Stroke Survivor: How I Got Rid of The Antichrist - A Wellness Story

Originaly Published on August 19, 2015 on LinkedIn. See original article here: 
How I Got Rid of The Antichrist: A Wellness Story

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Musa Pam, MBA

Founder & CEO at Plateau Asset Management

This isn’t what you think.  According to Askangels.com, '666 as mentioned in the Bible, in the book of Revelation does say in Chapter 13:18,"Here is wisdom. Let him that hath understanding count the number of the beast: for it is the number of a man; and his number is Six hundred threescore and six."'

I first set out to write this in commemoration of May being Stroke Awareness Month. Additionally, I was inspired because the Safety  Training Topic of May 2015 for my company Sodexo was: "Global Health and Fitness Month."

With all this in mind, I logged in to My Fitness Pal app one day in May as I do daily, and I was confronted with the reality that I had lost 66.6 pounds. My first reaction upon seeing the number 666, decimal notwithstanding, was that this was a bad thing. It’s what I was raised to believe as a Christian. But then I quickly realized in my case, it IS a good thing, something that’s taken a great deal of hard work and dedication to accomplish. So what’s the why and the how, you ask? Below, I describe the four main tools and methods that helped me reach my weight loss goal.

Let’s start with the 'Why.' On New Year’s Day 2011, I checked something off my Bucket List: Watching the ball drop in Times Square on New Year’s Eve. It was truly something to remember. Following the chaos of the activities, I went back to my favorite watering hole to decompress. House of Brews on the corner of 8th Avenue and West 51st Street in New York, is a nice two-level quintessential Irish Bar at the heart of Hell’s Kitchen (again with the evil metaphors, right?). There I engaged in small talk with a tall, dashing, confident fellow named Brian (@briandanielsfit), who would become a friend. Originally from Michigan, he had settled in New York to start the next chapter of his life following his meritorious service as a " Top Gun," a proud member of the 320th Artillery Regiment of the US Army's 101st Airborne Division out of Ft. Campbell, Kentucky participating in Operation Iraqi Freedom.  He was at the bar that night to wait for his girlfriend Brianna (now fiancee and mother of their handsome toddler Gabriel) who was bar-tending. Besides he said, he couldn’t stand large crowds and fireworks. Understandable when you learn his story. That’s when he told me his story. I cried then and many other times we’ve gone there together or that I’ve thought about it. 

November 15, 2005 is a day that will be seared in Brian's memory forever.  He was the sole survivor in Taji, Iraq, of an Improvised Explosive Device (IED) attack on the Humvee in which he and 4 of his comrades were patrolling. This past Memorial Day weekend as have all others since he started to learn to walk again and fend for himself, was a poignant reminder for Brian to be thankful for his, his comrades’ and their families’ service and sacrifice, but he admonishes us to remember the fallen on Memorial Day; and to thank all veterans on Veterans' Day.

Brian has since transitioned from working retail at Kay Jewelers, to pursuing a career helping others as a personal trainer, where he helps and coaches clients to become fit while he instills confidence in them, teaches them to care for their bodies and harness their abilities.

By October 2011, partly because of his new-found passion to become a Personal Trainer  and partly for my insistence that I wanted to become healthier, Brian introduced me to the concept of the Basal Metabolic Rate , or BMR while he was studying to become a trainer. I was psyched! I started packing my gym gear for my out-of-state trips, played in my Annual Alumni Soccer match at Massachusetts Maritime Academy, and ran in my company's 5k for charity - my 2nd ever 5k run.

In layperson’s terms, BMR, a function of a person’s age, gender, height, weight, and other factors, can tell one how many calories she expends without doing much work. Once you know what this number is (for me it was approximately 1,600 calories) assuming a sedentary lifestyle, one could then identify a weight loss target. For example, Mary weighs 160 lb. She would like to lose 20 lb. If her BMR were say, 1,400 calories, then she could limit herself to 1,200 calories per day or a deficit of 1,400 calories (200 calories per day x 7 days) per week until her scale gives her the great news of attaining her target. All things being equal, she could accomplish this in 50 weeks. Using the rule of thumb that 3,500 calories equals about 1 pound of fat, you need to burn 3,500 calories more than you take in to lose 1 pound. So in Mary's case, this means she could attain her goal in about one year, with 2 weeks to spare (20 lb x 3,500 calories per lb = 70,000 calories. 70,000 calories / 1,400 calories per week = 50 weeks). Of course the more active the subject, the greater the number of calories burned and thus, the faster the weight loss or the more calories one could consume without falling off track. Here's a nice My Fitness Pal blog article on metabolism to help explain BMR better:

https://blog.myfitnesspal.com/a-beginners-guide-to-your-metabolism/

Here's perhaps the most important 'Why?'

Those of you who know me well know that I suffered a Cerebrovascular Incident or CVA, a.k.a. Ischemic Stroke on January 20th, 2012 (my late brother Yakubu's birthday). The resulting effects of the stroke was hemi-paresis (or partial paralysis) on my left side. Thanks to inpatient rehabilitation at Spaulding Rehabilitation Hospital, Boston, outpatient rehabilitation at Brigham and Women's Rehab Services in Foxboro, MA, and ongoing care by my neurologist Dr, Salvatore Napoli of the Neuro Institute of New England), I am happy to report that I've regained much function on my left side, with hopes for much more to come.

The cause of my stroke? Patent Foramen Ovale (PFO), also known as a hole in the heart. This is a condition probably  made most famous in this area by New England Patriots Hall of Famer and former all-pro linebacker Teddy Bruschi for having suffered the same fate. My cardiologist told me we're all born with this hole and it closes naturally in all but abut 10% of the population. For the unfortunate 10%, any clot that forms elsewhere can travel through this hole straight to the brain, bypassing the lungs' filtering capabilities. Heretofore, according to the calculators, I was not obese, but at 215 lb, I was considered overweight on the BMI scale. By January 2011, I had lost about 5 lb, and thought I was well on my way. Among factors that had put me at risk for stroke, were the PFO, nicotine use, a sedentary lifestyle (frequent travel, low exercise levels, long hours sitting in an office environment), family history (dad died from stroke, 1989), and weight.

Another good metric, probably more important than the two I've already mentioned (Weight and BMR) is the Body Mass Index or BMI. I've purposely talked about my results and how to achieve them first. But how does one determine what a goal weight should be? Enter the BMI. Several calculators exist online now, and I'm pleased to see that my healthcare provider (Brigham and Women's - Boston, MA) now attempts to calculate it for you as part of the Patient's Visit Summary. According to the National Institutes of Health (NIH), "Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women." This is where I disclose that I received bad news from my Primary Care Provider at Brigham and Women's in Foxboro, MA. You see, during my annual physical in 2013, I discovered that I was now 5'8" tall, not 5'9" as I'd previously been. Why did this matter, you ask?  Well since BMI takes height into account, and I had initially set a goal weight of  170 lb, I had to readjust my goal given my new height. I set my new goal to 160 lb in order to achieve a BMI of <25.0.

http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Without further ado, here's the answer to the most typical question I get: "So... How did you do it?"

Before I answer that, let me set out some basic points of information.

Back to how I got rid of the devil. I recently shared these with a CEO connection of mine who was complimentary of my weight loss:

Fitness Trackers:

First, I’ll start with a video I found on CNET.com similar to one I consulted in 2013 while researching fitness products. You can’t go wrong with any of them, but I have the #3 product, which is a great deal now at under $100.

http://www.youtube.com/watch?v=9-iIlglCe8Y

I chose the Fitbit Flex Activity Tracker:

I use this to track my steps, calories burned, and sleep. Battery life is about one week. I love that you can shower with it, so I really only take it off to charge it. I also have an accessory pack so I can change the band from time to time. Fitbit also now provides the ability to accessorize with Tory Burch gold and silver bracelets. Available online, at Best Buy, Target or other electronic retailers for about $99. Bracelets available elsewhere.

http://www.fitbit.com/flex

Weight Scale:

According to Peter Drucker, You can't manage what you can't measure

Withings WS-50 Smart Body Analyzer:

This smart scale measures weight, fat%, pulse, indoor temperature and air quality, and even now gives you the weather. It was a hit in 2013 at the Consumer Electronics Show in Las Vegas, so I pre-ordered it and was one of the first to get it. It communicates and syncs wirelessly with Fitbit Flex and My Fitness Pal. Available online, at Best Buy, Target or other electronic retailers for about $150. 

I started by setting a weight goal based on my desired Body Mass Index. My revised goal was to get to 160 lb, so at 148 lb, I’m just playing to see what I can maintain. I call the graph of my weight loss my dead cat bounce, similar to the concept in stock market analysis. Maintaining the low point or band is the challenge going forward, but unlike the markets or individual stocks,  I'm not looking for a bull market rally to the upside.

http://www.withings.com/us/smart-body-analyzer.html

Diet and Nutrition:

My Fitness Pal:

This is the dashboard I use to bring everything together. Each of the two products above have their own apps and website, but I use this as an aggregator. I set my calorie goals, and it helps track what I consume minus what I burn in calories as reported by Fitbit. I input meals and everything I consume (as much as I remember). However one chooses to track calories, it's important to be disciplined. The 66.6 lb photo at the top shows that as of May 2015, I'd logged into My Fitness Pal for 580 days in a row! Every food imaginable is in the database, and if not (like restaurant meals), you can estimate it. You can also manually input exercise, and form a small group of friends to help motivate each other. It’s a free download on iOS or Android, and the website is great. You can input data into either your phone, PC or laptop, and it’ll sync to all. It contains an ever-growing searchable database of meals. I haven't searched lately for something and not found it. They even have nutrition information for Black Velvet, my favorite championship cerebration beverage of choice at Patriot Place's CBS Scene Restaurant. Unless you've lived under a rock, you'd know we've had plenty a cause to celebrate sporting success in New England the last decade and a half, since the turn of the century.

At Sodexo, we have a healthy, nutritious, food offering called Mindful that integrates with My Fitness Pal. It’s offered in at least one entrée per meal where applicable. Mindful or not, to add meals to their daily diary, visitors to company-run cafeterias can just scan the bar code from a particular meal on the menu using the My Fitness Pal app on their phones. Health conscious employees and HR and benefits departments love it.

Additionally, perhaps shopping exclusively for healthy, organic food choices at Trader Joes which opened near me in 2012, may have something to do with it. Their "Two Buck Chuck" Cabernet is an amazing deal too. As an inpatient at Spaulding, I looked at the diet I was placed on, and asked why I was on a cardiac diet. When the doctor said she wasn't sure, I asked to remain on it and thus got used to the right portion sizes, fat content and low sodium meals, then tried to build on it at home on discharge. I carried over "Sausage Saturdays" to my home meal planning. To pick up where the hospital left off, I bought pre-packaged frozen "Smart Ones" meals, until I became comfortable with cooking with the right ingredients and apportioning the right quantities and nutrients. I really haven’t stopped eating any particular thing, except for some fast foods. When I’m on the road and stop at McDonald's now, I order the lowest calorie healthy options like the Filet-O-Fish at 390 calories.

Besides measuring against my daily 1,500 calorie goal, My Fitness Pal helps me to ensure attainment of a good daily nutrition balance of  55% carbohydrates, 30% fat, and 15% proteins.  Their recent affiliation with iconic brand Under Armor (as part of its Under Armor Record suite of apps) provides a strong underpinning for success and as a global force for good in the health and fitness space going forward. It is available on iOS and Android.

http://www.myfitnesspal.com/

My Fitness Pal

As far as diet goes, I have not eliminated a single thing from my pre-stroke diet other than caffeine. Because I used to enjoy plenty of sugar with my coffee, and because I craved nicotine when I drank coffee, I triangulated this as an unnecessary evil and eliminated it from my diet. Looking back now, I couldn't have imagined I could go one morning without coffee, or at least a portion of my 48 oz daily dose of java. As I write this in August 2015, I am please to report that my "Quit It" iOS app reports on this graphic that I've been nicotine free for 3 years, 6 months, 2 days, 10 hours and 5 minutes. The savings of  almost $13,000 isn't too shabby either.

If you’ve read to this point, I commend you. In summary, I've only really used 4 tools to lose weight so far:

1. Fitbit Flex Fitness Tracker
2. Withings WS-50 Smart Body Analyzer
3. My Fitness Pal Nutrition and Calorie Tracking app. 
4. Fitness (I visit the gym for about 2-1/2 hours 3-4 times a week, doing about 95 minutes of cardio exercise, light weights and stretching), then until recently, once a week I did wellness sessions with my Physical Therapy Aide at Brigham & Women’s in Foxboro, MA. I had the pleasure of working with several therapists and PTAs in the last 3-1/2 years and they were all good, but none had a greater impact upon me than my last. Tyler McCarthy is a primus inter pares, a first among equals. He capitalized upon the gains I'd made with my previous therapists, and helped me break several barriers. Among them, we built my confidence, muscle strength and stamina; strengthened my hamstrings, biceps, quadriceps, triceps, lats and glutes; and promoted active hand, arm and leg extension. I went from being able to do just one push-up to doing 100 in 10 months; we built on my leg strength to the point where I was able to get on a treadmill and elliptical for the first time. I am able now to do 3.5 mph on a limited basis on a treadmill. He was also instrumental in helping me to safely take what we worked on in Rehab to my gym. We got me back on the golf course, where playing with him, I beat my goal of breaking 70 for 9 holes by 8 strokes in 2014 on my first try. 

Now 3-1/2 years post-stroke, I have learned to adapt more to my new physical abilities. I enjoy independent living, and I've rekindled my love for one of my biggest passions - golf. I took golf lessons for the first time ever this summer through the Spaulding Rehabilitation Hospital Adaptive Sports Program (this being the 97th PGA Championship Week,  I have to give props to PGA Pro Rick Johnson, an amazing teacher who specializes in working with golfers of various abilities in his Back In The Swing  (BITS) program. He truly has changed my golf life for ever as I now play golf once a week one-handed. For the first time since my stroke, I recorded a personal best sub-60, 9-hole score of 57 last Sunday 8/16/15. 

I pride myself in doing all this mostly without outside help, but cannot ignore folks who have supported me along the way, especially those who look at me and fail to see anything but ability. It’s been nice to receive some unsolicited feedback, and I've enjoyed giving small informal talks to peers, students and small groups along the way as my way of giving back and raising awareness. It's been nice to give back through financial support and by volunteering as a Peer Visitor to the Inpatient Stroke Program at Spaulding Rehabilitation Hospital, Boston.

I wish you all who read  this the very best in your wellness journeys, and I'd be happy to hear if you have any questions or comments, or if you’d like to learn more about any of the tools or concepts I mentioned such as Fitbit, Withings, My Fitness Pal, Mindful by Sodexo, etc.

Individual results will vary obviously, but for me, this is what worked. This being the 21st century, I realize technology cycles last less than 2-3 years or less in some cases (Nike for example, recently nixed the Fuelband). As for you, pick your poison to help you get rid of the devil, be it smartwatch or wearable fitness device, yoga, fitness plan, nutrition, meditation, medical procedure, or some combination thereof... just do it, because YOLO -  You only live once.

Full disclosure: I am not now, nor have I ever been a paid representative of any brands I discuss; however I do own minuscule positions in UA and FIT as of this date. It's been encouraging though to see two prominent personalities I admire - President Obama and future Hall of Fame Coach Bill Belichick of the New England Patriots, each embrace fitness by sporting a wearable Fitbit device in public. I'd say those are ringing endorsements if I ever saw one.