byeonbi-yak

I decided to cheat and buy myself some laxative to see if I can rid myself of any remaining demons. I'm expecting an outpouring in the next 24 hours.

speed test

The weather was better today, so I walked home and, when I got to my apartment, took a break and then walked the park loop three times to test my walking speed.

Result: I'm already pretty close to normal. The thing I'm lacking is endurance, and the more I think about it, the more I realize it's because I was basically flat on my back for a week.

I just used the ruler function on Naver Map to roughly determine that the park loop I walked is 937.5 meters in length. I'm able to walk the loop in almost exactly 12 minutes. I started at 6:56 p.m.;,finished the first loop by 7:08, did the second loop by 7:20, and finished the final loop by 7:32 p.m. That's about the speed at which I'd walk the loop even before my stroke. With a bit of algebra, I saw that I was walking at a rate of 4.685 kph, and since my goal speed is 4.8 kph, I'm already most of the way there. Walking is a repetitive activity, so it's good to be rewiring my brain to walk.

The question now is endurance. Walking home was a sweaty affair today, and doing those three loops required some effort. But I'm surrounded by opportunities to improve my endurance, so I'll be walking the stairs in my building, the stairs along the Yangjae Creek, and plenty of other local paths. Reaching my goal of 30 kilometers at 4.8 kph looks attainable.

Tomorrow, we begin the real training.

why no weight loss?

I have never been more faithful to a new diet than I am right now. I monitor my blood pressure and blood sugar twice daily. I'm eating at a daily caloric deficit that varies between 500 and 1000 calories (assuming a basal metabolic rate of about 2550 calories per day, according to MyFitnessPal), and an accumulated loss of 3500 calories is supposed to equal a pound of weight loss. After initially losing around 9 kilos while in hospital, I'm down to somewhere between 119 and 120 kg. By my calculations, if I've been averaging a caloric deficit of 750 per day since leaving the hospital, then I should be at a caloric deficit of about 7500 calories by now, i.e., I should have lost another kilo.

Instead, I'm stuck. Despite the caloric deficit, I'm just not going below that plateau. There could be a few reasons why, and we'll have to see how things pan out before we can determine more accurately what might be going on. Some theories:

1. I did finally poop Sunday night, but there's plenty of accumulated poop left, and that's skewing my weight. I should take a laxative, get everything out, and see how much weight I've really lost afterward.

2. Once I add exercise to the regime (as I plan to do starting tomorrow), the weight will start dropping again. The body is simply clinging to its current weight because it's resisting attempts to lose. It just needs a little coaxing, is all. (While I'm at it, I think the reintroduction of exercise is going to drop both my blood-pressure and blood-sugar levels. Blood sugar has traditionally been way low after a long walk to Busan.)

3. I lost muscle weight while lying in bed in the hospital, and whatever weight loss I'm experiencing is being offset by the regain of muscle weight.

4. Patience, grasshopper. Weight loss isn't linear, and there's no reason to fret over a single kilogram. Every body is different, so my weight-loss pattern will be unique to me. I should expect the topsy-turvy, not a smooth, linear drop in weight. Thinking should be in terms of months, not days and weeks. I should check my progress again in a few months.

Any or all of the above notions could be in operation. It's hard to know. For the moment, I just have to ride things out and see what happens.

For the most part, except for a day like today when I had three keto gyros, I eat leafy salads and chicken breast—the diet of movie stars training for action roles. If I drink soda, it's always diet. Having studied up on nuts, I know to avoid cashews and embrace walnuts, almonds, peanuts (in moderation), and macadamias. To that end, I bought myself a bag of roasted, salted macadamias. I don't eat more than a quarter cup at a time, so I'm not worried about salt affecting blood pressure.

I'm learning about dessert alternatives like chia pudding (which relies on chia seeds' gelatin to create a pudding-like consistency), and I'm watching keto-recipe videos on YouTube, of which there is no shortage. I'm pondering the irony of being put on blood thinners—which make me bleed more easily—while having to do finger pricks to monitor my blood sugar.

I'll have more to say about my numbers once I start training tomorrow. I'll be very curious to see how exercise affects them. The body is supposedly a machine, after all.

gyros, keto and regular

Some pics from last night and today. Keto tortillas made last night:

I don't have a taco press, so for two of the tortillas, I used a combination of two cutting boards and a rolling pin. As a result, one tortilla looks like a nightmare while the other two are somewhat more round-looking. Your dough starts off tan, but after a minute on a ripping-hot stove, it turns white, as the recipe notes. You cook the dough for 60-70 seconds on one side, then only a maximum of ten seconds on the second side. Despite being made with almond flour, the tortilla had an aroma that was pretty tortilla-like. The guy who developed the recipe said he went through many iterations.

I tried part of a tortilla last night right after making it, and it tasted pretty good. The dough actually smelled good, too, while I was kneading it. This is likely thanks to the inclusion of vital-wheat gluten.

Here's today's lunch spread:

Meat, close-up, and cut a little chunkier this time:

What a keto gyro looks like:

The boss isn't here today to enjoy the meal, but the rest of the troops enjoyed it just fine, and there are some leftovers for the boss to nosh on tomorrow. In all, I'm happy with this recipe for keto tortillas; it doesn't taste eggy like many keto breads, and as I said before, there's no off-putting coconut flour or psyllium-husk fiber to ruin your day. 

keto tortillas

I believe I have found my new keto-tortilla recipe. It makes tortillas that are thick enough to use as gyro flatbreads (but not quite as thick as naan), and I'll have photos of these tomorrow. The recipe itself includes a good bit of detail, and the lack of both coconut flour and psyllium-husk fiber is a relief. The tortilla is a wee bit salty, but that may be my fault. The recipe I came across makes four small tortillas or, in my case, three somewhat larger tortillas. Now if only I can find a good keto recipe for burger buns...

I guess the gods have spoken

I was going to do my speed test today, but it was hot during the day, then it was raining during the evening, so I'll do the test sometime tomorrow.

Gyros are close to prepped. I think the meat is satisfactorily frozen, and all I have left to make are my keto flatbreads.

Oh, yeah: my food processor broke. I think I can fix it with superglue, but I may just have to reorder a particular part. We'll see.

it finally happed!!

You know.

prepping gyros

One way to prep your gyros:

1. combine ground beef, lamb qeema, oil, and spices; grind into a paste; freeze

2. while your meat is freezing, prep veggies: olives, lettuce, tomatoes (and red onions, I guess)

3. prep your cheese (feta)

4. make your tzatziki (yogurt-cuke base)

5. make/prep your bread (naan for regular crowd; keto for me)

6. with beef now frozen, slice into strips; pan-fry

7. make sure everything is containerized

8. take to office, reheat meat, and serve

today's agenda

Gonna head out to Itaewon in a moment to get some lamb qeema for Greek gyros. Might also pick up some flatbread while I'm out there—not for me, but for my coworkers. For myself, I'll be trying out a new keto tortilla recipe that makes tortillas thick enough to qualify as flatbreads, and with no coconut flour and no psyllium-husk fiber, which tastes absolutely vomitous to me. (You may recall an attempt I'd made some years back to create keto tortillas using a recipe that included psyllium husk; the result was godawful.) Expect pics tomorrow, although you've seen my gyro pics before. I'm hoping the new phone, with it's new camera, will photograph the meat more accurately.

some PowerLine Pics of the Week

meeting up with JW

I met my buddy JW today. His texts before meeting were hilarious; I got the impression he had no idea of the gravity of a stroke, even a minor one. "Have you recovered? Can we walk Saturday or Sunday?" JW texted earlier in the week. If you've followed my blog, you know JW's been my walk partner for over a year.

When we met (I took a cab to the meeting spot because I'm not ready to walk the 5 km yet; it'll be another few weeks before I do that, I think), JW's son was there as well. I was touched that the son wanted to come along and see how I was doing. He's a teen, now, and coping with how the pandemic has wreaked havoc on school. JW was, of course, his usual JW self, which means he didn't show me much Western-style sympathy. I had to endure a lot of "I told you so"s and "you'd better"s, but I know JW well enough to know that he may sound like an asshole sometimes, but that's his Korean style of sympathy. I also know JW smokes, so any health advice I take from him comes with a grain of salt.

Our meeting didn't last more than an hour; the day alternated between cloudy and rainy, and JW forced me to walk rather a lot (about 80 minutes total if we include a shopping trip I took to Costco in the morning). The walking reminded me that I really need to time myself and pin down my exact walking speed. On the graph I made, I gave myself an estimated speed of 2.5 kph, but I really need to know whether I'm currently going faster or slower than that. So that's tomorrow's project—figuring out my current walking speed. And starting June 1 (Tuesday, I think), I'll be on the clock with my various fitness projects, walking up stairs, doing pre-pullup exercises, etc.

Still haven't pooped. Lots of farting, but nothing in the missile silo. Maybe tomorrow.

monkfruit

I was all excited to try monkfruit as a sweetener; my buddy Tom had been singing its praises. I'd heard of monkfruit before Tom mentioned it, but I didn't know much about it. Wikipedia notes the original Chinese designation comes from Chinese Buddhism and translates to something like "arhat fruit." An arhat is an enlightened being who is something like the spiritual ideal of Theravada/Hinayana Buddhism. 

Anyway, I just got my package of monkfruit sweetener from iHerb... and it's basically just like erythritol. Like erythritol, monkfruit sweetener is essentially a sugar alcohol, which means it confers that "cool" feeling on the tongue that you get when you eat, say, mint. I thought monkfruit would be different, more like Splenda or stevia, but now it feels as if I simply bought myself more erythritol. What's the point? At least it doesn't affect your blood-sugar levels (another property it shares with erythritol). Everything I do now comes back to blood pressure and blood sugar.

I tried making a keto smoothie with monkfruit sweetener, ice, diet Chilsung Cider, and blueberries, but my tiny food processor wasn't up to the task, and neither was my blender, which sucks and needs to be changed. No more smoothies for a while. I'll have to switch to chocolate avocado pudding and chia pudding. Chia seeds are on the way from iHerb, and at this point, I've got plenty of keto-friendly sweetener.

I do still write in French

Email written to my buddy Dominique just an hour or two ago:

D,

Désolé de ne pas avoir répondu jusqu'ici.

En Corée, on fait la même chose qu'en France—vaccin en deux phases. Il y a des rumeurs qu'on va pouvoir se balader démasqué dès juillet, donc j'attends ça. Pas vacciné pour le moment, mais je le serai bientôt; il y a des centres et des cliniques partout. Je ne sais pas comment on va déterminer qui a été vacciné et qui est toujours sans vaccin ("passeport"?), mais j'imagine que le gouvernement trouvera un moyen. (Oh, comme je déteste le gouvernement...)

Le rétablissement continue post-AVC. On dit que les trois premiers mois sont les plus importants; heureusement que je n'aie pas perdu de fonction mentale (tu t'imagines si j'avais perdu la capacité de parler français et/ou coréen?); c'est juste le côté physique qui est problématique. Après être sorti de l'hôpital, je continue à maigrir. Je dois visiter l'hôpital le 10 juin; après cette visite, je vais commencer un régime anti-diabétique assez sérieux basé sur un livre que j'ai lu quand j'étais sur le dos à l'hôpital. (Un ami britannique a suggéré le livre.) Je me remets peu à peu.

Bon, j'espère que tout va bien chez les Ducoulombier. Merci pour ton email et à très bientôt.

Pax,

Kevin

Just to prove I still have my language faculties.

seen on Instapundit: what's wrong with this sentence?

What's wrong with this sentence seen on Instapundit?

Having waded through the details of this dispute, it’s plausible that Gaetz is getting a bad rap and that Adam Kinzinger was misled by a deceptive edit.

This error happens with annoying frequency. Actually, I see more than one error.

can't sleep, can't poop

It seems I no longer need six hours a night of sleep. If I was a night owl before, it's even worse now. Today, Saturday, also seems to mark my third day of not pooping, but I'm hoping to drop a load later today. I'm sure that's the very thing you've been hoping to hear, so there we are. Switching to eating salad, broccoli soup, and chicken breast has done a number on my intestines, and while there should be plenty of roughage waiting to come out, it's just not coming out. I've taken my fiber tablets to help stimulate peristalsis, but so far nothing. We'll see what the day brings. The real question is whether I'll report if anything happens.

one revision

 The walking graph should also have included a second variable: speed. Revised graph:

I've retroactively changed the graph in the original post.

the plan

So while I was in the hospital, at the behest of a friend, I read Dr. Roy Taylor's Your Simple Guide to Reversing Type 2 Diabetes. The book provides a simple, two-month plan to help you reverse your diabetes (and like Jason Fung's book, it does assume diabetes is reversible... not curable, per se, but certainly not progressive and lifelong, as many still assume). After you go through the initial two months, you slowly reacclimate by reincorporating more-or-less regular food into your diet, and after a month of reincorporation, you can then eat a modified low-carb diet with occasional cheat days. As I mentioned before, I'm planning to follow Dr. Taylor's harsh two-month program, after which I'll switch over to Dr. Fung's intermittent-fasting regime, which I think will be better for me. Dr. Taylor's program uses diet shakes, which has me worried about sugar, but (1) he says the amount of sugar is overall negligible, and (2) I plan to incorporate exercise into my daily routine, which ought to lower sugar levels.

Dr. Taylor's program requires you to ingest no more than 800 calories' worth of food per day during those first two months—no cheat days. The lack of cheat days shouldn't be a problem, at least for the moment: since the stroke, I seem to have lost my appetite for most things, so I'm not dealing with cravings (the stroke has changed several things, mentally). If I follow the program as literally as possible, two of my meals will be diet shakes and one will be little more than vegetables. I already eat Paris Baguette salads for lunch, so this shouldn't be too hard. 

After I finish the two months (and hopefully reverse the diabetes), I'll move into a maintenance phase that will, I suppose, last me the rest of my life. My own vision of this is to follow Dr. Jason Fung's intermittent-fasting regime, but with two cheat days per month. With all the walking I hope to be doing, having two cheat days shouldn't be that big of a sin, although I realize that going insane on a given cheat day could be bad for sugar levels, etc. That's going to be a struggle. Maybe for some months, it'll have to be just a single cheat day.

I'm not planning to start Dr. Taylor's program until after June 10th, which is when I have to make an appearance at the hospital, diaries in hand (blood sugar and blood pressure). The two months during which I'll be following Dr. Taylor's program are among my least favorite months of the year, so that's another good thing. Anyway, that's the plan. Check in again soon for more fun and excitement.

graphs and objectives

Even if you end up going off course, it's nice to have a course—some direction to point you generally where you want to go. So here are some graphs I've worked hard to create. I may end up diverting from them, but they at least give me some idea of where I'm starting and where I hope to be come December 31. For each of the graphs below, click on it to look at it more closely. Leave any questions in the comments section. I will note that, if I follow the walking graph in particular, I probably won't be doing my seaside walk this year. That doesn't feel too tragic given what I've already learned about Korea's coast (very crowded, smells of fish), but we'll see how I feel in a few months.

For what it's worth, the BP shown on the BP graph is much higher than my current blood pressure, at least according to my new monitor. Also, my weight is now down to 118 kg (260.15 lbs.) from a pre-stroke high of 128 kg (282.2 lbs.). We've been down this road before, of course, but the difference now is that I don't want to die, which is a big motivator.

So, graphs:

The pushup graph is pretty straightforward. As stated earlier, 50 pushups by December 31.

I graphed the planks out in seconds, not minutes, but it's still 2 minutes a side. 

I felt almost silly graphing pullups.

As noted above, if I follow this graph, I'll be at full speed by December 31, but I won't be walking the coastline this year.

Sets of stairs, straightforward. 

If you look carefully, the angle of different parts of this graph is different. 110 kg by September 1 seems eminently doable at my current rate, especially once I begin adding exercises to my routine. 100 kg by December 31 also seems doable as long as I stick to the current program.

Blood sugar down to 90 by December 31. This is more a scatterplot trend than a linear progression. Daily blood sugar is all over the place. Right now, I'm varying between 139 and 110. I'll be happy if I can stay below the red line. 

Resting heart rate: straightforward.

So there we have it: numbers I hope to achieve by December 31. Is it doable? I think so, but I admit I may have to adjust along the way. Don't think of any of this as written in stone. It's just an attempt to visualize a way forward. 

America Uncovered asks, "Is SK betraying the US for China?"

Unplug, I say. Past time for US troops to leave South Korea.

what I'm working on now

I'm working on graphs that show the sort of progress I want to make from June 1 to December 31. Some people have already privately told me that my schedule is too accelerated, and since I can't even do a single pushup in my present state, I sort-of agree. But life develops best under pressure, and when it comes to doing pushups, pullups, and things of that nature, some pressure is, I think, necessary. For what it's worth, I'll be following programs that don't even start you on the exercises you're trying to master: the pullup program, for example, has you starting off ridiculously easy by doing horizontal tractions in a doorway. I'll quit these programs and revise my schedule if even these exercises prove to be too difficult, but for the moment, they all look doable. So expect graphs later.

pushups

pullups

planks

blood pressure

blood sugar

walking

stairs training

resting heart rate

weight

—Not necessarily in that order. Stay tuned.

finally figured out the whole blood-sugar-machine thing

The blood-sugar monitor sucks, but it's part of my reality for now. I finally figured out how to use it this morning, so I can now look forward to plenty of finger-pricking. Hooray. This morning's reading was 160, which is high. The ultimate goal is to get it down to a routine 90 by December 31; we'll see whether that's possible. I worked on some graphs yesterday to chart out my progress; I'll talk about those in a different post. I did notice I was a teeny bit less tired yesterday than on Monday, so maybe we're seeing some progress in that area as well.

More later. 

BP machine lowballs

My new blood-pressure device lowballs me—at least my diastolic number.  I'm coming in under 80, which is a damn sight different from the 90-some that I was reading while I was in hospital. Either the hospital was reading me too high, or the new machine is reading me too low. Another possibility could be that my pressure has radically dropped over the past four days, but I wonder what doc would go with that hypothesis. Then again, the new machine makes my systolic out to be 130-something, which is high. So who knows what's going on? I sure don't. All I know for sure is that I have very little trust in these machines.

next step: learning about my new machines

I probably should've started using my BP monitor and blood-sugar monitor days ago, but the hospital's just going to have to make do with a few days' less data. I had hoped to learn a lot about my new equipment this morning, but as usual, I got up too late, so I'll work on my equipment tonight. More news as it happens.

yup—no longer interesting

Sure enough, my site stats have dropped ever since I left the hospital. As I suspected: you're only interesting when you're sick. Technically, I'm still sick, but to the impatient mind, I'm not nearly sick enough. Ah, well.

first day of work

Work wasn't as awkward as I thought it might be, which was nice. My American coworker wasn't as talkative as he often is: that was a relief, and I was able to get the day's work done without interruption. My Korean coworker was extremely solicitous, although he kept trying to offer me all sorts of Atkins-unfriendly food.

Despite my having no strength, I went out and bought a few things after work (I left early). I got some graph paper from my local stationery store, then I went to the previously closed medical-supply store and shelled out for a blood-pressure machine and a blood-sugar device. I also wanted one of those pill boxes with the daily labels, but the lady said she didn't have any such thing, and that Daiso was my best bet. I'll hit Daiso tomorrow. 

I wish I had my strength back, but it really seems to have left me. As I said, I hope this doesn't last more than a week. I've got places to go and people to do. More on this as it happens. 

My boss already knows my situation, so none of this was a surprise to him. I feel extremely weak, utterly strengthless, and I hope the sensation goes away in a week of so. I keep telling myself that I'll check back in three months and gauge how far I've come. I can't help but think that that physical-therapy session really took a lot out of me. Hopefully, once I heal, things will be better. For now, I just endure.

if you're interested in the diabetes question, watch this

This is becoming increasingly common knowledge, but many doctors cling to the old ways:

Atkins, keto, and various other diets all start from this premise.

from the PowerLine Week in Pictures

2,972,120

So, here's a final post about my time at the hospital, and about how I see things playing out in the near future. According to my boss, the amount I ended up paying was the net figure after insurance was taken out. That figure was 2,972,120 won. Seems like a lot, but I'm sure I would have paid a lot more in the States. It all went on my credit card, which now sets me back about two months in terms of paying the credit card down. I guess you could say it's better to be inconvenienced than to be dead.

I was at Samseong Hospital a total of seven days plus a few hours: almost a whole day in the ER followed by nearly seven days as an inpatient. For much of that time, I did little more than lie in bed except when I got tested or sent to therapy.  Over the final three days, I started walking around just to punctuate the tedium and start myself on the road to recovery. This was better than just lying in my bed depressed. 

Over the course of eight days, I underwent a battery of tests: a chest X-ray, an MRI, two CT scans, eye tests, and God-knows-how-many blood-pressure tests and blood-sugar tests. I was passive and patient through it all, accepting this as my fate. It wasn't until the hospital staff wanted me to stay beyond Friday for my heart that I finally put my foot down and refused further treatment. My heart might not be fine, but it's carried me this far.

There were repeat visits from doctors who said overlapping things about my health: the need to follow a better diet, to exercise, to take the meds they were going to send me off with. Two doctors struck me as rude; the rest were fine. One seemed almost flirtatious. 

While I learned plenty from my physical-therapy session, I now realize it took a lot out of me. Just today, I tried walking to a nearby medical-supply store that was barely a kilometer away, and I was pooped. Took a cab back. Before the stroke, I could eat twenty kilometers for breakfast, but I guess things are different now. Part of the problem may also have to do with spending a week in bed. I doubt that that helped my muscle tone. 

On the final day, I was billed; I got a last round of advice about the meds I was to take, and I got the meds themselves. My boss, serving as my guardian, was there to help me through that final process and then drive me home. Felt good to be out of the hospital and back in fresh air. The small of my back appreciated the chance to sit in a normal posture. The boss promised to take my fan back to my desk at the office; I, meanwhile, shuffled back to my apartment. 

I don't normally refer to my apartment as "home," even though I consider Korea a second home. Before I began working for this company, I used to stay at any given job no longer than maybe three years. With such a transitory lifestyle, what's the point of calling anyplace home? But Friday, when I flopped into my bed, it felt like coming home.

Took a shower after trying and failing to poop. The shower felt good. I'd worn my hospital gown for a week, and despite showering twice during that time, the gown still felt stinky and gross. It was good to scrub off a week's worth of hospital grunge. I had gone to the ER on a Friday, which meant I was at the end of a laundry cycle, i.e., there wasn't much for me to wear when I got back. Luckily, I had a spare shirt plus extra socks and underwear. 

Weighing myself was a revelation. I had apparently lost 9 kilograms in the hospital. I was down to 119 kg. Maybe I should stroke out more often, right? Still fat, of course, but now, there's a little less of me to love. Or as my boss joked, a little less to hate.

So the hospital gave me homework. I have three weeks' worth of meds and an appointment to go back on June 10th. I'm supposed to take the meds faithfully, exercise minimally, and keep a diary of my blood pressure and blood sugar. To that end, I have to buy a BP monitor and blood-sugar equipment, which includes the little strips that go in the machine as well as the finger-prick thingie, which I came to hate in the hospital. Getting stabbed, even a little bit, four or five times a day was no picnic. 

I tried walking out to the med-supply store late today, but they were already closed. Figures. All that damn effort for nothing. I'll try them Monday morning.

So what's going to happen over the next few months? I should probably start by writing about where I am. I'd say I have about 80% functionality of my right side. I have balance issues when I walk, and I walk slowly. I have trouble opening those little foil-covered, bubble-shaped pill containers. Based on today's walk, I'd say I'm walking a bit less than 2 mph, i.e., less than 3 kph. No way I'm making it down to Busan in a timely manner at that speed. I can otherwise function on my own: dress myself, wipe my ass, feed myself.  I haven't tried cooking yet, but I bet I can do that, too, albeit slowly. My right side is weak. I say 80% mostly based on the neuro tests I was constantly doing, but the actual number may be a bit less than that.  And before we go any further, I guess I should explain a "neuro test." This is from a text to a friend:

They ask you your name. Sometimes they also ask the date. They flash a light in your eyes. They make you go "Eee" and then stick out your tongue. They make you touch your nose and their fingertip with both of your fingertips (one at a time). They ask you to grip their fingers to test your grip strength. You have to lift your legs for five seconds, then they tell you to resist as they try to push your legs down. They ask you to take your right heel and touch your left knee, then run your right heel down your left shin to your ankle and back. [You then do this with the opposite leg.] Sometimes they ask whether you've gone to the bathroom.

For the most part, that's the neuro check. Also for the most part, the docs all thought I'd done a fine job, although at least one worried about the balance issues when he did an extended neuro check, making me walk in the hallway. Overall, though, they seemed fine with my going home, and they never suggested that I come back for more physical therapy.

So now you know my baseline. I have trouble with some minor stuff (including typing), but I'm functional. So let's talk about where we go from here.

Here's where I'd like to be: as I told my buddy Tom, I still want to do my east-coast walk later this year. Specifically, this means being able to walk 30 km a day at a rate of about 4.8 kph. That's actually faster than my average rate in the past, but it's a worthy goal. I'd also like to be able to talk normally. As my boss noted, I sound better than I did when I was stroking out, but I also sound out of breath when I talk now, and I also sound a bit as if I have a speech impediment. Not good.

Along with those goals, I have other goals, all of which I wrote up during my long hours of free time in the hospital. Here are my strength goals by the end of the year (Dec 31): (1) 50 legitimate pushups, (2) planks at 2 minutes per side, (3) two legitimate pullups. Keep it simple, right? Here are my health goals by year's end: (1) blood sugar averaging 90, (2) resting heart rate at 70, (3) diabetes gone, (4) insulin managed, (5) blood pressure at classic 120/80, (6) waist-to-hip ratio of 0.9. My cardio goals: (1) 30 km of walking at 4.8 kph by Sep 1, (2) stairs (in my building) 3 times (up, not down). My weight goal: down 10% to 110 kg by Aug 1; down further later. I also want to keep doing some version of the exercises I learned during my physical-therapy sessions, but those are more a matter of continuing my therapy and not about reaching a given goal (unless that goal is total rehabilitation). 

How to accomplish these goals? Well, I need to chart that out, so I'll be buying some graph paper and working on that over the next few days. My friend Neil linked me do a "get rid of diabetes" program by a British scientist named Roy Taylor. I know my Korean docs won't agree with it because it's too cutting edge, but I'll be doing it, anyway. Taylor's program dovetails in many ways with that of Dr. Jason Fung; both recommend rapid weight loss and adherence to a low-carb regime. I'll be following Taylor's program initially, then switching to Fung's for what I assume will be the rest of my life. While on Fung's program, however, I will allow myself two cheat days per month so as not to go totally insane. Taylor's program won't allow me any cheat days, but it's only for two months. (There's a maintenance phase after the initial phase, but I prefer Fung's way of handling that.)

Near as I can figure, the docs say these are my conditions:

• diabetes (too much sugar in the body for liver and pancreas to handle)
• atherosclerosis (hardened arteries)
• hyperlipidemia (fat/bad cholesterol in the blood)
• high blood pressure
• weak heart (ejection fraction, per Bill Keezer, i.e. the heart's ability to pump blood)

Pills, diet, and exercise ought to take care of most of that. I'm hoping that, by following Dr. Taylor's and Dr. Fung's programs, I might even wean myself off some or all of the drugs. We'll see. Korean docs seem about twenty years behind Western docs, so they might not want to admit I've gotten rid of, say, my diabetes. But again, we'll see.

So there's plenty to do, and the prospect of death is a great motivator. Plenty of people, in ways both polite and rude, have told me I'm statistically too young to have had a stroke, but as I wrote a few days ago, I saw people of all ages in the stroke ward. My emphasis right now is on thinking positively, living in a goal-oriented way, and doing what I can to avoid having a second stroke, which can occur with some stroke victims.

Stroke recovery is something I read about while lying in bed at the hospital. (As I've said, I had plenty of free time.) Apparently, for most stroke victims, the bulk of the recovery happens within the first three months after the stroke, which doesn't leave me much time. Important concepts for stroke recovery are neuroplasticity and myelination.  Neuroplasticity is the brain's ability to rewire itself after an injury, and an ischemic stroke, which leaves dead brain tissue, definitely qualifies as an injury. With dead brain tissue becoming scar tissue inside my head, I have to rely on neuroplasticity to help me heal. A part of the brain not normally associated with the functions that need to be relearned can wire itself to become competent in the needed skill. Myelination, meanwhile, has to do with the formation of neural pathways that are coated with myelin, a fatty substance that aids in the transmission of neural impulses. Habit-formation aids myelination, so repetitive activities, like typing and walking, help the brain to relearn anything it might have lost. As neural pathways myelinate, things become easier to do. This process carries no guarantees and isn't necessarily a path to a total cure, but myelination obviously helps with neuroplasticity. I have to be an active participant in my own recovery; passivity is not the way to go during the recovery period.

This brings us to an interesting issue. Some stroke victims work around their injuries and disabilities by finding new ways to perform old activities, like buttoning their shirts. While there's a practical dimension to doing this, it isn't always the right choice, especially for us stroke victims who have suffered only minor strokes. If the goal is to aid myelination and neuroplasticity, then we sufferers of minor strokes need to do what we can to perform normal activities normally. That's a demanding order, but not impossible, and it's necessary to train our brains and promote healing. In my case, I can say that a brain rewired to do everything differently would be useless to me. This obviously doesn't apply to people who have suffered severe strokes and who have little choice. So as much as possible, I'll be buttoning shirts, walking, typing, and wiping my ass as normally as possible to retrain my brain.

I think that covers everything I wanted to say for now. Future blog posts will focus more on goals and my progress toward those goals. I can see that my blog numbers have generally gone up since the stroke, possibly because having a stroke makes you a Suddenly Interesting Person. I certainly don't mean to be cynical about the attention and kind support I've received from friends, coworkers, and family. To those people, I am nothing but grateful, but one has to wonder. Those of you who think analytically will doubtless have tracked the length and complexity of my recent blog posts as a way to gauge my mental state; as I'm sure you realize, my marbles are all in place, but physically, I've got work to do. I've been blogging, texting, and writing emails in English, French, and Korean this entire time, so I'm pretty sure my brain's language centers were unhurt by the stroke. 

Anyway, that's all for the moment. More later. Thanks, as always, for reading.

placeholder

I've got a lot to say, and I'll say it later today. Stay tuned.

back home

With many thanks to my boss, who acted as my guardian, I'm now back home. And after a week of not being able to get any proper sleep, I'm now too tired to write The Ultimate Blog about my recent and ongoing adventure. So that might have to wait until tomorrow. Sorry. 

out of here soon

In theory, at least, I ought to be out of here in the next few hours. There are a few practical issues that need resolving, such as the question of my prescriptions and the matter of pay/insurance. But one way or another, I should be outta here, lesson well and truly learned. 

I think this will be my final post from the hospital. I'll eat breakfast, get my before-you-go sermons from whichever docs come to see me, figure out prescription and payment details, then follow my guardian out to the parking lot so he can drive me back to my place and allow me to have a weekend.

Things will obviously be changing from now on, but I'll be writing about all that later. Right now, I'm simply savoring the prospect of leaving this weird little self-contained universe and getting my life back. 

physical therapy

I just did my physical-therapy session. It was hard, as well as a learning experience. I was acquainted with many different exercises, and I received a lot of practical advice. So let's run through what I learned. 

I went through two sessions, the first more demanding than the second. In the first session, I was seated at a table and given a bar to hold horizontally in both hands. I then had to do something like a pushup motion, but forward in front of me instead of facing downward and pushing against the earth. This was hell on my shoulders, and though the therapist asked me to do thirty sets of ten "pushups," I managed only fifteen.  (In my defense, the bar was heavy!) Next, I had to do eighty sets of ten-second squeeze-and-holds with a spring-loaded grip-strength device in each hand. I had to do this within five minutes, but I didn't manage more than 60 sets. All of this was hell, though I admit it beat lying in bed.

The second session took place in a gym-like room. My therapist for this session was a friendly twenty-something guy who proved quite helpful. We did some exercises involving sitting down and standing up; we did some stair work with a step stool, and we finished with a 26-minute session on an elliptical. I've always liked ellipticals and rowing machines; I think they're far more entertaining than your typical treadmill. Overall, this was a much more pleasant session. 

So I now have a small repertoire of exercises I can perform at home or in a nearby park where we have gym equipment. The bar exercise can be converted to pushups; the grip-strength exercise can be converted to any number of other grip-strength exercises. Stair work is just stair work, so I'll already be doing that daily. The stand-up/sit-down exercise is something I can do at home, and it's probably the only exercise for which I can't think of an analogue. As for the elliptical, well, we have a bad elliptical in our park, but it'll do. A good elliptical usually has a fly wheel; the one in our park doesn't. But the park elliptical will allow me to perform the necessary motions, and that's what counts. 

Overall, I'm glad I went through this physical-therapy session. I now have exercises that I can do over the next few months in the hope that this will help my brain heal and allow me to regain some function. In the meantime, I'm focused on getting the hell out of here. Tomorrow is my final day. 

as I suspected

Today's lunch was bibimbap, so as an experiment, and because this was my final lunch here, I ate the rice to see what would happen to my blood sugar. Sure enough, it spiked. 186. Remember I'm down to 130 otherwise. 

Look, there very well may be a such thing as "good" rice, but in terms of blood sugar, rice is rice. And today's informal experiment showed that nicely. So I'll be avoiding rice and such from now on, except maybe on cheat days.

lower-back pain has finally started

My hospital bed is adjustable, but I normally leave it in flat mode. This is partly because I have a tendency to toss and turn, so having the bed in knees-up mode and then trying to roll over to my side is inconvenient at best. 

Not to say I haven't played with the controls. Of course I have. But in the end, I always return to flat mode. 

Up to this point, the bed's hardness hasn't bothered me, but now, on my last full day at the hospital, I'm finally starting to feel the effects of the hardness. The small of my back and my knees have all started to complain, which makes it hard to sleep. (It doesn't help that the old couple in the berth next to mine also likes to keep a light on at night.) So I'm sitting at the 15th-floor lounge for the first time, writing this entry. Maybe a few hours away from the bed will cure my ills. We'll see.

sigh

Today is my last full day in the hospital. I'm so ready for this to be over so I can go back to living my life. I have physical therapy later this afternoon, so at least I have that to look forward to. More later. 

farts

OK, so we have to talk about farting. Korean men are often notorious for farting if they think of themselves as the big cheese in the room. But here in the hospital, I get the impression that almost everyone feels permitted to fart.

So I've started farting along with them. I haven't heard a single nurse fart (they're all young girls), but older women taking care of their men fart almost as often as the men do. I have now joined the intestinal chorus, although I admit my farts are rather timid compared to some of the thunderous utterances I've heard.

It's liberating. Maybe we should bring this ethos to the office. A good fart every now and then would do us all a world of good. 

Possibly the funniest/most horrifying fart experience I've ever had in Korea involved the owner of a small company. This was years ago; I was in my twenties. I was supposed to do private work, and I had to be interviewed by the CEO. I recall sitting primly in a leather chair; the CEO sat across from me in an even more plush piece of furniture. At one point, while I was talking, he cut a massive fart that must've gone on for almost thirty seconds. The fart sounded like a toad being slowly impaled by a spear. The CEO obviously didn't care about farting in front of a prospective employee, but the worst part was how he maintained eye contact with me while I was trying to talk. I can never forget that experience. 

No one at the hospital has tried farting so aggressively, thank God. So I'll content myself with adding my little poots to the symphony of flatulence happening around me.

four laps

I walked three laps around my floor yesterday, and four laps around my floor just now. It was slow going; my legs are like Jell-O, even the good left one. So I guess I'll be relearning how to walk. It was easier to walk yesterday, when I could lean on my IV tower; today, it was just me, and there were times I had to keep myself from collapsing.

There were other walkers out as well; what else is there to do around here? I was envious of the ones who seemed to have no trouble walking. Why the hell were they even in the stroke ward?

I'm setting goals for myself, and I now realize I need to factor in speed with my goal-setting. I had originally wanted to set just distance goals, but I now know I have to factor in how fast I can move. I'll be talking more about goals once I'm back home. 

For now, I'll just bask in the victory of doing four laps.

during the night

 Sometime during the night, the blog passed 20,000 hits for the month. Yeah!

here's what I learned

Thirty seconds of research on Google can be very educational. So here's what I learned: there are several types of insulin shots. Their effect lasts anywhere from thirty minutes to four hours. I've been chronicling how my blood sugar has been going down steadily since I stopped eating rice over several days. It's been two days since I had the shot, and my blood sugar is fluctuating between 140 and 160 points below where it was when I got here. Would you conclude that this is all thanks to the shot? Yeah, me, neither.

For the record, my blood sugar is around 130. That's not horrible for a diabetic, but for non-diabetics, normal is around 70. So I obviously still have plenty of work to do. 

Happy Buddha's Birthday

Some old line art stored on my phone:

post-breakfast update

Breakfast used to come right at 7 a.m., but lately, it's been coming later and later. Today's was at 7:35 a.m. Makes me wonder when lunch will be. 

A couple updates:

1. The father/daughter duo got moved to another room early yesterday afternoon. They've been replaced by another husband/wife couple. The wife is nice, but the husband (who hasn't yet acknowledged my presence) has bowel problems that force him to go to the bathroom several times an hour when he's awake. 

2. My IV and IV tower disappeared sometime in the night. I have only vague memories of this happening. I'm wearing some sort of remote heart monitor; the monitor itself sits in the front pocket of my ridiculous pajamas, and it's attached to a mess of sensors stuck to my torso. The monitor got put on before the IV tower disappeared. Translation: I have way more freedom of movement. Which is nice. 

3. Blood sugar this morning was the lowest it's been in a while. I've dropped over 160 points since arriving here. If this continues, I won't know what to do with myself. 

4. I'm pretty sure I need a shave. Today, though, I won't be doing anything more than washing my hair and brushing my teeth. 

I have no idea what's in store in terms of tests, etc. Today is the Buddha's birthday, so I'm hoping it'll be fairly quiet. We'll see. 

UPDATE, 12:30 p.m.: no docs thus far. Just nurses checking my blood sugar and blood pressure. I think they might try a full frontal assault tomorrow. 

the comedy of error

My blood pressure gets checked regularly. At first, this happened right along with my neuro checks, but somewhere along the way, BP started to get checked separately. Here's the thing: I get the need to check my BP at intervals, but the girls who do it never seem to learn: if they're not standing next to me, my pressure cuff will pop off. The first few times the girls walked away and let my cuff pop off, I sighed and mentally forgave them. Now, I just think it's funny because the girls never learn.

Pop goes the pressure cuff. I should be videoing this. 

wheelchairs

I've discovered that I love being pushed around in wheelchairs. Anytime I have a scan or test on a different floor, a wheelchair is brought to my room, I get in (on?), and I get wheeled to my destination. 

Wheelchairs are cool for us big people because they strain under our weight, which makes them roll funny. You can feel the chair's frame flexing around you as you roll; if you've never experienced this, I highly recommend it. Of course, if you're small, you'll never know this particular pleasure.

So, yeah: I think I love wheelchairs now, although I do feel sorry for the orderlies who have to take me from place to place. Poor bastards.

bad and good news

I was told I had an eye appointment at 3 p.m. Around 2:30, a nurse rushed in to give me eye drops to dilate my pupils. Around 3, I was wheeled to the first-floor office where I was given an eye exam. The exam itself wasn't so different from the eye exam you get in the States when you're getting new glasses or contacts. There was the puff-of-air test and the stare-at-the-landscape-until-it-comes-into-focus test. There was the stare-straight-ahead-while-I-shine-a-light-into-your-eye test. I was told my eyes are fine, which doubtless disappoints some of the docs working on me. 

I then had to go to another office to have my retinas photographed. This involved staring at a symbol that turned green and became a glaring light that, I presume, shined all the way to the back of my eye. Look straight ahead, look up, look down, look left, look right. By the time I was done and back at my berth on the 15th floor, it was 4:30 p.m. I had spent most of my time just waiting; the tests themselves didn't take that long.

So the good news is my eyes are fine, unaffected by diabetes or high blood pressure. The bad news came with a doctor who came to see me twice, once before my eye exam and once after. She talked about the results of my ultrasound, and according to her, I have a very weak heart. She was very friendly, but she basically gave me the "you could die if you leave our care" spiel, and I decided right then to refuse treatment. In case you think I'm out of my mind, let me explain. 

I asked the doc whether this condition had come upon me suddenly. As I knew she would respond, she said no. So I told her that, despite having that condition, I had already walked across Korea three times. So to my mind, I can live with a weak heart as long as it can take me across Korea every now and then. I also asked whether I had the right to refuse treatment, and she said of course. So I refused treatment. I plan to leave here on Friday. I'm not staying longer. They're already asking me to take a whole suite of pills for blood pressure and blood sugar, along with anti-stroke medication, and I have to change my diet radically as well. I think that's enough. And hey: if my weak heart kills me, then so be it. (The doc actually tried to threaten me with death or return trips to the hospital. She even asked, "Are you okay with dying?" at one point. That's not how you persuade someone, especially someone who's not afraid of death.)

There were two other doctor visits today. An older female doc did little more than be loudly preachy about the causes of stroke, my relative youth, and the need to change my ways. By this point, I'd heard variations on this theme hundreds of times, and the preachy tone didn't help. The other doc came to talk about what I can and can't eat, but I think I blogged about her already. 

I believe another doc is coming by this evening to try to talk me into further treatment, but I told the other doc (Miss "Are you okay with dying?") that he needn't come if he's going to give me the same damn spiel. 

As I see it, if I take my pills, follow the right diet, and exercise plenty, I'll lose weight and remove almost all the issues plaguing me. I do plan to include one or two cheat days every month, but otherwise, I'll behave from now on. I've learned my lesson. I just emailed my French buddy Dominique, and we compared hospital notes. He was in for appendicitis not too long ago, and he had to stay longer because of various infections. He said the experience made him philosophical about life; I get where he's coming from. 

Anyway, that's the update for now. Like Dominique, I'm taking stock of life and thinking of how to re-prioritize things. More on that when I'm back home. 

UPDATE, 10:30 p.m.: the other doctor never came by. Maybe he got the message. I realize this invalidates all the work done with ultrasound, but frankly, I don't care. But who knows? Maybe the doc will come by tomorrow or sometime before Friday. 

some hospital images

My name abbreviated to KIMK at the ER:

The fan that's saving my life right now:

Hard to see, but fingertips full of pricks:

Blood sample taken by nervous nurse (11 a.m.) who couldn't find the vein in my elbow the way the 6 a.m. nurse did:

The nervous nurse did try the elbow first. The hole on the left is from the 6 a.m. nurse:

My IV drip:

And that's the view from the hospital bed. 

showered

I'm showered, my teeth are brushed, and I've washed my underwear, the latter undergarment now hanging by my bed for all to see. The very nice husband/wife couple left yesterday and got replaced by a father/daughter duo. I heard that the father will get scanned and will probably be out of the hospital before Friday, so I'll be around to see a third pair of people. I sometimes think they're keeping me here to milk my insurance.

At 6 a.m. today, a nurse came in, stuck a needle in my left arm, and took a blood sample. This sort of random occurrence happens all the time here. My right index and middle fingers are riddled with tiny scabs from the many pinpricks I've received for blood-sugar readings, always preceded by a singsong warning from the nurse that sounds like "따끔" (ddaggeum) as the pin goes in. BP readings are hilarious: the cuff keeps popping off my arm, and they never learn their lesson about this. It's not that I have especially huge arms; I'm just a Westerner, and Korean hospitals aren't really prepared for Westerners and their Western dimensions. Of course, if you're a Westerner and tiny, you're good. I did ask one nurse what they do when a Korean wrestler comes in (those guys are huge); she lamely replied that they've never had such a person. That's probably not true. 

Not sure what's in store for today. I hope not more tests, but you never know. I'll write more later. 

UPDATE: the nutritionist swung by at 10 a.m. to tell me about all the things I can't eat. I already know what those things are, but I appreciated her cheerful presence.

UPDATE 2: just got news that I'll be visiting the ophthalmologist around 3 today. There's a worry about possible deterioration of my eyesight. Not surprising, given that they're tossing around terms like "atherosclerosis" and "hyperlipidemia." Eyesight is always a worry in such situations. 

tomorrow, we shower

I washed my hair yesterday, but I haven't showered since I arrived on Friday. I have an IV in my right arm, so showering means sponge bathing. Awkward, but better than nothing. I'll wash off the stink of four days and, unfortunately, put the same dirty pajamas back on. Ick. But as I said, better than nothing.

ultrasounded

Just got back from ultrasound and had another triumphant poop. I also figured out the toilet's bidet function, so I enjoyed that. A senior doc came to visit this morning; he re-emphasized the need to stay on pills for the rest of my life, to lose weight, etc. 

Little else to report for the moment. My boss will be coming by shortly with yet more stuff I need. More news as it happens. 

Oh, yeah: the doc said I'm here until Friday. 

ADDENDUM: I'm getting a CT scan soon. More on that in a bit. 

ADDENDUM 2: Three ultrasounds and one CT scan later, I have no idea whether I'm done for the day. No one lays out a schedule or tells you what's coming next. 

I've come to realize that life for a patient in the hospital is a mix of the rigid and the flexible. Every four hours, your neuro check. Meals at 7 a.m., noon (unless you're getting scanned like me), and 6 p.m. BP and blood sugar tests at seemingly random intervals. Also at random intervals: the arrival of a bright-eyed nurse to say you've got a scan "now," with "now" meaning "sometime in the next hour or two." I'm a creature of routine, so getting three ultrasounds and a CT scan today was not pleasant, and not knowing exactly when they'd happen was even more unpleasant. And I still don’t know whether the day is over. 

Why three ultrasounds and not just one big one? I wouldn't blame you for wondering. Near as I can figure, each part of the body has its own ultrasound room: lower cranium, neck, and heart. Stupid, but there's another truth about hospitals: they're atomized bureaucracies. And with so many moving parts, things sometimes fall through the cracks. I was almost wheeled back to the wrong floor earlier today. A male nurse almost directed me to the wrong scan. (He initially said CT but meant my third ultrasound.) Doctors and nurses work shifts, which means different people have to keep track of the same things. It's a miracle the system works at all. I'll say this: overall, it works. But it's clumsy. I wonder if there's a way to make it better. 

ha

My blood sugar has dropped 50 points since breakfast. The nurses will attribute this to their insulin shot; I maintain it's because I've stopped eating rice. I don't know how long the insulin shot's effects are supposed to last, but if 72 hours pass and my numbers stay low, I'm calling it for the rice boycott, and I don't care what they say.

boss came by

I listed my boss as my guardian, and he came by today armed with a charging cord, three 500-mil bottles of Coke Zero, and the thing I wanted most: my fan. Life is a thousand times better now that I have the fan. I'm happy to be charging my phone, and I'm happy to have the Coke Zero, but the fan is everything. Maybe I can get some actual sleep, now that the air around me is moving.

The boss went through the usual bureaucratic trouble to get to see me. He had to take a corona test (streamlined to just the nasal swab I'd talked about last year); results didn't come out until today.  He was told he also needed to have my alien-registration number, which made him wonder aloud how he was supposed to know that.  (He had to text me to get it.) Korea is often a bureaucratic nightmare, so none of this was surprising. I did feel bad that he had to go through so much red tape, though. And on a Sunday. 

I forgot how loud my fan was. Luckily, the couple in the berth next to me (the husband is the patient) have been very kind and helpful, so of course they said my fan wasn't noisy. The wife has been extremely kind, taking away my tray after every meal, and showing me where the water dispenser is. The husband also offered his phone charger to me; I didn't take him up on the offer, but I was thankful for his kindness. I'm lucky to be berthed next to such people.

In other news: no talk of surgery. We're sticking with drugs to unclog some clogged passages in my head. They're also trying to get my blood sugar down, but the problem is that they keep feeding me rice. How the hell am I supposed to reduce my blood sugar if half my meal is carbs? Silly people. So I've decided to stop eating the rice. They just gave me an insulin injection, so when next they see how much my numbers have gone down, they'll probably attribute the drop to the shot, not to my stopping carbs. Ah, well.

So this was a full-on ischemic stroke, which means there's now some dead brain tissue in my head. This will turn to scar tissue, and since this was a mild stroke, I expect to be near 100% in six months. Obviously, all my previous talk of dieting will finally have to become more than talk; I'll take this as a sign from the cosmos and consider this a close call. This could've been a lot worse. 

All for now. This is taking a lot out of me, and blogging by phone is never convenient. More later.

no Wifi

I'm on the 15th floor of the main building of Samseong Hospital. I finally asked a nurse about Wifi. Her response: on the 14th, 15th, and 16th floors, so much medical equipment operates on Wifi that regular Wifi for regular folks is impossible. Alas.

I finally pooped

Took nearly three days, but I finally pooped.  I know there's more waiting to come out, but every time I go to the bathroom I only pee.  So this was a bit of a noteworthy triumph. Maybe more later.

it's still the stroke ward, but...

So I think I misunderstood.  I wasn't being moved out of the stroke ward so much as down the hall to a non-specialized room.  I no longer have sensors all over my torso.  Am not sure how long I'll be here, as they might move me again.  Anyway, I'd love for you all to come visit, but they're following a strict corona protocol that prevents group visits and pretty much limits visitors to whomever you selected as your bohoja, i.e., your guardian.  Life is boring, but the food is okay.  I'll have more to say soon.