One of my friends was recently in Joplin for an appointment. She had arrived early and decided to visit a Main Street store. I won’t name the store she visited because I know many stores have employees who do the exact same thing. This friend of mine has lost more than 30 pounds this year. She was browsing through the clothing racks when a sales girl approached and informed her, “The store doesn’t have anything in your size, the sizes only go up to XL and you’re a lot bigger than that.” My friend was mortified!! That young woman was extremely cruel in her comments. She did a great disservice to her employer, not only will my friend never re-enter that store, but I won’t shop there either. Additional future non-shoppers will include those women my friend warns about the store so that the mean sales person does not ambush them unexpectantly. So, even though she could not have found anything to fit herself in that shop, she sometimes purchases gifts for her daughter who is a size medium, but she will never purchase a gift for her daughter there.

I decided to blog about the store incident because while I was sharing the story with my mother she became so angry with the young woman for saying such mean and cruel things to my friend. Looking at it from the point of view of someone spoken to that way (I have had similar experiences), I believe it was wrong and in bad taste.

Why would anyone have a bad attitude towards overweight people? Could it be that a previous overweight person became enraged because she could not find anything in the store that was her size? Could it be that a previous overweight person complained to her in a hostile and cruel tone what a waste of time it was to walk all the way from a distant parking place, because she couldn’t park directly in front of the store, just to find out they didn’t carry her size. I don’t know what would trigger a young woman to treat a prospective customer in an unwelcome manner, but lots of people don’t like serving overweight people.

I remember the inspections my food would receive when I went to eat in a restaurant. I remember not being capable of fitting into an amusement park ride. I remember not being capable of fitting into the waiting room chairs at the doctor’s office. I remember not being capable of fitting into the dentist’s treatment chair. I remember having to shop online for my clothing because size 32 was not carried locally. I remember sleeping in an oversized recliner because I couldn’t breathe if I lay down in my bed. I remember not fitting into the bathtub. Even attempting to sit in the tub would have been a big mistake, how would I have gotten out?

My point? I caused people more work when I was obese/overweight. I consumed larger portions of food. I had to have a table, could not fit into a booth. I had to stand in the waiting room or risk the chance of getting stuck in a chair; so special chairs would have to be purchased to accommodate me. The arm of the treatment chair at the dentist’s office had to remain in the up position because of the width of my hips, and then I didn’t have anywhere to place my right arm. Furniture wore out faster, and then we would blame it on sloppy construction of the furniture. Let’s face it, when I was overweight, more material was needed for my clothing, more sturdy materials were required for the furniture I used, more space was required when I went anywhere. My hips and knees would cause me extreme discomfort if I stood or walked very far or very long, so I couldn’t endure long waits and I am pretty sure I was probably cranky a lot of the time.

So What? After a great deal of thought and consideration I have decided, it is not nice to be impatient with anyone, EVER. I understand the pain my friend experienced because of the words spoken by the young woman. I also understand the frustration of the young woman who may have had to deal with cranky overweight women in the past. She has probably had just as many cranky non-overweight customers to serve, but she likely put up with them because in her mind she was more likely to earn commission money off of them.

What keeps us up at night? Even when you go to bed at a reasonable hour, how many times do others interrupt your sleep? I have no problem with sleep, but Chris does. He is a light sleeper and the slightest noise disturbs him. He uses earplugs, but they fall out while he sleeps, so he is frequently under-rested.

Last night, a Friday night, our 17-year-old had been at my mother’s house helping her with a few chores and then she fed him. My mother had bagged for freezing a mess load of corn on the cob. Her freezer is already full to overflowing. My mother was raised in the 50’s by parents who had grown up during the Great Depression era, so my mother is unable to stop her OCD habit of “stocking up” on food for when times get tough. Her pantry is always full and it would take her an entire year to use up all the supplies in her large upright freezer. So, since she has used up the entire stocking up space in her freezer, she now stores things in my under-used freezer. Actually, I have an extra refrigerator in my basement for spare milk, butter and eggs. It also contains the remainder of a cow we had processed a couple of years ago that was ruined by the loss of power during the ice storm last year. Our OCD problem with food is “can’t waste it”. My particular “don’t waste food problem” is linked to starving Chinese people. I learned when I was a little girl, if I wasted food or didn’t clean up my plate, a bunch of children in China would be made to suffer starvation. How do you dispose of frozen beef? It seems wrong somehow to just throw it out, but it would be reckless to eat it, and if it would be reckless for us to eat it, we can’t feed it to our dogs or cats either. It is a quandary. My mother’s corn was placed in our small chest freezer, there’s plenty of room to spare since we don’t stock up on stuff.

Back to the story, Robert came home at midnight. The house was locked up. Robert has a key to the house, but he had left it in his car. He knocked and knocked on the back door until Chris finally got up out of bed to find out who was knocking on the back door. Chris opened the door, discovered it was Robert, and then asked Robert, “Why didn’t you use your key?” Robert responded, “I left my keys in the car.” Chris questioned, “Why didn’t you bring your keys so that you could get into the house?” Robert, “Because my hands were full.” (He was toting two or three Wal-Mart bags full of ears of corn that had been placed in freezer zip lock bags) Chris, “Are you going to leave your keys in the car all night?” Robert, “No, after I put the corn in the freezer I’m going to go out through the basement and get my keys.” Chris ends most every conversation with Robert the same way, closes his eyes, shakes his head and then comes and tells me “I worry about that boy sometimes.”

Robert will be 18 soon, we wonder about the way he reasons things through. His plan was to carry in the freezer bound food, get someone to unlock and open the back door for him, he would then place the food in the freezer, unlock the downstairs door and get his keys out of his car and then return to the house. What kind of reasoning is this? Door is locked; hands are full, go back for the keys later? The good news is Robert is a senior this year, which gives us one more year before he gets launched out into the world to make his own way.

Fatigue is one of the common causes of overeating. Fortunately for Chris, he is way too active to ever allow his appetite to cause his weight to escalate.

The top loser using the 28-day program dropped 10 pounds!! We had a little club challenge on the Jacob’s Ladder last Friday, the top climber on the ladder was Kim Webber. She was able to sprint 205 feet in only 2 minutes!! The challenge was to see who could climb the greatest distance in 2 minutes.

This past week I received my Zumba training kit. I had never heard of Zumba until this past month. Group exercise set to music is great and I have learned to like it as much as any normal person could possibly like group exercise. I lead a boot camp style program, but with fall coming and the dancing style routines are gaining popularity, I gave in and purchased the training kit.

I’m thinking we will have to add mirrors to the group area, it will be difficult to teach the routine without mirrors. I’m not real crazy about exercising in front of a mirror. I’ll have to come up with an arrangement of the mirrors that creatively keeps everyone comfortable.

First I want to provide an update of the losers. The average loss is turning out to be 2 pounds a week; except for one of the ladies who is keeping all the rules and following the exercise plan, she has dropped more than 8 pounds!!! I am so proud of all the participants because they are proving that when you combine moderation with accountability you get positive results. If anyone is interested in trying this 28 day program, it will soon be available for download at our website (www.neoshofitness.com) (free by the way).

I was reading Dr. Gott yesterday and my “what the” meter was triggered. Here are the highlights:

· 76-year-old HEALTHY woman
· Recent lab blood tests were normal
· Routine fecal occult test was taken
· Blood found in fecal slides
· Gastroenterologist performed colonoscopy
· Gastroenterologist performed endoscopy
· Gastroenterologist performed capsule endoscopy
· All three procedures proved negative (NOTHING WRONG)
· Now same woman 78-years-old still HEALTHY
· IDENTICAL tests repeated
· IDENTICAL test result
· IDENTICAL same procedures performed colonoscopy, endoscopy and capsule endoscopy
· IDENTICAL NOTHING WRONG results
· Two physicians participated in figuring out her problem this time.
· HEALTHY woman is WORRIED because blood was found in her feces and two doctors and a specialist could not explain to her the cause of the bleeding or if she should be doing something to make it stop.

Dr. Gott told the woman the two most common causes of blood in fecal occult testing is hemorrhoids and anal fissures.

The questions this woman should have asked Dr. Gott:
1. Why was a healthy 78-year-old woman put through so much, for nothing?
2. Why didn’t the doctor simply take a look at her rectum before putting her through all of these tests?
3. Why, after two years, did her doctor put her through it all over again?

Any procedure that requires sedation is risky. Any procedure that requires exploration of the inside of the body comes with risks. I have two local examples that I know about personally:

1. A 31-year-old strong, healthy man, recently discharged from the marine corp., was experiencing some rectal bleeding. He went to see his doctor; the doctor scheduled him for a colonoscopy. The colonoscopy was performed and during the procedure his colon was torn. The tear in his colon was not noticed during the procedure and he was sent home. Diagnosis: hemorrhoids. Two days later he is in so much pain that he can hardly walk. He returns to his doctor to find out what is causing the pain. The doctor was unable to determine the cause of the pain so he was given a prescription for pain control and sent home. Next day, the pain had escalated to a level so bad he couldn’t get out of bed, he couldn’t walk. His wife transported him to the ER where no diagnosis could be made so he was sent to Joplin for further investigation. The doctor who examined him in Joplin immediately realized he was dealing with sepsis. Now they have a diagnosis, the Marine is rushed to surgery, opened up in a big way, the colon had to be removed because of extensive damage, his gall bladder had to be taken out because the infection had damaged it severely, and the tedious task of cleaning out the toxic debris (bile and fecal matter) that had been released into his body cavity. The doctor in Joplin saved his life; he spent several weeks in ICU with several life threatening complications before he was stable enough to return home. I must also tell you that the recovery from this was not easy. This former Marine, with a wife and two young children, over six feet tall and formerly a muscular 210 pounds, is now sporting a colostomy bag, weighs barely 140 pounds, and he is still unable to return to his job as a construction worker. All this damage was done because his doctor didn’t bother asking him to pull his pants down and take a look at his rectum to see if there was any obvious cause of the rectal bleeding before ordering a colonoscopy.

2. A 59-year-old female with a concern about some rectal blood spotting and something that felt like a growth at the opening of her anus. She went to her doctor and explained what she was concerned about, he ordered a colonoscopy. Her diagnosis: hemorrhoid and a skin tag.

Why must a colonoscopy be ordered to get a diagnosis of hemorrhoid? The colonoscopy is an $8,0000 procedure. In both of these cases if the doctor would have had these two people pull their pants down and take a look in an area that neither one of them can look at by themselves, they could have made the diagnosis right then and there. Why don’t doctors simply take a look-see before they order all these tests? Don’t we need to be a little more frugal with our medical spending as a nation? If there is nothing wrong, do we really need so many expensive lab tests ordered to prove it?

If you have never had a colonoscopy, let me enlighten you. The preparation for the procedure is the WORST!! Two days prior to the procedure you must do a nothing but clear fluids diet. The day before you must drink this thick sweat tasting stuff. This drink is thick and nasty; it is most similar to gulping down a half cup of someone else’s sweat. You drink it first thing in the morning and then a second dose at noon. I was told I could mix it with apple juice to make it more tolerable. I don’t know if it was more tolerable mixed with apple juice because it was like drinking someone else’s sweat mixed with apple juice. Then you stay close to a bathroom and wait for what happens next. It’s not too bad in the beginning, but as the day goes on, your bottom starts to wear out. The burning and chaffing is very painful. Then the day of the procedure, you get to be admitted and placed in a room, prepped and then wait for your turn. The sedation is injected and no memory of the procedure is possible. In my situation, four years ago, I had been losing enormous amounts of blood from my rectum, so much blood that at the time the colonoscopy was ordered I was slipping into shock from blood loss. The colonoscopy revealed to the specialist how extensive the ulcerative colitis had become.

Let’s take a look at the manpower involved in this procedure:
1. Doctor
2. Operating room Nurses
3. Hospital nursing staff
4. Anesthesiologist
5. Specialist
6. Hospital kitchen staff

Let’s take a look at the resources involved in this procedure:
1. Saline solution
2. IV & line
3. Anesthesia
4. One meal prepared by kitchen staff
5. Sheets, gowns, bathroom materials

The use of all these resources runs well over $8,000. Seems like a lot of people put to work and use of a lot of material resources for a diagnosis that could have done with a visual or digital exam.

As a nation, we can no longer keep our eyes closed thinking that our insurance plan is free medical care. Insurance is not free medical care; the premiums paid by everyone are growing out of control because of those individuals who are abusing the system.

Doctors are ordering tests and procedures to rule out the big stuff that might be wrong, instead of treating the small stuff that might be wrong. If the problem is simply a hemorrhoid use an over the counter product, if the over the counter product doesn’t solve the problem then try the next level of care. REASONABLE is what we each need to be, without reasonable people making reasonable decision you end up with chaos.

The first week ended on Thursday. Two of the participants dropped 4.5 pounds. A couple of them were unchanged (that means they found balance). The others were in between half pound, a couple of 1 pound losses, a two pound loss, the point of the four week program is to get control.

How many times do you get on the scale and hold your breath hoping it isn't higher than the last time you stepped on it? Imaging four weeks when you know the scale is not going to move upwards! That is positive control. Actually, we each have control of the scale all the time, it isn't possible to gain weight on accident. You either eat too much or you don't. If my weight goes up, it may not be because I want it to go up, but it wasn't an accident either. When I don't flip the package over and take a look at the calorie count, that was on purpose. Case in point would be a couple of weeks ago, we were in Joplin and stopped at the gas station. I wanted something to snack on, I went in and found a muffin, I didn't want to know how many calories were in that stupid muffin, I wanted to eat it! But, I had to know, so I flipped the package over and discovered there were more than 800 calories in that one single muffin! OVER 800 CALORIES!!! How did they fit so many calories in such a little bittie muffin??? After I knew, I couldn't put that muffin in my mouth. I could have if I hadn't turned it over and looked at the calorie count, but not after. If I choose not to look at the calorie count, that is on purpose. If I put the food in my mouth, that is on purpose. So, you can't gain weight by accident.

I don't like it when I behave in a way to cause on purpose my weight to increase. I would prefer to behave in a way to cause my weight on purpose to decrease. Some weeks, I would prefer to behave in a way to cause my weight on purpose to remain unchanged. What I really dream of is to be in control of my weight and the control to be effortless.