February 12th

Waiting for the staff to call me back to put on a little drafty gown for my annual [or biannual or so...] physical, I filled in about half the questions on the five page questionnaire they had mailed me. Much of it was lifestyle related, and I had questions before I answered their questions.

In the back when Doc Cody came in [not his name] I had the questionnaire and I had a printed out list of issues I had, but the first thing I did was ask him straight out, "Doc Cody, much of my life is coloring outside the lines. What I do is legal but beyond what is acceptable to most folks. What do you feel you need to write down and what do you feel you don't need to? It will affect how and what I ask and tell." To his credit, he sat his pen down, put the questionnaire aside without a glance, and told me that I could comfortably tell him anything and he would only write down what was absolutely medically necessary. It isn't just a matter of luck - I researched and interviewed when it was time to chose a doc under my medical plan.

Much of our day was spent discussing issues related to weight. When I quit smoking 9 years ago, in my early 40s, I weighed around 180-190 lbs. Over the next few years it happened gradually. My eating intake didn't change much, although I did become more and more sedentary as my ankles and knees got more and more painful. The normal metabolism changes that occur in your 40s apparently occurred along with all the other contributing factors and I weighed in today at 269. I asked them to discount it for clothing and shoes but they weren't buying it.

We discussed a liposuction for medical reasons as opposed to aesthetic reasons. I can't help but think if we can jump start the weight loss with 20 pounds or so, I could keep that momentum. We discussed exercise - I can't do impact, even distance walking is agony - and he mentioned that whatever non-impact exercise I started had to be for 60 minutes at a time. Apparently the first 30 minutes uses your regular calories and the second 30 minutes is more of a catabolism, and with a stable calorie intake can lead to weight loss. I've decided I need to find someone with a stationary bike that they want to get rid of cheap, and I'll put it in front of my computer. I figure if I can't get up in the middle of the night to piss without checking new mail, an exercise program right there is the most likely to be done. We also decided on a med change, adding one new one to an existing one, as the combination has had a documented good effect on weight loss. The new one has a sedative side effect, so I may start getting over 3-4 hours of sleep at a time. I'm cooking more stir fry, more steamed vegetables, smaller meat portions, changed to rice bran oil for cooking.

Even though it isn't in the formulary for my HMO Doc Cody gave me a renewal subscription for Viagra which I pay cash for outside the HMO. At the end of the appointment I found out that he needed some fasting labs and I had had breakfast so I'll have to come back in a few days for a 12 hour fasting draw. I got the x-rays they wanted ["No, I'm sorry. Those nipple rings are permanent. You can tell whether or not I am developing congestive heart failure with a couple little ring silhouettes in the picture." ... "I said no, they don't come out!"] and I headed on home.

It's late, but I'm trying to take some steps to ensure that live will continue good for this slut. I do have concerns, but I've always taken the long view and would really like to be able to continue to. Anyone out there got an exercise bike they aren't using?

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