The (Relational) Space Between Us

Hey, it’s not as bad as it sounds.  We had our third week of what I have begun to call “Fat Class.”  Week three is reserved for prospective bariatric patients and the support people.  It was a full room, and good for those people who brought someone.  There we were, the 5 or 6 of us who brought no one, in the back row looking at each other knowingly.  We live alone, some by choice, some not, and I am confident we’ll figure something out when the time comes.  I’m sure I could get a member of my family or a co-worker to come and sit with me to make sure I’m okay.  I’ll sleep downstairs to be close to everything relevant.  But this night, I was flying solo.  Come to think of it, if I were a pilot, flying solo would be a badge of honor; it’s something one has to graduate into.  Go me.

flying solo
from robynhobson.com

It was a good class, which surprised me, because it wasn’t as much about food as it was relationships.  One of my favorite sayings regarding the fairer sex comes, of all places, from Popeye: “It’s been proven through history that wimmenz a myskery.” Dr. W. was discussing the relational system, and how it needs 3 things from all involved to keep going

  1. Flexibility
  2. Adaptability
  3. Accommodation

    Feminist popeye
    The mystery is what the hell happened to her forearms.

If one of these things is missing, the system starts to break down.  To put these things into a diagram, draw a box, and write “ME” in it.  Then draw a large circle to the right of that box.  To the right of that, draw another box and write “YOU” inside.  That circle represents the relational space.  This is where things get worked out.  I pour in my thoughts, needs, hopes, and wants.  You pour in yours.  And from that we get our compromise.  We say, “When you ____, I feel ______, and what I really need is _____.”  Keep in mind, this means that we have to tell people what we want, and we have to be direct.  Now, write all the wants and needs in the circle.  Remember the Tinker Toy exercise, where we draw spokes off the circle and figure out how to get these things in the circle?  We are NEVER, EVER stuck in a problem!voodoo doll

Picture instead a fight. Arguments and fights happen when we don’t use the relational space, and instead go around it.  Draw an arrow from your box around the top or bottom of the circle directly to your partner’s box.  Admittedly, I have worn a path of fire in the area around the outside of the relational space.  Which is why I was alone on support night, let’s be honest.  Anyway, that path leads to the pyramid of escalation.  On the base, level 1 is discussion and compromise.  Level 2 is “Attack, defend, counterattack, retreat.”  Level 3 is the level reserved for goading and button pushing (you know who you are).  Level 4 is verbal abuse – demeaning, name calling ugliness.

Argument
Careful, lady.  I’ll bite that finger clean off.

And the tip of the pyramid is physical abuse.  If something comes at us from levels 2 or 3, we must always respond from Level 1.  We could say, for example, “Could you help me understand what some of your concerns are?”  It gets to what is happening in their head, not addressing the escalation.  Nothing good ever comes from anything above level 1!

Before the class  started, I was talking to a guy in the back with me.  He mentioned that he’s been doing the exercise, eating the way he is supposed to, and he still feels like he’s gaining weight.  I feel exactly the same way!  I met with the dietician Friday, and she thinks I’ve hit a temporarily plateau in my weight loss.  She thinks because I’ve been trying to stick to 1200 calories a day that my body thinks it’s starving and is slowing things down.  So we’re going to add a few hundred calories a day and see if that changes things up.  I also need to change what I eat every day for lunch to keep my body guessing.  Not the first time I’ve heard that.  So tomorrow I will spend time looking for other lunch alternatives.  I was only up a pound over a two week period, but I still see that as going in the wrong direction.  I mean, I wound up here by overlooking one pound at a time.  It eventually became 100.  As the saying goes, a nickel here, a dime there, and pretty soon you’re talking about real money.  At least I think that’s the saying.

Gain weight
Um…no.

I was approved for the in-lab sleep study two Wednesdays from now, so I’m (not) looking forward to that.  I mean, I sleep naked, so between having to wear something to bed and being in a strange bed on a weeknight, I may not sleep at all. Thing is, the in-home sleep study isn’t as comprehensive, and apparently many people end up needing the in-lab study anyway.  So no sleep, and I might get to come away from it with a stinking C-PAP machine.  And I get to go to work the next day.  Awesome.

No Sleep
Thursday’s warning to my coworkers

The Neurologist and the 4 Components of Functional Eating

What do the two have to do with each other?  Absolutely nothing.  It just describes my day.  Or perhaps a secret 8th Harry Potter book.  You decide.

I went over this afternoon to see the neurologist for a consult.  It was supposed to be for sleep apnea, common for us non-wee folk.   But it also became a consult for my migraines.  I bought my very first house in July of 2015.  bout 3 weeks later, I fell down the second floor stairs, and hit every damn step on the way down.  I was buck naked and holding an empty laundry basket at 6:30 in the morning.  When I hit the bottom, I thought I had broken my hip.   I decided that if I could put weight on it, it wasn’t broken.  I limped around the kitchen – not broken.  I had to go to work, so I hopped in the shower.  A burning went up my arm – it turns out I had a second degree burn on my forearm from the carpet.  I got to work and my eyes started going in different directions.  I left work after a few hours, spent the rest of the day in the Emergency department, and have had migraines since, including one Thursday that brought for the first time nausea and vertigo.  That scared me a little.  That was not my first concussion.  Far from it.  I am not a pro football player, but I was a boy, and I am now a man, and I find myself sometimes in situations that result in concussions.  Don’t ask.  And if you haven’t seen the Will Smith movie Concussion, see it.  Great movie.  Not really about football at all.

Anyway, the neurologist gave me the choice of what to treat first.  I decided to treat the sleep apnea.  My reasoning was that I have to sleep every night, and I do not have migraines every day.  Also, there is a chance that by taking care of the sleep apnea, it may take care of the migraines.  The reverse is not true, and could also result in more kids for me, the side effects of which did not seem particularly pleasant.  So the medical group will submit to the insurance company for preauthorization, and we’ll see if I can do the in-lab test because it’s more comprehensive and I want this taken care of.  I rushed back to work for three meetings, then got back in the car and went back to Portsmouth, literally across the street from the neurologist’s office, for the behavioral psychology sessions required through the bariatric program.

Tonight we discussed the 4 components of functional eating patterns:

  1. Portion regulation – have a strategy
  2. Food selection – read the labels!
  3. Interval eating – eat by the clock, anywhere from every 2 to 5 hours. Meal, snack, meal, snack, etc.
  4. Compensation – if you overdo it on food and possibly stretch your pouch, then its time to increase your exercise, reduce your calorie intake, or both.

Good stuff.  Next week we’re supposed to bring at least one of the people in our post-surgical support them with us to class.  I will be attending alone.  I have support, but they will only be here if I call them.  I kind of prefer it that way.  Perhaps I’ll feel differently when the time comes.  My family are the type that are always offering to jump in and help.  I love that about them.  There are a few others, a few people at work, and a few people outside of work, but they have their own lives.

Do any of you have any thoughts about this?  I’d love to hear them.  By the way, dear reader, if you are considering bariatric surgery, I strongly urge you to subscribe to two blogs I absolutely love: rny4me just had gastric bypass surgery and chronicles it warts and all, and banded carolina girl offers a fresh perspective and encouragement.  I’ve drawn a lot of strength from those two, and I likely have not told them in any way, shape, or form, but thank you.  You are keeping me on the path.

I’d Count Sheep, But I Can’t Breathe

Well.  I feel like it’s been a while!  I’m not sure if I warned you, but I have no concept of time, specifically days of the week.  I am rarely late, because I was in the military for almost ten years, and as the saying goes, “If you’re not 15 minutes early, you’re late.”  That being said, I may have forgotten to pick my niece up last Wednesday because…well, I had no idea it was Wednesday, and I put the reminder in my phone on the wrong Wednesday.  It was a nice night, and she was in good humor about it, so all is well.  I took her sister, my younger niece, to see Star Wars: The Force Awakens yesterday.  She is twelve and she loved it.  We talked about it through dinner, and I was able to relive my childhood a bit as I told her about the first three movies.  1977…seems like a hundred years ago.  But that’s not why I write this blog. Yet.

Star Wars Original poster
As I recall, this was the original movie poster and the cover of the book.

I had my first appointment with the Nurse Practitioner Friday afternoon.  It was a gorgeous day, much like today.  We did things a little backward, scheduling my second appointment with the NP and another with the dietician.  The psychologist and the physical therapist will be contacting me soon to schedule appointments, I was told.  I remember thinking that this was getting real.  As I waited,  I read your blogs to keep my mind clear (thank you!!).  Then I was being called in.  I got on the scale and due to some last minute cheating, I had only lost 6 pounds.  The more I thought about it, that’s two pounds a week, which is good!  But I could have done better.  Who has a problem with that type of thinking?  Speak up and let me know why, would you?Jealousy

The other thing I was thinking was that the NP was kind of cute.  Probably too young, but cute nonetheless.  I don’t ever want to make a play for someone on my team anyway, but it was going through my mind as she fiddled with her hair for an hour and change.  We went over in minute detail my application, which was essentially my health history.  She did say she didn’t think I would have a problem with the surgery and a successful outcome, because I am on the low end of the bell curve.  So…for a fat guy, I guess I am the skinniest. I’ll take it, because it made me feel good.talking-nonsense

We talked about the medications I am taking.  We talked about the need for a sleep study, to which she is referring me.  Apparently the guy will come to my house to do it.  It’s convenient and creepy at the same time.  It makes sense, though.  I don’t sleep well unless I am in my own bed.  I get my best snoring done there, apparently.  I would’t have mentioned the sore throats I wake up with if I hadn’t been told by a house guest somewhat recently that I stopped breathing during the night several times.  And I am an awful sleeper.  The NP told me the C-Pap would make a huge difference in the way I sleep.  My question was once I have the surgery, would the sleep apnea and snoring stop?  She said it likely would, but that there were two types of sleep apnea: obstructive sleep apnea, which according to the Mayo Clinic’s website, happens when the throat muscles simply relax and the added fat on the neck adds weight to the windpipe and suppresses breathing; and central sleep apnea, which is when the brain fails to send the proper signals to the muscles that control breathing.  In the words on my NP, if you’re central, you’ve always been central, and you’ve likely always snored.  But if it’s new, it’s likely obstructive and that can be dealt with.  As a side note, the Mayo Clinic lists a third type of sleep apnea, complex sleep apnea syndrome, which is the fusion of both types of sleep apnea.  It must be super-sized, to be a syndrome. Wow.

sleep-apnea-snoring-350
How do these people sleep with the lights on?

Anyway, we talked about family history.  It was at this point I realized that most of my father’s side of the family is dead, including him.  I have no way to get the information to answer those questions.  It hit me in that moment.  I am still a little adrift over that, but I am an adult man, and I have to be my own anchor, not count on my father’s family to be one for me.

Donkey adrift
*sigh*

We talked about support.  What type of support would I have post-surgically?  Does my PCP support this surgery?  Do I have supportive friends? My mother is willing to stay here for a bit, and be a frequent guest until I am up and running on my own again.  My sister is busy, but she might check in from time to time too.  Maybe a few friends from work would help after work and on weekends.  It almost makes me miss being married.  You know, having somebody there who helps, supports, loves, but is there all the time and doesn’t leave.    My doctor does;t really support having the surgery, probably because I’m on the skinny side of fat.  I’m “only” 100 pounds overly ideal weight.  I carry it pretty well because I’m tall, but it’s all in front.  The down side is that my PCP is also my mother’s PCP.  He is in favor of her getting the surgery, but she won’t.  She’s resigned herself to being a large woman, I think.  My doc is a great guy, he really is, but our paths diverge at this point.  And since I don’t need his blessing for the surgery, I am forging ahead.Hahahaha. Nope
Finally, I’ve only told a few friends about this plan. One, the one I work with, is really supportive.  She’s a little older than my oldest daughter, but we have more of a friendship…I don’t know.  It’s strange.  But she says if I need anything, she’ll be here, even though she has a husband and two young children.  But I have this other friend who really pissed me off this weekend.  I hadn’t spoken to her for 15 years.  She suddenly reappeared up here in New England after many years down south, and wants to resume a more active friendship, which is fine.  She’s had a couple small strokes over the last three or four years, but is still okay.  Her memory is just a little off.  She asked me to explain to her why I was getting the surgery.  I told her I had heath issues, and I needed help getting this weight off, and frankly the fear of dumping and/or death is a good motivator to keep the weight off.She jumped in and started challenging my decision to do this, asking me why in the world I wanted to undertake something so severe.  I got upset. I told her it was because I am fat, I am unhealthy, and I am close to being a 50 year old man who makes his own damned decisions and doesn’t have to  answer to anybody – ever. I said it in a tone that left no doubt I was pissed off and ready to go toe to toe.  She backed off (and spent the next twenty minutes apologizing needlessly) and the conversation went on, but I will not forget that any time soon.  I do not need people in my life that are less than 100% supportive of my decisions.  I don’t need brown nosing yes men, but I will no longer defend myself to someone else.  Whether I’m right or wrong, stand by me, offer me counsel if you must, but I will be making the decisions.decisiveness