Giving Thanks

Last year on Thanksgiving I hit my head while playing kick ball with my cousins (yeah, we’re not exactly the Kennedys). This led to me having an EKG and the discovery that sometime in the past that I had a heart attack, which led to changing my Crohn’s medication for fear it was effecting my heart function, which led to a bowel perforation and my current ostomy.

So what am I thankful this year? Just being alive and able to celebrate another Thanksgiving with loved ones! Which may be as much as any of us should be thankful for.

Onward!

Advertisements

Crohn’s Update and Fitness Quest: The Consequence of Measuring Muscle Mass

So, in my constant quest for greater fitness I thought it might be fun to engage a couple friends in a challenge to see who could lose the most body fat in the next few months (by the start of spring).  I decided that I should switch out my trusty Tanita scale that I’ve been using for some years with a Taylor scale that I’ve also been using on and off (to paraphrase that old saying: a man with one scale knows how much he weighs, a man with two is never sure). The reason being because though both scales measure body fat percentage – and are pretty close in their measurement – the Taylor scale has a few more

Scales
The Tanita and Taylor scales – both good

features including a calculation of hydration and muscle mass, all of which are uploadable into an app for easy tracking. For the challenge we have decided to use waist/hip ratio as our measurement tool, but I thought I’d follow my progress on the scales, too. Since I do weigh myself everyday anyway.

The “new” scale works nicely and as I said the body fat percentage corroborates with the other scale. But, today I took note of the other measurements. Fat mass was where I expected at about 25% (needs to be under 20), body water at 59% – a little dehydrated which isn’t surprising since my colon isn’t there absorbing water anymore since my ileostomy – and my muscle mass was at just over 30%. Now, you’ll notice that these percentages added together total more than 100%. I haven’t found it in the documentation yet, but I suspect that the body water figure is independent of the other two and is calculated off the remaining body mass (organs and skeleton). So, based on these readings my body is a little over half fat and muscle. So far so good right?

Well, I then wondered how my muscle mass compared with the average guy – you know, because we guys are all about measurements and comparisons with other men (to prove we’re better). Since I’ve been working out I’ve always assumed that I had more muscle

buff dave
Me during my “glory” days

mass than most men. I know that my arms are larger, even now in their “depleted” state (a little over 15″ in circumference compared to the average untrained American male who is around 11″) they do flex and do not jiggle when I move them. I once benched 350 pounds and still am capable (I think) of a one time max of more than my bodyweight. Good for anyone, great for a man of my “advanced” years. Plus, you know, I have done squats in the past, too keeping my lower body pretty fit – even with too much fat around the hips (you should see the definition in my “marching band” calves).

So off to Google I go and search for “how much muscle does the average man have” and imagine my surprise to find out that according to my scale I not only have less muscle than the average man (about 60 pounds compared to livestrong.com’s average of 72 pounds).  I thought, “okay, but surely my percentage is higher.” Nope…

muscle-mass-percentage-chart

Not only am I low for the average man, I’m low for a man my age and older! How is this possible? I was only in the hospital for a week and recovery for six weeks. Can muscle mass be lost that quickly?

Now, I did come out of the hospital 20 pounds lighter than I went in. This would equate to a loss of about 2 pounds a day for my 10 day stay, but most of the weight loss was early. I never figured out why it was so much, as I doubt that a meter of intestine (the full length of my ileum) weighs that much since it’s essentially a hollow tube of muscle and skin. Maybe it was because of all the stuff that was leaking into my abdomen was no longer there, a lot probably water weight, and maybe an incidental “liposuction” when they cut through the fat and muscle to get to my innards. I just didn’t know. However, I felt that when I cam out that my chest and shoulders had disappeared on me. Could I

Me in hospital
Me shortly after surgery in August 2018

 

really have lost that much muscle that quickly? Or is my scale wrong. Did one operation undo 30 years of weightlifting and bodybuilding?

I think it will be interesting to see what happens over the course of the next few weeks and months as I continue into my workout routine. I will admit that I wasn’t doing a lot prior to the operation but I was lifting twice a week and getting in some cardio. Plus, there was the cardio rehab I had just finished earlier in the late spring. Muscle memory is a wonderful thing, but we all know that as we get older we don’t bounce back as quickly as we did before.

In fact, most studies indicate that as we age we lose a significant amount of muscle with some, if I recall correctly, suggesting men lose as much as 10% of their muscle mass for each decade after 40 (or earlier). Most studies also suggest that this loss is as much due to inactivity as anything as we tend to move less as we get older and that working out becomes less of a priority when family and career get involved (thus the rise of the so-called “Dad Bod” someone with some muscle on them but it’s covered in a layer of fat).

However, there are also studies that suggest that this muscle loss can be slowed if not completely reversed. That, contrary to popular belief, even people in their eighties and nineties can gain muscle. Maybe not as fast as in our youth, but gains can be made. In fact, I feel that I was at my strongest in my mid to late forties. Not necessarily my fittest, just my strongest.

Which bring ups an interesting tangent. I had a conversation recently with a young man who I’ve befriended at work. He’s a bodybuilder (though I don’t think he would consider himself one since he lifts primarily for “fun,” but I’ve seen his before pictures and he’s clearly a bodybuilder) and he asked me an interesting question: “do you know how men keep getting stronger as they get older?” I replied that I had noticed the same thing myself, stating that many bodybuilders seem to hit their prime in their thirties and how I felt I gained strength well into my forties. But he then said, “no, do you know HOW men keep getting stronger?” and I indicated that I wasn’t sure, perhaps the body doesn’t actually fully mature until a man is in his twenties or later.

Now, I think I can answer that question a little better. Men who keep getting stronger as they age also don’t give up. They stay focused on being a little better each day, at lifting a little more, running a litter farther.

Basically, men get stronger as they age because they think they can.

I think that I can, too. The best is yet to come.

Onward.

Fitness Quest: Memories as Motivation

So, the other day I was in a bit of a funk. Unusual for me as I’m normally pretty chipper these days (ha – I make myself giggle), but like everyone else I can get a good case of the “woe is me” and “life stinks” going on. This particular case was about the usual these days: “why can’t I lift this (insert heavy object name here)? I could last year. Easily!” or “can’t I bench more than that?” or “why does it hurt when I bend?” or my perennial favorite, “how come my shirt sleeves seem to have so much room in them?” (sleeve gapitis – it’s a real thing, Google it. Seriously.) All in all, I had a serious lack of motivation and started looking back to the “good old days” through pictures and social media posts.

What I found depressed me further. Here’s me goofing off after trying to climb one of Colorado’s 14,000 footers:

colorado

Here I am running a 5K:

rose run

Here I am looking possibly as buff as I ever have:

buff dave

Here I am about to go surfing for gosh sake:

surfing

And the coup de grâce, here’s the weight I was benching just a year ago. 255 for reps and sets:

255

All the makings of a good sob fest and longing for the glory years. Are they gone? Am I a has been? Has age finally caught up with me? Questions I’m sure most of us have asked ourselves and if you haven’t, you will.

But, you know what? I decided instead of wallowing in self-pity that I was going to use these images to motivate me.

My lungs and legs are still good. I can climb mountains. Maybe not summit, but I didn’t do that before anyway. I was climbing in Idaho just this past summer (well after my heart rehab).

I can still run a 5K and did just this past July. I bet I can beat my time next year!

I’m increasing weight in my bench each week. I can keep going and bench even more than I did a year ago!

And as far as looking buff – well, modesty prevents me from saying so judge for yourself:

dave gym (2)

Surfing? Sorry, that was a one and done! Fun, but there are sharks out in the ocean.

The best is yet to come.

Onward!

 

 

#oldguyslifttoo – Consarn It!

Those of you who follow me on other social media (yeah, both of you) may have noticed that I usually tag any remotely fitness related post first with #oldguyslifttoo. Though it clearly hasn’t caught on I’m trying to make a point with that hashtag.

It doesn’t take much observation to realize that in our culture and society fitness and athletic activities are the province of the young. In mo and t pro sports you’re finished before 40. A quick look through Instagram and you’ll find hundreds, if not thousands, of posts, pictures, selfies, swolfies, and not so random flexing poses of young men (and a few women) in front of bathroom mirrors. Each who seems fully dedicated to their particular workout, diet and intent on spreading their knowledge and enthusiasm to the world. Or at least get a date. Maybe both, I’m not sure, and I’m not criticizing this in the least. If it motivates anyone towards physical fitness I’m for it. Heck, if I had the abs and biceps of some of these guys I’d be right there in front of my mirror with my phone snapping a picture too.

But, you don’t see so much from older people. Go to a gym, again filled with folks under 40. Now I’m sure that there are a lot of reasons for this. The usual being other priorities. Career, family, etc. But, these reasons don’t explain all the middle-age men and women out there who have just stopped moving. The kids are out of the house, but instead of using the time gained from no longer running mom’s transit service they have doubled down on Netflix, Hulu, Amazon Prime and the like. Then complain that they hurt all the time or don’t have energy.

It’s time to change this folks. The benefits of daily exercise are well documented. Both men and women at any age can increase strength and improve quality of life with a moderate program of walking and weightlifting. Barring an underlying medical condition (and hey, I’m pooping into a plastic bag as I type this so I know about underlying conditions) you can stall father time. You may never have 20 inch arms or buns of steel again but you can keep your bones strong and muscles firm well into old age.

Which, for all you teens out there, doesn’t start at 30.

So, I’m proud to be an old guy who lifts, too. I hope you’ll join me.

And whoknows, maybe senior citizen swolfies will catch on too!

Onward!

Dave

Why We Lift: The Psychology of Working Out

So as some of you may know, if you read my other blogs such as Talking to Strangers, that for some time now I’ve been working on breaking through my introverted nature and have tried to talk to someone new each day. Usually a simple smile and a quick hello, but many times actual conversations. Over the years I’ve met a lot of interesting people this way and discussed many things. Because of my interest in fitness more than a fair share of these conversations involved working out, nutrition, and the like. I’ve talked about working out with several people who are experts in their chosen sport and/or activity: triathletes, marathon runners, bodybuilders, surfers, Division I football players (okay, one),  Division I softball players (helps when your niece is one), casual lifters,

adventure athlete athletic daylight
Photo by Pixabay on Pexels.com

mountain climbers, rock climbers, and a rugby player (who, by the way, was nothing like the stereotypical Rugby guy. He was friendly, personable – and I later learned through social media has a great sense of humor – and was not only well muscled but well proportioned. More like a physique model or competitor, not the burly “Bluto” type usually associated with the sport). Most of these people, started exercising because they participated in a sport in high school or wanted to prove something to themselves – the latter being especially true of the marathoners and triathletes.

But, there is a subset who work out – and by working out I mean lift weights – for a wide variety of reasons. Because of my own interest in weight lifting I want to focus on these men. Why the men? Well, one reason is that despite my reaction when seeing a mouse scurry across the room I am a man. The second is that from my experience very few women lift weights. Which is a shame because the benefits of lifting weights is well

man lifting barbell
Photo by Isabella Mendes on Pexels.com

documented for both men and women. As high school or college athletes, many women have lifted, but for some reason later in life they stop (as do most men I suppose). Some are afraid of looking like Schwarzenegger I suppose, which isn’t going to happen without chemical assistance and even if it does wide shoulders are making a comeback in women’s wear. Or, just as likely, their focus shifts to losing weight and running becomes the activity of choice.

So, why do guys start lifting and/or keep lifting long after their high school football days? My conversations reveal many reasons:

  1. He started lifting for a sport and discovered that he liked it more than the sport he was originally training for.
  2. He wanted to gain weight to avoid being bullied and/or intimidated by other guys.
  3. He wanted to be bigger and stronger than his older brother (a surprising number of men fall into this group).
  4. He started lifting with his older brother, father or another male member of the family and got hooked on both the weightlifting and camaraderie.
  5. His younger brother started lifting and he didn’t want him to get bigger and stronger than he was.
  6. He wanted to just better when he took his shirt off and have a reason to flex.
  7. He saw a muscular man as a kid and was impressed enough to want to look like that when he grew up (either in person or in a comic book or on television, etc.)
  8. He was a big kid and found that he liked getting bigger and staying stronger than his peers.

You’ll notice that among all the above reasons the classic, “to get the girl” doesn’t make the list. I don’t think I’ve talked to anyone who started lifting to attract girls! Impress other guys, you bet, but not women. It seems to me that to most men that attracting the attention of the ladies is a side benefit of looking better – if that’s his goal to start with.

affection blur close up couple
Photo by Rosie Ann on Pexels.com

Personally, I fall mostly into group 7, fell a bit into number 4 when my dad bought a weight set, and now just have gotten hooked on being stronger, bigger, and the “pump.” Obviously, though I’ve had superficial desire and have gotten stronger over the years (until my surgery this summer) I haven’t had the discipline to achieve the look of a bodybuilder. Darn diet and flat bicep peak!

By the way, and if you spend anytime on social media I think you’ll agree with me on this, there seems to be a whole new group who workout just to show off to strangers (a subset of group 6). Guys who don’t participate in sports but can’t wait to flex in front of a camera to try and gain followers on Instagram. Many seem to fancy themselves models, some are just trying to build their personal training business, but others just seem to like it when people like their photos and follow them. I’m guilty of following quite a few of these guys myself because of my habit of following back anyone who follows me. In fact, one of my favorite activities on Instagram is to use new hashtags just to see who starts to

man wearing gray tank top
Photo by mahmood sufiyan on Pexels.com

follow me. Use hashtags like #bodybuilding #weightlifting #exercise and you’ll get a dozen new likes and several more followers. Some are trying to sell their personal training packages, but most just seem to want followers. I know that some are hoping to get rich by monetizing their Instagram account and have discovered that flexing their biceps gets them followers and likes, but I can’t believe it’s true of every guy whose posed in front of his bathroom mirror.

To be fair, I might be a little harsh – if not hypocritical – on my description of this group. After all, there’s a certain amount of vanity and narcissism in participating on social media to begin with isn’t there? I mean does anyone really care what we had for dinner or how often we workout? But I think I’m right even if it’s a fine line between the guy who is genuinely tracking his progress and motivating himself and others versus the guy trolling for “likes” and fans. The former usually has before pictures and candid shots doing other things. The latter is never seen without the proper lighting and would never admit that he was once the proverbial 98 pound weakling (maybe he never was?). But, as so often I do, I digress.

Anyway, these are my observations. Am I right about these categories or way off base? Why do you workout? I’d love to hear from folks (at least those of you who read through the whole thing).

Onward!

 

Crohn’s Update: Accidents

Warning: this blog entry contains very frank content regarding bodily waste. It may not be appropriate for all audiences. Plus, you may learn more about me than you really want to know. But, if you’ve been reading my blog we both know that ship sailed a long time ago. 

I mentioned in an earlier blog (Crohn’s Update: Life as an Ostomate – What I’ve Learned So Far) that “accidents” will happen. Yesterday was for me the perfect storm of accidents and I thought I’d share to illustrate my point.

You should understand that I had last changed my appliance on Saturday morning. I should change it every 3 to 4 days in the perfect world, so I had planned to change it in the evening before retiring for the night as by my count that would have been 4 full days.  It’s also best to change the appliance (aka “the bag) when the stoma is less active. Which is usually in the morning or two or three hours after I last ate. In general though, I was feeling a little cocky as this had been the longest I had gone without incident in the past 4 weeks. I thought that I had gotten the hang of it and there would be nothing but smooth sailing from here on out. Riiiight.

I got through most of the workday without a problem. Then about an hour after lunch – when I knew my stoma would be active again (by the way, some people name their stomas – and possibly other body parts but that’s none of my business – I haven’t. My fingers don’t have names nor my toes, why should the stoma be any different?). I felt the  the bag fill up. I went to the restroom – conveniently located across the hallway from my office – to empty it and discovered that I had a small leak from the left side of the ring. The good news was that the dressing from my wound had absorbed most of it so my clothing was still dry including my underwear. I didn’t bring my emergency kit (extra bag, seals, etc) into the restroom so I cleaned up and went back to the office, shut the door, took out an extra seal from my kit and patched the leak. Problem solved!  I could make it through the rest of the day – darn, I’m good.  But, I determined to change the bag as soon as I got home.

I went the rest of the workday without a problem, as expected – yay, me again – and on the way home I remembered that I needed to stop at Costco to get my new membership card (I had signed up last week during a promotion at work). My patch was holding so I exited the expressway and went to the store.

Got my card with no problem, except the wait – not sure what the issue was but there were about five associates and one supervisor crowded around a cash register trying to help one customer while the line grew longer. Not Costco’s best “customer service” moment, but having spent time in retail I understood and waited patiently. Unlike the woman in front of me who left and the man behind me tapping his toe. But, I digress. I felt that my bag was getting a little full so after I got my card I went to the restroom to empty it before I looked around the store. I noticed the $1.50 hot dog combo and thought that I might have found my dinner.

In the restroom, much like anyone else would do, I sat down to do my business. For those who haven’t dealt with an appliance before, I found that it’s easier to empty from the sitting position. When standing it splashes too much and there’s a greater chance of mishap – or so I thought. This does involve dropping “trou” as they say and I’m sure most of you are familiar where the clothing ends up in front of you and the bowl. I removed the velcro fastners which keep the opening of the bag closed and flipped the opening towards the bowl. Instead, I release too soon and miss completely! The the contents, mostly liquid, spill onto the floor, into my pants and my underwear. PANIC ensues!

I wad as much of the flimsy toilet paper as I can and blot up the mess from the floor, my pants and underwear. I got the floor pretty clean, for a public restroom at least and I was confident the next person wouldn’t notice the spill or end up with any residue on their clothing. My pants and underwear, not so much. I felt that I had no choice at this point. I wasn’t about to go to the sink half naked to rinse off the remaining waste and I couldn’t sit there all day waiting for my clothes to dry. So, I pulled up my clothing, fortunately the contents all spilled inside and I didn’t see any obvious stains on the exterior of my clothes, winced at the wetness, untucked my shirt to cover as much of my pants as possible, and exited the stall. I washed my hands while checking myself in the mirror to see if I had covered up any spots that might start to show. On the way out I grabbed a handful of napkins from the snack counter (hey, I’m a member now) and passed up the quarter pound hot dog with drink for $1.50 (sigh) and headed straight to my car. “Have a nice day!” the cheerful attendant (guard?) at the door called after me.  Too late ma’am, too late.

At my car I put down the napkins on my seat to hopefully absorb any liquid that might soak through and drove home sitting in my own filfth (if you have a better way to describe it, feel free). Lovely…

Once at home I was pleased to find that the napkins I was sitting on were still dry and that the stain guard of my new pants, pleated to better hide the appliance, must work both ways as they seemed to contain the remaining moisture pretty well. Changed my clothes and checked my appliance. My patch from earlier in the day was still holding so I thought I might as well go visit my mother and like a good son take some laundry with me (I didn’t want the stain to set into the afore-mentioned new pants). For those who don’t know, unlike many adults living on their own I don’t own a washer and dryer. Hey, I have to have some social life right? And what’s more fun than a trip to the laundromat on a Saturday night? But I digress.

My mother was gracious enough to allow me the use of her washer and dryer while I helped her with the crossword and we watched a little television together (Wheel of Fortune, Jeopardy, and NCIS for those interested). When NCIS was over I folded my clothes, noticed that my bag was once again filling up so I emptied it, and then headed home to change the appliance. Life was good and everything seemed fine.

I got home, took my laundry in and started to put it away when I felt a wetness in my pants. A wetness that started to flow down my leg – down both legs! Dagnabit, I exclaimed, I sprung another leak. I once again “dropped trou” only to discover that I had not sprung a leak. I had neglected to re-attach the velcro straps after the last time I emptied the bag. My now active stoma was dumping itself straight through the bag and down my leg. At this point I did what any self-respecting ostomate would do in this situation. I uttered a few more well chosen exclamations (shoot, crud, and golly-gee if I recall correctly) and cried.

In that moment I just wanted to be normal again, I was tired of having this thing attached to me (after only 6 weeks), I hated that I was having more problems and accidents in one day than I think I ever had in 30 years of suffering with Crohn’s. I felt like a freak who couldn’t take care of himself and I just wanted it to go away.

Then, like a big boy, I stood up. Realized that the pity party wasn’t going to do any good. Also realized that two of the three incidents I just had were my own fault for being careless. Took myself and my jeans to the shower and cleaned up. I also thought of that saying, “people say to me ‘I don’t know how you do it’ and I reply, ‘I wasn’t given a choice.'”

Then I changed my bag, watched some reruns on television (American Dad followed by Hogan’s Heroes) and went to bed, warm and dry.

As Miss O’Hara would say – tomorrow is another day.

Onward!

 

Crohn’s Update: Good News and Frustrations of a New Ostomate

As I sit here eating my lunch – because my appetite is still quite strong – I was thinking about a few things regarding my surgery and recovery. Thought I’d take a few minutes to share them because, why not?

Healing: the healing process is frustrating slow. Not regarding the stoma, that seems fine, but the darn incision. Most of the incision is healed and scarred (lovely) but a couple spots just don’t seem to want to close and keep oozing. Not blood, but exactly what you think of when you hear or read the word “ooze.” So, I’m changing dressing twice a day to keep up with the flow and trying not to get too grossed out when I do. Yesterday at the doctor’s office he essentially cauterized a couple areas of what he called “granulation.” When talking about skin healing, granulation is the process where new tissue is created to fill in the gaps of the wound. It starts from the base up, so for a deep wound it takes some time. However, in my case, I had a couple areas that overgrew and formed small lumps on the scar. These may have been infected so the cure was to remove them chemically and one by “snipping” it off. The Good News: If all goes well, my oozing should stop in about a week or at least dramatically slow. I’m looking forward to not changing dressing.

Output: I can’t seem to get the hang of regulating the output of my stoma. Everytime I think things are settling down – so I don’t have to empty out every hour – I backslide. I’ve discovered that lemonade is a problem so I have to avoid that. I’m taking imodium like it’s candy (up to four pills, four times a day), and have eaten enough toast, applesauce, bananas, and rice krispies to bind up an elephant! But, I’m spending more time in the bathroom now than before the surgery. The Good News: The doctor thinks I’m making progress and have the tools I need to get there. I’m not de-hydrated and my weight is stable. He thinks I look “great” so there’s that. Of course, he’s only seen me two times now (part of the post-surgery clinic).

Breakage and Leakage: not fun anytime, especially in the middle of the night or when out and about trying to do normal activities. The Good News: I seem to have re-gained the hang of when to change my appliance. No accidents for more than a week now (knock wood).

Enough venting. According to the doctor I’m free of all lifting and exercise restrictions. I plan to start working out – slowly – this week and get back to tap dancing again next week.

And, then there’s my trip to Florida in about two weeks…

Onward!

 

 

Crohn’s Update: Life as an Ostomate – What I’ve Learned So Far

Well, it’s been a little over a month since I became what is known as an “Ostomate.” This is a person who’s insides have been altered to create a new opening for his or her intestine to empty through (aka a stoma).

Hopefully, to assist the few other new ostomates who may stumble across this blog here are a few things I’ve learned so far. Some the doctors, nurses and dietitians warned me about. Most, they did not:

  1. No matter how careful you are, no matter how often you empty your appliance, you will have accidents. It might be a leak or a blowout – but it will happen.
  2. Some of these will occur at an inopportune time like work (once), before a social function (once), or in bed (three times so far).
  3. Invest in a mattress cover. Don’t skimp on this. I got one that’s breathable and noiseless. Sheets can be cleaned. Mattresses, not so much.
  4. Have emergency kits on hand in your car and at work (a pre-cut appliance, powder, solvent, whatever you need to make a change). I also have spare underwear hidden in my office.
  5. Follow the doctors’ and nurses’ orders. I know, this should be a no-brainer, but it’s worth repeating.
  6. Be patient. It takes a while to adjust to life with your new friend.
  7. Try a pouch support of some kind. I have a band that I slip into with a built in pouch. Check on line there are several styles out there.
  8. Guys, suspenders are better than belts.
  9. Chew, chew, chew. The stomach is an amazing organ and very efficient at breaking down what you eat. But it can’t do it alone. Avoid “chunks” and chew carefully. Trust me on this.
  10. Share your story with friends and family. My first instinct was to not let people know what I was going through. But, there are more of us than anyone realizes. It doesn’t help to keep it a secret.
  11. Red dye is forever. Before you panic because you think your bag is filling with blood, take a deep breath and think, “what did I eat?” One popsicle or glass of Hawaiian Punch can put a very quick scare into you.
  12. Having stated the above (#9), remember it’s okay to be discreet. I don’t tell everyone I meet that there something different about me.
  13. You are going to learn a lot about how your food is digested. This can be interesting and disturbing at the same time. For example: fish smells like fish going in and coming out.
  14. Try to focus on the positive of your situation. Is your pain from Crohn’s, Ulcerative Colitis, or whatever issue gone? Hemorrhoids cleared up? And I bet you don’t miss having to strain to relieve yourself anymore.
  15. Don’t focus on what’s changed in your life, focus on what’s the same. Get back to your normal routine as quickly as you can and your energy allows. Remember, your life didn’t change – only your plumbing did! 

Don’t get me wrong, I have my moments of despair and depression, too. I have times when I hate that this thing was done to me and that now I’m not “normal.” But, I then focus on why it was done – literally to save my life – and that perhaps I was spared by God for a greater purpose. I just need to figure out what that is.

You know, like everyone should.

Onward!

P.S. – you’ll also get really good at estimating how many milliliters of liquid there are in any container. You know why…

 

Crohn’s Update: It Finally Happened – Surgery!

“Mr. Wahr, Mr. Wahr? Do you know what’s happening?” the young med student who just woke me at 4:00 A.M. asked me.

“I think so,” I replied. I had come in to the University of Michigan Hospital less than 24 hours earlier with abdominal pains that didn’t feel like a normal Crohn’s attack. Something was off so after much hemming and hawing I finally decided that given my heart history I really couldn’t take the chance that something was really wrong. Especially since the pains had started the day before and weren’t lessening as was the usual pattern with my Crohn’s, “but why don’t you tell me.”

She looked at me with sympathetic eyes and said, “you’re going in for emergency surgery. A surgeon will be in shortly to explain.”  Surgery? I had certainly anticipated this. In the Emergency Department they had determined that I had what they called a “micro fissure” of the fistula in my ileum. But, at least at that time, they didn’t think I needed surgery within 12 hours. So I had been moved to a room for observation.

Almost as soon as she finished her sentence a young man appeared at my bedside – why are all doctors so young now? –  in a polite, but firm tone he said, “Mr. Wahr, I’m sorry but you need to sign some forms to authorize surgery. Here, here, and here.”

“Surgery?” I asked.

“Yes, we can’t get your fever under control. Our only choice is to go in and remove the cause of the infection. Otherwise your prognosis…we’ll it isn’t good,” he said in a quiet, somber tone. I understood what he was telling me and started signing the forms.

“I need to tell you of all the possibilities of having this surgery,” and he listed off the usual complications and issues and then added, “and you may end up with a stoma.” By this time another surgeon had joined the growing group at my bedside. She seemed to be in charge.

“May end up with a stoma?” I asked, “how likely is that?” The new surgeon answered, ” well, we never go in planning to create a stoma, but until we go in I can’t say for sure. They’s be coming to move you to surgery in a few minutes.”

The doctors disappeared and my nurse appeared to start prepping me for moving to pre-op. As she moved my IV bags the transport team came in. “We’re going to take you down to surgery now,” the nurse said. I grabbed my phone and sent a quick text to my brother. If something happened during surgery, I wanted someone in my family to know what happened while they slept.

In pre-op I was greeted by even more medical staff. One of the anesthesiologists started to ask me a slew of questions, a woman who identified herself as a nurse held my hand and spoke to me in a comforting manner, then I heard doors open, multiple footsteps and could feel the group around me stiffen a little.

“Mr. Wahr, I’m the faculty surgeon overseeing your operation. Here’s what’s happening. The fissure you have is worse than we thought. The contents of your bowels are emptying into your abdominal cavity, causing infection. If we don’t go in and stop this, we won’t be able to bring the infection under control. The outcome will not be positive. Do you understand?” I nodded that I did. “We’ll remove the damaged areas of your intestine and when you wake up you will have a stoma. Do you know what this is?”

“Yes,” I replied, “but it sounds better than the alternative.”

“It is,” the surgeon replied. “You’ll be going into surgery now.” And with that they began to wheel me to the operating room. I noticed the time on a clock. It was not even 5:00 A.M. They were not wasting any time which told me all I needed to know about the seriousness of my situation.

A quick trip down the hall, during which I mostly observed the ceiling, and we were in the operating room. A white, sterile looking space filled with equipment and a woman sitting in the corner covered with a blanket around her shoulders. Part of the anesthesiology team perhaps? I’ll never know. A quick transfer from my bed to the “table” and the voice of the anesthesiologists who spoke to me earlier. “Are we ready? Okay, here we go.” A mask was put on my face and just as I was wondering if this was it and would I ever wake up, everything went black.

Next thing I knew, I heard a disembodied voice asking me questions, “Mr. Wahr, can you tell me where you are?”

“U of M Hospital, I’m having surgery.”

“Very good, everything went well. You’re going to a room now.”

I continued to drift in and out of consciousness for an unknown amount of time. It was about 10:00 A.M. when I finally seemed to actually wake up. I said a silent prayer thanking God for letting me wake up and yet another doctor came into my room. This, I would later learn, was the “attending” doctor for the intensive care unit I was in.

“Mr. Wahr? How are you doing?” he asked.

“I guess fine. Considering.”

“Yes, I understand. The good news is that the surgery went well. You do have a stoma, but the infection and fever are gone and you should make a full recovery. You were lucky,” he paused to consider his words carefully, “this was the kind of thing that people die from.”

“So I hear.”

He went on to tell me a little more about the surgery and that the surgeon would be in later to check on me (as he did each day I was at the hospital). He then left me with the nurse so I could settle in.

Thus begins my newest adventure with Crohn’s. In a way I always suspected that this day was in my future – yet it was still a surprise when it happened. Many Crohn’s patients end up in surgery and with stomas. I’ve managed to avoid it for more than 30 years so in that sense I’ve been fortunate. And there is the possibility that in 6 months or so, presuming that the Crohn’s is under control, that I could be “hooked back up” so that my colon can be useful again. So, all in all, I’m handling the situation pretty well.

My current concerns while I recuperate and adjust to life with an appliance attached to my side (which does get changed every three to four days): 1) dehydration – most of the water for the body is absorbed by the colon. It will take time for my small intestine to realize it needs to pick up the slack; 2) weight loss – even though my appetite is good, food is still passing through my intestine too quickly. As a result, I’ve been slowly losing weight (almost a pound a day). Something a lot of folks dream of, but be careful what you wish for. When I was first diagnosed with Crohn’s I dropped down to about 140 pounds from my then previous weight of 180 pounds before being stabilized. I sure don’t want to be that thin again. Plus, all the weight seems to be disappearing from my chest and shoulders and thighs. Not my belly where I really don’t need it. Muscle loss is certain at this point. There goes the last 30 years of training down the drain; 3) infection, which I’ve avoided so far, always a risk after surgery but especially for someone with a weakened immune system; 4) controlling the Crohn’s. My past medical regimen didn’t prevent the fissure which is an indication that the treatments weren’t working. The interesting thing now is that my Crohn’s has historically been localized to the ileum. Now that my ileum, about a meter’s worth of small intestine, is gone the question is will my Crohn’s flare up somewhere else?

That’s it in a nutshell. I’m managing to deal with the appliance pretty well so far with only a couple mishaps (one in the doctor’s office) and I’m looking forward to returning to work soon.

Of course, I’ll keep blogging about my experience in the hopes of helping someone else with the same or similar situation. There’s always hope folks and we are all in this together.

On a side note, I had an interesting experience that was repeated with three nurses as they prepared to give me an injection in the back of my arm. It went something like this:

“Left or right arm?” the nurse asks.

“Doesn’t matter. Left.” I reply.

“Okay,” takes my arm to prepare the injection site. Stops and says, “oh, I’m not sure what this is. Is there a tumor in your arm? Or is that your tricep?”

“I hope it’s my tricep.”

“Yes, I guess it is. Not used to seeing a tricep like this. Very impressive.”

Now, I can’t be sure if the comment – from three different nurses – means I have an oddly shaped tricep or if they just don’t expect a relatively well developed tricep on a…ahem…mature man (though I think it’s looking pretty puny right now). I’ll go with the latter as it makes me feel better about myself. You have to look for the positive in every situation after all.

Onward!

Not a Tumor

 

Fitness Quest: Spring and Summer 2018

Wow, it’s been a long time since I’ve posted (April) so there’s a lot to catch up on. Mostly good…

Crohn’s: we, my gastroenterologist and I, have decided to change my medication and I’m no longer on Humira and have switched to Entyvio (vendolizumab). She, my gastroenterologist, strongly suspected that the Humira wasn’t keeping me as well controlled as I thought and after consultation with my cardiologist – who now gets consulted by every doctor I have – recommended that I try something else. I’m all for anything that can better control my symptoms, of course, and so I now get infusions instead of taking a weekly injection. I’ve had some flares since starting the new treatment, including one that sent me to the emergency room while traveling out of town.

The issue wasn’t the Crohn’s directly, as the pain wasn’t that bad, but dehydration

ambulance architecture building business
Photo by Pixabay on Pexels.com

brought on by the Crohn’s. I just wasn’t going to take a chance since we think that a Crohn’s attack brought on my heart attack and my symptoms (severe chills) were just too unusual for me. I was so cold, inside my hotel room under my blankets, that if I were outside camping I would have thought I had hypothermia.

Long story short, one ambulance ride and two IVs of fluid later, I was back at my hotel feeling a whole lot better.

I’ve had one or two other minor flares since starting the treatment, but I’m still within what they call the “ramp up” phase of the infusions so the drug hasn’t reached it’s full efficacy (full effectiveness) yet. My next infusion is August 9th so we should know by then.

In addition to the Entyvio, we are also being more aggressive in treating my anemia – presumably caused by the Crohn’s – and have started getting iron infusions as well. Interestingly enough, if these work I’ll only need two and the benefits will last months and possibly years! The first infusion was this week and so far no side effects so we know I didn’t get too much iron. The second is next week and it will then be a few weeks after that before we know if it works. If all goes well I’ll have more energy and actually be breathing easier as well. Which means, you guessed it, less strain on the heart (concern #1).

Cardiac Health: I finished my cardio rehab with flying colors. My exercise therapist said I was a star pupil and an example for others and sent me off with instructions to

black and white blood pressure kit
Photo by Pixabay on Pexels.com

continue my work and a hope that he never sees me again – at least in rehab. If anyone out there has a heart issue and is offered the opportunity to take rehab DO IT! I left knowing my body better and more importantly my limits. I can judge when I might be pushing too hard and, just as importantly, when I’m not pushing hard enough.

Thanks to rehab I had the confidence to run in the Rose Run again this year.  This is the annual 5K to support breast cancer research held in Petersburg, Michigan in July and Burbank, California in October. If there are two more disparate communities to host the same event out there I couldn’t tell you where they are! Anyway, I didn’t beat my time from last year (sob), but I finished feeling good and, here’s the important part, without a cardiac event!

Massage:

board brown daylight destination
Photo by Pixabay on Pexels.com

I got my first deep tissue massage. I’ve been having some intermittent muscle pains, especially in my chest, and my primary care physician suggested massages as a regular treatment. Well, while traveling on business I was a spa in Saratoga Springs, NY and some free time so I treated myself to a mineral bath and a deep tissue massage. Wow! I had no idea how tight I was until my masseuse started her work. I was never in pain, but came close. She also confirmed that I had a couple substantial “knots” in my chest that one massage wasn’t going to get rid of. So she gave me a couple stretches to do on my own and suggested fascial stretch therapy. I’ve been looking into this and will likely give it a try within the next couple weeks. I’ll blog more on this later.

 

Yoga: 

man wearing white pants under blue sky
Photo by antas singh on Pexels.com

I did start yoga, but have fallen off the wagon. I need to get back on it as this does help with stress, breathing, flexibility, and a lot of other benefits. I been using routines on youtube led by Adriene. Her videos were suggested by a friend and I find her teaching method to be easy to follow and a good introduction to yoga. Plus, you can do it from your home. I’m sure most would say that a video can’t replace a good in person instructor, but honestly, I’m not reading to show my downward dog in public yet – let alone a warrior three!

Nutrition: Um, yeah, about that. Did I mention that I was traveling a lot? I have a lot of “adjustments” to make.  Moving on…

beef blur bread bun
Photo by Foodie Factor on Pexels.com

Overall Fitness: I’m still lifting weights a couple times a week. Not seeing much progress in this area and I haven’t been pushing. It’s time to make a few changes and a few gains. I can’t go heavy on lifts like the bench press anymore (see cardiac health) but as long as I don’t raise my blood pressure I can do pretty much everything I used to. Weight lifting was part of cardio rehab so I see no reason not to continue. Too many people don’t realize that strength training is especially important as we get older.

man in grey shirt and black bottom lifting barbell
Photo by Frame Kings on Pexels.com

I’ve read that the average man without training loses about 10 pounds of muscle each decade after the age of 30 (yes, 30). Regular resistance training (i.e. weights) can slow down and even reverse that loss. In fact, I would say in my case, I was actually at my strongest in my late forties. I may never bench 350 again but I can be stronger than I am now and less likely to fall and break something! I suggest you do the same.

Onward!

Mediterranean Diet