Determined To Succeed

Last night I had the hell scared out of me.

I had the occasion to do some catch-up with a friend of mine over dinner last night. It was a cool and casual dinner, and a few delicious happy hour pineapple martinis and mini-burger and egg roll appetizers were consumed. It was great, that is until my friend told me about a friend of theirs who had recently had a stroke, two of them, in fact…

…and he is only 38.

That news hit me like a ton of bricks. A guy who is ONE YEAR YOUNGER THAN I AM has had two strokes and is now dealing with the realities of recuperation and recovery from them, and he’s only 38.

“A year younger than me,” I thought to myself, ““My God, that guy could have easily been me by now.”

While the evening continued on for at least an hour past that piece of news it never left me. It sat next to me the rest of the night. It made me put down the appetizers and the martinis. It sobered me up and followed me home when the catch-up was over. As I lay in bed I thanked God, my lucky stars, guardian angel, mom, fate, destiny, karma and everyone and everything else I could that I was alive and well enough to be able to do the things I do these days. It is not news to you guys that I firmly believe my quality of life would have suffered severely if I didn’t lose weight and had remained 400 pounds. I had high blood pressure that would have kept going. I had arthritis that would have gotten worse with age. I had sleep apnea causing me to stop breathing during sleep. I might even be dead.

When I got up this morning I was still very troubled by the news I’d heard. I was also curious about obesity and the roll it plays in strokes.

For those of you lucky enough to never have known what a stroke is, a stroke occurs when there’s a problem with the amount of blood in your brain. The cause of the main type of stroke — ischemic stroke — is too little blood in the brain. The cause of the other type of stroke — hemorrhagic stroke — is too much blood within the skull.

About 80 percent of strokes are ischemic strokes. They occur when the arteries to your brain are narrowed or blocked, causing severely reduced blood flow (ischemia). This deprives your brain cells of oxygen and nutrients, and cells may begin to die within minutes. The most common ischemic strokes are:

• Thrombotic stroke. This type of stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot usually forms in areas damaged by atherosclerosis — a disease in which the arteries are clogged by fatty deposits (plaques).
• Embolic stroke. An embolic stroke occurs when a blood clot or other particle forms in a blood vessel away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus. It’s often caused by irregular beating in the heart’s two upper chambers (atrial fibrillation). This abnormal heart rhythm can lead to poor blood flow and the formation of a blood clot.

“Hemorrhage” is the medical word for bleeding. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Hemorrhages can result from a number of conditions that affect your blood vessels, including uncontrolled high blood pressure (hypertension) and weak spots in your blood vessel walls (aneurysms). A less common cause of hemorrhage is the rupture of an arteriovenous malformation (AVM) — an abnormal tangle of thin-walled blood vessels, present at birth. There are two types of hemorrhagic stroke:

• Intracerebral hemorrhage. In this type of stroke, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging cells. Brain cells beyond the leak are deprived of blood and are also damaged. High blood pressure is the most common cause of this type of hemorrhagic stroke. Over time, high blood pressure can cause small arteries inside your brain to become brittle and susceptible to cracking and rupture.
• Subarachnoid hemorrhage. In this type of stroke, bleeding starts in a large artery on or near the surface of the brain and spills into the space between the surfaces of your brain and your skull. This type of hemorrhage is often signaled by a sudden, severe “thunderclap” headache. This type of stroke is commonly caused by the rupture of an aneurysm, which can develop with age or be genetically inherited. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow to parts of your brain.

A transient ischemic attack (TIA, or ministroke) is a brief episode of symptoms similar to those you’d have in a stroke. The cause of a transient ischemic attack is a temporary decrease in blood supply to part of your brain. Most attacks last just a few minutes. However, in contrast to a stroke which involves a more prolonged lack of blood supply and causes some permanent damage to your brain tissue, a TIA doesn’t leave lasting effects to your brain. Still, if you’ve had a TIA, it means there’s likely a blocked or narrowed artery leading to your brain, putting you at a greater risk of a full-blown stroke that could cause more permanent damage. If you’re having a TIA, get emergency medical treatment and make sure your regular physician knows about it.

Why am I telling you guys this heavy stuff today? Because I want to scare the hell out of you, too. Why? The higher a person’s degree of obesity, the higher their risk of stroke — regardless of race, gender and how obesity is measured, according to a recent study published in Stroke: Journal of the American Heart Association who said the higher a person’s degree of obesity, the higher their risk of stroke – regardless of sex or race.

However, stroke is more likely among obese blacks than obese whites. Hiroshi Yatsuya, M.D., Ph.D., study lead author and visiting associate professor at the University of Minnesota in Minneapolis and colleagues followed 13,549 middle-aged black and white men and women in four U.S. communities from 1987 through 2005. Participants started the study free of cancer and cardiovascular disease.

During the follow-up period of about 19 years, 598 ischemic strokes occurred. The researchers calculated incidence rate — the number of new cases per 1,000 people per year — according to groups representing different degrees of obesity, using each obesity measure.

They found that incidence rates differed substantially between whites and blacks. For example, the stroke rate in the lowest BMI category was 1.2 per 1,000 person-years for white women and 4.3 per 1,000 person-years for black women. The rate in the highest BMI category was 2.2 for white men and 8.0 for black men.

“Black women had about three times higher incidence of stroke than white women in the lowest as well as in the highest BMI categories,” Yatsuya said. “But the correlation between increasing stroke incidence and increasing degree of obesity was apparent in both races and genders.”
“Since individuals with higher degrees of obesity tended to have higher blood pressure levels or higher diabetes prevalence, we further examined the relationship between the degree of obesity and ischemic stroke incidence by statistically adjusting for difference in blood pressure of diabetes status attributed to the degree of obesity,” Yatsuya said. “That significantly weakened the associations, suggesting these major risk factors explain much of the obesity-stroke association.”

My friends, strokes remain among the top five leading causes of death. The Archives of Internal Medicine published a study showing that people who are overweight by 20% or less carry a 50% increased probability of suffering a stroke. The study also explained that being more than 20 percent overweight carried a risk that was twice as high. Because of these statistics, it’s important to know how weight and strokes are related. The tell-tale effect is that extra weight affects arteries by narrowing them. With narrowed arteries, it becomes easier for blood clots to form, which could cause a stroke later on. The narrowing of the arteries can be compounded by hypertension, low exercise level and a diet that contains a lot of cholesterol. Unfortunately, some (but certainly not all) overweight people don’t exercise regularly and eat high-cholesterol diets, which increases their stroke risk dramatically. On the flip side, healthy eating habits and exercise can decrease your risk of a stroke later on.

As I sit here and type I am looking out of the stop sign-shaped window next to my desk. I am looking at the blue sky above (which has, at most, a very few whispy clouds floating through it) and I feel as though I’ve woken up from a nightmare. Losing weight has had a dramatic effect on my life to say the least. However, I realize I have been concentrating on the effects you mostly see and feel, not necessarily on the effects you DON’T see: like how much I’ve prolonged my life and like how much I’ve dramatically reduced the chances of strokes, heart attacks and diabetes all by losing the weight I did. Sometimes good can happen when you cannot see it and these positive effects are there the more you see your numbers come down on the scale.

Having the hell scared out of you may add grey hairs to your head, but sometimes being scared is a good way to avoid being scared to death. Know what I mean?

All you can eat.

All of us have heard of that offer and most of us have taken advantage of it at one time or another taken advantage of it either at office parties, salad bars or restaurants like Old Country Buffet. I have friends who think buffets are great and others who think buffets are nasty and to be avoided at all costs. But no matter which way you slice your ninth dinner roll, “all you can eat” is one of the biggest problems facing our country today particularly in our fight against obesity.

My first experiences with “all you can eat” came when I was a kid. My mom used to take me to a small place in Hyde Park called the Cafe Enrico on 53rd Street. From what I remember it was pretty cool and being a kid I thought it was the pinnacle of fine dining. And on Friday nights this treasure from my childhood served an “all you can eat” fried perch dinner. Living without much money meant this was a wonderful option for us to not only eat out but also eat well, and we took full advantage of it.

Again…

…and again…

…and again.

I remember one time in particular when I got three helpings of that delicious deep-fried perch. Hell, I even think I pissed off the waitress at the time because I remember seeming annoyed she had to keep bringing me slices of this culinary delight.

As I grew older, “all you can eat” took on different forms. I loved (LOVED) my Chinese food “all you can eat” buffets. Oh My God, are you kidding? They are delicious to me. Deep-fried orange/spice chicken, rice, beef with peppers – yummy. I could eat all day. But most notably in my life was Old Country Buffet. My mom loved eating at Old Country Buffet for the exact reasons I loved eating at Cafe Enrico. If you have ever been to an OCB you know they serve lots (AND I DO MEAN LOTS) of foods that are not that healthy for you. But it was cheap and mom liked it (and so did I) so we ate there again…

…and again…

…and again.

As we have become the heaviest nation in the world I am reminded of the “endless bowl of soup” parable I heard while attending One Day University recently in New York. Amherst professor Catherine Sanderson told us about the study of people who were given a magic soup bowl which was rigged from the bottom to always fill with soup no matter how much the consumer ate. At the end it was found that people using this “endless bowl of soup” at  two- to three-times as much as people whose bowls were allowed to empty. This proves that not only the attractiveness of food but also portion size influences eating decisions in our country.

And in this economy I can’t say I completely blame us for wanting a “bigger bang” for our buck.

But you guys know as well as I do quantity does NOT equate to quality.And just because you can have three or four plates of crap doesn’t mean you are eating well. It just means that we, as a country, are eating to excess.

My mom always did the best for me she could and I know that. I actually feel horrible writing about these times with my mom going to Friday night “all you can eat” perch nights because they are treasured memories with my her (and some Pac-Man games were thrown in there, too). However,  it is part of why I became an obese child. I am sure that part of what drives families to places like Old Country Buffet on a regular basis is that want to provide food for the entire family but it is also part of what makes families and children in this country obese as well. But we need to stop. Eating so much is slowly killing us. We are sacrificing eating healthy for sheer size and that is wrong. I am living proof of it. Or should I say my high blood pressure, sleep apnea and aching joints were proof of it.

If I do eat “all you can eat” these days it is at a salad bar and I only have two helpings at most. Not just because I get fuller faster now but because I give my brain enough time to register that I have eaten and I am getting full. I make the conscious decision to walk away and not go for a third or, mom help me, fourth plate. And I know that making smarter choices like these equates to one thing…

…I know I will be living a much longer life.

Am I here to tell you never to eat “all you can eat” ever again? Certainly not. There will always be people in your life who love the Old Country Buffets of the world (I love you, mama). But if and when you can use the money you’d spend and go to a grocery store. But fruits and vegetables. Make meals at home. Create a yummy soup that could last for days. Put yourself at the top of your priority list instead of your wallet.

By doing that you’ll not only help your waist line (and our collective American waistline) but you’ll be able to enjoy life’s many wonderful foods for many more years to come.