to my very core. That is just how I think. So, I am going to build my strategy around a quote from Lord Kelvin (later restated by Peter Drucker) that has worked for me in the past. “If you cannot measure it, you cannot improve it.” Or, stated differently, if I can measure it, I can manage it. That is what I am going to do. I will measure everything! Plus, I will hopefully mix in bit of another scientific principle, the act of measuring something changes its outcome.

3. I am going to embrace technology to aide in measurement. There are thousands of apps for my iPhone that can help. The first app is Apple Health which is built into the iPhone. Plus Apple Health is already tracking steps, stairs climbed, etc. I supplemented with Lose It to track food and drink consumption and My Water to track water intake. I will also start researching fitness trackers like Fitbit. Plus, I am going to look for a wifi-enabled smart scale to track weight.

4. I am going to focus on a few areas that will have the biggest impact. My goal is to have calories in be less than calories burned.

  • I will ensure that I am consuming sufficient water for hydration based on my weight and activity level.
  • I will ensure that I am reducing calories to a level where I am losing weight but not starving myself.
  • I will increase exercise through walking to try to get to the recommended 10,000 steps per day. Hopefully I can find a way to convert to calories burned

5. I am not going to give up anything I like. I am going to keep drinking and going to bars. I am going to keep eating the things I like (pizza stays, juicy steaks stay, etc.). I a, not going to deprive myself and am not going to let this suck. It has to be a good experience not horrible or it won’t last.

6. I am going to reduce my alcohol intake. I plan to shoot for 2 days per week without alcohol intake at all. Then, the other 5 days will include a reduction. The calorie monitoring will help with this.

7. I am going to embrace an important life hack I have learned about myself to make this work. In the mornings, when I complete my shower, my brain switches into work mode. I am in a rush to get out the door and anything that stands between showered Tony and work is going to get removed. I don’t know why, but that is just how my brain works. So, anything I want to accomplish in the morning has to be before I take my shower. Plus, pre-work morning activities are way more reliably in my control and likely to be completed than any other time of the day. This is something I learned over the years and proved when I started daily journaling in November of 2016. So, in the morning, pre-shower, I will start going for walks as long as weather supports.

8. I am going to share my goal and progress along the way with people around me (Liz, family, friends, coworkers, social media) so the can help hold me accountable. This reduces the likelihood that it will just be a flash in the pan because failure will be very visible.

9. I am going to reduce my work hours by coming in later in the morning. I can reinvest this time for exercise and begin managing stress. I will target arriving 8:30-9 in the morning instead of 7-7:30.

10. I will make this my priority. This is what my mission is right now and other things (like work) are secondary. The good news about that is that this is a project where success in in my control. This will make it a lot better than the perpetual daily failures in my other projects.

So, I have a strategy/plan for how I am going to accomplish my goal. But, I don’t really have a S.M.A.R.T. goal yet. I need to quantify my target – long and short term. Since weight loss is my focus, I will use weight targets as my metrics.

At my height, the BMI chart defines me as obese. I will move from obese to overweight from a BMI perspective at the 225 mark. So, that is my long term goal, to get out of the obese BMI range. So, I guess my long term goal is to lose 100 pounds and get to 225. An average of 2 pounds per week is considered the most aggressive weight loss rate that is considered healthy based on my research. At 2 pounds per week, factoring in some setbacks along the way, I am pretty much looking at a 1 year timeline.

So, my long term goal is… Lose 100 pounds and reach the 225 pound mark by June 18, 2018.

Now, to set some short term goals so I can stay motivated – the bigger you are, the easier it is to lose weight quickly. So, I am going to be more aggressive in the beginning.

  1. Lose 5 pounds by July 4th
  2. Lose 10 pounds before vacation, by 7/21
  3. Lose 25 pounds by Oktoberfest (9/23)
  4. Lose 50 pounds by Christmas 2017
  5. Lose 75 pounds by St. Patrick’s day 2018

I will see as I go if those goals are realistic or not. Now, time to get started putting my plan to work!

So, now what?

First day after the doctor visit and it is a Friday. Woke up with only one thing on my mind – my health. That continued at work so I spontaneously decided to take the afternoon off to think. I needed to pack my car for the lake (going to our cottage at Indian Lake) before Liz got home from work, so that gave me several hours of me time.

My doctor visit was eye opening and a big reality check. I am now dealing with 40 years of bad decisions and the results. Plus, I wasn’t done yet, still have the results of my blood work to look forward to in 2 weeks.

I really could do nothing differently, but I think those results could and likely would be tragic for me. I would essentially be saying these are the last 20 years of my life. But, that isn’t what I want to do. I don’t want that for me and I definitely don’t want to subject Liz to that.

Plus, there is another aspect to all of this…. I actually really want to get healthier. I hate being so overweight.. I hate not being able to buy clothes in normal stores and having to always be concerned about weight capacity on things like camp chairs. I hate not being able to do things that I know Liz wants to do like horseback riding. Plus I hate the little aches and pains, the terrible stomach and being so self-conscious all the time.

Unfortunately, it is way too easy to keep doing what I am doing instead of fixing it. I want to get better and have to challenge myself to do so. I want to change, I want to win and I want to be better!

I don’t really know how to do this. I don’t have a plan. I don’t even have a strategy, but I will by the end of this weekend. I am going to be at the lake so it will be a little relaxing and I can do some Googling and some planning.

I will walk away from the weekend with a strategy for success, it will be something tailored to who I am, it will be something I can stick with and I am going to take action. The time is now!

D(octcor) Day: 6/15/2017

From the minute I woke up, I was very nervous about going to the doctor. What would happen in the visit? What would he tell me? Is there something major wrong with me? Do I really have to do this? Plus, I knew he would tell me the things that I already know about myself that I don’t like to think about.

My doctor is in a building in my old neighborhood. He is actually an LPN and it is a non-profit medical center. They often focus on people who are uninsured, sometimes homeless, sometimes mentally ill and most cannot pay. So, one of the forms presented to me was for me to request financial assistance – I didn’t fill that out because my insurance worked great. So, after finding the place, I walked in the door and went to front desk where I was presented with the big clipboard of forms.

I started filling out the forms and they were the standard fare of personal information and contact info. Then there was the insurance information. Then came the health profile. Some things on these forms really jumped out at me and ratcheted up my anxiety even a bit further:

  • Alcohol habits: I rarely add up how many drinks I have over the course of a week and it was surprising to me when I did.
  • Exercise: I had to report myself as being on the bottom level of the scale for how much exercise I get.
  • Family health history: I don’t know a ton about my family health, but what I do know wasn’t good – diabetes (paired with obesity), cancer (paired with smoking), early death.
  • My health conditions: a lot of the illnesses or conditions that are on the form happen to me occasionally.
  • Depression: when completing the questions about depression, I scored myself higher than I would have liked. But, as I reflect on how I answered, I think I was too pessimistic.

I completed the forms and waited for my turn. The nurse (who I immediately hit it off with) came out and called my name. We walked through the door an immediately stopped at the scale. Here is comes, I bet I am 305-310 pounds based on my lifestyle. I stepped on the scale and….. 325! Holy shit! How in the world did I get to be 325 pounds?! That is very disappointing, frustrating and embarrassing.

We got to the exam room and went through collecting vitals and lots more questions (some overlapping what was on the form). Blood pressure: 120/80, that’s pretty good. Temperature, heart rate – no idea where this landed. Alcohol consumption amount, stress levels, exercise levels, health conditions… the nurse seemed surprised at some of my answers which drove even more anxiety. We wrapped up and she told me that the doctor would be in in a moment.

The doctor came in and we reviewed some of the items that I came to talk about, my answers on the form and to the nurse and he did his own tests – heart, ears, throat, thyroid, etc. Then, we talked through the biggest areas of concern and some actions I should be taking:

  • Weight: number one concern is that I weigh FAR too much and need to begin addressing it quickly. This should be helped by the next 3 concerns / recommendations.
  • Nutrition: I need to start eating better and be more conscious about the calories and nutrients I am taking in.
  • Exercise: doing none, need to find a way to do more.
  • Alcohol: I am drinking too much, an unhealthy amount. It adds tons of extra calories, it slows my metabolism and could bring other health issues. He went as far as to ask whether I thought I needed some counseling to help – that was a shocking question to me! I don’t drink THAT much and I know plenty of people who drink more.
  • Posture: my shoulder and neck posture suck and he guessed that I have been in IT and similar jobs for years, hunched over a computer. I need to find exercises to help fix this and it will eliminate some of my shoulder pains.
  • Work Hours: He asked how many hours I am working each week. I explained that I stopped counting when I moved into my current job because I kind of didn’t want to know. Then, he made me walk him through a typical week and we counted that I worked 60-65 hours per week on average – wow! This was a concern because it is driving the next issue.
  • Stress: a lot of my answers and symptoms (including the digestion problems that brought me in) point to having too much stress. We talked about how prolonged stress can lead to death and a variety of serious medical issues. My acid reflux, which is pretty bad at times, is likely driven by stress and weight.
  • Sleep: my quantity and quality of sleep are both poor. Sleeping an average of 4-5 hours per night is not enough to recharge my body or to get good, rejuvenating sleep. So, the quality of my sleep is poor because of the amount and my weight contributing to snoring and such.

So, that’s all pretty bad. The worst part about this, is that none of the concerns we had discussed so far were things out of my control. They are problems that I have caused for myself over the years and I am the only one to blame.

Next was the big moment, he told me that he was going to want to draw blood to send for lab tests to see if there are other issues we should be addressing. The last time I had blood taken, I was a kid (probably 10-12). They had trouble finding a vein and I almost passed out as they were digging. Pretty traumatic and probably part of the reason I don’t go to doctors.

The nurse came in and brought her vampire kit. She put the band on my arm, stuck the needle in and missed the vein. She then tried again and kind of got it, but the flow was really limited. So, she started working the needle around to get it better. I started sweating, feeling chills, feeling a bit light-headed and she saw it on my face. She immediately stopped and I was ok. So then recommended that I go to the main office location (just 2 miles away) where a phlebotomist could draw the blood instead. You mean I have to go through this again?!

I made a follow-up appointment for 2 weeks out to get the results and headed to the other location. I went in and got right to the phlebotomist and sat in her “office” – more like a closet with a chair in it. She took a look at both arms and identified a vein that looked most accessible – the same one that failed before. But, hey, what the hell, let’s do it! She put the band on my arm, stuck the needle in and bingo! Blood started flowing just fine and it wasn’t all that uncomfortable. Ultimately, she took 6 vials of blood and I felt like a juice box!

I walked out and headed to Starbucks for some food and then stopped by home to fill my wife Liz in on everything. Then off to work. While there, I told my story many times to my friends in the office who all wanted to know how it went. As I was telling the story, a couple of them talked to me about the drinking and it started making me feel like an alcoholic, that made me feel awkward.

What am I going to do about all of this? Doing nothing isn’t really an option unless I want to die early like my dad. I need some time to think….