MY AMAZING WIFE lost her pregnancy weight; I did not.
That’s kind of how it all started. Just over 32 years ago on March 26, 1988 I married the most amazing woman, and at the time I was a woefully skinny 165 pounds (74.8kg, way too thin for my 6'0" (183 cm) height and big-framed body type). Within six weeks, we learned that we were expecting our first child. Michelle was SO SICK with morning sickness all the time, and quite literally the only food she could keep down was my totally amazing malted milk shakes. So I made one for her every night. Of course, I gulped one (or more) down, too. Nine months later we were blessed with our first child (of six), Justin. Michelle lost her pregnancy weight almost right away; I, of course, kept mine. We went on to have five more children over the next 10 years, so… yes… rinse and repeat five more times.
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| Me, in an old suit that fit me at about 280 pounds, and in my new suit, at 200 pounds. |
I’ve gone from having to wear 4XL shirts and 46-inch waist pants to now regular XL shirts, and my-now-34-inch waist pants are no longer snug (will be in 32s before long). IT HAS BEEN AMAZING!!!
Everybody’s thoughtfulness has motivated and inspired me to keep pressing forward, despite hardships and challenges, and the very fact that I have motivated so many others has me wanting to be successful with this for the rest of my life. I won’t let you down; I’ll keep this weight off and be healthy!
Through it all, the #1 question I’ve heard is “How did you do it?!” So here I share my journey with you…
SEESAW
Recognizing the obvious problems of obesity, I’ve tried to fight it for the last three decades. It was winning. Occasionally, I’d do everything right: diet, exercise, sleep (OK I’ve always been a horrible sleeper so I failed in this category), and within weeks I would lose 20 pounds. However, no matter what I did my weight loss stopped there; I couldn’t lose any more. So I’d give up, go back to “normal” and by the time I added on another 25 pounds or so, I’d repeat the cycle. Hence the 30-year weight-creep.
As such, my doctors and I thought I would be a prime candidate for weight loss surgery because I could lose weight… to a point. I had heard nightmare stories about the traditional gastric bypass surgery and wasn’t too keen on that. However, doctors told me of this relatively new method, a sleeve gastrectomy, generally more tolerable and more effective long-term. I was in!
PREP/SKEPTICISM
In order for my insurance to cover this, they required quite a lot. Specifically:
1. BMI: I had to medically document at least five years of continuous BMI (body mass index) of at least 35% (35% body fat). Fortunately, I’ve been seeing the same family doctor for 10+ years and this was all well-documented.
2. Meetings: I had to meet with my surgeon, Dr. David Brown of Idaho Bariatric and Metabolic Institute, monthly for six months, to prepare for pre- and post-surgery life.
3. Pshrink: I had to pass a psychological evaluation. Whew! Dodged a bullet in passing that one! I was cleared to mentally “handle” this surgery.
4. Nutritionist: I had to meet with nutritionists to learn about my new diet, and even start that new diet and adapt to it before surgery.
5. Weight Loss: I had to demonstrate that I could lose weight, before the surgery.
That last one, above, was super easy. True to form, I started on the journey and within two months had lost 20 pounds. I could lose weight, indeed. However, for the next four months, even with the new diet, I could lose no more.
The requirement to meet with my surgeon monthly was supremely annoying. After all, I had committed to this and just wanted to move forward right away. In hindsight (always 20/20), I am now so grateful for this arduous requirement. I solidly believe that six months of prep work is the single biggest key to my success with the journey to date.
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| Me at 325 and at 210. |
Now I’m a huge believer. All of that came true! I now even like broccoli, those ridiculous little green trees! My new diet (more on that later) calls for a lots of meats, cheeses, avocados and other high-fat foods with no sugars nor carbs, and also foods like non-root vegetables, and eggs. Last November in Seoul at a pub I ordered water and a cheese plate, and one of the cheeses had apple chunks in it. My colleagues laughed at me because I couldn’t eat that cheese as it was too sweet (they didn’t think it was sweet at all). In January I had a bite of fried pineapple at a churrasco in Tokyo, and it was so sweet it had me on the verge of losing all the wonderful Brazilian meats I had just enjoyed.
An additional part of the pre- and post-op diet prep was that my surgeon taught me new ways to eat (the process). These include:
- No drinking... anything at all 30 minutes prior to and during a meal.
- Chew... every bite a minimum of 30 bites.
- Wait... a minute between each bite of food.
THE BIG DAY
With all that prep done, the day had come. On September 17, 2019 I had the surgery. It was about an hour-long procedure that the doctor said went very well.
WARNING: This next paragraph may be a bit graphic for some readers, so please proceed with caution. I want to be open and transparent about my journey. Not just share the successes, but also share with you the ugly stuff, too.
When I started waking up in the surgery recovery room, I was a huge, vomitous monster. Oh man the vomiting!!! It’s kind of hard to describe how awful this was. For hours, too, I was unable to pee. Not an uncommon reaction to anesthesia; however, once my bladder ultrasounded at 900+ cc of urine (nearly 1L or 1 quart!), in came the catheter. Finally, everything calming down and I was transferred up to my regular hospital room some 5-6 hours after surgery (quite a bit longer than usual). To add insult to injury, my blood pressure was bouncing all over the place. This yoyo would swing from a high of like 220/160 back down to a closer-to-normal 135/90, and back again, constantly. Later that night I hit my low, the darkest hour in all of this. Sometime around 2am/3am, laying in a quiet, darkened hospital room I had what was probably an anxiety attack. Amidst the pain and barfing, I certainly thought and may have even uttered aloud to nobody in particular, “Oh God! What have I done?!”
However, the next day things started to turn positive. With my BP yoyo-ing they kept this barfmonster in the hospital for two nights instead of the usual one, but I was allowed to go home on September 19th. Then the fun really began. No… seriously… parts of it were quite fun!
AFTER THE SURGERY
For the first three weeks after surgery, I was on a completely clear liquid diet. However, after 3-4 days I started keeping all of this down as the barfing subsided. After that, I had to do another three weeks of an “interim” diet where I could introduce eggs, no-sugar cheeses, and avocados. We visited the import cheese section of our local grocers and my love of cheese has deepened.
The most fun part of this first six weeks was the daily weigh-ins. Over the last 193 days I’ve lost an average of 0.65 pounds (0.3kg) a day; however, in this first six weeks there were days that I lost over two pounds – it was crazy!
I had been told not to travel for at least three weeks after surgery, which as most of you know, is quite difficult for me. I normally travel up to 300 days a year, mostly to Asia, but also to a lesser extent Europe and even domestically. I wanted to do this right, though, and I committed to stay home and not travel for six weeks. Right at about six weeks I had a need to travel to China, a big trip. So to prepare for it, Michelle and I planned for and pulled off an absolutely amazing 3-day trip to Branson, Missouri beginning on October 21st – I made it just over four weeks. We had great time!
After those first six weeks, I could return to my “new normal” diet, details to follow.
MY NEW DIET: HYPER KETO
When people hear of my new diet they often ask, “How long do you have to follow that diet?” That’s just it… IT’S LIFELONG. It’s not a transition diet; it’s what I’ll enjoy for the rest of my life, and I’m committed to it. It’s essentially a no-sugars-and-carbs, high-protein, high-fats diet. Some would call that a “keto” diet where your body stays in a constant state of ketosis. The average American consumes about 400 grams (about 14 ounces) of carbs every day. For the Japanese (I’ve looked it up since I spend so much time in Japan), this is about 350 grams. The typical “keto” diet allows 50g to 100g of carbs per day. I strive for no more than 20 grams. Think about all the foods you eat; this is pretty tough! However, I’ve gotten pretty used to it, and I don’t really even count carbs anymore, unless it’s a rare “cheat” day and I pop up over 20 grams of carb in a day (I don’t believe I’ve ever done more than 50g in a day since I started all of this… well except for three days before surgery when the whole family went to Cheesecake Factory and I ordered their three-cheese pasta as a “last big hurrah”).
So what does this mean? It means,
- No pasta, grains, nor breads. I kinda miss pasta but I certainly don’t crave it (again referencing the way the surgery retrains your brain). Completely restraining from bread isn’t a big deal (though lately a grilled cheese sandwich has sounded good). I’m not gonna lie: Asia being my life, I do miss rice.
- No fruit. That’s right… fruit has a lot of naturally occurring sugar in it, so I eat almost no fruit, and I’m OK with that.
- No root vegetables. Though leafy greens, broccoli, asparagus and some other veggies are allowed, things like potatoes, carrots and other root vegetables are absolutely out – loaded with carbs!
- High-protein, high-fat. At first, “Drink only whole milk” and “Sure, dip your fried asparagus in lots of butter” sounded completely contrary to a weight-loss regimen, but I cannot deny the obvious results (though, milk having some carbs, I drink only about one cup every other day)!
I haven’t eaten potatoes; I haven’t had an ice cream sundae in more than 8 months. I will drink an occasional “zero” soda (no fat, no carbs, no sugar) – still not that great for me, but hey… I’m human. I tried a regular Coke in Japan last month and absolutely couldn’t stand it. I’m sure I drank no more than a single ounce, but it tasted so gross to me that the rest of it went down the sink.
THE SCIENCE BEHIND KETO
Yeah, I had heard about keto and was always skeptical, but am now a huge believer.
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| March 9: I bought an entirely new wardrobe. |
Sure… there are critics of the keto diet, that it doesn’t supply your body with enough of what it needs. And no diet is perfect (in my view). But… the results are in and who am I to challenge them? All that said, I take a daily bariatric vitamin, I’ll occasionally eat slightly-higher-but-still-low-carb foods when my body feels a genuine need, and my doctors and I are watching all of my blood chemistries and otherwise ensuring that I’m healthy.
And… oh… that “genuine need” that I mentioned above, welcome to the biggest side-effect of a keto diet: constipation. I’ve always considered myself a “regular guy” but now I’m anything but regular – haha! I have a daily dose of MiraLAX, and whenever I need to I’ll eat some fruit, strawberries or the like, to meet my regular needs.
BIGGEST LOSER
Dr. Brown has indicated that I’m one of his “biggest losers” in his many years in practice. As such, there have been times where we’ve worried that I could be losing weight too fast. To make sure I’m doing this safely, my doctors have ordered quite frequent blood tests to monitor all of my blood chemistries. Back in November, I had a potassium deficiency. We solved it by eating a half-a-banana (averages 27g of grabs per banana) every other day for a couple of weeks. It’s back to normal now. In December we started noticing that my liver enzymes were substantially off. We took measures against this, and now all of my enzyme levels are perfect. As are all of my other blood chemistries. It’s amazing!!!
BIG SIDE EFFECT
So here I am the picture of health and fitness, right? Well… yeah… pretty much! However, one very common (so I’ve come to understand) side effect of rapid weight loss is the development of gall stones. We first saw mine back in January when they did an ultrasound of my liver in diagnosing my liver enzymes challenges (the gall bladder is part of this scan). I had that ultrasound in January and the following day took off for Beijing (fear not, the last day I was in China was January 9th) and Seoul and Tokyo. On the flight over, I had very mysterious back pains which were persistent that whole trip. By the time I landed in Beijing the blood test results were in with a warning from my primary care physician, Dr. Robert Perko: “Watch for abdominal cramping in your upper right side, and nausea. Oh… and don’t be surprised if you have some pain radiate into your back.” Oh really?! That explained the mysterious back pain.
We tried to deal with it naturally over the last couple of months, to no avail. Long story short, I ended up in the hospital emergency room on Wednesday, March 18 in agonizing pain, low-grade fever, and incredible chills. I’ve done the sepsis thing before, so that was a huge concern. Fortunately, there was no infection, and after scrambling to find an available operating room in the COVID-19 era, Dr. Bren Heaton removed my gall bladder and the huge gall stone therein; a single stone larger than a large grape. That was this past Monday, March 23. The first two days of recovery were particularly rough, but now I seem to be on the mend pretty well, only slightly worse for the wear and tear.
There is general consensus that gall stones are a frequent side effect of rapid weight loss, so I solidly blame the weight loss for this last couple of weeks, which have, frankly, been pretty awful! However… would I do it again? ABSOLUTELY!!!
POSITIVE SIDE EFFECTS ALL AROUND
Yes, gall darn it, the gall stone episode was pretty horrible. However, the positive side effects have been many! Here’s a brief summary:
- DIABETES: For more than a decade, with A1C tests measuring in the mid-to-high 6 range, they have called me “pre-diabetic” and I was on Metformin daily and they monitored me frequently. For a couple of quarters, I even popped up above 7 in my A1Cs and they called me “diabetic.” My latest A1C test was 5.1, smack-dab in the middle of the “normal” range of 4-6; they no longer call me diabetic nor pre-diabetic, and I’m off nearly every single one of my medications, including the diabetes-controlling Metformin.
- BLOOD GLUCOSE LEVELS: Related to above, we tracked my blood sugar levels in real-time quite a bit, and my finger-pricking glucometer had become my friend. While a blood glucose level of about 110-130 mg/dL is relatively normal, mine would occasionally pop up to as high as 220. That wasn’t a big problem; my big problems were when it crashed! I had noticed that if my blood glucose had dropped to 100 mg/dL, I started feeling slightly sick: a very mild but still slightly annoying headache. When it approached 90, I was feeling worse: bad headache, lightheadedness, dizziness, slight fatigue. If it every dropped below 80, I was down and out for the count! Super awful headache, dizzy to the point of not being able to balance, super upset stomach, panic & anxiety… general doom. Doctors had warned me that if I dropped below 70, I could go into a diabetic coma.
Well… there was a day about six weeks after my surgery that by about 4pm I realized that I had forgotten to eat anything that day. I realized that because I started getting a very slight headache (nothing terrible; just barely noticeable). Out of curiosity, I broke out my trusty dusty glucometer. 74 mg/dL!!! Previously that would have put me in to a near coma; now it gave me only a barely noticeable headache. Before surgery I would have 2-3 Rizatriptan 10mg tablets (migraine medicine) every week. I think since surgery I’ve had 2-3 TOTAL. - IMPROVED EYESIGHT: Now… this one came as a complete surprise. Last month I had my first eye exam in about 18 months, and I ended up needing a new glasses prescription because my eyesight HAS IMPROVED! This is a result of my blood sugars stabilizing, bringing all sorts of benefit to my eyesight.
- ENDURANCE/ENERGY/EXERCISE: Previously, ascending just 3-4 steps would get me winded. Now I can RUN several flights of stairs and not get all that winded. That’s right; I can RUN. Due to my knee replacement in July 2015, I cannot run on flat ground and I especially cannot run downstairs or on a declining slope – way too much impact on that new hardware and skeletal infrastructure. I have discovered, though, that I can run upstairs and I quite enjoy it! My favorite workout course are the stairs leading up to Shinagawa Station in Tokyo, on the Konan side of the station. As I recall, it’s 52 steps and I’ll run up those stairs, rest while taking the elevator back downstairs, and repeating… over and over again! I get weird looks, but I don’t care.
KEEPING WATCH
In the interest of transparency (I told you I’d share the full journey), we’re watching my heart in all of this. Now… I’ve been extremely blessed with a good ticker, having pretty decent blood pressure my entire life (135/85 was “high” for me) despite being obese. My heart rate (pulse) has also always been normal and healthy. However, since the weight loss my resting heart rate is a low 42bpm. Even with vigorous exercise (running) I’m hard-pressed to get my pulse above 120 to 130 bpm. The ideal max heart rate for someone is 220 less their age: mine should be about 167. As the doctors and I are keeping very close watch of my health, I was referred to and this coming Tuesday, March 31 I have an appointment with a cardiologist and we’ll probably do some stress testing, etc.
Saw a specialist about my unusually low heart rate. Doc said,
- If it were consistently in the 30s, we'd recommend a pacemaker NOW.
- Even in the 40s, if you had any other symptoms (chest pain, shortness of breath, dizziness, etc.), we'd also be talking about a pacemaker NOW. As I'm asymptomatic, we will just watch it.
- Just to further evaluate the situation, in addition to long-term monitoring (and a plan in place for if I ever do get symptoms), I have a heart stress test scheduled for April 23, giving me a month to recover from my gall bladder surgery last week.
- It's very likely I'll end up with a pacemaker in 10-20 years.
So it's actually all news that I'm very happy with, for now.
SECRETS TO SUCCESS
Next to “how did you do it?” the next most popular question of me is, “What’s the secret to your success?” I think these things are key:
1. NO LONGER HUNGRY: I stop eating when I’m no longer hungry. Previously, I stopped eating when I was full. THERE IS A DIFFERENCE. In fact, one time during this journey, when at Del Monico in Las Vegas eating Japanese wagyu and Alaskan king crab, I ate one bite “beyond full” and my wife and kids who were with me said they’ve never seen me run so fast, as I sprinted (as best I can) to the restroom and nearly lost that amazing meal.
2. DIET ADHERENCE: Sticking to this diet is key. I don’t ever cheat! Well.. that’s a lie. However, I cheat rarely, and when I do, it’s for some need my body is feeling. And it’s in extreme moderation. Even in my worst cheating I’m still at one-eighth of carbs consumed by most Americans.
3. EXERCISE: Mostly walking. I’ve tried to do a lot of this. And climbing/running stairs. I’ve strived for and often met (especially while traveling) at least 10,000 steps per day. Right now five days out of gall bladder surgery I am not supposed to exert myself nor lift 10+ pounds for 4-6 weeks. We just got a new climbing machine and treadmill, and I can’t wait to get back on them!
4. NO EMOTIONAL EATING: Admittedly I have an edge here. While I certainly LOVE food and have some favorite foods, I’ve never been an “emotional eater.” I never ate to battle depression nor anxiety. I’ve rarely eaten to cure boredom. I’ve never “needed” to eat to counter anything else going on at the time. This is a big advantage I have, and I’m not sure how to instill that in to anyone nor to train for it.
5. SOCIAL EATING CONTROL: I’m in business development; have been for 35 years. I’m an extrovert who frequently gathers with a lot of friends, colleagues and family where social eating is a thing… an important thing. Yet, I practice discipline in saying, “No, I’m sorry, with my diet I cannot eat that.” Honestly, growing up and still practicing my faith with abstention to alcohol and tobacco, this has become quite easy over the years. I can’t tell you how many business deals I’ve done in bars yet never lifted a drink! However, the difference now is that I tell people of my journey, and they ensure I don’t cheat. It’s amazing!
6. SUPPORT SYSTEM: I’m so grateful for my ever-loving, ever-supporting family!!! I’m so glad they cook keto meals when I’m home, despite me telling them not to worry about it, I’ll find something else. And my friends and colleagues have been absolutely amazing.
GOING FORWARD
My target weight when I started all of this was 200 pounds, but I told my surgeon that I would be ecstatic if I hit only 220. He said I could easily beat that, and thinks I’ll setting somewhere in between 180 and 190. Some have asked, “What if you don’t stop losing weight?” to which I say I’m not concerned. Lately the weight loss has dramatically slowed; it has taken 72 days to go from 220 to 200, an average of just a 0.28 pounds (4.4 ounces or just 126 grams) per day. I am NOT worried about wasting away to nothing, but I do believe that 190 is realistic.
I have been profoundly inspired by all of those that I have, ironically, inspired. I’m glad I’ve shared this journey with others. I am beyond grateful for all of the support that EVERYONE has shown me. I would be letting so many people down if I backtracked in this journey. That, and my desire to be around a long time for completely amazing grandchildren (up to six now!), I am committed to this for life, and I appreciate you sharing in my journey.
Thank you.
