7 Lessons I Learned Running a Marathon

Over Memorial Day weekend 2017, I had the gift of checking off an item from my bucket list: running a marathon. I didn't cover the 26.2 (my GPS said I went 26.4) miles at a particularly quick pace, but I did, in fact, run the entire course. Looming even larger than the speed at which I completed it is the context in which it comes. As I've indicated on my blog here more than once, I've been on a journey of weight loss and improved health over the past couple years (here's a link to my most popular post from a while back). Two years ago this spring, I was at my all-time-high weight, suffering on many levels and in many ways. I was depressed and discouraged. It's hard to describe how much different I feel physically and emotionally today - my run on Sunday is a positive sign of changes already afoot, and yet a reality. As I reflected on the experience this morning, Memorial Day, some lessons came to mind, some that have emerged over the preceding months: 

1. Judging people, positively or negatively, based on big flashy moments is fraught -- reality is always much more complicated than the surface level (or even well-informed) perception. We hardly know ourselves accurately - let alone other people! 

Perhaps this isn't a lesson I learned exclusively through this experience, but at the very least, it was reinforced by it. I can recall a great number of incidences in my life where, at a sporting event, presentation, concert, or other spectacle, I felt incredibly impressed with the feats accomplished by extraordinary people on stage. Watching in person the winner of an Ironman race cross the finish line, for example, I was in awe of how a human being could do such a thing - and look so relaxed while doing it! What a great person, I thought. How incredible! Feats like this are just outstanding.

On the other end of the spectrum has truth as well. We're all familiar with gawking over news stories of the latest fool who's worst moment made him famous. We pass judgment gleefully on facebook about the moronic lady who locked her kids in the hot car to go shopping, or the maniac who stabbed someone on the subway because someone looked at him wrong. We write these folks off as intrinsically evil. What terrible human beings! How incredible. Only fundamentally flawed people could so something so idiotic. 

The reality, I think most of us know, is that neither great achievements - nor great failures - sum up our humanity...sum up who we are. Nor do they necessarily indicate what it took for us to get there. It's easy to fail to appreciate the years of ACEs (Adverse Childhood Experiences) that set the stage for a drug addiction. It's nearly as easy to fail to appreciate the years of training and practice it took for that Ironman winner to prance over the finish line with hardly a hair out of place (from my perspective).

Neither of these vantage points accentuate the incredible importance of grace over it all. 

Many, many situations in life aren't as singular or momentous as they seem on the surface. It's far too easy to judge them in either direction: superlatively excellent or horrible. We love to reduce people to their most common denominators, to narrow causes and effects down to singular details. But reality is always more complicated than that. We know this.

On a much smaller scale than any of the examples above, take the marathon I ran. It was an achievement for me, absolutely. I completed a goal I had set for myself. I feel good about it. And it is certainly an indicator of a positive path I've been on over the past 24 months. But the reason it happened isn't because I'm a superior human being, or have a high pain threshold, or have a lot of willpower. It didn't happen because I'm a particularly talented athlete, or just wired for it. It didn't happen because I'm worthy or especially remarkable in some way. (But friends, surely, thank you for the shout outs on Facebook, your well-wishes are appreciated). 

The truth is that I've been thinking about, preparing for, and training for this thing since last fall. Since then I've run 3-4 days per week, without fail. I've run half-marathons in practice a dozen or more times this spring. Just about two weeks ago, I completed a 4-hour, 20-mile training run in the heat. Through the winter, I ran in the snow/slush/rain more times than I can count. I was that guy out on the pavement with gloves and a beanie, flashlight strobe flashing, trying not to get hit in the 5pm winter darkness. I was the guy hopping over ice-slush puddles and snow banks. Over the past months, I dragged my rear out onto the trail when I didn't feel like it, when I didn't want to, when it was cold and I was warm on the couch in front of the TV. 

"I ran the marathon for 6 months, not 5 hours."

26.2 miles on Sunday was an accomplishment, sure, but it all wasn't about that moment. And it certainly wasn't earned only in that moment. There was so so so much hard work along the way. And there was an incredible amount of grace (at the top of the list has to be my family who tolerated me going out for a 3-hour runs on perfectly good family weekends). 

So that's the first lesson. Resist judging people according to outlier situations, good or bad. No one can be reduced to whatever moment. Lots decisions and occurrences and pain happens along the way to get us to them.

I ran the marathon for 6 months, not 5 hours.

 

2. The real fight is between your ears. Without a doubt, I've been through quite a lot of physical change over the past two years. That bit is for sure. Two years ago, I wasn't even able to run or jog a full mile without stopping to walk. And the truth is that no amount of willpower would've gotten me to 3 miles or 5 or 20 in that state. I had real physical limitations, as all of us do. So hear me, I'm not saying that everything is in the mind, success isn't ONLY willpower. I have lost 80lbs and 20% body fat over the past 2 years.

And now I'm going to use the dreaded conjunction "but," which implies a negation of all that has been said before. 

BUT. What happens in our minds is absolutely significant. And in many ways, that is where the real battle plays out. I know this to be true in terms of eating habits, even post bariatric surgery. As I wrote in some of my original posts on the subject, I came to see surgery (accurately I believe) as a tool, not a magic wand. It was one of many strategies that would prove helpful for me in achieving a healthy weight.

What I learned later was that my dream of coming to a time when I wouldn't have to pay attention to my diet would never materialize. The mind game is with me to stay. And it continues. I have to pay attention to what I eat. Full stop. This dynamic applies to probably the vast majority of areas in our lives where we wish to see growth. As character develops and solidifies, sure, hopefully the decisions we are trying to develop become more automatic. But the battle to get there was always up top. 

Something I experience in living color while running my first marathon is that by far, the most difficult stretch was the final 6 miles or so. It was brutal. Miserable, honestly. Maybe I shouldn't be surprised, my training program had me run 20 miles at the maximum. Maybe it isn't odd that I was fine over the period of the marathon for which I had trained. 

I've heard people talk about "the wall" - and I'm not sure I really experienced that. I wonder if it might've been some combination of dehydration and sodium deficiency.  But I'll tell you, I considered quitting more than once in those last few minutes. At one moment, I saw some soft grass in someone's yard and was tempted just to lay down and go to sleep.

The final miles were very painful. Very difficult. My pace had slowed. The spring in my step had weakened. My muscles ached with every clomp. Like I said, I had run 18+ miles several times in training, and each time I came prancing into the house with great positivity and confidence. That last hour of the marathon though, it's a lot. "This is hard," I told myself. Its different than the rest of the training. 

I feel as though the whole race is run in that final window. Training makes it possible to have that challenge available in the first place. 

Marathon coaches (I've enjoyed the Marathon Training Academy podcast over the past few months) talk about the importance of mental toughness, preparing for the mind games, making plans for how to keep your head in the game, etc. I didn't take much of it seriously honestly. I had my audio book (this Sunday, it was the classic "Fahrenheit 451" - I know, nerdy), I had my music playlists, and I had my common practices of reflecting on identity and calling in life while running. I wasn't worried. But especially in those final two miles, all that support went out the window. The music shut off. Fellow racers around me had thinned out drastically. There were no cheerleaders along the trail. I fell back on feeble sounding prayers - just a couple words more often than not. "Help me." "I can do this." "Please." 

When I rounded the final corner, with just a few hundred yards to go, my brother-in-law came running over to report that I had just about a minute left to pull in under my goal time. It was a painful stretch. I might've just walked without that carrot in front of me.

Thinking about the next marathon attempt, I'm already strategizing in my mind, how I can prepare myself for the mental jousting I experienced in that final hour of the race. Is it possible that each day of training should resemble just a bit of sticking with it despite the pain? I had confidence going into the race of my physical preparation. But I wasn't ready for hard mind-work of sticking with it at the end. This dawning reality is both encouraging and clarifying - but also disheartening and confusing. 

Marathons are completed at least in part by means of mental tenacity. This is my conclusion. And the same goes for many aspects of life in general.  

 

3. The right gear can help improve attitude -- and getting the right gear can become an obsessive distraction from the work at hand. I like gear, granted. I'm a techy, I love the hunt, I love a good deal, and I love having the right tool for the job. I like to shop, I like researching. Fine. I own all that. 

Something I was shocked about is just how much money people spend running. I mean, really. It's perhaps the purest physical endeavor for humans. And yet, we've gone and commercialized it. I mean, with a sport such as golf or downhill skiing, the assumption of cost is a little more obvious. Lift tickets, special boots, fancy parkas, country club memberships, custom clubs, expensive clothes, the list goes on and on. It's part of the territory for sports like that. But running?

What more could you possibly need than perhaps shoes and socks?

Well...

A running watch with GPS is hugely helpful, a smart phone for bragging about your run, shorts and shirts with technical fabrics, compression underwear, running shoes at $150/pair (many people have 2 identical sets to rotate runs), longer sleeve clothes for colder climates, rain proof gear, lights, gloves, hats, visibility gear for being seen on the road, nutrition items, special electrolyte beverages, and the list goes on and on and on. Runners World magazine is just the tip of the ice burg on the marketization of such a simple endeavor. Many might join me in my critique. It says a lot about American culture (and perhaps others) that we have found a way to make money on running. 

And with all that being said. I must say that small comforts on such long stretches of athletic effort are hugely valuable. The right fabrics and the right technology are insignificant details that are unnecessary in the end. But they lend a modicum of confidence and improve your attitude while out on the course.

Technology isn't everyone. It can be obsessive. But it can be helpful. (This lesson might be one I already believed haha)

 

4. Training - preparation - rehearsal - in proper amounts - brings confidence. When I lined up amongst the crowd on that Sunday morning. I might've not looked like the other runners around me. But I felt I belonged. I believed I had earned a spot. I knew I could do what was set before me. I wasn't arrogant, I knew it would be hard, but I had a healthy dose of confidence.

It's absolutely true that finishing the race took, in the end and in the moment, more mental toughness and determination than I had ever anticipated. But my level of confidence would have been no where near its point before the race had I not put in the hours of prep over the previous months. Sometimes athletes or performers are asked by the press or whoever about how they were able to do what they did on such large stages, in such big moments. And often it seems like those questions don't really register with the athlete. 

I wonder that observation it has something to do with the preparation ahead of time.

I'm no expert. I'm not elite. Running a marathon was one very small blip along the way for me. I'm not a professional athlete. I'm not exceptional. But my practice did lend me confidence. 

I have close friends who are musicians - I'm almost certain this dynamic plays out in their lives. Hours and hours and hours of practice and preparation might not smooth over all nerves. But when they step on the platform, they know they can play the piece of music. A friend of mine has a quote on the wall of her studio that reads something like: We practice so that what is in our hearts can come out in the music we play. The practice doesn't take the heart out of the performance, it enables the real emotive moment to more readily take place. Practice isn't to make a perfect performance per se, its more about creating a connection, about how we feel and make others feel, its about putting on display the deeper more important thing over and above technical ability. 

I find this to be true in my craft of preaching. When I have prepared well, when I have preached the sermon dozens of times before I step onto the platform, when I have spent hours before the mirror, prayed over the material and had debates about it with friends, when I have submitted my manuscripts to critiques and painful cuts by trusted advisors, I have a sense of peace and confidence when I step on stage. The moment becomes far less about me as a person - me as a performer - me earning adulation. And likewise, I find that in these circumstances, my heart feels more free to express what God has put there. The message has been internalized and a calm confidence and authenticity shows itself.

I love that feeling.

And in a sense, that's how I felt when I got to the starting line. Calm. Happy. Few nerves. Light. 

 

5. Setting goals - with real deadlines, with real consequences attached - is incredibly motivating. Duh, right? How many times in my life have I heard this? How many times have I been to seminars or sat in class or had conversations with people I respect who have rattled off the importance of the practice? In this experience of running the marathon, the lesson sunk in a little more fully. 

What I have observed in myself over the past couple years, is that without a hard goal in front of me, it's far too easy to not do the little things along the way that are necessary to achieve it. If the goal is etherial or "it'd be nice" in nature, the dynamic doesn't take hold. Without the race on the calendar, I'm way more likely to keep my rear end on the couch when its cold and rainy.

But if there's a deadline, a date, a financial sacrifice, and preferably a public demonstration, my level of motivation changes. This might be personality, granted. I got bit by the performance/achievement bug while in high school and the thought of not living up to expectations gives me the hives. I turn projects in on time. I get A's if at all possible. I show up on time. I do my best not to disappoint. And so in the area of fitness, I'm much much more likely to practice and prepare and train if I know there will be a test at the end of the rainbow. And that's true even if the pot of gold is 5 hours of suffering.

Not all of us are wired this way. But I know that if I want to continue the lifestyle of regular exercise, I need to plan on an event. Don't ask me what that is at the moment, one week out from my marathon. But in the coming month, I plan to settle on the next event: cycling, running, triathlon, climbing, or whatever. This is something I've learned over the past 6 months. 

I, for one, need the goal to put in the time. 

 

6. Running a marathon is as much about the journey as it is about the destination. This is something I've already hinted at in this article. And it's something that sounds ridiculously cliche. And yet I've found it to be true. Honestly, much of the marathon itself was a blur. The day flashed by. I have memory - but it was all so quick, easy to miss. By the time I got 4 hours in, I'm pretty sure I was in low-sugar, low water, low-something stupor for more or less the rest of the day. I wasn't the best conversationalist with all my friends and family members who showed up to greet me over the line. The truth I found is that, if running a marathon is mostly about that experience, it's probably not worth it. I didn't find it magical per se. It was fleeting. It was over and then I was in the van driving home.

As I've mentioned, a couple years ago, I could hardly string together one mile of continuous running. For the bulk of my life, I've told friends and coworkers that in order for me to run, I would have to be chased - or I needed to be in some kind of competition whereby the running was disguised. Sunday morning basketball for 90 or 120 minutes felt like another thing entirely to me than just going out to pound the pavement. I hated running. It hurt. It was uncomfortable. And the only thing I could think about while doing it was, "when can it be over?" 

Many of my readers might be nodding their heads. This is the experience that many have around the sport/activity/torture.

That is no longer the case for me however. I relate to it entirely differently today. In all honesty, I've learned to enjoy running. I like how I feel after a good workout, I like the fresh air, the freedom, the moments of silence or audiobook listening. I like being a fly on the wall, getting to people watch, or getting out in nature. I love it. In fact, today, post marathon, I miss it if I go more than a day or two without it! The first week after the race was particularly hard because most guides say that you shouldn't run for a week AT MINIMUM after a marathon, to ensure proper recovery. Some trainers insist on a 26 day recovery of no/minimal running. 

Far from requiring discipline for me to get out there on the course. It's taking discipline for me NOT to run. 

The lesson I see in this is that the journey has a lot in it for me. I didn't adopt this new orientation because of the sunday marathon, the destination. I adopted it because of the training, the journey. And although the destination was valuable to me, and brought good things to my life (see the section re: goals above), the greater gift overall arguably came through the training over the months. A genuine enjoyment of an athletic activity like running is a gift to my life, I can't be more grateful for it.

 

7. Finally - trust. Over the course of the training and prep for the marathon, I listened to a ton of different advice. And honestly, there's a massive amount out there. Just as with any subject, the opinions of experts and armchair-experts alike span the gamut. What I ended up doing, what we all do, is taking the advice of one person, one school of thought, and ignoring or eschewing the advice of another. By taking one path, I rejected the other options. I made a decision and chose, CHOSE, to trust it. 

Listen - for those friends of mine who are religious and highly sensitive to choosing the right path out of all the options, I get it. And I'm not advocating just mindlessly picking an option. But life is full of different paths that are inconsequentially different, or simply too numerous to adequately and fully explore. We can't be experts in everything. We have to trust someone's advice - we have to submit to coaches - we have to give ourselves over to the better judgment of people who know something more than we do. It's unavoidable. And if we don't, the paradox of choice (see Barry Schwartz) will fill us with anxiety and overwhelm us in the mean time.

There's probably a dark side in this somewhere: we can infantilize ourselves and try to shuffle off all responsibility by outsourcing our decisions to authorities. But that's not what I'm describing as my lesson here. 

The thing I discovered is that at some point, I had to make a choice. And in this case, i found the choice stress relieving. I found it peace-giving. Choosing a plan and sticking to it's point of view helped remove some of the mental energy I needed to make an endless parade of smaller decisions. Once I started my 16-week training, the outline was laid out. 3 runs a week. One short with intervals, one mid-length and quicker than my marathon pace, and one long but slow. Cross-train in between. Rest at least one day a week. (this is the one I used, if you're curious, recommended by a local coach I approached on twitter). I could pencil the whole thing out in a day and it'd be set for weeks to come. When I got to the given week, there was my plan. I didn't have to debate for hours in my mind whether it'd be better to follow up yesterday's run with another run, resting, or a bike ride. The plan laid it out for me. 

In this, I learned once again the incredible value of trust - and reliance on someone else, one someone higher/bigger/better than myself. In Christian spirituality, we talk often about trusting God - of whom, I believe, it is an understatement to say is bigger than myself. This process of training for and running a marathon taught me anew that I can't be an expert in everything. I have to choose a plan to follow, I have to follow in someone's footsteps. Yes, I'll be pioneering here or there. I'll experiment. But its absurd to assume that I can live my whole life and not be in anyone's debt. I stand on the shoulders of giants, and so do you. We must trust to live well.

 

And that's the end folks. Until the next goal finds its way to the calendar...

Every Pizza is a Personal Pizza...if you work hard and believe in yourself

Too soon? (At least from a guy who had bariatric surgery just 15 months ago?)

The other day amongst some friends, the conversation floated to the subject of ice cream. We chatted about our favorite flavors and cafes. One person remarked how they could eat this certain brand every day if it were available. Everyone chuckled and nodded affably, myself included.

I have quite a long history with ice cream. I love the stuff. And I happen to be quite a discriminating consumer; at this point I literally won’t waste the calories, money, or time on low-quality product. Part of...

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To Sleeve (or Not to Sleeve) Series - #4, How I Gained My Weight

(This is part of a series I posted on my other (formerly anonymous) blog, tobypass.wordpress.com)

 

Well it didn’t happen overnight.

I may have mentioned that I wasn’t always heavy. It’s true. And I certainly wasn’t always THIS heavy either! At 308, my current weight is at a lifetime high.

My weight has fluctuated over the course of my life much as I gather it has for most overweight people. I have been on many diets and I have always regained the weight (and then some). I recently watched an HBO documentary about how our body works against us to maintain a given weight — driving us with food cravings, extra efficient muscles, and a super slow metabolism — all to keep us from losing more weight and in fact pulling us back to where we were. One doctor on the documentary said that our body regulates weight in as precise of way as it does blood pressure or sodium or any other complicated system. My own internist has told me much of the same — that my body kind of ‘settles in’ to a give weight and will fight tooth and nail to stay right around there.

This concept REALLY helps me to have a bit more compassion for myself given the situation I’m in. I’m not a victim in all of this. I know I have made choices — many choices — some good some bad. But I know too that what I’m suffering through is also a form of a disease — and that I’m this weight not ONLY because I have poor self-control. This seems to be the narrative of our culture and certainly is the narrative I tell myself routinely.

Anyways, to the topic at hand. How I gained all this weight.

I remember having to do calisthenics outside on the playground as a first grader. The whole school did as a matter of fact. At the end of the workout each morning, everyone had to run a half mile or so around the very large playground area (at least it was large to me as a 6 year old!!).

I remember being rather slow. I wasn’t heavy per se at that time. Just not a fast runner. Never-the-less I remember being embarrassed of my body. I remember feeling ashamed of myself. I felt defective and bad. It didn’t help that the coolness level of our social system was determined by foot speed.

I finished last or near last essentially every day. I got tired easily. My feet hurt. My chest heaved. My legs hurt. I just couldn’t keep up.

While I don’t know for certain — I think this collection of experiences was the beginning of my issues with food and body size. I think these moments began to create in my mind a sense of destiny — that I would inevitably and always be ‘fat and slow’.

It’s weird though. I loved sports. Still do. I have always liked to play. I like to watch too. For many years in my life, I even participated in organized athletics. I was good at quite a few. (Still am). But my weight has always been a hindrance. From the very beginning — to this day.

So there’s that.
Several other factors came into play as the years went by.

First – Family Culture. As with many people in American culture, my people use food as an accessory to life. We eat when we’re happy, we eat when we watch the game, we eat when we’re sad, we eat when we’re mad and plotting against that jerk who hurt us. In fact, we use eating as a justification to get together in the first place! This in itself isn’t a bad thing either! Many cultures use food like this. It’s dreadfully common in American culture. And I learned it thoroughly in my family tribe.

My family never has eaten particularly well — (or poorly per se) — just ordinary home-cooked american fare by and large. But they do EAT. In fact, someone who doesn’t eat (and well) — sort of stands out like a black sheep in the culture and will more likely than not be goaded into getting more food on his/her plate. Some of the older women in my clan take particular delight in doting on the men, bringing them plates of food and deserts, ensuring their drink cups are full and their mashed potatoes are well gravies. Eating has always been encouraged. My people aren’t generally thin; they’re not profoundly overweight either. Plump. Happy. Well-fed.

Adding to this is our family culture of how food is used. More or less, I grew up learning that when something happens in life: be it good or bad, food is a very helpful way of working through it.

Win (or lose) that little league game? “Let’s go get Dairy Queen!!”

Rejected by a friend? “How about we commiserate over a milk shake?”

Get all A’s on that report card? “Let’s go out to eat and celebrate!”

Missing that loved one who passed away? “Well Chinese food it is then!”

Get accepted into that college? “How about a prime rib?!”

Seahawks playing in the big game? “How about a mountain of chicken wings!?!”

Ordinary Sunday night in June? “COOL! Let’s eat hamburgers and hotdogs and fries and macaroni salad and chips and…”

No matter what it was, our family always found a way to dig in hard. We laugh and gossip and eat and eat and eat. It soothes the soul. It masks the pain; it commemorates the joy. And in many ways, it is a beautiful thing.

It also ended up being a harmful thing for me in certain ways…

So as an adult, to this day, whenever something good happens — whenever something bad happens — whenever I complete something difficult or finish a project — whenever I get done with a week or a hard day — whenever I do something I’m proud of — whenever I do almost anything, the way to commemorate it that immediately comes to mind is food. Ice cream, a cake, cinnamon rolls, a dinner out, sweets, something special.

“Let’s celebrate”.

I’ve done it all my life. And I’m overweight now — in part because of it.

Second – Training –

It’s weird. I grew up in a religious culture that prides itself on healthy eating. I was part of the Adventist Christian tribe (still am actually — not in a fanatic/loony way though). It’s a pretty conservative bunch all in all although there are some more progressive/open pockets with which I identify.

Anyways, one key part of Adventist theology is healthy living and a healthy diet. Many many adventists are vegetarian or even vegan because of this principle. If you’ve ever heard of “Blue Zones” — 4 key regions in the world where people live abnormally long — and often well into their 100’s — well, Seventh-day Adventists in Loma Linda California are one of those blue zones. That’s my people. I grew up in their culture…in which the vast majority of people I knew ate EXTREMELY healthy. I mean — SUPER SUPER ahead of their time healthy. I have a grocery store in my town that would put whole foods to shame…and has for 40 years. It’s unbelievable. Local. Fresh. healthy.

Never the less — my HOME culture was not quite as strict on the whole religious culture of healthy eating. In a way however, I actually think that experience was better than some of the rigidity many of my friends had. I can imagine myself developing a whole other relationship to food that involved binging and hiding, sneaking and experimenting due to a lifetime of denial. Instead, my home culture was more moderate — albeit somewhat chaotic.

I lived in a divorced single-parent home for much of my childhood. My mom worked full time and had her own business. She had three kids in private school to worry about and a house with 10 acres to manage. Although she worked incredibly hard and is quite competent, something had to give. It was just about all she could do to put food in the fridge, period — let alone teach each of us kids in careful detail how to eat the healthiest possible meals. Much of what I learned about eating as a kid and teenager came from commercially produced and marketed products. I warmed stuff up from the freezer section from costco, learned to make french toast with syrup, I grew to like bagged caesar salad kids for a season, and downing carby soft pretzels with cream cheese. I don’t resent the way I ate as a kid — or the reality of the situation I was in. It’s just the truth.

I grew up learning how to graze. I grew up learning how to eat what was available at the time and what I could grab out of the fridge or freezer. I grew up not really knowing how to control portions or even knowing what appropriate portions were. Hell, half the time I ate my meals in front of the computer screen or with a game controller in my hand. I don’t know what it looks like — really — to live in healthy balance. I don’t totally know what it feels like to be satisfied. To feel comfortably full. To not snack. To eat healthy.

Of course, when I was at school, I ate an ok vegetarian meal but even those were hit and miss in terms of their healthiness.

This ‘education’ piece is yet another aspect of my life that has played into my obesity. It doesn’t tell the whole story. It doesn’t make me a victim. I’ve made choices and still do. To this day — I’m still learning. But it’s hard for me to not admit that my background has played a role.

Third and finally — Coping

This is the big one for a great many of us in America (and I kind of already alluded to it in my first point here).

We use food to cope with our emotions – with daily life – with stress and sadness and anger and fear. Food feels good. (Perhaps moreso for some of us than for others). Food is a way of escape.

I have learned this many times over throughout my life.

I learned it when I couldn’t make friends with other kids at school and I came home and had an ice cream sundae.

I learned it when my brother’s dog died and there was nothing we could do about it but go out to eat at our favorite mexican restaurant.

I learned it when my grandparents died and I consoled myself with sweets.

I learned it when I screwed up on a test and washed the stress down with a milkshake.

I learned it when I lost my brother as a teenager and people brought us casseroles and pies and cookies and lasagnas.

From an early age I believe I ingrained a pattern in myself that food is a good coverup for uncomfortable and negative feelings…in fact, I think I learned that food could even help me not have to really think about or face those things directly. Instead of digging into the source of my loss — accepting it — wrestling against it — raging with it — sobbing for it — I could sidestep it completely. Not really explore it. Almost act as if it weren’t there. I could eat and eat and eat… And it’s like it would just fade.

Many things in our lives can do this.

Success. Exercise. Good Looks. Thinness. Money. Career. Degrees. Oh and of course the usual suspects: Sex. Drugs. Alcohol. Porn. Gambling.

In the Christian tradition, we sometimes talk about this dynamic as putting idols up in our lives — “what are the things you go to to make yourself feel ok?” we ask. “Instead of God, what do you look for? What do you reach out for? What do you need? What makes you ok?”

For me – it’s always been food. And often — it’s been ice cream.

Today — a strong craving for food is actually a trigger for me that I’m feeling something strong. It’s often the first thing I recognize. The food dynamic is so hard wired into my way of doing things that I don’t often feel the feeling first — I feel the craving and then walk backwards reasoning, “oh, I must be stressed or afraid or angry or sad…I wonder what’s going on?”

All these things played into my life over time — and each probably played off of (and complicated) one another as well. I’m sure there were other factors adding to the mix too (such as the great American industrial food complex and marketing machine, dieting patterns, lack of primary medical care etc.). I mean, would I have ended up so addicted to food had I been born 50 years earlier? Seems unlikely. But it certainly could’ve been possible.

In any case, those pieces bounced off one another for years in my life and produced weight gain, negative patterns, binging, unconsciousness, and the quintessential yo-yo dieting. And I do consider dieting to have played a realistic roll in all of this. I decided to take on my first diet in 2001 at the age of 20. I feel sad writing this and reflecting on it. I was about 260 lbs and (as I do now) felt very negative about my weight and appearance. [What I would do today to be 50lbs lighter!!] Anyways, I did the atkins diet for about 8 months and I was very serious about it. I cut out candy and sweets. I didn’t eat bread. I was a true believer. I lost a lot of weight. 40lbs or so. Everyone commented on how I looked. I had/got to buy new clothes because my old stuff was too baggy. I felt proud.

But that was during a year of service in college. (Think peace corps). In the summer following when I was back working at summer camp, the stress of work and 18hr days pushed me back into old patterns. My body betrayed me. By the time I was back in school in the fall, I had already regained some of the weight I had lost the previous year. By the following winter, I was back over 260 again.

Over the years, I’ve been on weight watchers (twice, both times losing more than 30lbs), carb restrictive diets (losing 20+), dieting pills (losing 30-40), etc., etc., etc. — ALWAYS to regain the weight. This is discouraging to recall. This is discouraging to remember. This is discouraging to hold as I look forward.

And I guess it is to be expected. This is the norm. This is what it looks like to inhabit an overweight body. Ours pulls us back to the weight with incredible force.

I’m heavy for many many reasons. I’ve gained all this weight over many many years. It’s been slow. It’s been a lot of food. It’s been a lot of small choices. It’s been a great collaboration of forces — some outside my control. Some within.

I want to close this post with a quick word on responsibility. I don’t write any of this in an effort to ‘pass the buck’ as it were. Earlier in this post I kind of alluded to the fact that we live in a culture that hasn’t really come to understand weight gain as anything more than a sign of poor self control. Without a doubt, I’ve had my moments. I’ve over eaten. I’ve eaten by myself. I’ve gone to drive thrus by myself. I’ve binged. AND I’ve also been influenced and impacted by a variety of forces outside my control or choice. It’s a system.

I have responsibility. It’s my life.

But I think saying ‘the reason I’m overweight is because I’m a slob’ is nonsense in the same way as ‘it’s because I’m a victim’. The truth lies somewhere in between. And I believe deeply that in order for me to recover, I will need to have compassion for myself. To give myself grace, as we call it in the Christian world. Unconditional love – unmerited favor. The benefit of the doubt.

We can start from there.

To Sleeve (or not to sleeve) Series - #3, The Bariatric Surgery Clinic “Information Session” Experience

(This is part of a series I posted on my other (formerly anonymous) blog, tobypass.wordpress.com)

One of the first ‘official’ things one has to do in checking out the possibility of having bariatric surgery, is attending a lecture on the subject by a physician or surgery group.

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Just a few weeks ago, I attended just such an information session. It was organized by a clinic out of Spokane, but which services a good chunk of the Eastern Washington region (Rockwood Bariatrics). I chose this group because it was recommended by my primary care physician (and also my father, who himself is a physician).

In talking with a few people I know personally who have undergone the procedure and related lifestyle change, it became clear that going through with it via a comprehensive clinic such as Rockwood in Spokane is the wisest choice. Rockwood Bariatrics (and others like it) provide psychological, dietary, group, and ongoing medical support before and after the procedure.  For this group, bariatric surgery is all they do — all day long — every day. They have a special OR dedicated to bariatric surgery, they have a special bariatric ICU and bariatric recovery units — all who do this work every day. Their entire work is dedicated to these few weight loss surgeries.

In my estimation — if I were to go forward with bariatric surgery, it’s a no brainer to do it with a clinic like this instead of a general surgeon who might be confident but certainly not as experienced — and completely absent the social supports.

Now — apparently, one does not simply walk into one of these specialist bariatric surgeon’s offices for a consult… In fact, the 3hour information session, beyond being informational and helpful, is a requirement to be seen. Period. (Luckily, it was free, and held in a nice hotel board room on the river.) But only after a person fills out paperwork, hands over insurance, and chit chats with the nurses, etc., is he/she blessed with a introductory consultation with a surgeon.

On one level, this seems like a lot of red tape before having a simple conversation. On the other hand, I don’t really blame the doctor for trying to weed out the field a bit. For certain people, a simple surgery to make it so you lose all your excess weight might be really tempting — a cheap, dirty and easy fix! The reality of what the surgeon explained in his lectures, is that an entire permanent lifestyle change is absolutely essential for long term change to take root. Without adequate education before and after, the surgery doesn’t have much of a prayer for success. My impression (an entirely subjective and probably prejudicial take) at the meeting I attended was that the majority of the attendees were in a lower/poor income class, poor education status, and poorly informed regarding basic matters of health. If my observation had any truth to it, it further justifies the reason for additional education ahead of time — as those who could be the most vulnerable might also be ones misguided into surgery.

The meeting was held in a hotel conference/ball room and there were perhaps 25 people present. Tables were set up with 2-3 chairs at each (and only on on one side) so attendees could point toward the front and take notes at the same time. Water was provided. It was nice. I could tell the group went to some expense to create this information session — [and clearly it is also a recruitment tool for their business].

In any case – this is what happened.

First – one of the doctors in the group (in this case Doctor Mathew Rawlins) got up front and gave a presentation for a little over an hour. He talked about obesity, obesity related illness, and surgery as the “only known long term successful treatment to the disease of obesity”.

[An aside — I found his description of the problem as a disease to be quite helpful and non-shaming. Kudos.]

Anyways, he had a powerpoint slideshow that documented the success rates of patients who have undertaken bariatric surgery, its history, and its safety. I’ll probably write more detailed posts about these options later but more or less, he outlined three different procedures that seem to be commonly done today (any one of which are referred to as ‘weight loss surgery’):

  1. Gastric Bypass — the oldest procedure, originally developed to treat other medical problems back in the 50’s or 60’s; and with a well documented history of success for weight loss and associated comorbidities (albeit with some complications/downsides).
  2. Gastric Banding – (pictured) — a newer procedure where a piece of hardware restricts food entering the stomach.
  3. Gastric Sleeve or Gastrectomy – the newest procedure (Dr. Rawlins says he’s been doing it since 2007 and that it’s been around since maybe 2004?) – in which a significant portion of the stomach is actually removed.

For each of these, he outlined risks, complications, benefits, and documented outcomes. It became clear rather quickly that he does not at all favor gastric banding as a procedure because (according to his experience), people have a difficult time getting the right balance with it’s size. If the band is too tight, people can’t really eat and end up vomitting or having reflux. If it’s too loose, people don’t get much positive weight loss effects. To get it just right is difficult tedious. To make matters worse, so he said, sometimes the stomach can actually get pulled up through the ring and become necrotic…this apparently is an emergency  and must be fixed immediately. Anyways, he pretty much discouraged that one very thoroughly. I couldn’t help but think to myself that that one (while also less successful statistically in terms of weight loss) is also much cheaper and less invasive than the other two. Conflict of interest? Probably not. But I couldn’t help but think it.

Regardless, he spent a lot of time detailing exactly how the procedures for the other two were done and how they compare in terms of risk and outcome. His conclusion is that really, it comes down to personal preference and comfortability of the individual patient. He doesn’t think there’s much difference. They’re both good solid solutions.

Second – The clinic had a video of their dietician giving a lecture. This was less than impressive because it wasn’t a live person but what can you do? She talked about what the new diet would look like for a person who has gone through this surgery — she talked about what the workup and preparation looks like for a person who is getting ready for this surgery. Even though it was a video – it was crystal clear that if a total lifestyle change isn’t made, the surgery won’t work.
This isn’t a quick fix.

They aren’t just removing a bunch of fat and doing all the hard work that I didn’t want to do. (and of course, I’ve worked incredibly hard over the years managing my weight) — But this procedure is more like a ‘kick in the ass’ or a ‘boost’ on the road to recovery. And for most people, it works. They get to where they want to be. And it costs them something.

I’ll write more about what a post-surgery diet might look like but suffice it to say — it appears quite a bit different from how I’ve been living and eating — which is largely by guestimation and desire. A great deal of care will need to go into ensuring proper nutrition, proper balance, enough protein, the right foods. They said that the volume in a sitting will be reduced to about 1/2cup — and that about 6x per day. Because volume will be so much smaller, what a bariatric surgery patient does eat must be packed with quality. He/she could fill up on a 1/2cup of mashed potatoes but that isn’t very nutrient rich. This will take planning and care. Which my diet has little of now.

And this realization is kind of dawning on me in general — in order for me to achieve a healthy weight, I’m going to have to pay attention to what I eat. There’s no getting around it. I’ve sleepwalked through my diet for my whole life — simply eating out of emotion and desire. And this is where it’s got me. I can’t imagine that I will be able to go back to a place where I’m totally unconscious. One way or another, I will need to pay attention. I need to learn how. This is whether I have surgery or not.

Anyways, the third, thing that happened was a short discussion about insurance and next steps. Apparently this clinic has case managers that lead patients through the entire process — and it’s quite a process!!

It begins with an examination of insurance coverage (mine covers it as far as my conversations with my company) psychological evaluation, doctor consult, dietician meetings, lab tests and any other required testing, a pre-op diet to shrink the liver (this is both required and essential apparently), and the list goes on and on and on. As I alluded, this clinic also has quite an extensive post-operative system of group meetings and support that conceivably goes on for the rest of life.

SO where I’m at in the process right now is waiting to talk with a case manager about exploring it further…As well as waiting to speak once again with my primary care doc about what I’ve discovered since we last met.

To Sleeve (or Not to Sleeve) Seres - #2, How My Weight Affects Me

(This is part of a series I posted on my other (formerly anonymous) blog, tobypass.wordpress.com)

As I referenced in my first post, I am currently 6’1″ and 308 pounds. This churns me out at roughly a BMI of 41.

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I carry most of my weight around my midsection. The other day I joked with a coworker that my fat is mostly between my ears and my butt. Perhaps surprisingly for a person at my weight, my legs and arms are relatively lean and actually quite muscular. I’m in a 42in waist pants now and my shirts are 2XL but they need to be long because my torso is where my height comes from. My neck is a fabulous 19″!

While I’ve been ‘the big guy’ for about as long as I can remember (first grade?) I’ve always been very active, strong, and engaged in sports. I love to be outside and to go on adventures. The caption here is one my oldest son snapped of me one day when we were out romping around in a nearby park. This actually makes me think of one of the key ways my weight is impacting my life.

I am seeing myself struggle getting around more and more. This is hard to admit. Hard to write. I get winded more easily than I used to — I feel the burn in my butt and thighs far sooner on in walks and hikes. My knees hurt at night after I’ve played hard or exercised. My back spasms up when I try to jog or run. My ankles pop and click as I jog along. I can’t do many pushups or sit-ups, which means I have hard time getting down onto or up from the floor to play with my boys.

Overall — physically — I am struggling. And more and more. I know that some of this can be a product of age (I’m 34). But I also know that I’m at my heaviest weight in my life — and I feel it. Over the past year, I’ve even witnessed myself turning down invitations by friends and acquaintances to go do something active — because I’m worried about my physical limitations or inabilities. Or even moreso, I’ve turned them down because I’m embarrassed of my limitations. I don’t want to hold them back or be humiliated by my lack of physical acumen. This, I know, is only a self-fulfilling prophecy.

I’ve never been one to have a lot of hangups over body image or appearance — but now that my size is actually starting to hinder my ability to be a good dad, to have fun, to do things I want to do, I’m starting to have difficulties. I feel shame about how I look not so much because of how I look — but because of what that means about what I can do.

Next, I do have some medical issues associated with my weight that have cropped up. One is Sleep Apnea. This may have been latent in my life for a long time before my initial diagnosis 4 years ago. I never remember getting really sound sleep as a teenager or young adult — and when I started using the CPAP machine, WOW, I felt amazingly better. Recently I’ve found that I have a pretty severely deviated septum and also really really large tonsils (they pretty much touch all the time). The ENT doctor said both could be fixed in one surgery and that my apnea would probably be helped — but that because of my weight, he couldn’t recommend it. This was an experienced physician in a large city hospital. And his message was: “lose 10 BMI points and this surgery will help you leaps and bounds. At this point, it will be a waste of money.” So that’s fantastic

I have High Blood pressure due to excess weight, and my cholesterol is consistently high (in the mid 200’s most recently), but who knows if that’s primarily because of my diet/weight or family heritage? In any case, I’m on a couple different medications to treat both of those issues. And I’m also taking Metformin in a low dose as a form of appetite suppressant (and I’m not sure if It’s to try to stave off insulin resistance). So far, my blood sugar labs have always come out normal (even if sometimes on the edge) — but I feel as though that is just a ticking time bomb.

Finally, I think my weight is also threatening my longevity – which in turn has implications for relationships with my kids. I feel sad and embarrassed about this. Of course this is related to the previous item but I see it as another effect altogether. If I have 10 fewer years than I might otherwise because of my current weight (as compared to a healthy one), this represents untold relational depth, experiences, wisdom passed, and loved shared. Once I’m into my 60’s, 70’s, and 80’s — we’re talking about the season of retirement and enjoying grandkids. My weight right now is threatening cutting that time unnecessarily short! What a price to pay for a little steak and ice cream today!!

Stringing throughout each of these is the emotional impact of all of these. As I’ve alluded, i feel great shame and embarrassment for where I’ve allowed my body to evolve. I keep my eating secret in many circumstances and I hide the full extent of my addiction to food. I feel depressed and hopeless about my situation more often than not and if I allow it — I can slip into despondence, helplessness, and a sense of victimhood. It’s a terrible state of mind — both in terms of its unhealthiness as well as it’s negative experiential nature. It is unpleasant feeling for me to be the weight I am.

And the truth is probably that It’s a pipe dream for me to imagine that all of these negative thought patterns are gonna just poof into thin air if I were to simply lose weight. My process needs to be both getting healthy physically and emotionally. Just like any addictive process.

To Sleeve (or Not to Sleeve) Series - #1, Background

(This is part of a series I posted on my other (formerly anonymous) blog, tobypass.wordpress.com. An index of all posts in this series is located at the bottom of this article.)

People write blogs for many reasons.

The reason for this blog is my weight.

308lbs this morning and at 6'1", that's a BMI of 41.

A few weeks ago my doctor asked me if I've ever considered bariatric surgery.

(I hadn't).

But because of the trust he had built with me over time, I was willing to hear him out... I did a little research on the matter. I spoke with some friends, read some articles online, and checked out several recent peer-reviewed medical journal articles. My initial investigation provided me with enough positive insight (to my surprise) to at least explore the possibility of having surgery more fully.

This is where I'm at right now. In May of 2015.

So this blog then will become both a personal journal (to make sense of my thought/decision process) as well as a documentary of my experiences along the way (which perhaps will be particularly interesting if I end up going forward with surgery).

My name is Kris and I live in the NorthWest with my wife and two sons (3 & 6mo). I have worked full time as a pastor for about 9 years. It is the only career I've had thus far and while it can be quite stressful at moments, it also is a wonderful gift. At 34 years of age, life is good and full of hope -- except for that nagging worry of health complications that might arise due to my obesity.

Thus begins the journey.