Goodbyes, WLS, Baseline, and the 12-Week Shape-Up

Farewell, Dear Friends

There's a large green apple slush on my desk, with Nerds. I just got it from Sonic, so it's not shedding dew drops yet. This is my dessert. Well, my second dessert. My first dessert was a half-a-pint of Talenti caramel ice cream with sea salt and caramel truffles that I had after lunch.

Lunch? It was McDonalds. Dinner was Skyline. I probably packed away 4000-4500 calories today. Is this a normal day? Not exactly. I've been spending the past week having food funerals. Every day, for lunch and for dinner, I visited an old fast-food stomping ground, ordered my favorite meal, and savored every processed, sugar-laden, carb-heavy mouthful.

Goodbye Junk, Hello Clean

Why am I saying goodbye to my old friends? Because a week ago, I received the materials from the VA that would start me on my journey towards weight loss surgery (WLS), a vertical sleeve gastrectomy (VSG), to be exact. I've not been approved yet - there's still some testing to do - but step one begins tomorrow. What is it?

Step 1: Participate in a 12-week, VA-managed weight loss program and lose at least 14 pounds.

If I clear the Step 1 hurdle, then the only thing between me and WLS is the testing, which I am working on knocking out during the next 12 weeks. If I have good results and am a good candidate for surgery, then I could be approved for surgery as early as September with surgery soon after.

And why am I having WLS? The truth is, I'm bad about cheating. Really bad. I've probably lost 150 pounds in my life, and regained it each time, then some. I cheat, then I feel bad, then I just fall off the wagon. I never had anyone to help me remain accountable. I never had the internal motivation to hold myself accountable. And darn it, bad food just tastes so good. WLS would be a tool to help me when my motivation is lacking. To remind me there are real and physical consequences to falling off the wagon.

Baseline

In March, I had some baseline testing done. Not because I thought I would be going through WLS, but because I found out I had VA coverage after 16 years out of the Navy. I wanted a full check up and tune up. I'm glad I got this done, though, so I know where I started. It's actually not bad despite the weight, but there is a spot or two for improvement.

Everyone has to start somewhere, and this will probably be the scariest post I write for this blog - the one where I share my baseline, because it's also known as "the mess I got my body into."

Weight
* Current weight: 320 lbs.
* My dietician's goal for me: 143 lbs.
* My personal goal: 140 lbs.

Blood Pressure
* Current BP (as of March, 2014): 137/79
* Ideal BP: <= 120/80
* Not too far off here, but I usually run 120/70, so the 137 had me troubled. The doctor wasn't concerned, though. My next visit I had, in April for my heart, had my BP at 121/73... so we're all good!

Lipid Panel (defined ranges from Mayo Clinic results web page)
* Current cholesterol: 162 mg/dL
* Desirable cholesterol: < 200 mg/dL

* HDL (good) cholesterol: 35 mg/dL
* Good HDL: > 50-59 mg/dL
* Best HDL: > 60 mg/dL
* According to my doctor, this number can be easily brought up with exercise. Isn't it convenient that I'm just about to start exercising? I'll love to see where this number is at in a few months.

* LDL (bad) cholesterol: 106 mg/dL
* Near Optimal LDL: 100-129 mg/dL
* Optimal LDL: < 100 mg/dL
* Very close to optimal, but still in a good range. I'm surprised, to say the least. Thanks, body!

* Current triglycerides: 104 mg/dL
* Desirable triglycerides: < 150 mg/dL

Metabolic Panel (defined ranges from IWMF and MT.gov)
* Current Glucose (fasting): 88 mg/dL
* Ideal Glucose: 10-99 mg/dL

* Current Sodium: 139 mEq/L
* Ideal Sodium: 136-144 mEq/L

* Current Potassium: 4.1 mEq/L
* Ideal Potassium: 3.7-5.2 mEq/L

* Current Chloride: 109 mmol/L
* Ideal Chloride: 96-106 mmol/L
* High levels can indicate dehydration, which, after 12 hours of fasting, is a distinct possibility.

* Current CO2: 24 mmol/L
* Ideal CO2: 20-29 mmol/L

* Current BUN: 9 mg/dL
* Ideal BUN: 7-20 mg/dL

* Current Creatinine: .75 mg/dL
* Ideal Creatinine: .8-1.4 mg/dL
* Low levels are "not common and not a cause for concern," but they can indicate malnutrition. Another side effect of 12 hours of fasting? Or maybe I'm not getting enough of the right vitamins. <-- Quite possible.

* Current Bun/creatinine ratio: 9
* Ideal BUN/creatinine ratio: 10:1 to 20:1
* Again with the malnutrition, but the creatinine level was so close to ideal that re-testing might change both of these numbers to ideal levels. Or taking a multi-vitamin.

* Current Calcium: 8.6 mg/dL
* Ideal Calcium: 8.5-10.9 mg/dL

* Current ALP: 77 IU/L
* Ideal ALP: 44-147 IU/L

* Current ALT: 19 IU/L
* Ideal ALT: 8-37 IU/L

* Current AST: 24 IU/L
* Ideal AST: 10-34 IU/L

Thyroid Function Test (defined ranges from Medline Plus)
* Current TSH: 2.01 mIU/L
* Ideal TSH: .4-4.0 mIU/L

EKG Test
* Normal!

So I have no thyroid issues or any other obvious issues lending to my weight gain. It's just good, old fashioned eating improperly.

Finally, I had one other issue I was concerned about: During bike riding, I was wheezing, coughing, and had a super-tight throat and chest. My doctor gave me an inhaler and I've not had a single issue with the wheezing, coughing, and tightness after ending a ride since (except the usual "Oh my god, I need air" gasping because I just rode hard). I had a heart stress test to rule out a heart condition, and my heart looks great. So it looks like I have EIB (exercise-induced bronchospasms) - nothing insurmountable with proper management, so yay for that!

Here We Go!

Starting tomorrow morning, myself and three of my work colleagues are starting a 12-Week Shape Up! program I created. I'm neither a nutritionist nor a fitness expert. I'm not a doctor, or a nurse, either. This program leaves a lot open to interpretation, which means you have to be your own advocate, learning from fitness and nutrition experts, or talking to your doctor or nurse as this program progresses.

Do you want to come along with us? It's easy!

1. First, weigh yourself. Get a starting baseline to work from. You can also do your measurements, your BMI, or even go to the doctor and get a full blood work-up. You need a baseline so you know how far you've gone. 
2. Second, be accountable. Find friends, family members, or internet buddies to help you through this. I'm using MyFitnessPal. It's available on Android, iOS, and on the PC/Mac. If you want me to be your motivational pal, friend me using my MFP name: Skylara. (Note: It's not very intuitive how to do this: Go to where you add friends, select the Email option, add my MFP name in the email spot and DO NOT click the blue-and-white plus sign, add your name, add your message, and send!)
3. Set realistic, but challenging goals. Set goals you know you can accomplish, but have to work at to do so.

12-Week Shape up! Week 1 Challenge: Write everything you eat down (try MyFitnessPal - it's a great way to journal exercise and food). Shoot for a set number of calories by week. I do it by week because you're going to have good and bad days. Don't let the bad ones get you down. Find a good calorie counter (like this one from the Mayo Clinic) and determine your daily caloric intake, then multiply by 7.

The mantra for this week is to write it down!

Ready? Let's go!

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Disclaimer: I am not a medical professional. Please speak to your doctor before beginning this or any stage of the 12-Week Shape Up!