Friday, August 6, 2021

"After Weight-Loss Surgery, a Year of Joys and Disappointments"/ "An airport pianist received more than $60K in tips when an Instagram influencer recorded him playing"

Jan. 4, 2017 "After Weight-Loss Surgery, a Year of Joys and Disappointments": Today I found this article by Gina Kolata in the Globe and Mail.  It seems to be the condensed version.  I found the article to be very inspirational to be more healthy.  It was also educational by learning about weight- less surgery.


It was Oct. 11, 2015, and a middle-aged man and a young woman, both severely obese, were struggling with the same lump-in-the-throat feeling. The next day they were going to have an irreversible operation. Were they on the threshold of a new beginning or a terrible mistake?

They were strangers, scheduled for back-to-back bariatric surgery at the University of Michigan with the same doctor. He would cut away most of their stomachs and reroute their small intestines. They were almost certain to lose much of their excess weight. 

But despite the drastic surgery, their doctor told them it was unlikely that they would ever be thin.

Nearly 200,000 Americans have bariatric surgery each year. Yet far more — an estimated 24 million — are heavy enough to qualify for the operation, and many of them are struggling with whether to have such a radical treatment, the only one that leads to profound and lasting weight loss for virtually everyone who has it.

Most people believe that the operation simply forces people to eat less by making their stomachs smaller, but scientists have discovered that it actually causes profound changes in patients’ physiology, altering the activity of thousands of genes in the human body as well as the complex hormonal signaling from the gut to the brain.

It often leads to astonishing changes in the way things taste, making cravings for a rich slice of chocolate cake or a bag of White Castle hamburgers simply vanish. Those who have the surgery naturally settle at a lower weight.

Over the last year, I followed Keith Oleszkowicz and Jessica Shapiro — a computer programmer and a college student — from their surgeries through the transformations that followed. The operation, increasingly common as obesity threatens the health of millions of Americans, changes not just the bodies of those who have it, but also their lives: how they see themselves and how they relate to their romantic partners, co-workers and families.


As the pounds fell away in a society that harshly judges fat people, Keith and Jessica, two ordinary Americans, would go through an extraordinary experience, one that brought both joys and disappointments.

Jessica, 22, lived with her mother and grandmother in Ann Arbor, Mich., and worked at Panera Bread preparing food. At 5-foot-3 and 295 pounds, she had a difficult life. She needed a seatbelt extender on airplanes. She was unable to cross her legs. She had acid reflux and mild sleep apnea, which meant she woke up at night about seven times an hour.

A doctor told her something that shook her: “You are only 22, but your body is much older than you are.”

Even worse were the constant struggles of being fat in today’s society. She never had a date and no man ever seemed interested in her. Total strangers lectured her on how to eat. 

And she suffered unexpected humiliations, like when she went to an amusement park with friends and the ride attendant pulled her aside and asked her to try pulling the safety bar over her stomach. It didn’t fit, and he turned her away.

“Every day of my life, I’m just aware of how overweight I am,” she told me as she sipped a cup of water at a Starbucks near her home.

She tried programs like Weight Watchers, but her urge to eat, as powerful as the urge to breathe when holding your breath, defeated her. It is a drive, obesity researchers say, that people who have never felt it find hard to fathom.

“It’s like a physical need,” Jessica said. “It’s not just a longing or just a passing urge.” It is, she said, “like a kind of hunger that like kind of claws at you from the inside out.”

The surgery, she said, “is a last resort for me.”

Keith’s circumstances were a bit different. He was 40, married with a teenage son, and worked as a programmer at a big automaker. His wife, Christa, had had the operation two years before, after pondering it for nine years. She lost 143 pounds and felt that her life had been transformed.

Keith’s older brother had had the surgery, too, 16 years earlier, at a time when many doctors were splitting patients open instead of doing the surgery laparoscopically as they do today.

The complication rate was much higher at that time, and the death rate at one year after surgery was 4.6 percent, verging on unacceptable.

“We were not in a good place then,” Dr. Amir Ghaferi, a bariatric surgeon at the University of Michigan, told me. The one-year mortality rate today is 0.1 percent, safer than gallbladder surgery or a joint replacement.

Keith, at 5-foot-9 and 377 pounds, was not as fat as his brother had been, but he was having physical and medical problems. He somewhat hesitantly listed some of them: His joints hurt; moving around was an effort; he could not bend down to tie his shoes; he had sleep apnea and had to use a continuous positive airway pressure machine to push air into his lungs when he slept; he had high blood pressure.

He had lost 10, 20, 30, even 40 pounds at a time over the years with various diets, but he was plagued with insatiable urges to eat. The weight always came back.

“I’ve tried everything I can,” Keith said.

But, he stressed, it is not as hard for a guy to be fat as it is for a woman. And he’s right. Researchers have found that there is more prejudice against fat women than against fat men. Still, Keith suffered many indignities.

As a child, he was teased and became so ashamed of his body that he could not bring himself to undress for gym class. So he wore his shorts and T-shirt under his school clothes and spent the rest of the day with those sweaty clothes underneath. He even had his own amusement park moment, at the same place, Cedar Point in Ohio, where Jessica had been embarrassed.

Yet he had a hard time committing to the surgery. It was such a big step, and once it was done, there was no going back.

In the end, it was Keith’s son who tipped the balance. “I don’t want you to die, Dad,” he told him one day when the two were playing video games. He looked up at Keith, saying, “Dad, we need to do something.”

The Operation

By the day of their surgeries, Oct. 12, 2015, Jessica and Keith had spent months preparing.

They had had medical and psychological tests. They went to counseling and mandatory sessions explaining what was going to happen, and what to expect and how to eat afterward.

They learned that the gastric bypass operation both had chosen (it and a procedure called the gastric sleeve are the two main options) leaves patients unable to absorb some vitamins and minerals. 

They would need to take supplements daily for the rest of their lives. And because the rearranged digestive tracts can dump sugar into the bloodstream too quickly, they would have to be careful about sugar intake or risk “dumping syndrome,” which can cause vomiting, sweating and shakiness.

For two weeks before the surgery, Jessica and Keith followed a high-protein liquid diet to shrink their livers. People with obesity often have large, fatty livers that can get in the way during the operation.

The day before, Jessica stood at her kitchen counter preparing a mango protein shake with mango flavored Crystal Light and protein powder. It smelled foul. She forced herself to swallow it.

“I am excited,” she said.

At 6:30 the next morning, a nurse and a surgical resident wheeled Jessica into an operating room on a special wide gurney. They slid her onto an operating table that was set as low as it could go because bariatric patients’ abdomens rise high, as if they were domes.

The surgeon, Dr. Oliver Varban, started by inflating Jessica’s abdomen with carbon dioxide to give him more room to work. Then he made seven small holes in her skin and inserted his equipment, including a cylindrical tube containing a tiny light to illuminate her abdominal cavity, lenses, mirrors and a tiny camera to project the scene on a computer monitor above Jessica’s head. The screen showed gleaming golden bubbles of fat that were surprisingly beautiful.

Dr. Varban used what looked like a miniature table tennis paddle to push Jessica’s liver aside and give him a clear view of her stomach. Her intestines were obscured by fat, so he used a special surgical grasper to gently push the fat aside.

It might seem reasonable for Dr. Varban to simply remove some of the fat from Jessica’s abdomen, but doing that, he said, would result in a bloody, hemorrhaging mess. He explained that there is a mile of blood vessels in every pound of fat.

Dr. Varban cut off most of Jessica’s pink and healthy stomach, leaving a pouch the size of an egg. He stapled and sealed the pouch with a device that looked like a saw-toothed pair of shears, leaving a shiny metallic edge of staples. Then he grabbed the top of her small intestine and attached it to the stomach pouch.

A couple of hours later, he was done and it was Keith’s turn. The operation was the same, but Keith’s fat looked different, more yellow than golden, and lumpy. And there was much more of it — his organs were buried in it. Men tend to have thicker abdominal fat, Dr. Varban said, and it is slipperier, harder to grasp with the laparoscopic instruments.


Jessica and Keith spent two nights in the hospital and then were discharged, with instructions to follow a liquid diet for a couple of weeks and then gradually add solid foods.

Jessica was surprised by the pain. When she was home, recuperating, she started to have second thoughts about the surgery. One day, she sat down and cried.

“I had like this awful buyer’s remorse,” she said. “I was like, ‘What did I do to my body?’ This is not reversible, there is no going back.”

Improving the Technique

For years, surgeons thought weight-loss operations worked because they made the stomach so small that it hardly held any food. And with the bypass operation, they made it even harder for food to be digested. Of course patients lost weight.

But some things just did not add up.

A simple surgical treatment, the gastric band, which constricts the stomach, was widely used when it was first approved in 2011 but fell out of favor because its effects on weight were variable and almost always smaller than those of the other operations. It still is used (New Jersey’s governor, Chris Christie, had one), but it now accounts for just 5.7 percent of weight-loss surgeries.

At a recent meeting of Michigan bariatric surgeons, one doctor asked for a show of hands. Who in the room would refuse to do a gastric band procedure even if a patient asked for it? Just about every hand in the room went up.

“The most common operation with the band now is an operation to remove it,” Dr. Varban said.

Even leaving aside the gastric band issue, the idea that the bypass and sleeve surgeries were a mechanical fix, by limiting the amount of food a patient could eat, did not seem right.

Wiring people’s jaws shut would keep them from eating, noted Randy Seeley, who holds a doctorate in psychology and is a professor of surgery at the University of Michigan. But, he asked rhetorically, “If I wired your jaw shut, would you be more hungry or less hungry?”

In contrast, patients who had bypass and sleeve operations reported that they were not particularly hungry afterward, and that their incessant urges to eat vanished. Even more surprising, their taste for food often changed.

Dr. Lee Kaplan, an obesity researcher at Massachusetts General Hospital, recalled a patient who asked him: “Are you sure they didn’t operate on my brain? Food does not call out to me anymore.”

Another, who used to seek fatty and sugary foods, said, “I crave salads now.”

Dr. Justin Dimick, a bariatric surgeon at the University of Michigan, said a woman who lost 200 pounds told him that before the operation, a Reese’s peanut butter cup gave her such a rush that it was, she said, “like an orgasm of pleasure in my brain.” Now, she said: “It’s just peanut butter and chocolate. What’s the big deal?”

Experimental data support these reports. Both patients and rodents who had surgery are actually more sensitive to the taste of sweets: Receptors on their tongues detect smaller amounts of sucrose.

The data, the patients’ stories, made no sense if all surgery did was make it harder to eat, Dr. Kaplan said. Both the bypass and sleeve operations, he added, “drive the body to want to eat less.”

But why?
Some, including Dr. Seeley and Dr. Kaplan, looked for answers by studying the surgeries in fat rats and mice.

“What you find very quickly is that rats and mice lose weight just the way you see in humans,” Dr. Seeley said. “It’s remarkable.” Surgery changed the weight the animals’ bodies settled into. And, as with patients, their tastes in food changed.

For example, Dr. Seeley gave some rodents the exact bariatric surgery operation that humans get while he gave others, which served as controls, sham surgery: 

Researchers opened the animals’ abdomens and then sewed them shut. The bariatric surgery animals lost most of their excess weight and then stabilized at a lower weight.

Then the researchers put all the rodents on a diet. All lost weight.

Three weeks later, the animals were given as much food as they wanted. 

Those that had had the sham operation ate until they were back to their original weights. 

Those that had had the real bariatric surgery ate until they reached their post-surgery weight.

“Surgeons often talk about bariatric surgery as a tool. You have to follow all these instructions,” Dr. Seeley said. It only works, they tell patients, if they follow a diet and exercise program.

“My message is that the rats don’t appear to do it that way. They don’t know it’s a tool. They just naturally change lots of things in the way they relate to food.”

Three Months Later

After plummeting soon after the operation, Jessica’s weight began to fall more slowly. By January she had lost 65 pounds.

Jessica and Keith, too, had mixed reactions.

A year after his surgery, Keith weighed 284 pounds, down from his starting weight of 377, but not at his projected weight of 230. It is increasingly unlikely that he will get there.

But he looked and felt transformed.

“Some people I haven’t seen in years don’t recognize me,” Keith said.

“And I do have more energy,” he added. “It is a huge difference.”

Yet he is still fat, and still feels big. “I expected all my weight to be gone,” Keith confessed over lunch at a sushi restaurant near his work. “I wanted to be 230. I was hoping.”

And he misses his former lust for food. “I just liked eating before. I liked to eat.”

Jessica lost 112 pounds, just about exactly what was predicted.

“I expected myself to grieve a lot more for my loss of my old relationship with food, and I didn’t,” she said.

She began classes at Eastern Michigan University in the fall but dropped out in October, explaining that she did not like the courses and had a lot of anxiety. 

While she waits to apply to another college, she is working at coffee shop near her home. She still lives at home.

Before her operation, she could blame her stalled life on her obesity. Now, she says, “I don’t have an excuse anymore.”

“I’m smaller,” she said. “But it’s been gradual enough that I still feel like I’m the biggest person in the room wherever I go.”

On the other hand, her acid reflux is gone and she had the confidence to buy a bike.

She wants to lose another 40 pounds. Her plan is to start with that awful liquid diet she was on for two weeks before her surgery. In the meantime, she has not bought new clothes, holding off until she loses more weight. She says she will consider having plastic surgery to remove loose skin after she loses more pounds.

Yet, Jessica says, although she has mixed feelings about the results of the surgery and although she is disappointed that her life has not changed as much as she hoped, she does not regret having the operation.

And she had some triumphs.

She went back to the amusement park where she had been so humiliated when she was turned away from a ride, too big for the safety bar to go over her.

Now she fit.





Jul. 24, 2021  "An airport pianist received more than $60K in tips when an Instagram influencer recorded him playing": Today I found this article by Meryl Kornfield on Yahoo 
News:

It was a usual Wednesday for Tonee Valentine (Carter), a professional piano player at terminal A of Atlanta's Hartsfield-Jackson Atlanta International Airport.

Valentine's hands slid across the keys, his black brimmed hat bobbing. Amid the noisy and chaotic travel hub, the pianist provided rhythm.

Author and motivational speaker Carlos Whittaker, on an hour-long layover to Nashville, noticed. He saw the pianist "playing his heart out," opened Instagram and began recording. Whittaker, with a following of more than 170,000, panned to the meager contents of the blue tip bowl atop the piano and went up to give money. That's when the two struck up a conversation, Whittaker asking if the pianist would participate in his podcast "Human Hope."

"He asked me: Do I have hope in humanity?" Valentine told The Washington Post. "And I told him no. I didn't see it."

"Of course, that changed," Valentine added.

Within minutes, Whittaker's following and strangers began sending money through cash apps, contributing more than $10,000 in a half-hour and $61,000 in two days. Messages flooded in, people sending their appreciation of Valentine's talent and passion.

Since, the 66-year-old musician has gained more than 10,000 followers on Instagram and has become a destination for fans flying into the airport.

"This guy, Carlos Whittaker, blew into my life like a tsunami," Valentine said. "I was having a typical day at work, and now, I've been blessed by this man and his followers."

When Whittaker started talking to him, Valentine shared he received nightly dialysis treatment for kidney disease. Despite the hours-long time spent hooked to an IV, the man told the Instagram star that he had it much better than others.

This is not the first time Whittaker's followers, which he calls his "Instafamilia," have contributed to helping others: They've funded a pregnant woman living in an RV, a woman with epilepsy who wanted a seizure alert dog and lodging for inner-city Brooklyn children camping in Alaska's wilderness, Whittaker said.

Inspired by the generosity of Whittaker's online family, Valentine said he intends to pay the money forward instead - although he said he was considering getting his car's oil changed.

Eleven years and 87 countries later, Valentine had traveled the world as a pianist on cruise ships, he said, returning to playing at a local restaurant. That's when a man approached him with an offer: There was an opening at the airport. Valentine declined, but the man asked him to try it out for an hour.

"I tried it for an hour, but I stayed for three," he said. "I was having such a good time, 13 years later, I'm still there."

An airport pianist received more than $60K in tips when an Instagram influencer recorded him playing (yahoo.com)

My opinion: Aww.. what a happy and positive article.  There's a video clip and Valentine plays well.


Aug. 4, 2021 "American couple who retired in Nova Scotia leave $4.8M to local hospital": Today I found this article by Haley Ryan on CBC News:


An American couple who found peace in a small, seaside Nova Scotia town will continue serving the community for years to come.

Tim and Diane Ledvina posthumously donated $4.8 million to Liverpool's Queens General Hospital Foundation, the largest single private donation the foundation has ever received.

"They loved people," Tom, Tim's twin brother, said in a recent interview from his home in Easton, Md.

"They moved to a new country, to a small town, and they didn't just kind of lock themselves up in a house. They went out and met the community and made it their own."

Work in the auto industry as an engineer brought Tim to lots of international destinations, such as Germany and Japan, Tom said.

American couple who retired in Nova Scotia leave $4.8M to local hospital | CBC News


Jul. 27, 2021 "‘Arthur’ To End At PBS Kids After Season 25": I like this picture of Arthur smiling and giving the peace sign.  I posted this on Facebook.  


I used to read the picture books as a kid.  I saw the show and it was fun to watch: 


Arthur, the longest-running children’s animated series in the history of American television, is set to end with its 25th season.

The iconic children’s series will end on PBS Kids with its final season debuting in the winter of 2022.

‘Arthur’ To End At PBS Kids After Season 25 (yahoo.com)







Aug. 1, 2021 My birthday: I put this on my Facebook page:

Hi, my birthday is coming up on Aug. 11.
1. May you please get me some scrap printer paper from your work? You know the paper that was printed on one side and are put in the recycle bin. I would like to reuse them and reprint on them. Thanks.

2. Dry erase markers.


Aug. 3, 2021 Beyond Meat: I tried this vegetarian burger at A&W.  The patty looks like beef.  It doesn't taste good or bad.  It doesn't taste like anything.  I only ate the patty as it is without the bread or veggies, because I wanted to really taste the patty. I'm not ordering this again. 

Aug. 4, 2021 Century Palace restaurant: I went out to lunch/ dim sum with my parents and grandma today.  It was kind of busy there.  The food tasted good like the deep fried shrimp and chicken legs.

This is good to break out of the routine and go out for 2 hrs for fun.

I hardly ever go out for fun.  I do have fun by reading the news on the internet and watching TV, and those self- development videos.


Free astrology birth chart: You type in when (date and time) and where you're born, and this will tell you all about you.  I know my sun sign which is the zodiac sign you're born in.  There are ascendant sign and moon sign. 


There are all these planets in your sign and planets opposite other planets.  I read my chart and it was pretty accurate in my personality.  

You should check it out to see how accurate it is for you:



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