Showing posts with label The first 90 to 100 days. Show all posts
Showing posts with label The first 90 to 100 days. Show all posts

Thursday, May 5, 2011

It's Cinco De Mayo

It's Cinco De Mayo. Besides being Mexican Independence Day, it also the 90th Day since my gastric bypass surgery. In theory, I am all healed up. My body has finished recovering from the surgery. I am no longer in the recovery phase of the game. I am now in the "life beyond surgery" phase of the game.

I guess that means it is time for a full blow progress report.

First of all, my surgeon (or at least his team) is/are pretty happy with my progress. I have had no complications. Thus far, no vitamin or mineral deficiencies have appeared. My exercise load has shot through the roof. My knees are better. Oh yeah, I just happened to have lost 46.8 pounds in the past 90 days, and 67.4 overall.

I started this odyssey at 330 pounds. After two weeks of liquid dieting, I weighed in at 309.4. This was my weight at the Providence St. Joseph Hospital, just before surgery. Today, I weighed in at 262.6. I've been tracking this thing pretty carefully.

As you know, 262.6 is not precisely where I expected to be on Cinco De Mayo. Whilst laying in my Hospital bed, I though I would be at 237 or 238 come today. I expected the early rate of loss to continue right up to the present moment, and Doctor Quilici assured me that 70 pounds of weight loss within 90 days of the surgery was typical.

On the other hand, each time I've checked in with Team-Quilici, they've assured me my progress is just fine; even a bit rapid. They insist that they want to see no more than 0.5 pounds of weight loss per day on average. I'm a little ahead of that at 0.519 per day. If I were losing weight any faster, they would consider that dangerous.

Why? Follow this logic. One pound of fat contains 3,500 kcal of energy. To lose a single pound of fat, you must consume 3,500 kcals less energy than you expend, over some interval of time. Concomitantly, you must maintain a deficit of 1,750 kcal per day in order to lose 0.5 pounds of fat per day over a long period of time.

Since my surgery 90 days ago, I have averaged 0.519 pounds of fat loss per day. This means I have maintained an energy deficit of 1,816.5 kcal per day, on average. Scientifically speaking, there is no other way I could have arrived at my present result. 1,816.5 kcal is a big energy deficit. I've skipped an entire daily meal-plan for an average woman, each day, every day, for the past 90 days. Any more might be dangerous.

Of course, 0.5 pounds a day for 90 days should result in 45 pounds of loss. This leaves me in quandary. I don’t understand Quilici's statement regarding 70 pounds in the first 90 days. If he was thinking of total losses, combining liquid diet and post-gastric bypass weight loss, the figure of 70 pounds makes a lot more sense. I got damn close to that figure with 67.4 pounds.

Others who were not so carefully to maintain their lean mass might lose more and hit 70. That isn't the good kind of loss, tho. Also, I just might have been heavier than 330 at the start of the liquid diet. I wasn't tracking my weight that closely in those days. It was too depressing. If my weight were 333 at the start, I nailed the average; but that's only a possibility.

What is the final goal? Just what am I shooting for? Where is the finish line? When do you declare victory?

It depends on which doctor you speak with. Dr. Bachner (my knee surgeon) insisted on a 30% mass reduction. He believed this was the minimum mandatory necessary to keep my knees functioning. Dr. Saedi (my GP) recommended 18% body fat as the maximum allowable fat ratio. Those two figures correlate reasonably well. They are in accord.

Presuming that I still have 190 pounds of lean mass, and presuming the goal is 17% body fat is the goal, my target body weight can be computed as follows: (190/ (1 - 0.17). This is equal to 228.915 pounds. At this point I would have 38.915 pounds of fat and 190 of lean.

The docs indicate that they will declare victory at 231. It would be wise to go a bit further than the minimum standard, though.

Based on a lean mass figure of 190 pounds, as tested before my liquid diet, my body fat percentage today is 27.65%... and falling. Of course, this is provided my lean mass has not changed.

I should have a new series of composition tests done to determine whether my lean mass has changed. My GP did an informal Tanita test a month ago, and it indicated that I had 192 pounds of lean mass. Why not use this figure? It is not as reliable as submersion/buoyancy/displacement testing. Until I go through a full re-test, I will continue to work with the 190 figure.

Any change upward or downward in my lean mass will jar the figures considerably.

Based on all the figures I've been keeping, when will I reach the goal-line? Sometime in early July. Anywhere between 7/1/2011 and 7/8/2011 I should cross the goal-line.

Incidentally, I will be visiting my brother and sister in San Francisco on June 11. My little sister hasn't seen me since Christmas. I will be 86 pounds down at that point. My brother hasn't seen me since a few days after the surgery. I was at 307 at that time. They both aught to be stunned if I show up at 244.

Start
------------------------------------------------
Starting weight := 330
Weight on surgery day := 309.4
Today's Weight := 262.6
Total Lean Mass := 190
Total Fat Mass := 72.6
Fat Percentage Today := 27.65 %
------------------------------------------------
Ideal Fat Percentage := 17.00 %
Ideal Body Weight := 228.915662650602
Ideal Fat Mass := 38.9156626506024
Distance from Ideal Weight := 33.6843373493976
------------------------------------------------
Days since Start := 104.468055555556
Days since surgery := 90.0722222222222
30 Days Post-Surgery on := 3/6/2011
45 Days Post-Surgery on := 3/21/2011
60 Days Post-Surgery on := 4/5/2011
75 Days Post-Surgery on := 4/20/2011
90 Days Post-Surgery on := 5/5/2011
------------------------------------------------
Total weight loss := 67.4
Weight loss since surgery := 46.8
------------------------------------------------
Loss per day (overall) := 0.645173298589414
Loss Per day since surgery := 0.519583050638376
------------------------------------------------
Mass reduction percentage := 20.42 %
Completion Percentage := 68.08 %
Pounds to Half Way Mark := Already Done
Days to halfway := Already Done
Half way point := Already Done
Projected Easter Weight := Done 268
Projected Easter Revised := Done 268
Projected Weight 5/5/2011 := Done 262.6
Revised projection 5/5/2011 := Done 262.6
------------------------------------------------
Weight at 90% mass := 297
Weight at 80% mass := 263.4 on 5/3/2011
Weight at 70% mass := 231
------------------------------------------------
Date for 90% mass := Already Done
Date for 80% mass := Done 5/3/2011
Date for 70% mass := 7/4/2011 11:14:11 AM
------------------------------------------------
Fat Percentage at 90% mass := 36.03 %
Fat Percentage at 80% mass := 28.03 %
Fat Percentage at 70% mass := 17.75 %
------------------------------------------------
Revised Date for 80% mass := Done 5/3/2011
Revised Date for 70% mass := 7/7/2011 11:14:11 AM
Distance from 70% mass := 31.6000000000001
------------------------------------------------
Visit San Francisco Date := 6/11/2011
Days until San Francisco visit := 37.03125
San Francisco visit projected weight := 243.359190156048
San Francisco visit revised projected := 244.084375
Total loss before San Francisco visit := 86.6408098439524
Projected Body Fat Percentage := 22.16 %
------------------------------------------------
Last Quilici Last appointment date := 3/28/2011 11:00:00 AM
Days since last appointment := 38.0097222222222
Last weighin at Quilici's office := 281
Loss since last appointment := 18.4
Next Quilici Next appointment date := 6/28/2011 11:00:00 AM
Days past surgery (appointment) := 144.0625
Projected appointment Weight := 234.547566767409
------------------------------------------------



Tuesday, February 8, 2011

I’m looking forward to Cinco De Mayo this year

Intro

For those who don’t know, the 5th 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.