Found And Lost, Part 4

 (The Mind Meld - James Horner)

Looking back on that first visit, there was something absolutely brilliant about my bariatric dietician's order that I consume much larger amounts of protein.

Most people don't really think about how much meat you'd need to consume in order to get to 80-100 grams of protein in a day.  Most folks don't keep hundreds of grams of good protein hanging around the house in a readily consumable state. This meant more trips to the store to obtain meat.  Since I was going to the store more often, I could get fresh meat.  I was eating it quickly enough that I never had to buy frozen protein.  

Going to the store more meant I was walking more.  I never realized what was happening.  I just knew I was basically getting to indulge in my carnivorous lifestyle on doctor's orders.  Life was good! 

Mind. you, I'm not a complete moron.  

While I prioritized my protein intake in the form of chicken and lean red meats, and occasionally bacon, I also made sure to have some kind of vegetable with my meals.  This usually came in the form of a salad or raw baby carrots.  This meant I was also blowing through bags of pre-made salad and baby carrots, which meant I was going to the store more often for fresh produce.

Which meant I was walking more.

By the time the end of May rolled around, I felt noticeably better, though I couldn't exactly put a finger on why.  I just knew that I was anxious to get back to the Bariatric Center and see if I'd started losing any weight.  

In early June of 2019, I briskly rode the elevator up to the third floor where my doctors' office was, checked in with the same radiantly hospitable receptionist, and ... waited.  An eternity later, which my watch insisted was only about three minutes, a nurse called my name.  Once again, I went back for the visit before the visit, and the first place we stopped off was the scale.

I didn't even hesitate.  I hopped up onto it, waited for the numbers to stop moving, and ... I was still fat.

Sorry, morbidly obese.  I'll get that right one of these days.

Nothing had changed.

I walked back to the exam room with the nurse, absently answering her questions and exchanging pleasantries on autopilot while my mind started processing what I knew so far:

1. It had only been a month.  
2. Safe weight loss frequently happens slowly. I discussed this very fact with my physician during my first appointment, and the internet agreed with her, meaning it was a fact.
3. I'd done what I was told.  I'd done the protein thing.
4. Something should have happened!
5. The doctors had admitted that they were operating off of educated guesses rather than running plays from a book.
6. ...I was broken.

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My parents and relatives made sure that I grew up listening to just as much classical music as I did classic rock.  My siblings and I all have a foundational understanding of the giants of the classical world, and I'd chosen to leverage some of that in an attempt to slow my mind down while I waited for my physician to enter the room after the nurse had left.

Bach's Adagio Concerto for Violin and Oboe was reaching its midpoint when she arrived.  Bach's brilliance was rewarded with a smile as she closed the door.  "That's nice," she offered.  "I don't hear most people listening to classical music anymore."

As with the nurse, we exchanged pleasantries and confirmed that, no, the number on the scale hadn't changed at all.  I had taken the time to plot my most common meals out within my food diary, and I showed her my work to be sure I hadn't done something wrong or misunderstood the instructions from the last visit.

I hadn't.

"I want to try something else with you in addition to your food intake changes, if you're willing."
"I'm sort of in the wrong place if I'm not willing, aren't I?"
"We're not here to force you into anything.  I'd just like to make a suggestion."
"Shoot."
"You've already said that you've started walking a little by simple virtue of having to go to the grocery store, right?"
"Yes."
"I'd like you to consider setting aside a little time, two or three times a week to go outside and walk."
"What are we talking about here?  An hour?"
"No.  Ten minutes."
I blinked. "I'm sorry?"
"Ten minutes.  That's all I want.  Two times a week, maybe three if you're feeling good."
"Okay, I'll admit, I'm...confused.  What is ten minutes going to do?  Do you want me to jog or something? How quickly do I need to walk?"
"No, I absolutely do not want you to jog.  Certainly not now, maybe ever.  You're a big guy.  Jogging puts an incredible amount of strain on your joints if you're in good shape.  You're not.  What you are is a big guy.  The simple act of hauling yourself around for 10 minutes will accomplish everything I want out of you right now."
"Ten minutes."
"Ten minutes.  No more than three times a we

We got up to leave and another question popped into my head.  "Why now?  Why didn't you ask me to start walking last month?"  She finished charting something on her laptop and closed it.  "Two reasons.  First, your body wasn't ready for this yet.  I sincerely think that the reason why you haven't started losing weight is because your metabolism isn't used to looking at protein for its energy source.  Your 'engine' isn't rigged to run on that fuel.  We want to change that, and the single best way to force your body to go looking for protein instead of fat for fuel is to push it physically.  In your case, we only need a little push to start that engine again."  We shook hands, briefly discussed seeing her again in another month, and I started down the hall to the psychologist's office.  At the last second, I turned around. "Wait.  What was the second reason?"

The physician smiled at me and said, "Baby steps.  I'm interested in your success, and we have time to go slow.  That means only asking you to take small steps, even when I think you might be able to take larger ones.  I ask you to take a step so small that it doesn't even feel like a step and I still get progress.  Safely."

I smiled back.  "Baby steps."

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"Listen, before we get started, can I ask you kind of an important question?

I was sitting in my psychologist's office now, nestled in one of those suspiciously well-appointed chairs.  Something had been bothering me.

My psychologist leaned back in his chair, smiled, and said, "Shoot."

"How the hell do you pronounce your last name?"

That elicited a laugh. "That's your important question?"

I nodded. "Yeah.  People say my last name wrong all the time.  I'm used to it, but it still bothers be a little.  I like to learn people's names if I think I'm going to be spending a lot of time around them."  Then I pursed my lips a little.  "As I'm sitting here, I'm coming to grips with the fact that I'm probably going to be here for a long time while we work this out.  The polite thing to do is at least learn your name."

The psychologist smiled again, very gently. "You're worried that this isn't working.  That's perfectly understandable, especially in your situation."  He took a moment to study me again before asking, "How much time do you spend thinking about what your sleep specialist said to you?"

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Back in 2016, I almost killed myself driving home from a visit with my family in Ottawa.

No, not like that.  Maybe I should rephrase.

Back in 2016, I nearly got myself killed driving home from a visit with my family in Ottawa.

I remember it happening vividly, which is kind of ironic given my current mental and physical state.  I'd been exhausted for...I couldn't remember how long.  Years, maybe?  I'd learned to deal with it, or at least I thought I had.  At the time, I had no idea how much my lack of sleep was slowly eroding my cognitive processes and decision-making abilities.

All I knew on that drive home was that blinking felt amazing.  Blinking felt like...cool water on a hot day.  And I was on a straight stretch of highway, with my cruise control on, and I could blink over and over and over again.  I could even blink for extended periods of time...

The road was straight.  It made perfect sense.

The texture on the shoulder of the road ended up saving my life.  That thing that sounds like you're running over a really angry 8-bit video game frog that's the size of a house?  That's what woke me back up.

My wife and one of my best friends -- the respiratory therapist, oddly enough -- had been begging me to go have a sleep study for months.  Maybe longer.  They knew something was wrong.  I didn't disagree, I just...didn't think it was wrong -enough-.

The noise from the shoulder of the road crystalized a few things in my mind as soon as I opened my eyes.  Between one second and the next, several things snapped into focus, another remarkable feat considering my weariness:

1. I should be dead right now.
2. Someone else should probably be dead too.
3. That someone could have been my wife.  Could have been my nieces and nephews.  Could have been my friends, or their brand new baby girl that they worked so hard to concieve.
4. It's time to get off the ride.

I'd always told myself that I would live life on my terms, however I wished, until something gave me a sign that it was time to start doing it differently.  I would ride the ride until I could no longer.  Then, after I'd had a good long run, I'd start doing it the other way.  I always assumed that the sign would be something less...

Permanent.

I went to go see a sleep specialist the next week. They gave me a briefcase full of hardware and instructions to put it on. Then they sent me home to get a good night's rest.

For the record, anyone who has ever done an at-home sleep study will know how much of a goddamned joke that is.  You don't get a good night's anything with a monitoring box the size of an old-school Gameboy strapped to your check, two nasal cannula strapped onto your nose, a blood ox sensor on your finger, a heart-rate monitor strapped to your chest and your belly, and wires running everyfuckingwhere. Still, I somehow managed to bag around 8 hours of sleep that night.

I woke up the next morning, packaged the equipment back up, and returned it to the sleep center.  They assured me that someone would download the telemetry in the next day or two.  The results would be analyzed and a report would be generated in about a month, at which point I'd get called back in to discuss them.  I thanked them for their time and went home.

Two days later, I got a call back from the sleep center.  They very politely requested that I come in to talk about my results.  Right now.

What followed was one of the fastest trips I'd ever made on the highway in my car, and a rather terrifying half hour with a sleep doctor.  He informed me, shocker, that I had sleep apnea.  Badly. Really badly.  Like one of the worst cases he'd ever seen.  I made the mistake of asking, "How bad is bad?"  That's when he brought the science out.

- Most forms of sleep apnea are caused by either nasal blockage of some sort or body mass compressing the airway.  Translation: You're so fat that your throat is collapsing on itself when you lay down.  Except that wasn't my problem.
- In extremely rare cases, sleep apnea can be caused by the brain failing to send strong enough signals to the respiratory system once a person stopped voluntarily breathing during their waking hours.  Translation: You go to sleep, you stop breathing. That was my problem.

'Hooray,' I thought.  'I'm a statistical anomaly!'  I might have thought something else but the doctor kept coming at me with the science.

- Out of the eight hours of sleep that I thought I got, my body processed less than two.
- Out of every sixty seconds, I was only breathing for about 20.  Which meant...
- Every hour, I was experiencing around 60 low oxygen events.

I was literally suffocating in my sleep.  

In an attempt to keep my body alive, my brain would panic and cause me to seize violently in bed on occasion, forcing me to wake up and start breathing voluntarily again.  My wife thought this was hilarious the first few years of our marriage.  She says it got old after that.  Then it got scary.

"I sort of need to sleep," I said dumbly.

"I'm aware of that," the doctor responded, deadpan.  Translation: Stop talking and let me finish.

I was given an auto-titrating CPAP rig, a full face mask, and told that under no circumstances should I ever spend less than three hours a night wearing it.  For possibly the first time in my life, I did not argue with a doctor.

For the first time in longer than I can remember, I went home that night and slept like a baby.

That's how I missed Iron Mike Tyson rolling up to my house, walking into my bedroom, and using my entire torso for a punching bag in the middle of the night.  I don't remember it happening, but that's the only explanation I could think of to explain how I felt the next morning after around a nine hour snooze.

I was MISERABLE.  From my guts to my forehead, I felt like someone had beaten me.  A lot.  I felt bruised, battered, sore, stiff, and a bunch of other less flattering things.  

Eventually, I convinced myself that I had to get up.  Which is to say, my bladder convinced me that I had to get up.  I had to get up about an hour prior to that, I was just in so much pain that I didn't really want to move.  All I wanted to do was lay in bed and try not to breathe.

The irony is not lost on me.

Eventually, I summed the willpower to pull my mask off -- Jesus, shut the thing off first!  SO LOUD! -- and then I rolled over, sat up like a spring-loaded mouse trap, and abruptly crumpled out of bed and onto the floor.  Neither of my legs was working properly.

A very small part of my brain started to panic at that point.  Fortunately, the remaining ten percent was on hand to begin analyzing the situation rationally.  "Fear is the mind-killer," I mumbled.  Had I suffered a stroke during the night?  Had my lifestyle finally caught up to me on the morning after I decided to do something about it?   One by one, I began testing my extremities.  I could move them all -- I'd sat up in bed after all, and I remembered having to use my arms to do that. -- but they all felt oddly...disconnected.  Like I was moving them under water, without the resistance that comes with it.

Then the reality of the situation hit me right between the eyes and I began to laugh hysterically.  

I was well-rested!  Not just well-rested, I was brimming with energy compared to my life over the last several years.  My limbs worked perfectly, it just took considerably less effort to move them since I actually had excess energy with which to do so.  I was so unused to moving my limbs at full energy that I was physically uncoordinated.

Also, my bladder was screaming at me.

Urination is the mother of invention.  I figured out really quickly how to crawl into the bathroom and used the sink and toiled to haul myself to a seated position.  Then, after I'd gotten situated and the requisite evacuation had started, I began playing with my arms, marveling at the experience of the whole thing.

After about a year, my bladder finally registered empty.  I reached down, grabbed my drawers, and promptly stood to pull them up.  At which point my legs gave out on me and I crumpled into the wall.  Again.  With my pants around my knees.

Not for the first time that morning, I was glad that my wife was already gone at work. 'This isn't the first thing she's walked in on though,' I thought.

I ended up belly-crawling down the stairs that morning and taught myself how my legs worked again in the privacy of my living room.  It took me about an hour. The entire time, my torso was screaming at me.  Turns out, my ribcage wasn't used to taking full, deep breaths of air for prolonged periods of time.  None of the bones or tissue were used to it.  They were all sore from being used fully for the first time in... a long time.  The enormity of that situation sat with me at the kitchen table while I ate breakfast that morning.

Three weeks later, in mid-November, I was told to report back to my sleep doctor, who would be introducing me to a cardiologist.  They went over the telemetry from my CPAP and were both universally pleased with how the machine had appeared to compensate for my brain's lack of vision.  As long as I continued to use the machine, I would be okay, but I would be using it for the rest of my life, however long that was.  Both doctors expressed amazement that I was still alive at that point, and that I hadn't had a heart attack or suffered some kind of injury as a result of falling asleep at an inopportune moment.

I elected not to tell them about the blinking incident.

They warned me that they hadn't really seen anyone who had been so compromised for as long as I'd been, and that the next year of my life could be potentially interesting as my body figured out how to get back to normal.  Everything was out of whack.  Everything might take its sweet time getting back into whack.  Metabolism, weight loss, appetite, brain chemistry, all of it. No one knew when things might happen.

Or if they would at all.

Those were bridges that I would have to cross as I arrived at them.  If I arrived at them.

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I hadn't realized that I'd been studying a picture on my psychologist's wall for several moments before I murmured, "A lot."  I pulled my eyes away from the picture and looked back over at the shrink. "I think about what my sleep doctor said a whole lot."