JMT-J

NurseBob_1
JMT-J??? I’ve decided to keep a journal of my John Muir Trail planning, training, prep, logistics, etc., and then the trek itself. Actually there will be a couple of journals – this one is text-based, the other one will be video-based and posted on my video blog). So, if you’ve any interest in the logistics, etc., as well as the trek itself, stay tuned-in. Otherwise… 🙂

For now my biggest challenge has been figuring out how to incorporate the time required for training hikes into my daily/weekly schedule. The time demands of teaching for a nursing program and tracking 150 students are challenging, and it’s very easy to put off the excercise and focus on trying to stay abreast of the work, the students’ needs and expectations, as well as managing my own expectations about the quality and quantity of my work.

Today’s goal: Start this blog journal, capture and edit related video to post on my vblog, and most importantly, do at least a 3.5 mile hike with pack and camera(s).
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Well, it’s post training hike. Shot some video; met a PUC Business Major student who expressed an interest in hiking the JMT and had two brief but enjoyable conversations. Video needs a little post-processing, so Friday??? 🙂

Want to know more about the JMT?
Very enjoyable video on Netflix: Mile, Mile and a Half

Stay Well!!!

Bob

Three, count ’em, Three meals a day!

NurseBob_1
Well, as of last evening, my cohort has progressed to three “actual food” meals per day, with consideration regarding the meal replacements, which can also be included depending on need.
For me, I’m still including a couple of the chocolate shakes (320 calories total per day) in my meal planning. They are convenient, and while not absolutely “tasty,” they are better than a mere “OK.”
Since I am hoping to continue to lose weight for awhile, I’m targeting a total of 1200 calories per day, and the old carpenter in me seems oddly attached to 3-4-5 (a handy right triangle for determining if a corner is “square” – 90 degrees). Of course, I need to adapt that to my current situation: Weight loss, and the multiplier of 100 for each digit. Thus, the reality of my plan is actually… Breakfast – 500 calories, Lunch – 400 calories, and dinner – 300 calories. However, I’ve broken away from the traditional “three meals per day” and am back to what I did as a child – grazing my way through the day. The variation? Now the first six hours of the day will be breakfast and a mid-morning snack – the first 500. Then lunch and a mid-afternoon snack that combine to the the next 400, and finally dinner and an evening snack that complete the plan with the last 300 calories for the day.

Perhaps the most significant change to my diet behaviors (this is, after all, a behavior modification program), has been to break free of my “addition” to milk, half and half, and white sugar. Like an alcolholic, I always made sure that there were sufficient supplies of all three on hand. And “sufficient” could be read as “lots.” I’ve not touched the unholy trinity for over four months, and attribute most of my weight loss success to that simple change. I do, at times, really miss the cream in my coffee, and that “white” concoction sweetened excessively. Happily, while missed, it’s not missed to the level that I can’t wait to get back to the pattern. Surprisingly, I really am OK for the vast majority of the time with keeping the new status quo – coffee “whitened” with unsweetened almond silk, then sweetened with a touch of stevia. While it tastes nothing like what I used to drink, it is surprisingly acceptable. And on those days when I need something more, I do a mocha instead, using the soy-based chocolate shake – though that does add 160 calories. The silk adds at most 15.

I’m off on a five day trip to Death Valley with my best friend. The challenge on the trip will be to make appropriate menu selections from the restaurant fare. I believe my friend can be easily recruited as a supporter for my continuing goal.

Well, time to post grades for my RN students, then pack and prepare for my 04:00 departure tomorrow. If all goes well, there should be some photos, and maybe a video or two, to share. Fingers are crossed; there’s a report of another “super bloom” in Death Valley. I had the good fortune to see a similar event in 2005.

Stay Well,

Bob

Fifty, and counting…

 

Bob at 240#

Bob at 240#

Actually, this image is closer to where I am now…

NurseBob_1

While it is some 15 years older, it’s closer to my current look. The weight is right, but I am MUCH more grey… As Billy Pilgrim would say, “So it goes.”

For the first time in the better part of a couple of decades, when I walk towards the mirror in the bathroom, I don’t cringe; in fact, I’m pleased with what I see. While not at the goal I’d set, I’m on the right side of the curve, and feeling I just may make it back to what I weighed back when a college student. FWIW, that’s still heavier than what the BMI charts indicate are “correct” for my height. However, those charts have wide error ranges. If I get down to 170+, I will be ecstatic. As it is, I am able to see parts of my anatomy that have been hiding for quite some time. And, more importantly, my wife is very, very pleased with my new, reacquired physiogonmy.
In short: On Track.

Stay well,

NurseBob

T Minus 45 and holding…

Bob at 240#

Bob at 240#

Well, if your memory of “T Minus… and Holding” has you recalling NASA’s missions to land a man (uh, person) on the Moon, then you’re likely in my age cohort. If not, well you’re likely a bit younger than I.
Then again, from my current perspective the phrase has nothing to do with Space, NASA, or astronautical adventures. Once again it’s a weight reference. In this moment it’s my hovering around 193 lbs (87.72Kg or 13st 11Lb – I LOVE Scotland and the Scots!!!), which is a couple pounds away from 50 pounds lost. Fifty is neither my goal nor a magic number, but has become significant since I’ve been feeling stuck.

What’s up? Well, I’ve been hovering at that weight for most of the last week. And, “Why stuck?” you ask… Well, I’m struggling to stay on plan; struggling to increase my level of exercise from sedentary to not sedentary. Did I mention struggling to stay on the plan and not exercising enough?

’nuff said. The short, insight-less vision: some weeks are harder than others. This week has been one of the more challenging. In my last group meeting we were all to select a partner we could confide in. While there is an individual I would like to add as an understanding “sponsor,” he’s out of town. Hell, he’s out of country in Patagonia. So, I’m opting to use my other connections as part of my support network. Those would be all of you on FB, Twitter and Linked-in. I appreciate all the wonderful expressions of support I’ve received from all of you. While I may not always adequately acknowledge the support and comments, they are deeply felt and appreciated. Setting out on a more beneficial and insightful path, I have come to realize it’s time to use other additional resources and help. This is not something easily accomplished in state of emotional or social isolation, which is where I tend to go in times of stress.

Thus the work continues. Currently my greatest food/feeding challenge is when I have engagements that have me traveling in the greater Bay Area during business hours. I find I’m near OCD in my newfound desire to eat in places, and have dishes, I don’t normally care much about at all.

Where do these near-overwhelming urges and desire originate? Who knows? Is it just my physiological being, my body, saying, “Eat More! I need FAT! I need SUGAR! Oh, and a bit of protein would be OK too. Then again, is this related to my gut bacteria, my microbiome , calling the shots? Who’s in control, or out of control, here?

Short answer: I don’t know. All I “know” is, at times I am very hungry, and if I’m out and about, the temptation is overwhelming. On the other hand, and perhaps most importantly, I know you are out there on my side; rooting for me; and whether I want it or not, reminding me of the goal.

So, the story, and challenges of my weight loss journey continue, but not without a massive “Thank YOU!!!” to you all. You have no idea of how important and effective your support has been, and will continue to be… 🙂

Stay Well,

NurseBob

42… :)

Bob
42? Why does that get a smiley? Well, ask Douglas Adams, or read his book… According to his fictional characters, 42 is the answer to to life, the universe and everything. If only…

For me it’s a milestone in my quest to return to a smaller, former self. As a result of my medically managed diet, and my adherance to the diet (well, 98% of the time), I’ve now lost 42 pounds. More than halfway to my goal of 70 pounds. If/when I get there, I’ll be back to my high school weight, which is where I was supposed to stop, but didn’t/couldn’t.
Coupled with that happy achievement my wife and I took a Christmas/New Year’s vacation to Santa Fe, NM, whereupon I not only did not gain any weight, but managed to lose a couple more pounds. Not bad for both a vacation and the Holiday Season.
Other benefits: New/Old wardrobe: Clothes I’ve not fit into for years (maybe decades?) now fit. 🙂

Thus, while I did not strictly adhere to my meal replacement diet while out of state – my cousin’s wife’s New Year’s roast beef dinner with poached and caramelized pears for dessert was too inviting to ignore, it did not stop me from returning home lighter than when I left!!! 🙂

Stay Healthy

Medical Weight Management

NurseBob_1

My self-directed and self-managed attempt at a ketogenic diet this time last year was successful until… my wife and I traveled to Santa Fe, NM just after Christmas for just a week.  While on the road I went off my diet after having lost 20 pounds; upon our return home I was unable to resume the resume my plan, and, as happens to many, most? I had a “rebound” experience and gained back the 20, plus 5.  Argh!!!

I came to the conclusion that I could not do this on my own, and that my best bet was to enroll in a medical weight management program.  Last week I started in earnest with a Kaiser-based program. The program has demonstrated good results in the past, and I know from a personal contact who successfully did, and remains on, the program (officially 82 weeks, but apparently, a life membership for support meetings), that long term success is possible. Though a KP member, this program is outside of the KP benefits, so it’s out of pocket, about $800/month for the first four months, which includes weekly meal replacements.  After that initial period the cost drops significantly, but having not reached that point, I’ll hold off on any cost estimate for now.

My long term goal is to lose about 70 pounds. I have, in the first week, dropped 12 pounds.  Now, much of this is likely to be water, so I expect this weekly number to drop pretty rapidly to a more realistic 1-2 pounds per week.
Since weight loss tends to be physiologically sexist, I do expect to experience a more rapid rate of loss than most of the women in my cohort.  For now my diet is 960 calories daily, with a less than wonderful menu of two shakes, two soups and two nutrient bars per day.  To the credit of those at KP who designed the program I’ve not been starving, just had moments of elevated hunger.  I know that to get to sleep I need to have that last nutrient bar in the last hour before bed.

I will see if I can manage a weekly update on both the experiences and, I hope, successes of the experience.

The numbers:
Height: 5-10 – Hoping/expecting this won’t change over time… 🙂
Starting weight: 241 lbs
This week: 229 lbs
Goal: 170

Stay Well!

Bob

I Quit Drinking for This?


I’ve been sober 90 days now, and I guess I didn’t know what I expected from sobriety, but I really didn’t expect what’s happened.  All the feelings I used to escape: the hurt, the anger, the frustrations of everyday life, everything I’ve tried to avoid most of my life, is in my face!
I know that drinking is not the answer, at least I know it in my head, but my gut keeps telling me: “Have a drink! Get rid of those nasty, painful, feelings.”  It’s not easy.
What to do?  Go to meetings, for one.  But even at a meeting it’s hard to admit to wanting a drink.  That’s a topic that rarely comes up, at least at the meetings I attend.  The topic of drinking, what it’s done in the past, what it could lead to in the future, all fine and dandy.  But admit to wanting a drink?  Apparently risky territory.
What else? Call my sponsor.  Good idea, but if I’m really willing to call my sponsor, I’ve found that I’m not really at the greatest risk for taking that first drink, buying a bottle…

Continue reading

It’s HIPAA, not Hippo! – Protecting your private health information in the Electronic Age

NurseBob

NurseBob

Is your personal health information at risk of being shared with the world? Unfortunately, the answer is Yes!
There
are some interesting parallels between federal acts, icebergs, and hippos, all three keep their bulk and associated dangers submerged and out of sight.  Of course, most of us are familiar with the fate of the Titanic after its encounter with an iceberg, and I don’t think it’s too hard to find scary stories of hippo encounters if you follow stories of African safaris or some of the reality shows.  But, what are the risks associated with the Health Insurance Portability and Accountability Act? (HIPAA)  Wasn’t a primary goal to protect the privacy of your personal health information?  Well, sometimes the best intentioned legislation goes awry, especially when there are competing, and perhaps even contradictory goals contained in the same act.  Anyone remember the reason the HAL 9000 computer murdered most of the crew in Stanely Kubrick’s film of Arthur C. Clarke’s 2001 – A Space OdysseyConflicting directives! Continue reading