When to Walk Away from the Experts

I was challenged the other day over my decision to go through with Bariatric surgery, when it is entirely possible (in theory) to lose weight the "natural way" through diet and exercise. Indeed before I was approved for surgery, I had to demonstrate that I could lose weight on my own. And even though it sounds counter-intuitive, I will continue to lose weight and increase my strength and mobility through diet and exercise. The surgery is a boost but it is not an answer to significant and sustained weight loss.

I won't go in to all my reasons, but there was a mental switch that triggered, where I had enough of the conventional wisdom. How many times should a gal beat her head against the same wall, before she walks away from the wall?

I am reminded of another story of expert advice gone horribly wrong, in the story of the settling of the prairie dry belt in the book, "Empire of Dust: Settling and Abandoning the Prairie Dry Belt" by David C. Jones. When I was young, I learned in school that prairie farmers were partly responsible for the dust bowl because of poor farming practices. They cut down trees and deep-furrowed the loose soil which then blew away. All through my young life I watched farmers in our parkland, a little farther north from the dust bowl, faithfully plant tree lines around their property. This was the farmer's penance, to compensate for the ignorant practices of the past.

Then I read Jones' book and found out that the deep fallowing farming practices were the prevailing wisdom of the time.  Promoters and agrarian experts alike claimed that bumper crops could be gleaned from a land short of rain, solely on the moisture retained in the soil. Many farming families, hopeful for a new life, answered siren call of free land. The prairies were settled, then abandoned again, in huge numbers between 1909 and 1926.

Imagine a farmer following all conventional wisdom. Some years he experiences success. In dry years he loses it all again. He plants again in hope of a good year. He follows the "Campbell Method" ever more finely, believing it must be somehow a failure in execution. Sometimes he succeeds and he believes again. Then drought follows drought in successive years. Finally he is exhausted, destitute and entirely driven from hope. To save his family, he packs up and quietly leaves, indebted, the fallow land left in the hollow hands of the banker. For the farmer, his former faith is fatally snapped by reality. To survive, he must launch out on his own wisdom, taking an untrod path, and holding his breath that he and his little family will survive.

It boggles my mind that even today, this failure is left resting on the shoulders of the poor farmer, who was simply following the experts.

There's a time to step back and admit when a pet method simply does not work. There is no shame or failure in trying something else. It may be the only way to survival.

When it comes to weight loss, it is possible to simplify the whole process to a matter of Calories In - Calories Out (CICO). It does come down to this. Logically, if a person is gaining at a certain calorie intake, the only way to lose is to reduce the intake or increase the burn. Eventually the energy deficit will reap the expected result, as the body can't be built on air alone. But for some reason, some people seem to be able to eat more and still lose weight, while others struggle. Why some fail is baffling. Are they measuring their food wrong, failing to log all their entries, closet eating, or messing up their metabolism to such a degree that they require a dangerously low calorie intake? The dieter is left to blame.  She follows the instructions ever more finely, believing it must be somehow a failure in execution. Finally she is exhausted, entirely driven from hope.

I smell an expert failure. There are factors at play yet left undiscovered.

Oh, and in case this story has you wondering, I'm hopeful. The surgery went well, I have very few food intolerances, and I am close to achieving a weight target that will take me out of the obese range.

Privacy and Emergency Contacts

The unthinkable happens, and an employee is injured on the job - after hours - and is being transported to the hospital. (Let's call our unfortunate, Fred). In a safety culture, the first goal is to prevent the unthinkable, but if such a thing were to happen, are we prepared to provide support and information in those first critical hours?

I'm talking about personal private information and the workplace. There is an exception to disclosing private information without direct consent in cases such as Fred's accident. Human Resources or Payroll typically collect this information on hire. Exceptions to direct consent are typically written in to the regulations to allow for quick disclosure of this information, to Fred's "In Case of Emergency" (ICE) contacts.

"If a reasonable person would consider that it is clearly in the interest of the individual and consent cannot be obtained in a timely way (for instance, emergency contacts)" - A guide for Businesses and Organizations on the Personal Information Protection Act, Rev. November 2008 (p. 27)

Typically this information is kept on the employee file, and is collected in the first few days on the job. There are a few things to consider, however.

1. Is there a plan in place (say, annually) to confirm and update the emergency contact information?
2. Is there a contingency in place to access this information after hours? 
3. Do the supervisors know about this contingency plan?
4. Is there continued protection of this information from unauthorized access? 

But what if we asked a broader question; can the employee self-manage their ICE contacts through a tag or on their cell phone, while still protecting their privacy rights? Paramedic Bob Brotchie began promoting the saving of "In Case of Emergency (ICE)" information on cell phones in 2005. His idea gained international attention as a result of the London terrorist bombings that year. The idea is to include emergency contact names in the phone directory (i.e. last name ICE) so that an emergency responder can quickly work out who to call. This has become a little more complicated as most phone screens now lock, but new apps have filled the need. 

The apps available have gone steps further including personal medical information, allergies, and so on. Keep in mind however that for emergency responders, wealth of detail hinders rather than helps their cause. Having an emergency contact to call (who can fill in on existing conditions, allergies) is of primary importance. 

Bob Brotchie has endorsed an ICE tag made in Canada that bypasses apps altogether and provides a durable tag that can be attached to a keychain, backpack, running shoe, or helmet. All that is included on the ICE tag is two contact names with phone numbers. Nothing else is disclosed.  http://iceincaseofemergency.ca/

An employer may offer such a tag to employees who work off-site and after hours, that they could voluntarily manage and update as necessary. This eliminates the privacy, currency, housing, and accessibility concerns of the traditional emergency contact form maintained on the personnel file.

Further reading:

Federal Privacy Emergency Kit
https://www.priv.gc.ca/information/pub/gd_em_201305_e.asp

Information Sheet No. 5: Personal Employee Information
http://servicealberta.ca/pipa/documents/InfoSheet5.pdf

Evaluating apps:
When selecting a health-related app, pick one where the developer is open and transparent about their privacy policy, is specific on what information is being collected and how it will be used.  Ten Tips for Communicating Privacy Practices to Your App's Users

Thighs

With this extreme weight loss it is still a job getting used to my new size, but I am getting there. What seems to help is measuring, putting my stats on a size chart, and looking in the mirror. I am getting used to what am now. 

I am a grandma with lots of spare wrinkles and lumps so I try and look with an uncritical eye; observing but not judging. 

Have you noticed how the thighs have a terrific spread? Sit down in the hot tub and they spread out like mounds of leavened dough, ready for punching and baking. It seems all out of proportion somehow. 

Our legs aren't sticks; they're triangular. Our legs are levers, powered by large muscles.

Speed Skaters have terrific thighs. 

Mathieu Giroux

Strong thighs give me launching power, and propel me out of my chair. No twiggy for me, tottering on stick legs. I've got places to go and things to do. 

Random thought; true infinity scarf

On September 9 2014, Apple launched the iPhone 6 at it's keynote presentation. The event was nearly usurped by #scarfguy, AKA Tommy Krul, with his fashion grabbing infinity scarf.

I love my olive infinity scarf, a gift from my daughter and granddaughter. 

It goes well with my new cream-colored wool winter jacket. As I hustled to work, my mind going a million directions as it will do in the morning, I got to thinking what a cheat this scarf was when I first saw one. There's only one small change needed to it's design to make it a true infinity.

Why not?

Before and After

Effort perception is inversely related to experience. That is, the more often we climb the mountain, the smaller it gets.

Social psychologist Emily Balcetis in an informative Ted talk demonstrates how when it comes to fitness, some people quite literally see the world differently from others.

Now I've lived this. This is what exercise looked like when I started a year ago:

Sisyphus was a Greek hero who was punished by the gods to lift the same boulder up a mountain for eternity. Similarly, I was encouraged to exercise more but the effort required seemed monumental. I was morbidly obese. Every movement took planning, and the effort to climb in to the cab of a Ford F-150, missing it's running boards, downright embarrassing. Exercise also did not seem to have a direct bearing on weight loss. Twenty minutes on a treadmill is "meh", nothing in exercise world, and all strenuous efforts bought me was sweat, pains, and water weight. A seemingly purposeless exercise.

Positive psychologists confirm our need for purposeful effort and meaning in what we do. This need is expressed in various ways by Martin Seligman, Jonathan Haidt, and Mihály Csíkszentmihályi.

A turning point was a 21 day challenge given to me by my fitness instructor Angie Bryant, to walk for forty minutes a day on the treadmill. There were no targets set for pacing, just minutes. Just as well, because I ambled along on that treadmill at a snail's pace. I likely would not have done it at all if it weren't for that magic finish date. The promised reward was five pounds down. Which didn't happen. I was right upset about that.

But then I noticed something. My little legs had mastered a new pace. They demonstrated this when I got lost visiting my dad at the hospital, I was able to run all over that place with little effort. I had gained stamina without my even being aware of it.

That little revelation led me to sign up for a 5K walk and then another. Having a walk to prepare for kept me on the treadmill.

Then the walks got easy, and I asked myself "What now?" Which led to classes at the Running Room and targets this year to run a 10K and a Mud Hero. I am running and resting regularly now. I have got over the "hump" and now movement is my new normal. If I skip a run day I am restless and bored.

This is what exercise feels like now that it is routine:

Go, Endorphins!

Now, there are still aches and pains, but I rate them. The burning muscle pain is evidence that I am pushing to a new normal. This is "good" pain. In a few days I will be more capable than I am today. Sharp pain however means stop. Tendon or joint pain means dial it back, I am doing it wrong. I have become more body-aware, and my body is responding by letting me do more. 

Interview of experienced climbers. 

The next time a fresh-cheeked fitness instructor blissfully tells you to keep going, it will be worth it in the end, take a second to believe her just a bit. Given a little more effort and a little less effort than you think, you can be doing things you formerly thought impossible. 

Note to self: A study on Initiatives to Motivate Change 

Evolving Self

As I have broadcast over the past months, this has been a year of physical transformation . In a week I have an appointment with my psychiatrist and there will be questions about how I am feeling. Shall I give her the Cole's notes version, or really get in to it? Because there's lots of feelings, and an evolving sense of self. As my body downsizes, there's a mismatch between what I think I look like (can't keep up), there's the different reactions from people around me (face it, our self image is often defined by the reflections from others), and my innermost self.

There's a great article by Kerry Colpitts, who describes the social changes associated with significant weight loss.

MONDAY, JANUARY 26, 2015

Guest Post: The Unexpected Side Effects of Significant Weight Loss. 

I don't intend to repeat those thoughts here. I'd rather talk more about my innermost self and the effect of the physical changes on my mood.

I wonder how much others really are interested in my innermost, but that's what is most significant for me. As a well-socialized introvert, I still prefer my own scintillating internal dialogue. Translating for the external audience, well, is exhausting. But here I go. If I write it down, I might save having to repeat myself. When I was my largest, there already was a mismatch between my inner image and my external self. Inside I'm slim, I'm dynamic. Denial and avoidance are very handy tools, and they worked pretty well as long as flitted past my reflection real fast. Now I gaze in the mirror longer. I measure, I compare. There are new bones to discover and I lay in bed at night feeling my rib cage, my collarbone, my shoulders. I massage the loosening rolls of fat in my back.

Frankly, I'd be happy to stay where I am. At the top of my ribcage I am my smallest, a size ten. The excess fat and skin at my belly and my breasts means I am size 12/14 for slacks, but I need a Kim Kardashian sized bra. I am a pear with breasts.

If I stay tucked in with firm support gear, I get around without too much flopping. Besides the change in appearance, my lighter self can now move. And that is what I am most excited about. I run. I Zumba. My improved mobility and energy is so transforming, I'll fight to keep it.

But back to that inner self. I began checking with my ID back in January, confirming that the conscious choices I had made weren't going to be sabotaged through the back door. Was my inner girl satisfied with these changes? I was blessed with two powerful images of my inner self, which I carry around in my mental wallet. The first was of the dancing Hippo from Fantasia.

I translate this to mean that even as a large woman, I wanted to dance, to be graceful, and to live artfully. There's some pathos in the hippo's dance along with the laughter. We are all in on the joke that she isn't as lovely as she imagines. And yet she continues her dance. I've been gentle and respectful to that inner hippo as I've gone along. I ignored the unwelcoming glances from a few ignorant Zumba participants, and danced anyways. I'm still there dancing and the offended found somewhere else to go. I imagined myself as lovely as the instructor, as I performed my low-impact modified moves. As long as I zipped past the mirror real quick, the illusion remained. And I danced. These days I check the mirror more often to make sure I am dancing to form, a little amazed at my new look. And I throw an encouraging glance once in a while to the larger women. 

The other image is older and more important. I came across the related photo when I was sorting out mom's estate. It's a picture of me when I was six and had started gymnastics. I vividly remember the feeling of accomplishment as I performed a move that I could not do before. 

My six year old self felt for the first time that the sky was the limit and with determination and training, there is nothing I couldn't do. I reveled in the joy of my body. How that got squashed is a story for another day, but now as a fifty-something grandma, I've got that feeling back. 

I think I'll end there. Have you captured the sense of art, excitement, and joy that I've found? 

There will continue to be unease as my inner self and outer body adjust to each other. I am resigned to an evolving shape that will likely end up even lighter than it is today. I don't experience the dissatisfaction of many bariatric patients who discover that they don't snap back to pa re-college ideal. It has never been the shape, the desire for a smooth belly and trim breasts that drove me to change. This is a mature body with its own joys and challenges. As long as I move, I am very, very happy. 

Added personal notes:

Mirna, the fat running girl

Jackie Stringer, triathlete

Mergers

Pet peeve Friday. A first world problem is too many choices, and distinctions without a difference. I'm talking Coke and Pepsi, products that consumers may have passionate preference for, but who cannot distinguish in a taste test. There are corporate and discipline mergers I would dearly love to happen, simply because the distinction barely matters, and the duplication of effort is a waste in itself. Why do they remain separated? History, biases, tradition. Corporations build an identity of their very own, perhaps our first non-human creation, and by themselves they will fight for individuality.

Here's some mergers I would dearly love to see:

Google and Apple. I want their cool apps to blend seamlessly, not fight each other for supremacy.

Meditation, Hypnotism, and brain mapping. There's something going on here, but the "disciplines" are wrapped up in too much woo. They use different terminology and imagery. But I'll bet you dollars to doughnuts they are doing the same thing.

Physiotherapy and Chiropracty. Again, time to kill the woo.

Victorian Order of Nursing and Nurses. Nail trimming? Really? Wrap up this venerable organisation and get on with it.

There's another reason I'm keen on merging and productivity. Our society is going to undertake a major shift in the next twenty to twenty-five years. Economics will be turned on it's head. We will reach peak population growth. And climate change, an amorphous impersonal threat, will demand collaborative world-wide effort to stabilize. The old ways of competition won't stand up and all of us have to start thinking about getting along in new ways.