Week 227 Update

This morning I was happy to be alive! Outside it was 53°, dark—but the sky was just beginning to lighten—as I stepped on Mr. Scale at 06:23. He responded with, "186.0 pounds!"

Sometimes you have weeks that contain events that will stay sharp in your memory for the rest of your life. This has been just that sort of week.

Last year was extremely stressful for me, and it depleted my reserves for stress tolerance. This year, while being much better, has had added it's own stress. Dotti being scheduled for two more surgeries, along with some job related increase in stress pressure has made the last few weeks tougher, and then working out the final edition of the new E-Letter for DWLZ was the final bit of stress on top of the rest of the cocktail. Was something bound to give way? Perhaps. In any case it did.

The week that was:

Saturday - I weighed-in at 187.0 pounds. We were in Olympia, Washington visiting with our son LeRoy. It was cool enough outside so we could open his sliding glass door and have the fireplace burning away and still be comfortable. LeRoy knows that a fire in the fireplace is one of my favorite things. Since my weigh-in was completed, I could even enjoy some marshmallows that we toasted over the fire. J

We had a nice quiet day visiting. We took a drive to Costco where we had a Very Berry Sundae (6 points), and then we visited the mall near LeRoy's house, to just walk around for a while. Later we had dinner at a Mexican restaurant near his home. Our waiter seemed to enjoy the word "perfect," because whenever we ordered something he would bless it with the evaluation: "perfect!" For the rest of the weekend together, we often would declare that things were "perfect," and would get a chuckle out of it. (It is the simple things in life sometimes. J)

When we got back to the apartment, I decided to take a walk. I took out my GPS and set out to get in 3 miles. I walked a loop on the little trail that is in a park near his home, and that I have walked before on a previous visit. The trail is a bit under a mile and I was thinking that a little variety might be better than just walking the loop 3 times anyway. So, after doing the loop I headed off up the road. It had a nice sidewalk, and provided a safe walking environment. I felt pretty good, but I was often reminded that I had eaten a large and spicy meal.

As I approached the home stretch, on the last half mile or so, I started getting a pain in my chest that shot right through me. Was it my back shooting forward to my sternum? Or perhaps it was an old injury that I have at the sternum, shooting backwards to my spine? Then again, the big fear, maybe it was my heart! I finished the walk in trepidation.

When I got back to the apartment, the pain receded, and I was left to mull it over.

I had eaten 63.0 points for the day, which wasn't too bad after having 30.5 points for dinner.

Sunday - I weighed 187.0 pounds. We packed up our stuff in the morning and got it ready to put into the van. We then went to lunch with LeRoy at Red Robin. I got off with having only 8.0 points, by having a salad.

We sadly said goodbye to our son, and headed back home. The weekend was soon ended, and another week of work was staring me in the face. Oh joy. L

I had eaten 39.5 points for the day. I had averaged 51.25 points-per-day so far, and that was only a little high. Usually the weekend is where I eat the highest number of points-per-day. So, I was in pretty good shape to enter the rest of the week.

Monday - I weighed 186.0 pounds. That was better than the 187.0 I saw the day before. I arrived at work knowing that I was not going to walk. I was still thinking about the pain I had on Saturday, and didn't want to push it.

I had a quiet day at work, and when I got home, I worked with Dotti on getting the final touches on the first edition of our E-Letter. The butterflies of doing something like this for the first time were flying around. I felt it was good at the end of the night, but was it good enough? Added stress.

I ended up eating 31.5 points for the day, dropping my average for points-per-day down to 44.6, below my normal maintain level (46 points). I was right on track for eating now for the week.

Tuesday - I weighed 186.0 pounds again. Once again I didn't do any walking at work. I gave it some thought in the morning, but decided to take a little more rest.

The day was quiet at work, and in the afternoon Dotti called me up to ask if I was interested in walking with her that evening to Sweet Tomatoes. I almost never pass up a chance to take a walk with my Dotti. I figured that it would be a nice walk at a reasonable pace. I should be okay. So, I agreed. In fact I was looking forward to it.

When I got home Dotti was ready to go. I put on a flannel shirt because, even though it was comfortable at the time outside, the sun was fast on its way down, and it would be cooling off soon. I brought along a red flasher to clip onto my shirt for the walk back also, when it would be dark.

When we first set off from the house; my chest started to hurt again. However, as we went along, it got better, and by the time we completed the 2.1 miles to Sweet Tomatoes, my chest felt great. I felt very pleased with that. I was thinking that if my heart was having trouble getting oxygen, the longer I exercised, the worse it would get, not better. I ate my 19.5-point meal feeling better.

On the way home, I felt good at the start, but about half-way home suddenly I had a stabbing pain in my chest. Oh great. It seemed worse when Dotti held my left hand, rather than my right hand. Was it my back being stressed somehow, producing pain? Why didn't it go away after I made it home? It did lessen to a dull ache, but it remained. Do I call 911? Do I wait until morning and go into see my doctor? All of these questions were going through my mind, and Dotti looked at me and said, "Let's go to the emergency room, or you will be stressing over this all night." And so we did.

Stress has been building the last few weeks, as our schedule has been hectic, Dotti has had one surgery, and another is pending, only a week away. There have also been some issues with my job (I hate to fly, and this year the pressure is on to do lots of flying). I have had several other projects brewing, including getting things ready for our first E-Letter to go out.

And suddenly I started getting chest pains. I have had chest pains before but they were normally easily traced to stress, and occurred only when I was at rest, almost never when I was exercising. This was a new set of circumstances.

The emergency room was a zoo. If I had of been on the verge of dying, I probably would have done just that, because I got shuffled around to several chairs, only to wait for a couple of hours before they finally ushered me into a examination room. (The American Heart Association recommends not going to the emergency room directly, but instead, if possible, calling 9-1-1 and having an ambulance come and pick you up. First of all, you start receiving treatment immediately when they arrive, and you usually get seen sooner once you get to the hospital. At the very least, you may be able to lie down while you are waiting to be seen.)

Once I got into the ER examining room, things were better. I was put on a table and they asked a number of questions and had me rate my chest pain on a scale of 1 to 10. (It was fortunately down to a "1" and holding.) They shot some nitro glycerin under my tongue and checked my pain level. They ended up doing that 3 times, all the while watching my EKG.

Later a nurse wheeled my bed down to Radiology and I had a chest X-Ray. When the nurse who had wheeled me down to radiology was getting me ready to be wheeled back to my ER room she joked, "We have to take you back to your room, she won't let you stay here." I replied, "It is sad when they don't want you around." The lady x-ray technician laughed at that. She said I was the nicest patient that she had had for quite awhile. That made me feel good. (The nurse explained on the way back that often in the ER they don't meet people who are at their best, since they are often in pain, or have other problems. I told her that I could understand that!)

Meanwhile, as I was lying on the bed in the ER, midnight rolled on by.

I had eaten 41.5 points for the day.

Wednesday - I was surprised to see that the entire time that I was in the hospital, they never once checked my weight. They asked what I weighed, and when was the last time I weighed. J So for this day, I compared my weight from Tuesday and from Thursday and, since they were only a half-pound apart, I used the higher number of 186.0 pounds. By using that method, I weighed 186.0 pounds.

Meanwhile back on the ER bed. . . finally, sometime after 2 AM, the ER doctor said that he didn't see anything on the EKG that worried him, but the pain was still a concern, so he was going to check me into the hospital overnight and have me run a stress test on the treadmill the next morning.

I was happy to hear that he hadn't seen anything haywire with my EKG! However, being admitted was a bit of a shock. Since I was born, and my Mom and Dad brought me home from the hospital, I had gone 54 years, and even had my tonsils and my gall bladder removed without ever having spent a single night in the hospital as a patient. (I have spent many nights in the hospital being there for others, especially Dotti, but being admitted myself was a new one on me.)

It was after 02:30 when they took me upstairs in a wheelchair, and got me settled into my room in the CDU (Clinical Decision Unit). My room was more of an alcove, with a curtain pulled over the entranceway, which took up an entire wall of the room. However, I had the place to myself. (We were later told that the CDU at this hospital had only been open for about 3 weeks.)

They hooked me up to a wireless EKG setup, that had an instrument package that would fit into the pocket of my hospital gown. (I said to the nurse, "These gowns must have been designed by someone like the Marquee de Sade." I was thinking to myself at the time they certainly seem to be created with humiliation and degradation in mind. Is this really the best that our currently world class medical system can come up with for patient attire?) Somewhere between 02:30 and 03:00 I fell asleep, after Dotti, knowing that I was not in any immediate danger, had headed home.

I woke up at 04:00 with a splitting headache from a "crick in my neck," that I got from sleeping on a pillow that didn't give my neck proper support. I rolled up a blanket and created my own pillow and got to sleep for about 45 minutes before my nurse woke me up at 05:00 to take some more blood, as well as to check my blood pressure. I said, "It is nice that they put in the IV needle last night then, so you won't have to stick me again."

"Oh no," she replied. "Once they put the saline in, it messes up what we get out. I will have to poke you again." I was thinking something humorous to sayJ, but then thought better of it, as she might not think it as funny as I might, and she had the needle in her hands.L Oh well.

Afterwards I tried to get back to sleep, but I found that I was wide awake before long.

I didn't have a book to read, and so I ended up doodling for a while on the patient brochure they had given me. The oncoming day shift nurse spied what I was doing and grabbed a couple of sheets of blank paper for me to draw on. That helped to pass the time. (Later she asked to look at my drawings and very kindling fawned over them, and asking me if I painted as well. She is a very good nurse and knows just what to say to make her patients feel good.J)

The nurse also located a newspaper that was a couple of days old, and I browsed through that until breakfast, which arrived around 08:00. I ate and then about a half hour later a nurse came by to tell me that since I had eaten breakfast, they couldn't do the stress test until after 10:00 to give the food some time to settle in. (I was thinking that I would have been happy to do the stress test at 06:00 and gone home for breakfast. ) The meal actually wasn't too bad. (Blueberry bagel, 2 bacon strips, 1 cup 1% milk, 8 oz. cranberry juice, and ½ cup oatmeal for 12.0 points.) I journaled on my patient's brochure.

Dotti showed up soon after breakfast carrying a Starbucks coffee. Seeing her smiling facing coming around the corner sure cheered me up! I said, "Oh you brought me a Starbucks!" She laughed and said, "No you can't have coffee this morning." I replied, "I know." L

Finally the nurse showed up to take me down to do the stress test. I was feeling pretty confident that it would be okay by this time. I had been on a monitor, even when my chest was hurting a various times, and my heart signals apparently looked good. All my blood test results had come back negative. Whatever the problem was, it didn't seem to be my heart. They let me put on my pants, and my tennis shoes before we walked down to the room where the stress tests are held. After I got all wired up for the EKG for the stress test, while we were waiting for the doctor, the nurse and I visited and it turned out that we were orignially from the same area of California. I was born in Loma Linda, and one of her relatives was as well. She was born in St. Bernardine Hospital in San Bernardino. I had my tonsils out in that same hospital when I was 4 years old. There were a few other interesting coincidences, and before I knew it, the doctor arrived and we were ready to start.

They started the treadmill out on a 10% incline at a slower speed. Then every couple of minutes or so, they increased both the speed and the incline. By the time I reached the final stage, it was inclined like the Multnomah Falls path and I felt like I was moving along pretty fast. (No readouts were visible on the treadmill, and so I am not sure how fast I was going.) My heart rate was up over 151 (target heart rate was 141), and my blood pressure peaked at about 175 over 85 if I am not mistaken. But most importantly, my EKG output on the computer screen looked nice and steady. The nurses who were present kept saying that it looked very good. The doctor had his head buried in the sheet of paper that was rolling out of the printer, and he didn't say much.

At each point along the way where they were going to step the speed and incline up, they would warn me that it was 10 seconds until the next stage. So, when they said, "10 seconds to go," I asked, "Until the next stage?" I was feeling very good and felt I could probably handle one more increase, at least for a while. They laughed, "No until the end."

As the treadmill started slowing to a stop, I walked for a while, until it was going pretty slow, and then I stopped walking, allowing the belt to take me to the rear of the machine so I could hop off the back. Three people all instantly were lunging towards me like they were afraid I was doing something very dangerous! I was confused, and I took a quick look at my wiring thinking that maybe I was going to pull it out of the machine or something, but I had plenty slack to spare. As it turned out, they were afraid that I was going to break my neck, or ankle, etc. However, I was standing safely on the ground waiting for them by the time they got there. I have developed the habit of dismounting that way at the gym, where the only route to and from the treadmills is from the rear of the machine. There is no way to step off to the side without stepping onto another machine.

They monitored my blood pressure as it normalized and quite soon it was back to 115 over 80 or so. The nurse said that my blood pressure had responded well within the norm throughout the exercise.

I didn't get the total time and distance that I walked during the stress test, so I didn't put down any miles or aerobic points for that bit of exercise.

I got all disconnected from the wiring, and when I got back up to my room, I was told that I would probably be leaving in 30 minutes or so for home. I did have my wireless EKG monitor restored to operation, but I was allowed the continued dignity of having my tee shirt, pants and tennis shoes on. (I was starting to feel human again, moving from the status of patient, towards being a free man.) The IV connection that was inserted into my arm in the ER the night before was still in, even though it was never used after drawing the blood in ER. Once they said I could go, they would be pulling out the needle, and disconnecting the wires. I would be free!

Since it was after 11:00, I was happily talking with Dotti about going to Sharis with her for lunch, and looking forward to getting a cup of coffee. A lady came by with the lunch trays, but I told her that I didn't need mine, as I would be checking out soon. A few minutes later, a nurse walked in and said that the doctor who was present during my stress test saw something in the EKG that he wanted to talk over with a cardiologist before I could leave. Since the cardiologist was still busy doing rounds, it would be a while. I should take off my shoes and settle in. She pointed at the dreaded hospital gown with a sad look on her face. She knew I was eager to get out of there. I felt like I had been punched.

I was faced with a situation where if they didn't like something from the test, I would be looking at another night in the hospital and a nuclear camera study the following day. (In 1990 I had had a nuclear study done as part of my initial stress test.) I took off my tee-shirt and my shoes. I put on the gown, but I left my pants on. I figured I would remain optimistic, at least a bit.

So, there I was in the hospital bed, and what was I fretting over? Besides my heart, how was I going to get the E-Letter out on time if they held me over for another day of testing?

Time passed slowly as we were waiting. Dotti asked a nurse if I could get my lunch tray back, just in case I had to stay. Soon, thanks to their efforts, I was eating another hospital meal. I felt bad eating it because Dotti was hungry and waiting. However, if I had to stay another day, I wouldn't get another meal for several more hours. The meal consisted of Bowtie pasta with a tomato sauce, a roll, green salad, steamed vegetables, real coffee, with some cream that the nurse grabbed for me, and large slice of chocolate pie with a whipped cream topping. The pie looked better than it tasted, but it didn't taste half bad. The whole meal came to 18.5 points. That took care of me, but Dotti was still hungry and refused to take any of my food.

Sometime after 2 PM, the cardiologist came by and he was a really personable man. We talked about my symptoms, and all the tests, and he said that he thought the stress test results looked very good. He was confident that I my heart was in good shape. He said that with my walking 1200 miles last year, and 780 miles this year, it would be uncommon for my heart to be diseased, not unheard of, but uncommon. (Talk about some motivation for future walking!)

He said he was sending me home, and he would like to follow up with me in a month just to make sure all was still well. We had already gotten his name from his nametag because he seemed like a great doctor, just in case we might need a cardiologist in the future. Now we also got his phone number and the location of his office.

It felt like they were cutting shackles from off my ankles and my wrists as they removed their wires, tape, and the long needle from my person. I walked out to the car with Dotti with light feet indeed. On my paperwork it showed that I didn't have to limit my physical activities at all, and that made me feel good too. I am faced with managing my stress better. I have several tools to use to do that, and I have allowed them to collect rust. I will have to scrape off the rust and get back to using them regularly, so I can avoid these types of things happening in the future. In the meantime, I feel very fortunate that my heart is looking so good!

And so it turned out that I was released in the afternoon, and made it home in time to get our first DWLZ E-Letter sent off to all those who had subscribed. J It would have been bad form to be late on the very first issue!

I had a nice light dinner, and my total points at the end of the day came to 44.5. Even in the hospital I was able to journal, even if it was on my patient's brochure. J

Thursday - I weighed 185.5 pounds. I took the day off to see if I could lower my stress, and get some sleep after my nearly sleepless night in the hospital. (I can't imagine living like that for an extended period of time. I think my health would fail rather than improve.)

Dotti and I did a few stress-free things during the day. After visiting Costco, where we had a Very Berry Sundae (I do love those things), and picking up 3 pre-packaged lunches, each including a green salad and a turkey sandwich, we headed over to Portland to have lunch with Dotti's twin sister Catherine. We drove over to a park that they both had been to when they were young girls, and we ate our lunches at a picnic table. The sky was totally overcast, and Dotti felt a little cold, finally wrapping a blanket around her shoulders to warm up. Summer is quickly slipping away here!

It was a fun lunch and we drove Catherine back afterwards, fighting our way around road construction, around roads ending in forced wrong way turns, and past the ever-present one-way streets. Once Sister was safely back at work, Dotti drove me by where my Dad's little sister works. I hadn't seen her in 31 years, but I knew her right away. She is only 5'11" tall, and she is a sweetheart! We got to talking about upstate New York, my father, and other fun things. Finally we came to arthritis. She is 70 years old, and is plagued with a terrible case of rheumatoid arthritis, coupled with osteoarthritis. Her back has the same condition as mine does. The tips of all of her fingers appear to be "out of joint," bending between 45° and 90° the wrong way to the side. But she is smiling and PAIN-FREE, and she is still working in the same health food store that she was working at in 1974 when I saw her last. She said that her lack of pain came from some food supplements that she took religiously, and she said that if she stops taking them for only a couple of days things start to deteriorate. (As you might imagine, this boy is going to jump right into trying these things out and seeing if they will help lessen my arthritic pain. If they do, I'll be including them in my updates.)

We had a little something that we had to pick up at Multnomah Falls, and so we next headed out that way. We gave some thought to taking a leisurely walk up to the top. However, we only walked up to the bridge and then decided that might be enough after the week I had. J I didn't write down any aerobic points or distance for that short hike.

After we stopped by the gift shop, we headed back home. Dotti fixed us a nice dinner, and we settled in for a quiet evening.

I ended up eating 44.0 points for the day.

Friday - I weighed 187.5 pounds. (Dotti jumped up on the scale Friday as well, and then came right back down this morning.) It was not a question of overeating on Thursday. We check the contents of everything that we had eaten the night before, and there was nothing high in sodium. My guess is that the meal we got from Costco had something that was salty in it. I thought it tasted saltier than a turkey sandwich should have tasted when I was eating it. In any case it was just a temporary blip on the scope, and I wasn't going to worry about it.

When I got to work, I took a little one-mile walk, just so I could say I did. J The day was fortunately quiet, other than getting some computer work done, including ordering some parts. When my normal time for lunch rolled around I missed it. It was a half hour later that I realized how late it was. The entire day seemed to speed by and soon I was driving home!

Catherine was coming over so that she and Dotti would be able to go to a house party together to buy some goodies. I spent the time that they were gone playing on my electric piano.

This piano was my birthday gift, and I just love it. I play mostly "by ear." I pick out the melody and do some runs etc. with the right hand, but I have always been weak on the left hand. I can chord and so forth but it sounds pretty lame compared with what I can do with my right hand. This piano takes care of that "little problem." I just crank up the accompaniment mode, and it provides a drum beat, and a myriad of different running bass rhythm styles. All I have to do with the left hand is hit enough of a chord to make it clear what chord I want it to base its run on and it handles the rest. While I am having a ball with the right hand, I only have to keep the right chord playing with the left.

In addition to the wide variety of styles available, there is a huge variety instruments that the right hand can play. Playing the very same song with a new rhythm style sounds quite different. And changing the tempo can make quite a change as well. Then changing the instrument "voice" makes it sound really different once more. "House of the Rising Sun," "Paint it Black," "Midnight Special," "Amazing Grace," and many others that I have in my guitar book kept me fully occupied for quite a while. (My guitar book has no notes, only words and chords, but that is enough for what I do on the piano as well. J) Music is a great stress reliever too!

I ended up eating 32.5 points for the day.

How do I rate this week? I am reminded of the old grim joke, "Other than that, how did you like the play Mrs. Lincoln?" Then again, as the William Shakespeare title so correctly pointed out, "All's well that ends well."

Eating – I ate 42.36 points-per-day, easily below my maintain target number of 46. So, I did very well on my eating.

Weight – Other than the unexpected and short-lived jump on the scale Friday morning, I was within my target range all week. Yes, I was on the high end of it, but I was in it. I will take that any week that I can get it. My average weight was 186.29. That is a drop of an entire pound from last week! So, the 1-pound drop on the weekly weigh-in was real.

Water – I had one off day on Thursday. The rest of the week I did very well, getting in at least 7 cups each day. I averaged 66.29 ounces (8.3 cups) per day. Quite satisfactory.

Exercise – I have some good news and some bad news. Bad news first: I only walked 7.97 miles for the week. I would like to get in at least 25 each week. I also only earned 13.97 aerobic points, when a minimum of 30 is my goal. Now for the good news. I did walk nearly 8 miles! I did earn nearly 14 aerobic points! Also, I did a treadmill test, and walked up to the bridge at Multnomah Falls. It was not a great week for exercise, but at least I was moving. It leaves room for improvement, but it also gives me something to build on.

I hope to get in some additional exercise this coming week. I will feel a lot freer about walking without fear now that I have been checked out. J I don't plan any eating changes or changes in my water consumption, because I am happy with how I am doing and with how the scale is responding.

4 years, 129 days OP; a lifetime to follow.

-Al-

6 '3" 239.5/186.0/180±2/BMI:23.25/WK-227

GRAPHS:

Weight Loss Maintenance Year 1 Maintenance Year 2 Maintenance Year 3 Maintenance Year 4 2005 Walking 2005 Walking Data

2004 Walking Data