Friday, September 17, 2010

Finalizing Gastric Bypass plans

So whilst I wasn't watching football, exercising, cooking, eatting, showering, or using the restroom, I was filling out paper work this weekend.

Paperwork for what? For gastric bypass surgery, that's what. Well, how much paperwork can there be for such a thing as that? A shit load. There were some 38 pages of forms to fill out with another 13 pages of instructions explaining how to fill out the 38 pages of forms. I guess they intended to finish off the Amazonian rain forests forever when they constructed this bastard of a program.

Bastard is the technically correct word also. More about that in a second.

Stand back for a split second when I vent. Whilst you do, remember that I am a Quad-Virgo, the most observant dude in the zodiac.

With in the 38 pages of documentation I filled out were the following things:
1. Weight-age guestimates (how much did you weigh at XX age?
2. Diet histories (What are the names of the diets you have tried?)
3. Weight loss history (How much weight have you lost and regained?)
4. Diet Journals (Write down everything you eat for 5 days)
5. Psychological profiles (Were you sexually mollested as a youth?)
6. Eliminator filters (Do you want Gastric Bypass so you can become a super model?)
7. Perscription records (What perscription and non-perscription medication are you taking?)

I could go on. There were lots of things to fill out. It was a load and half.

What I found most irritating was the inconsistency of philosophy present in so many of the documents. Implicit within the psych survey is the notion that you are fat because of Freudian issues. Implicit within the diet journal is the Platonic notion that you simply lack knowledge of how many calories you consume. Implicit within the diet history record is the proposition that you may not have tried normal diets, or tried hard enough. I could go on and on.

What astute observer would fail to note the handiwork of several clashing world views? What logical theorist would fail to recognize a pile of documents assembled in a committee through a political process?

Folks, the medical industry is not of one mind on this subject. I know that. However, the fact that Gastric Bypass is now the formal approach to lifetime obesity indicates that we have finally come to some biological clarity on this issue.

Since the dawn of biological anthropology, we have known that there are three physical body types:
1. Ectomorphs: Very skinny people.
2. Endomorphs: Very fat people.
3. Mezomorphs: The perfectly athletic people.

Furthermore, those anthropologists who specialize in this subject have known what makes them different for some time. Yep, that's right. We've know for some time what makes them different, and it ain't what you think it is either.

Ectomorphs have very inefficient digest tracts that make them prone to waste food energy. If they consume more calories than a particular, biologically determined figure, the excess food energy will be excreted in the form of feces. Yep, that's right, they shit it out. They can't put a pound of weight on. Their systems won't allow it. All excess energy is ejected from the system.

Endomorphs have ultra-efficient digest tracts and metabolisms to boot. Endomorphs can process and extract just about all usable macro and micro nutrients from the foods they consume. Any excess is immediately stored as fat and laid away for an emergecy famine situation. This is true for many micro-nutrients as well. Fat soluble vitamins are stored up with fat inside fat cells. Unfortunately, the super efficient metabolism of the endomorph is capable of throttling-down to remarkably low levels when energy is scarce. The objective is to conserve reserve energy to the greatest degree. This makes dieting ineffective without lots of exercise.

Mezomorphs are the perfect people. These are the people we would all like to be. They have the optimal solution. Their digestive tracts and metabolisms are capable of extracting the uttermost farthing from food energy when they are engaged in body building. They are also capable of squandering and excreting most excess food energy when they consume it. Their metabolisms will throttle-down in famine conditions, but not to the remarkably low levels Endomorphs will. Mezomorphs can be energic, even when very hungry.

Darwinian biologists have considered the relative merits and demerits of these three categories, many times, and you might be surprised by some of their conclusions.

In the Environment of Evolutionary Adaptedness (EEA) ye good ole Endomorphs would be the most hearty survivors of ice-age conditions. We are constructed to survive those harsh ice-age conditions better than the rest of you. Boom and bust environments don't necessarily kill us off. We can survive things like Hollicosts better also.

Yep, that's right. Us disgusting fat people are Peistocene hunting and gathering survival machines. Were not fast, but we're pretty damn strong. We may not be pretty, but we are highly efficient.

Unfortunately, the extremely skinny people would only make out in pretty fair weather and good resource conditions. Come a hard freeze or a bad famine and they are dead.

The mezomorphs are an interesting case. Much argument has taken place about the theoretically perfect people. Their superior muscle-weight-speed ratios predict success. However, they have little protection against the cold, and little energy reserves for famine conditions. To make a long story short, most believe they would survive hard conditions, but be in poorer health, and far less prepared for reproduction, when good times begin to return.

You see, fat women have a lot of energy stored up and prepped for reproduction. They would emerge from a tough winter better prepared for spring fun. This is why some guys really dig fat women. You can make a very Darwinian case that it is adaptive to favor big, fat, strong women. Computer simulations have shown how the tribe with the thickest women can win in hard times.

Unfortunately, we are no longer living in the Environment of Evoluationary Adaptedness. We no longer live in boom 'n bust conditions. We live in a purpetual boom time. Copious quantities of calories are availible to us at all times. We have more food energy availible to us than we can ever need. Further, we no longer need run after our prey. We sit at desks typing all day.

What happens when you confront humanity with and endless supply of year-round calories, and a very sedentary life-style? Well, the ectomorphs shit out the excess energy, and stay skinny. The Mezomorphs need to workout to stay perfectly fit. A little diet here and there may help them also. The endomorphs... well, we balloon up like the Goodyear blimp Columbia. That's what happens to us.

Now, if we all still died well before the age of 50, most of this wouldn't matter much to an endomorph like me. I would probably be dead already. However, advanced Western medicine has extended our lives to absolutely incredible lengths. The doctors think I can live another 30 years... easy. Probably 40 years if I get Gastric Bypass.

Before continuing, I should mention that these facts of biological life leave little room for Freudian molestation explanations. They leave little room for Platonic knowledge and education based explanations. The nature of the endomorph basical rules out any potential for diet success. Guess what? This is why surgeons do gastric bypass surgery now. Since we now know that endomorphs are natural and biological type, why the intense pile of paperwork written from contradictory theoretical perspectives?

Only because the paperwork was assembled in a political committee by people who did not agree with one another. That is to say: for bad reasons.

But back to my main point.

I had to get over a lot of anger this past weekend. I have to admit, I bitterly resent the shitty choices life has set before me.

Dr. Bachner and Saedei have been clear with me: either I take 125-130 pounds off my highly-arthritic knees, or I can be sure of needing a wheel chair sometime in the next 6 years. Bone-on-bone grinding increases in my knees daily, the pain increases daily also. As the pain increases daily, I become more and more sure they are correct. Further, Bachner will not perform knee replacement surgery unless I loose this weight. Neither will most other qualified orthopedic surgeons.

This is horn one of the dilema: The wheel chair

I can escape the wheel chair, but not without considerable pain and consequences. The Surgeon will staple off approximately 90% of stomach, effectively making it useless tissue. Further, he will bypass the first 36 inches of my upper intenstine. After this, whenever I encounter a heavy fat substance, I will automatically throw up. Also, if I consume something with a bit too much carbohydrate, I will quickly be punished with physical pain very similar to that of a heart attack.

Remember, the surgical modifications to my system have been expressly designed to produce these results.

To avoid spending the next two or three decades of my life in a wheel chair, I need to allow the doctors to put scalpuls to my abdomine and wreck my perfectly efficient digestive track, and screw up my conservationist metabolism. For a fee, they will be happy to slice and dice my guts in this manner.

This is horn two of th dilema: Gastric Bypass.

Pick your poison: The wheel chair and an early death at some 450 pounds, or we will intentionally wreck you digestive tract causing permanent life-long difficulties of a different sort. Which option do you like better (A) or (B)?

Personally, I don't think I am such a rotten bastard that life should set before me such an incredibly crappy choice. What crime have I committed? What evil have I done that the fate should hammer me so? I bitterly resent having to make this decision.

I have to tell you, it was a fight and a half to finish that paperwork this weekend. I accomplished the mission after I finally accepted the following argument: What you were living some 30 years ago, and arrived at this point when there was no such thing as Gastric Bypass surgery? What then? You would simply have no choice. You would go into the wheel chair and die (sooner rather than later) as 450 pound man. Would that be a better fate?

On the upside, which is considerable, they say loosing 130 pounds takes 15 years of age off your body. Insulin levels, blood surgar level, triglycerides, steroid hormones, COX-1 and Cox-2 protegladins, stress hormone levels, everything improves dramatically with the reduction of that much weight. You can set aside the level of fatigue saved by not dragging 130 extra pounds around everywhere. Just focus on the blood chemistry. If all this is true, I can expect to regenerate to age 29, as I am now 44. Lest that sound crazy to you, I have heard and seen a few clinical studies that would blow your brains out.

By the start of the 2011 NFL Season, I should weigh something like 195 to 200 pounds. I will appear to be a solid mezomorph, as long as I keep my cloths on. My knees shouldn't hurt much on a daily basis. The pain will be controllable with simple over-the-countlike Excedrin and Aleve. My doc will be willing to do my knee replacement surgery for me.

There is an upside, but it is a costly thing indeed. Those costs cannot be dismissed.