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.

I’m looking forward to Cinco De Mayo this year

Intro

For those who don’t know, the 5^th of May is most famous in SoCal as the day the Chicano community, in our American south-west, celebrates Mexico’s defeat of the French Army on 5/5/1862. This is known as Mexican Independence Day. The interesting thing is that the celebration is for American Ex-Pats of Mexico only. The actual nation of Mexico does little or no celebration or commemoration of the event on this day. It just isn’t a big deal in Mexico.

It should mean even less to half-Ecuadorian, half-blueblood guy who doesn’t think often in ethnic and racial terms. So why the hell would I be interested in Cinco De Mayo 2011? Well, I’ll tell you about it.

Cinco De Mayo is exactly 90 days post-surgery

As you know, I just survived Gastric Bypass surgery. My surgery was delayed exactly 1 day due to insurance pay-authorization errors. I should have been in surgery on 2/3/2011. As it happened, the day was 2/4/2011. You can use the common VB.NET and C# DateTime functions to discover that 5/5/2011 is exactly 90 days later. You can also count manually with a paper calendar if you prefer.

So what the hell is the big deal about 90 days post-surgery? Well, I’ll tell you about it.

Typical results of Gastric Bypass

On 1/31/2011, I had my pre-op meeting with my surgeon, Dr. Philippe Jean Quilici. He is a real expert in this field, having performed thousands of these procedures. This has been his business for a long time. Of course, I was scared shitless, but this was the moment when I wanted to confirm one key point about the surgery.

“I have heard it said, and read repeatedly, that most of the weight loss happens up-front, in the first 90 to 100 days after the surgery. Afterward, the weight loss slows down. I have been told that people typically lose 70 pounds, post-surgery, during this time frame. Is this correct, Dr. Quilici?”

Dr. Quilici looked me dead in the eye, nodded his head in the affirmative and said, “For Roux-en-Y, those are the typical results that I have seen in my practice.”

There you have it from the expert. If I am on pace for a normal case, I should be 70 pounds below my surgery day weigh-in about 90 days after my surgery. So what does that spell out?

Just before they laid me down on the surgical prep bed, the surgical prep nurse asked me to stand on their well-kept and very profession scales. The scale said 309.4 pounds. Simple math will tell you that I should weigh in at 239.4 pounds on 5/5/2011… Presuming that I am on pace for a normal case.

How close does that put me to my final goal?

The next interesting question is this: How close does this 70 pound drop put me to my ultimate goal? Just what is the ultimate goal? Well, I’ll tell you about that.

Nearly one year ago, when I got onboard the very long assembly line that culminated in last Friday’s surgery, my General Practitioner was required to do a full-blown body composition test on me. She ordered a full submersion, buoyancy, and displacement test. She used her own Tanita BF-350 Body Composition Analyzer for comparison purposes. She also did several pinch tests, which all sources regard as the least accurate and least reliable approach to judging body fat.

Dr. Saedi juggled all these numbers in an Excel spreadsheet on her laptop and came up with the following conclusions:

• My total weight was just about 330 pounds. There was some wobble in the figure on different scales.


• I had approximately 188-190 pounds of lean body mass.


• I had approximately 140-142 pounds of body fat.


• A man of 43-44 years of age should ideally have no more than 18% body fat.


• Ergo sum, my ideal body weight is 230-232, presuming no loss of lean mass.

Incidentally, Dr. Quilici accepted this analysis, and put his stamp of approval on it. So there you have it folks. My Doctors are prepared to declare victory the moment I reach 232 pounds. We really should do a full-scale re-testing to make sure all the numbers line up, but still, they are prepared to declare victory at 232.

The significance of Cinco De Mayo 2011

If all goes according to the script, meaning no complications and typical results, I should weigh in at 239.4 pounds on 5/5/2011. This is a scant 7.4 pounds higher than my first ideal target weight of 232. Clearly, I will be extremely close to the ideal target weight, prescribed by my doctors.

I meditated on all of these figures as I lay in my recovery bed in at Providence Saint Joseph’s Hospital just a few days ago. To be perfectly frank with you, this analysis/realization boggled my mind.

It is astounding to think how quickly everything just may come together for me, and at level I have never been able to achieve given tough diet and exercise practices. Just 90 days after surgery, I will be within spitting-distance of my ideal body weight. 100 days after surgery, I just might be there. The key is to guard my lean mass. I must try to ensure that I lose the least possible muscle and bone density.

By Cinco De Mayo, my body may resemble London Fletcher more than it does Terrance "Mt." Cody. This will be an astounding transformation. Let's hope it happens.