ouroborous

So at this point I'm 90% plus sure it's not gout. I asked my Mom when I saw her this weekend, and she said that I'd been mistaken; she does NOT have gout. My Dad has it, but it tends to follow maternal genetics more, and his kidneys are failing due to advanced congestive heart failure, so gout isn't too surprising, sadly. Add to that the fact that simply not working out for a few days caused the pain and stiffness in my hands to completely vanish, and I think that the pain in my hips may be due to incorrect form when doing my crunches in the morning, and I really think that my wounds are self-inflicted. Regardless, since my insurance rocks and my doctor ordered the blood test, I got a draw this morning to test ureic acid levels, so I'll know for sure in a few days. Bottom line, I think I've been overdoing it (and using bad form). Now, I need to figure out how to do crunches so they don't hurt my hips and low back!

It's too cute for us guys... *must* *hide* my *eyes*

OK now I'm speechless...

Actually from what I can tell, lunges are kind of the gold standard for "safe, effective leg training" for us non powerlifters. And I have to say: a well performed lunge (good form, etc.) with weights is actually ten times as hard on my quads and hamstrings as 200+ on the bar on the smith machine. And they don't make my legs hurt! (Also, I've discovered that many of the "hardest" poses in yoga seem to just be modified lunges; warrior pose, anyone?)

Please remember that there are men on this forum (many of us with the first "normal" hormone levels... ever) who may be inflamed by sight of an LBD. We are not responsible for the consequences...

I hear you and I definitely share your frustration. Now that I'm much closer to the end of my weight loss journey than the beginning of it, I'm pretty much ALL plateaus. Technically I still have about 19 pounds to lose to be at a "normal" bodyweight, and my current goal is about 14 more pounds (I weighed in at just over 216 today, and I'd like to get to around 200-205, which would make me still overweight, but only just barely, according to the BMI charts). That being said, my body fat % is at about 20% and dropping, which is, frankly, pretty damn good for an American guy in his (early) 40's who works at a desk job, especially when you consider that my BMI was nearly 45 before I started (I have no idea what my body fat percentage was, but I'm sure it was just a horror show). I know that these last 15 pounds are going to be harder to lose than the first 120+ pounds were put together because my body is now in a constant fight with me over every single calorie, and the level of dedication required to "get there" is such that I am almost having to completely reinvent who I am as a person in order to even try to hit my goal. But the nice thing is that with the sleeve, I know I at least have a shot at it. Before the sleeve, no way Jose. But it wasn't all wine and roses on the way down, either. I hit a mini-plateau at around 250 where I thought "well, that's it, I'm done. I'm still obese, and I can't lose any more weight." This stall lasted several weeks, if I recall. I tried everything I could think of -- more Water, less water, more Protein, less carbs, the "pouch reset," more exercise... everything. Nothing made a difference. And then, right on the tail end of a vacation (where I wasn't eating great -- I was on vacation! -- and I even had some beer), I get home and BAM... 10 pounds gone. And then it just started melting away again, without me seeming to change much of anything. What changed? Who knows... some complicated internal body chemistry thing; I wasn't anywhere NEAR "goal," but for some reason, right around 250 lbs, my body suddenly freaked out and said "MUST... STOP... LOSING... WEIGHT!" Bottom line is that you have to have a little faith. The faith is, for me, in science and statistics: if you do the right things (be mindful of your eating, try to drink enough water, try to move as much as you can, get good sleep, etc.) and have patience, you WILL get down to at or near a "normal" BMI... eventually. It may not happen today, and it almost certainly won't happen as fast as you want. But it WILL happen, so you might as well not freak yourself out over it in the meantime. If you're still not there and you hit a plateau or gain a couple back, do a quick reality check -- am I doing the right things? Am I eating right? Am I moving (exercising) enough? Is my diet more slanted towards protein and complex carbs than simple carbs? If that's all in order, then it's just "one of those things," and it's better to just let it go and (try to) focus on all the good things your weight loss has already given you.

Well, the thing is that I've wondered about this achy fingers thing for a while. From what I read about gout, it's pretty common, and it's the most preventable and treatable of all forms of arthritis. If I *do* have it (I have to avoid leaping to conclusions and diagnosing myself until my doctor can give the final answer, of course), it would explain a long-standing mystery in a relatively benign way. It would fit a lot of the evidence (which always makes my scientist/computer programmer's brain happy), and it's something that I could treat by doing all the stuff I'm trying to do ANYWAY (maintain a healthy weight, keep my sleep healthy and sound, avoid too much red/rich meat and alcohol, and so on). So, while my initial reaction to the thought was denial because I thought it would mean lifelong, crippling, untreatable pain, it sounds like the opposite, if I have it. It's very treatable -- often without even needing medication -- and once treated, a long-term source of pain and discomfort might just magically go away. Where's the downside in THAT?

Oh, one last thing: it's very, very normal to plateau, and it's very, very normal to regain 5 or even 10 pounds (depends upon your frame; us bigger guys can gain 10 pounds as easily as you smaller gals can gain 5). When the weight gain starts getting into the 15 or 20 plus pound range, that's when something is going wrong in your weight loss, and I'd talk to your dietitian/nutritionist/doctor/personal trainer about it.

Say it with me now, folks: plateaus are a normal part of the process. Getting stuck is a normal part of the process. I know... we don't want to hear that. I didn't want to hear that. I still hover anxiously near the scale sometimes, worried about every bleep and bloop on the number. But the fact is that the typical weight loss of a sleever goes something like this: A HUGE, exhilarating loss at first... it's almost effortless. You fart and the pounds come off. You eat good and the pounds come off. You eat BAD (which, you know, for a sleever in the early days means something like "well, last month I ate a cookie...") and the pounds come off. The problem with this early phase is that it completely destroys our sense of what a "normal" weight loss and maintenance profile feels like. This early phase where the weight just drops off is not normal. It's great, but it's not normal. Once you start getting down to what your body thinks its weight "should be" (it's actually a great deal more complicated than this; your body doesn't really have any idea what you "should" weigh, it's just that feedback mechanisms start to come into play and exert more force than the downward push from the sleeve) the loss will become slower and slower. And it isn't just a "steady" slowness; it's not like your body will go from 5 pounds a week to 3 pounds a week to a pound a week in a smooth progression. In fact, at times you'll plateau for days or weeks or even months (near the bottom end of the curve) at a time. At times your weight will even go up slightly (slightly: a prolonged and significant gain is usually a sign that something is wrong, whereas a 5-10 pound gain is typically a Water weight gain or a normal plateau fluctuation). You can break through the plateau -- assuming that you're not already at the low end of body fat -- but it doesn't always happen when you expect it to happen -- sometimes you get stuck and then you cut your calories and up your exercise and nothing changes (or you even gain a little) for days at a time, and then when you give up, suddenly your body starts shedding weight again. And finally when you start getting down near or below the low end of normal body fat (for most of us, it seems like this is around 20% body fat; fat location along with factors such as age and genetics seems to determine your "realistic minimum body fat"), shedding every ounce is a lot of frigging hard work, every day, forever. Most of us have a hard time keeping up that level of dedication (else we wouldn't have been obese to begin with), so most people seem to stick around 25%-ish bodyfat, which is still technically overweight (and of course, those of us who are very self-critical will harass ourselves mercilessly over that fact) but is, in fact, much healthier than the 40%, 50%, or even 60% body fat that some of us started with. Indeed, it's healthier, on average, than most modern Americans! The real problem is that early phase, where weight loss was effortless and we could do no wrong. It's sad to say, but important to remember, that that is not the norm. The sleeve continues to be a tool, and as long as you don't abuse it too bad, you can be pretty confident that you won't spiral back into that morbidly obese category. But it's not zero work, it's not effortless. You have to start really working it after a point, and the lower your body fat gets (remember: measure body fat, NOT weight -- weight can fluctuate by as much as 4 or 5 pounds *in a single day* due to water weight changes) the more you're going to hit plateaus, of longer and longer duration, and maybe even see some backtracking. The great thing about the sleeve is that even if you gain a few pounds, unlike before you can be pretty confident that you can get rid of them pretty quickly with a little self-discipline. Sorry for the long post, but it seems like a lot of people have sort of unrealistic expectations about life with the sleeve, and then whenever they see a blip on the scale they freak out and assume all is lost. It's not lost when you plateau or rebound a few pounds. It's completely normal.

Interesting: http://www.beatinggout.com/2009/04/gout-and-the-sleep-apnea-connection/ Apparently sleep apnea (which I know I have, and which I'm not sure is under control) is strongly correlated with gout (of which I have a family history). I don't have any of the other risk factors -- diabetes, metabolic syndrome, etc. -- but the only-barely-treated sleep apnea plus the family history might just make this worth looking into. Thanks for the tip; I'll be sure to follow up with my doc after he gets back from vacation.

Yeah, I don't actually know for sure that my levels were fine; all I know is that nothing was mentioned on my last blood tests. If you can have gout without high ureic acid on the blood tests, how on earth can they diagnose it? I thought high blood levels of ureic acid was the definition of gout... I need to go do some research!

This could definitely explain the aching hips and back; I AM using the same mattress that I had before losing the weight. Not only that, but when I got the mattress, I was so tired of having to buy a new mattress every year (because my whale-like body would carve a huge canyon into it otherwise!) that I got one of the hardest mattresses I could find. I've had "buy a new, softer mattress" on my to-do list for a while now. I still don't know if that can explain the finger stiffness, though.

Heh, thanks for the tip. I suspect I don't have gout since my last blood tests came back fine, and I know they tested my kidney function (which I assume would include ureic acid). Just on the off chance, however, I emailed my doc to ask him (gotta love doctors available by email). It doesn't hurt to ask, right? If I have gout at 41, I will be extremely pissed off.

Good recommendations; I'm basically taking ZERO time off for healing. I think I need to find a way to work this into my schedule (without letting it become just another excuse for slacking off, of course -- I'm really good at that!)

Yeah, I'm doing cardio basically every single day because the kind of low-impact, high-intensity cardio I do I'm pretty sure isn't going to cause any problems, and I honestly think that unless you go insane with it, you CAN'T overdo it on cardio. I also do a body weight calisthenics style routine every weekday -- pushups, lunges, crunches -- and I don't think those are going to cause any lasting problems since I do them with body weight only and try to focus on good form. It's just the weight training that I think I need to regroup with and focus on good form and high intensity, rather than doing the training every single day. It's hard because I'm enjoying bulking up and getting leaner, and so I naturally want more. But sometimes I think maybe less really is more!

Sadly, I don't have access to a free weights bar; all I have is a smith machine, so I can't drop the bar if it's too much. This is one reason that I've been very careful to avoid putting too much weight on it; I want to add strength and bulk (and I agree, ultimately to add muscle bulk you need to lift heavy) but not at the price of blowing out my back or knees...

What a great and inspiring story! Keep up the good work!

I'm two years out, lost almost 130 lbs. Definitely considering the tummy tuck; I don't NEED it, but when you've lost this much weight and feel as generally good about yourself as I do lately, it sucks to have that one last area that you're embarrassed for other people to see. All the other "problem areas" of my anatomy can be corrected with just exercise and hard work, but the tummy isn't going away without a visit to the good doctor.

To switch off my "wannabe doctor" mode for a moment and put on my "regular human being" mode -- I felt a LOT of the exact same emotions as you, leading up to the surgery. In fact, even AFTER the surgery for about a month, I had lots of "oh my god, what have I done to myself!" moments. But that passed quickly and the weight just started falling off effortlessly. And this time, it's STAYED off. And if you had to ask me what my biggest regret about the sleeve is, I'm sure lots of people here would have the same answer: my biggest regret is that I didn't get this surgery a long time ago!