186.4 and contemplating a fourth surgery

So, the score this morning was 186.4. My weight has been bouncing in a tight range between 184,4 and 186.4 for some two weeks now. Ad meanwhile, my strength has been increasing considerably.

I can now do the Kettlebell Halo with a 45 pound canon ball. A couple of days ago, I dead-lifted 215 for two reps. I also pulled down 190 for a single rep, and military pressed 110 for 2 reps. I really should have gone for three. I'm doing 225 today. The last time I bench pressed, I got 215 for a single rep. I should have attempted a second, but I did not have a spotter, and I didn't want to wind up like Stafon Johnson.

Regarding squats, I am being careful.

I have only been squatting with the Kettlebells, as a part of the face the wall squad. This is a technique where you take 1 large kettlebell, or a pair of smaller ones, position the tips of your toes no more than 5 inches from the wall, and proceed to squat. This forces you to bend your knees and lower your butt, rather than lean forward. Leaning is cheating. If you bend your back while facing the wall, you will smash your nose. You just can't do it. This is the way to develop ideal form in the squat.

Incidently, I am using a Rubbermade storage box (slightly shorter than my knees) to measure the depth of my squat. This is what some people call box-squats. The objective is to chose a box slightly shorter than your knees, place it immediately behind you during the squat, and make sure your butt makes contact when you squat. In this way, you will hit the ideal 90 degree angle; no more, and no less.

Last time around, I grabbed a pair of 20kg kettlebells, cleaned them, held them in the front-squat position, and squatted 12 reps. It was good. The next day, I was mildly sore in all the right spots. Tonight, I am doing a pair of 24kg kettlebells. This will be very good.

Remember what the comrades say: A 45 pound Kettlebell is a lot heavier than a 45 pound dumbbell. That's because the little bastard is alive and squirming in your hand. It will bite your wrists also. Lifting that Kettlebell requires much greater concentration and stabilizer activities. It's very dynamic.

With all that said, I am facing a fourth potential surgery event. My injured shoulder is not recovering properly. I still feel winces of sharp pain in the right shoulder. My right hand is numb all the time. It is as if someone shot Procaine into the first three fingers of my right hand. Numbness comes and goes intermittently in my left hand.

This develops to a critical level when I lay down and sleep at night. I frequently wake up in the middle of the night, and early in the morning with numb tingling sensations killing my arms. It begins to go away when I get up and work the Kettlebells. As I mentioned before, it never goes away completely.

This does not seem to be circulation related. My skin stays pink. The flesh is usually warm. It might be cold in exceptionally cold surroundings, but that doesn't make my hands any different than those belonging to anyone else. This has something to do with the nervous system. I believe it is a pinched nerve in my right shoulder.

There does seem to be some evidence of inflammation. I received a size 10.5 Saffire blue ring as a birthday gift this past September. It was away too big for my ring finger. It sloshed around on my hand quite a bit. Now it fits perfectly. It's a little hard to take off. I did not have it re-sized. How in the world has my finger grown so much? Maybe its just inflammation?

My Chiropractor has done a series of 6 adjustments to my back and neck. So far, no dice. He believes that a protruding disk somewhere between my 3rd and 5th cervical vertebrae is the culprit. If true, I may be going in for a neck surgery like Peyton Manning.

One way or another, it looks like I am going in for surgery. I have decided I cannot live like this. It is becoming debilitating. I am fatigued and exhausted through the day due to a lack of good sleep. I have to fix this.

We'll see what Dr. Bachner has to say about it. An MRI on my wrists, shoulder and neck are in order.

222.2?

So I just stood on the bathroom scale a moment ago, and the digital read-out flashed 222.2. That is 222.2 English pounds. That's damn close to 100 metric kilograms, exactly.

What's the problem with that? Nearly two weeks ago, the Bod-Pod indicated that I weighed in at 221.2. We know the Bod Pod is 0.85 pounds lighter than the Tanita. Put that all together and it would appear that I have had two weeks with zero (0) progress. Not looking good.

Over and against this fact is the fact that all my clothing has loosened up tremendously in the past two weeks. Remember those 17 year old jeans from UCLA I told you about? The size 44x30 pants? I tried them on a few minutes ago, and I couldn't wear them in public. I would sag like a ghetto gansta-biache in those jeans. I am probably between size 40 and 38 right now.

I wore my throw-back Eric Dickerson jersey and blue shorts yesterday. The whole outfit was baggy. It wasn't baggy a mere two weeks ago. It was just about perfect two weeks ago.

I know that I know that I know, as sure as I am sitting here, that there has been a substantial contraction in my body volume this time around. I would be surprised if I measure in at anything above 92 liters tomorrow morning.

This may be the first-ever two-week cycle in which I make zero (0.0) progress on the weight front, but I doubt I have stood still. Most of these omens foreshadow a pretty sizable gain in lean weight, and a loss of fatty tissue. If I am extremely lucky, it will be a 7/7 situation. That is 7 pounds of lean gain, and 7 pounds of fat loss.

I know that sounds preposterous, but understand this: Muscle memory can raise your lean tissue weight in a snap, and I know my lean was higher than 145.2 pounds once upon a time. Further, 7 pounds of fat loss in two weeks is strictly average to below average for me.

Let's hope for the very best. I hope all the following happens tomorrow:

1. I get a sudden drop in weight tomorrow morning
2. My lean has increased 6 or 7 pounds
3. My fat weight has decreased 7 to 8 pounds.

If so, it will be a happy day of great progress.

I am way behind schedule

Way back on Saturday, June 18, 2011, I posted a blog in which I laid down some conservative hypothetical numbers regarding where I should be at this time. I just had a look at those hypotheticals and compared them to my real-world performance, and it doesn’t look good folks. I am behind the power curve by a considerable margin. The take home story is simple: I need a burst and breakthrough.

Here is the situation in a nutshell:

• According to my hypothetical projections, I should have been at 32.52% body fat on July 22
• The actual figure was 34%
• I should have weighed in at 219.938 pounds on July 22
• The actual figure was 221.2
• I should have had 147.95 pounds of lean on July 22
• The actual figure was 145
• I should have had 71.88 pounds of fat on July 22
• The actual figure was

The situation looks equally glum for this coming Friday. Take a look at these projections

• I should weigh in at 210.138 this Friday
• Right now, the bathroom scale is stuck at 218, meaning I am around 217.
• I think it unlikely that I will just suddenly plummet 7 pounds in the next 2 days.
• If I am lucky my weight will fall 4 pounds in the next two days, and my lean will improve.
• I am guestimating that my total body weight will be 213 this Friday. I hope I can hit that mark, but it may be difficult
• Speaking of lean, I should have 147.95 of lean on Friday. Let’s hope it is better than that.
• My Body Fat Percentage should be 29.59% this Friday. This would require a 4.41% drop from last time. That is far-fetched and unprecedented.

I have to admit that I am struggling a bit with the question of why my weight and fat levels aren’t dropping faster. I suppose everyone suffers a few plateaus during the course of a long marathon of weight loss, however, I am at a loss to explain why this is happening to me during a moment when I am intensifying the workout tremendously.

Just how much work have I done? Consider the following table for today alone.

Order	Exercise	Minutes	Kcal
1	Bike	22	268
2	Eliptical	22	348
3	Rower	21	237
4	Treadmill	15	192
5	Bike	16	195
6	Bike	13	150
7	Eliptical	16	250
		125	1,640

As you can see, I damn near burned half a pound worth of fat in the workouts alone today. This doesn’t include the 25 minutes I spent in the saunas tonight, either. 150 minutes is quite a long time to spend training and steaming.

With effort like this, I believe my progress should be dramatic, and I should be on schedule. I am bitterly disappointed that this doesn’t appear to be the case. Unless I get a big surge in lean weight this week, I am going to be very unhappy with my progress come this Friday.

The lower body ROM workout is now a doddle.

A moment of silence please... I just kicked the Lower-Body ROM exercise squarely in the nuts. I blasted all four minutes at 210 pounds of resistance and scored 121% on the meter.

What is the significance of this moment?

The last time I rode that horse, the year was 2009. On that occasion, it ripped a chunk of cartilage out of my right knee that set me flat on my back on the surgery table. This is how I was introduced to Dr. Evan Bachner. Favoring the right knee blew out the left knee, which put me back on the surgical table less than 4 weeks later. Bachner pulled chunks of bone out of my left knee.

My last ROM ride was the beginning of sorrows for me. My body weight spiraled up due to immobility and post surgical pain. Higher weight made it hard to exercise, exercise made the pain worse, which made me more immobile, which made me gain more weight. I was caught in a vicious negative feedback loop.

As you know, this vicious cycle was only broken by a visit to Providence St. Joseph Hospital and full Roux en Y gastric bypass. This was my most dangerous surgery every. Understand that this is nowhere near as simple as pulling a chunk of torn cartilage out of a knee. They open your torso and repipe your guts. Not everybody survives this surgery. I am a member of the good and lucky majority.

As you might imagine, getting back on that horse and doing that Lower-Body ROM exercise has represented one of my greatest fears in life. There have been many times in the past two years when I wondered why I ever spent $6,000 on a $16,000 machine that cost me more than $10,000 in flesh, blood & tears.

Of course, the vicious scorpion at work has chided me about this subject...

Well guess what? I just got up on that horse and rode it again. It was a doddle. I wasn't even breathing hard until 3:15 had already expired. I didn't sweat profusely until a minute or two afterward. For some 10 minutes afterward, I kept checking and rechecking my range of motion for any signs of inflammation in my right knee. There is no inflammation in my right knee, and it is now an hour later.

You can see the exercise here. This constitutes a major, major victory. This is almost like killing Osama.

Compared to the upper body workout, the lower body workout is trivial. This was never the case in the past. I could never do 4 whole minutes, period. I had to break it into 2 minute segments. Now it is easy. I guess losing something like 100 pounds makes a difference.

If there is a greater lesson in this story, I guess it this: You never know where providence will take you. I probably would never have conquered my weight problems without Roux-en-Y gastric bypass surgery. Given my good blood chemistry and my heart health, my insurance never would have approved this surgery. It was only a series of letters from Bachner, my GP and Dr. Quilici regarding my orthopedic problems that caused United Health Care to approve the surgery.

Now I have reversed the aging process by 15 years at the very least, and still counting. I am stronger and healthier now than I was at 30... not to mention better looking. I'm not into cosmetics, though.

Lately, I have been wondering how much longer I may live as a result of this surgery. Of course, you can die in a car wreck at any moment, but presuming I don't, how much longer will I live? The starving mouse studies suggest I should double my lifespan. That's no joke folks. Google Roy Walford and CRON.

Popular Science magazine just published a piece called "Why you will live to be 150". They are talking about everybody, not just us starving mice who have had Roux-en-Y. Google search for Dr. Bill Andrews, Geron, and Telomerase. He is working on the cure for aging.

The men and women in my Dad's family live a very long time. Grandpa kick off at 93. Grandma kicked the bucket at 95. My dad is 69, has kicked prostate cancer in the ass twice, and doesn't quite look 60. Nobody believes I am going to turn 45.

God, I have no clue how long I will live, but I can see no reason why I shouldn't make it to 90. Frankly, I should reach 100.

Just to close the loop for you, I would not be thinking these thoughts if the ROM hadn't ripped a chunk of cartilage out of my right knee one dark day in early October of 2009. Isn't strange how this event became the next best thing to a guarantee that I will make it to 100 years of age?

218.2 on the Tanita: Another major milestone has fallen.

Just a few moments ago, I weighed in at 218.2 on the Tanita bathroom scale. Of course, this means the Bod-Pod will have me at 217.35 this morning. This means I have lost another 3.85 pounds since the last Bod Pod test. At the same time, I know I am more muscular now than a week ago. The shift in emphasis to strength and intensity over duration of aerobic exercise is paying dividends.

Call me foolish, call me irresponsible, call me a dreamer, but there is something a little bit magical about dropping inside 220 pounds. This is another one of those mythical boundary points in sports. In football, a guy who drops from 300 to 250 has gone from lineman weight to linebacker weight. A guy who drops from 250 to 218 has dropped from linebacker weight to Safety weight. In baseball, a guy who weighs over 220 might be considered fat; a guy weighs under 220 generally isn't considered fat.

There aren't many big safeties like Darren Woodson or Steve Atwater left in the NFL, and this is a shame. However, I now weigh less than either of these two legendary defenders at their peak playing weights. My body fat percentage remains a lot higher than their's was, and they are both taller than I am.

Still, you would be hard-pressed to believe that I weighed in at 330 pounds just 6.5 months ago. At least two people I've met in the past several weeks ain't buying my story. They think I am bullshiting them.

I once predicted that the 215 pound-point would be moment when people no longer viewed me as an endo-mesomorph. They would simply see me as a mesomorph. I may have been mistaken about that. That moment might have already arrived.

More importantly, I have now officially lost more than 34.136% of my body weight. Slightly more than a third of me is gone. My body volume should now be 96 liters. God only knows what it was at the start, however, my body volume has dropped 21.1 liters since 5/13/2011. That's a hell of a lot of volume. That's 10 x 2 liter Coke bottles, plus an additional 1 liter bottle, and some change. Imagine carrying all that into the Bod Pod chamber with you... and then not having it anymore.

Of course, the most important thing is that I no longer suffer any knee pain, and my mobility is great. Occasionally, I need to rub my right knee with a little Camphor/Menthol/Methyl Salicylate compound after a tough workout out on the treadmill; but this isn't all the time. Further, I have no use for the Lortab I was prescribed. I just don't need it anymore.

Incidentally, I am starting that treadmill workout out at 3.6 miles per hour and a 5.5 elevation. 21 minutes later, I finish at 4.0 miles per hour and a 9.5 elevation. I bet you can't do that. One of the guys at work bet me I couldn't do that without holding on to the handles, which is cheating. He lost his bet. I proved it. I've seen some shocked expressions when people see the incline level of my treadmill at the gym. Some never knew it would go that high.

There are other side-effects beyond pain relief. Yesterday, I saw that Taurus girl--the one I sent flowers on her birthday--in the hallway as I was leaving work. She was engaged in an animated conversation with another girl. They were positioned on the route to the elevator, so I had to walk past them to get out of the building. As I passed, she interrupted her conversation to give me a big smile, and a 'hi, how are you?'

This took me by surprising. People don't usually interrupt conversations so animated to greet a passer-by. Further, she's basically given me the cold shoulder for 3 months... ever since I sent her Carnations for her birthday. This was an unexpected event. Not knowing what to say, I simply gave her a silent nod and passed by.

Still not sure what to make of this event, however, it is theoretically possible she likes me better at 217.35 than 261.0, which is what I weighed on 5/10/2011. Of course, this far-fetched theory... I'm reaching at straws here.

Outperforming the outperformance: Blowing the lid off the Doc's head

Intro

So I had my visit with team Quilici in some 90 days today. It was a lot of fun while it lasted. Now I know how it feels to be Julio Jones and blow up the combine. Unfortunately, reports of my god-like mastery are going to be greatly exaggerated as a result of a few clerical blunders. I intend to set the record straight in this blog entry.

The Official Story

So, after spending my customary 20 minutes in the waiting room, I was directed to room 1. This is where team Quilici weighs the patient, measures blood pressure, and takes your body temperature. My weight was 237.5 today. This was very close to the reading my Tanita at home gave me earlier in the morning.

The nurse practitioner who saw me immediately thereafter could not conceal how impressed she was. "It looks like you've bee loosing a lot of weight recently; 65 pounds in the last three months. You are making very rapid progress! Much faster than expected."

Of course, I rejoiced at the sound of those statements, but I wanted a bit of clarification. "What is considered normal progress? What would Dr. Quilici have projected in terms of weight loss? What did you estimate my weight would be?"

She answered, "40 to 50 pounds is considered great in 90 days. You are moving much faster than the rest of our patients. Your BMI is already down to 33. If you keep going at this rate you're going to be all done by your next visit in 90 days."

So, at first blush, it would seem that I blew the lid off their projections. 50 pounds was considered the top. My score was 65. I shredded the roof by 30%.

Ah! But there was more. I produced my BodPod documentation from the California Health and Longevity institute. I showed her that my actual fat loss was greater by at least 4 pounds, as I had actually added four pounds of lean weight to my frame.

She was very impressed. Normally, they expect lean losses mixed with fat losses. They just hope the lean losses are not particularly great. They certainly don't expect lean weight gain. We settled on the figure of 69 pounds of pure fat loss in 90 days. I walked out of there feeling like Superman.

You see! This is proof positive that I really am better than all these weak bastards. Better by 38-72%

Bringing it down to earth

Not so fast there Mr. Roof Shredder! It didn't take too long for me to figure out that the math had to be wrong. The first crack in the picture occurred when I back-checked my weight figure. Can it be true that my weight 90 days ago was 237.5 + 65 =302.5?

No way Jose! That was not the figure 90 days ago. I remember as clear as a bell that the score stood at 281.0 the last time I stood on Dr. Quilici's scale. Somebody must have made a clerical mistake. Somebody recorded my weight at 302, when it was 281.

There is more proof. The Bod Pod clearly documents the fact that I lost approximately 18.569 total pounds of body weight over the past 42 days. That actually consists of 22.636 pounds of fat and 4.068 pounds of lean gain. In order for the 69 figure to be true, I would have had to have lost some 46.364 in the 48 days prior to my first Bod Pod.

No way Jose. It didn't happen like that.

I called Quilici's office to verify, and they did indeed have my weight as 302 on March 28, 2011. That's not the only clerical blunder. They had my top weight at 325, not 330. I know for a fact my weight was right around 330 before I began the liquid diet. Might have been a tad higher than that. There is no question that it was higher than 325.

The Correct Score

On Quilici's scale, my weight dropped from 281.0 down to 237.5 between March 28 and June 28. This is a difference of 43.5 pounds. However, we should still factor in the 4 pounds of lean weight I gained during the past 42 days. Ergo, I lost 47.568 pounds of fat weight in the 90 days between March 28 and June 28.

This is a wee bit to the high side of his projections, but my losses are within the normal range according to Dr. Quilici's predictions. I am inside the pocket.

This is an average of 0.5285 pounds of pure fat per day over the course of 90 days. This required an average caloric deficit of 1,849.86 kcal each day for 90 days. That is a total of 166,488 missing kcal during this period. That's pretty impressive, really.

All of this is in pretty close accord with the numbers I have been calculating and publishing during this time.

Projections

The Nurse practitioner is not quite correct when she says I'll be all done by my next visit on September 29. Follow my reasoning.

• The Bod Pod had me at 240.082 last Friday.
• The Bod Pod stated that I had 91.454 pounds of fat on my frame last Friday.
• Dr. Quilici's scale and my scale closely accord.
• The Bod Pod is 0.85 pounds lighter than either my scale or Dr. Quilici's scale.
• According to our scales, I have lost another 2.582 pounds
• The Bod Pod would probably call it 3.432 pounds.
• I haven't slacked off the workouts, so I'll bet that was all fat weight.
• The fat loss figure could be a little higher than 3.432, but we'll go with that estimate.
• Ergo I should now have 88.022 pounds of fat on my frame.
• Another 47.568 loss will put my fat weight at 40.454 pounds.
• If my lean weight is, say 152, my total weight will be 192.454.
• 40.454/192.454 = 21% body fat.
• I will be about 4% shy of my final goal as of September 29.

Nevertheless, things are going pretty well. I have dropped a total of 92.5 bricks of butter. I am pretty much on track for victory here.

Bod Pod 4, the War to settle the score.

So I made my fourth visit to the California Health and Longevity Institute this morning. I don't want to play coy with you folks: I was very disappointed by the numbers. Whilst the progress was positive, and everyone congratulated me on 'good' results, these were the weakest numbers yet.

This was not as expected. I put in a hell of an effort during this two week cycle. I was expecting my best result set ever.

The cycle was hampered somewhat by my vacation in SF and the food poisoning I inflicted on myself there. However, even inside these negatives, there were positives. My brother and I walked up and down the hilly streets of San Francisco just about everywhere we went. It's really the only way to get around. I worked out on 2 of the 4 days that I spent there. I would have made it four for four, but the food poisoning stopped me cold for two days. Even so, I ate nothing on those two days. I just couldn't. When I arrived home, my weight was around 238.9

So just what were the numbers anyhow?

• My total body weight decreased 5.256 pounds to 240.082 pounds
• My total lean mass increased 1.478 to 148.628
• My total fat mass decreased 6.734 pounds to 91.454 pounds
• My body volume decreased 2.784 liters to 107.38 liters
• I shifted my body fat percentage to the right 1.91%

Most people would call that a victory after a vacation with food poisoning. Once again, I defied the laws of medical science by adding lean weight at the same time I reduced fat weight. This is a hard trick to pull off once. I've done it 6 straight weeks in a row. Most would say it is even harder for a 44 year old man with advanced osteoarthritis in his knees.

I would remind them I have had gastric bypass surgery and I am using a powerful pro-hormone. I have every advantage in this battle. I should be winning by larger margins.

I just don't feel the reward is commensurate with the effort level. During this cycle, I added Olympic rowing to my regime. I now hit 20-21 minutes on the treadmill, finishing at an incline level of 9. This generally burns 300 kcal. I immediately move to the Olympic rower, nail 2.5 KM for around 125 kcal. This usually requires 12-13 minutes. From the rower, I move to the bike and finish with 20-21 minutes for around 300 kcal.

That is a grand total of 55 minutes of exercise for 725 kcal.

I walked out of the gym after 7 such workouts during this cycle. I did this cycle twice in a day on two separate days. If you invested that much blood, sweat and tears in the gym, you would be expecting your best all-time result also. I didn't just get it. It's precious little reward for so much effort. I'd be lying to you if I said I wasn't disappointed.

Still, I guess I should be thankful that I have improved 6 straight weeks in a row. I have not gotten hung up on a frickin' plateau. There have been several slow periods during this weight loss program. There are moments of sewing and moments of reaping. Sometimes it takes a week or two for your hard work to bear some fruit.

Hopeful, my biggest cycle is immediately ahead of me.

I will see Dr. Quilici on Tuesday. I have some interesting paperwork to show him. I have an affidavit from my notary public for him. It will be interesting to see what he says.

Over the past 42 days I have done all of the following:

• Reduced my body fat percentage 6%
• Lost 22.636 pounds of pure fat
• Added 4.068 pounds of lean muscle
• Reduced my total body weight 18.569 pounds.
• Reduced my total body volume by 9.731 liters

Essentially, each week I am changing my body fat percentage 1%, losing 3.772 pounds of fat, reducing my volume by 1.622 liters, and adding 0.66 pounds of lean. This is what I have done for the past 42 days.

If my next 42 days look like the past 42 days, by August 5 all of the following will be true:

• I will have 68.818 pounds of fat on my frame
• I will have 152.696 pounds of lean weight
• My total weight will be 221.513 pounds
• By body fat percentage will be less than 31%
• My body volume will be 97.649 liters

Ultimately, that isn't too bad.

A major milestone is getting ready to fall

So, yesterday was another murder day. I woke up with a little shake weight and ROM action. I went to the gym at lunch for 45 minutes of treadmill and bike. I returned to the gym in the evening for another 47 minutes of treadmill and bike. I also hit the dry sauna for 12 minutes. I would have done the wet sauna, but the goddamn steam generator was broken again.

This morning I visited the bathroom, as is my morning custom, and after conducting a little business, it was time to weigh in. The Tanita said 239.6. I am officially under the 240 mark. I have officially lost more than 90 pounds now. Further, we know the Bod Pod gives a lighter weight by approximately 0.85 pounds. My estimated Bod Pod weight this morning 238.75.

I've gone from Nose Tackle size to Linebacker size between Feb 4 and June 18. It's been rapid.

All this adds up to one fact: The first major milestone is about ready to fall. I began this entire process because Dr. Evan Bachner, my knee surgeon, looked me dead in the eye and told me I needed to lose 30% of my body mass or I would sit down in a wheel chair sometime in the next 5 to 7 years, and never come out of it. The math is simple 30% of 330 pounds is 99.0 pounds. Bachner was telling me I needed to lose 99 pounds.

Today's measurement indicates I have lost between 90.4 and 91.25 pounds. The big marker is damn close; maybe 14 days away, maybe less. It should be noted that my rate greatly accelerated this week. On June 10th, the Bod Pod declared my weight to be 245.338. This morning, it would probably say 238.75. That is a difference of 6.588 pounds in just 8 days. That is a big loss; far faster than team Quilici would ever recommend.

It does indeed look as if I will hit that major milestone by the 4th of July. This was the predicted date according to the simple math I came up with a couple of months ago. It looks like my stats were and are right on the money.

I'm going to have a visit with Dr. Qulici's team in just 10 days. I hope I can hit 230 by that time. They will be shocked by the Bod Pod data. I am fairly certain I am outperforming my cohort. I don't think my surgery mates can lay a glove on me.

I did some fairly conservative hypotheticals in Excel based on the data I have accumulated, and you can see a snapshot at the top of this blog entry. If accurate, I will probably reach a so-called "healthy" body fat percentage by my next birthday.

This summer is going to be very interesting.

First blog entry after knee surgery

So, this is my first blog entry after having had knee surgery on the 8th of January. The surgery seems to have gone pretty well. Despite the fact that the surgeon made three incisions in my left knee (as opposed to two in my right) this has been a far less painful process than my last surgery.

I really could put weight on the left knee almost immediately after surgery. It was a bit tender on day two, but it was solid afterward. I could straighten it and bend it a bit immediatly without pain. None of this was the case with the right knee. I still have some ugly inflamation above the left knee, and I did bleed a bit (in the shower) from my stiches there last night. However, all things considered, this left knee surgery has been much easier than the right.

I was pretty grogged coming out of the surgery this time. Dr. Bachner came over to me and said "The surgery was successful. We found a lot and lots of things that could make you hurt." It sounded like he did a lot of work. I thanked him for his efforts. That is all I remember.

I do remember that it was approximately 11:30am when they wheeled me into the surgery room. There were atomic clocks posted on the wall all over the joint. It was 1:30 PM when they wheeled me into the recovery room. That means I was in surgery for almost 2 hours. Last time it was just 1 hour. Once again, it sounds like a lot more work was done.

The greater grog and the easier ride may have to do with the pain killers they gave me. I felt very little pain coming out out of the Propofol. Last time the right knee burned and throbbed and ached immediately. The abscense of pain this time may have had something to do with the local painkiller they shot into my left knee. It also had something to do with the double shot of Dolantin the surgical nurse shot into my IV bag. {By that two distinct injections into the bag.} It may have been related to the injection of Torodol they gave me. It could also have something to do with the Vocodine chaser she gave me. It may also have something to with the Norco + Torodol pills the doc prescribed for me to take later on.

Norco is literally twice as powerful as Vicodin. 10mg of Hydrocodone vs 5mg. Torodol is a hyper-strength NSAID that has to be taken with a meal because it can really upset the tummy. It is the very best thing for killing inflamation, but you cannot take it for longer than 5 days.

They obviously weren't taking any chances on me writhing in agony after the surgery. Once again, it sounds like the Doc did a lot of work on my left knee. I greatly appreciate the fact that I was able to sleep well all week. This has helped me to recover faster.

My second knee surgery has been scheduled for January 8th

So I got a very bad diagnosis from Dr. Michael C. Kupfer, and Dr. Evan Bachner today. The report on my left knee said the following:

1. Chronic tear of the anterior cruciate ligament. Prominent anterior tibial drawer sign.
2. Degenerative maceration of the anterior and posterior horns of the lateral meniscus. Horizontal cleavage tear posterior horn medial meniscus.
3. Marked degenerative changes in this patent with near-complete absence of of articular cartilage over both the lateral femoral condyle and lateral tibial plateau, marked thinning of the articular cartilage over the medial femoral condyle and medial tibial plateau. There are associated large marginal osteophytes.
4. Moderate sized effusion with thickened plicae seen in the suprapatellar joint space, both medial and lateral in position, as well as infrapatellar thickened plicae.
5. Two discrete loose bodies having marrow signal are seen posterior to the lateral femoral condyle. The first is 0.9 x 0.4cm. The second is 0.8 X 0.5cm.

The loose bodies with marrow signal is the most scarry element, worse than the ACL. They are obviously bone chips. This may mean my bones are leaking. These are the primary malefactors causing me a shitload of pain right now. Try walking around with a couple of bone chips floating around in the soft tissues of your knee. It hurts like a sonofabitch. I'm talking about sharp, jagged, knifing pain. Take a little too long of a step and BANG! It feels like somebody just stabbed you in the knee with a steak knife.

Dr. Bachner scheduled arthroscopic surgery for Firday, January 8th 2010. He is not going to attempt to reconnect the ACL. He's going to leave it snapped. The rest will be cleaned up as much as possible.

Frankly, I am really bummed out about this. I am still suffering post-surgical pain from my last procedure. Now this one will be much more elaborate than the first, which means more pain, and it will not result in a repaired ACL. I am going to be walking around with a busted ACL for the rest of my life, until the day I die. It seems rather heinous to go through that much pain, just to continue walking around with a busted ACL for the rest of my life.

But wait! There is more. I have been strongly counseled to get Gastric Bipass surgery. Both my primary care physician and my Orthopedic surgeon believe it is imperative that I take 80 to 100 pounds of weight off my knees. Otherwise, it will be the wheelchair for David. They want me to get real skinny. You can't carry my weigh on a busted ACL.

But wait! There is still more. Dr. Bachner emphasized the fact that I am still staring down the gun barrel at knee replacement surgery. Problems as profound as my left knee do not get resolved any other way. He just won't do it now, because I am "too young" and too overweight. He'll do it in 7 or 8 years when my weight is at 180.

So, pain is the forecast: Surgical pain, post operative pain, rehab pain. Oh yes, I almost forgot: I won't be able eat normally for the rest of my life either, so there will be hunger pains.

Arthroscopic surgery on 10-23-2009

My ROM rehabilitations was going just fine until Tuesday. Both knees were responding incredibly well to the ROM lower body workout routine. My left knee & leg are in the best shape it has been in 12-15 years. My right knee and leg were headed in that same direction, and then... bang! Something went bad awful wrong on Tuesday 10/13/2009.

I went through the workout normally. The leg felt great after the workout. That day, at work, the knee began to stiffen up and become painful. I limped out of work around 6:00pm in significant pain. After climbing two flights of stairs to get to my living room, the knee went hyper-critical. It swelled up to twice the size of its companion, and locked in a bent position. I could not straiten the joint. Putting weight on my right leg was excruciating, and mean crucifixion excruciating. I have a high tolerance for pain also. Climbing one flight of stairs to get to my bedroom was pure murder. My blood pressure was totally elevated by the time I got there. I was sweating.

I saw a bit of footage the next day which indicated that Troy Palamalu was going to return to action for the Steelers after his dreadful injury. I saw footage of him walking off the field after the injury occurred. I was no where near as ambulatory as he was. It was at that point that I knew that Dr. Bachner was going to perform some sort of surgery.

I spent about 24 hours on the couch doing heat a cold treatments. I pressed my steam cleaner into use for something the engineers had never intended it for. I steamed my knee joint. All of this helped. The inflammation steadily decreased, and I was able to begin limping with an improvised walking stick. When yesterday (Thursday) morning came, I was able to make it down the stairs to my car and drive to my appointment with the doctor. It sure as hell wasn't easy.

Sure enough, Dr. Bachner set the date for 10/23/2009 at the West Hills Surgical Center. 1:30pm is Propofol time. The surgery is scheduled for 1 hour. At the moment we don't know precisely what will happen. Bachner is uncertain as to what the damage is, although he suspects a burst cyst or floating bone spurs. The previous MRI stated that I had both components necessary for this condition. His basic plan is to investigate and clean out the knee. If there is a full tear of the meniscus, another surgery will have to be scheduled.

I always knew it would come down to this. I have known for decades that I would have a date with the A-Scope sooner or later. It is not the O-Scope as some people call it. Basically, I am optimistic. I think I am going to get a big gain out of this. When Dr. Bachner gets in there, I suspect he will find a lot of little bone spurs he can get rid of. I suspect that that cyst burst also, and he can flush the fragments out of there. If this is the case, I will make big improvements.