Thursday, November 18, 2021

A firefighter’s experience with bariatric weight loss surgery

From Fire-Rescue 1 Nov 18, 2021

“Rates of overweight and obese individuals in the fire service are higher than those found in the general public, ranging from 73 percent to 88 percent of firefighters.”

This disturbing finding comes to us from the National Volunteer Fire Council.

Other major fire service organizations have come to similar conclusions, with further research showing the outcomes of our poor health. The National Institute for Occupational Safety and Health (NIOSH) reports that in 2019, over 50% of all line-of-duty deaths (LODDs) were the result of sudden cardiac arrest.


"Throughout my fire service career, I constantly felt that I had to work harder and do more simply to break even with the 'in-shape' firefighters," writes Philip Clark. (Photo/Philip Clark)

We’ve been hearing these stats for years – but that doesn’t always mean we take action to avoid becoming a statistic ourselves.
“I was falling behind”

I cannot remember a time in my adult life, or most of my childhood for that matter, that I was not overweight. It was a constant struggle. I ate from boredom, I ate from depression, I ate just to eat. I did not have healthy habits.

Slowly I went from husky to chubby to big to fat to morbidly obese. Much like a frog in a pot of heated water, the change was so gradual that I didn’t notice it was killing me. I didn’t wake up one morning overweight; it was a series of bad choices and poor self-care that led me to my own downfall.

Throughout my fire service career, I constantly felt that I had to work harder and do more simply to break even with the “in-shape” firefighters. But if I was being honest with myself, I wasn’t breaking even. I was falling behind. My crew would have to work harder to complete the task because I wasn’t keeping up. I remember a time when working at a structure fire would be the only event of my day because I was physically spent after the call. I realized that I was putting not only myself but also my family and my fellow firefighters at risk.

The sobering statistics above, along with several personal realizations, led me to make a life-altering decision. I needed to make a change. I needed to start taking my health seriously.
“Preparing for the rest of my life”

In June 2020, I started the process of meeting with a bariatric center for weight loss surgery. The process, as I would learn, was more involved than I had realized. I would spend the next three months preparing for the rest of my life. I met with a dietician to discuss my eating habits, and together, we created a plan for success. I met with the surgeon who laid out all the requirements for my surgery to take place. I started a diet almost immediately following my first appointment, and over the next few months, I had regular checkups with my team to ensure that I was sticking to the plan.

At two weeks out from the surgery, I was put on a full liquid diet that consisted of creamed soup, yogurt, pudding, Jell-O and protein shakes. At the time, I was working a full-time night shift in a busy 911 system. Meal prep was a must because, as you can imagine, there aren’t many options for a liquid diet from a gas station at 3 a.m.

Finally, in October, the day came that changed my life. I joined the “Loser’s Bench.”

The surgery was simple enough, at least according to the doctors. Through five small incisions in my abdomen, they would remove around 80% of my stomach, essentially turning my stomach from a ball shape to a banana shape. The surgery not only creates a smaller “pouch” for food to fit in to but also suppresses appetite. The doctors projected that I would lose 75-80% of my excess weight simply from the surgery. The rest would be up to me and the lifestyle changes I enacted.
“The weight began to come off”

Recovery went well. My first two weeks after surgery required a clear liquid diet. This is like the full liquid diet, but it removes any liquid you cannot see through. If you’re thinking that this sounds unenjoyable, you’re right! I lived off of Jell-O and beef or chicken broth.


"I had cinched up my turnout gear as much as I could, but after losing 50 lbs., I looked like a little kid wearing his dad’s suit for dress-up," Clark said. (Photo/Philip Clark)

As the days passed, the weight began to come off.

For the next two weeks, I was back to the full liquid diet. By the end of my first-month post-op, I was allowed to eat soft puréed food. Let me tell you, chicken mush never tasted so good! By this time, I had lost about 25 pounds, and I was beginning to see and feel the changes.

January brought more good news. I was down about 50 pounds, and my clothes were starting to sag off my body! Even more impressively, I was starting to realize the difference that this weight loss was going to make. I wasn’t winded as easily. I had more energy. During training, I had more to give. I had cinched up my turnout gear as much as I could, but by this point, I looked like a little kid wearing his dad’s suit for dress-up.

As the pounds kept coming off, my mental health began to improve as well. I started to feel better about myself on both the outside and the inside. It was a whole new experience for me, but the best was yet to come.
“Is this how healthy people feel?”

By early summer, I was down almost 100 pounds. It was at this point that two very big events occurred – eye-opening events in my weight-loss journey.

The first was a working fire that just a year ago would have wiped me out and required at least a day of recovery. I found that I was able to make my SCBA breathing air last longer and that I didn’t feel as tired afterward. It was amazing to me that I had more to give when the job was done! Is this how healthy people feel?! Even though I am a paramedic, I had no idea that my extra weight was putting such a strain on my body, and I couldn’t believe that I had waited this long to take on this problem head-on.

The second event was the physical agility test for the career department to which I had applied. In the past, I talked myself out of these kinds of tests by making excuses – all out of fear of failure. I would wait to get the medical release signed until it was too late. I would make sure I was working on the day of the test and that I “wouldn’t be able to get off.” I was trying to protect my pride by making sure that if I didn’t take the test, I wouldn’t fail. On the day of the test, I was more confident and felt better prepared than I had felt about anything in a long time. It was hard, but I passed! Not only that, but I passed with a significant amount of time leftover! After successfully passing the agility test and the interview process, I was hired to be a full-time firefighter.
“You need to make the choice”

This journey has been hard. I still struggle with emotional eating, and I work every day to try to better myself. I find that there are days when I backslide, but it only takes a quick trip down memory lane through my photos to see how far I have come and to remember how much I do not want to go back to where I was.

I would like to encourage everyone reading this to take a moment to perform a self-assessment. Ask yourself the following questions:
“If my loved one – my daughter, my son, my spouse, my parent – was trapped in a fire, would I want ME being the one to have to make that rescue?”
Could you, without a doubt, do the job?
Could you give it your all and still have some left over?

If the answer is no, there is only one person who can fix it. You need to make the choice to make yourself better.

There is a quote from Greek philosopher Heraclitus that says the following: “Out of every one hundred men, ten shouldn’t even be there, eighty are just targets, nine are the real fighters, and we are lucky to have them, for they make the battle. Ah, but the one, one is a warrior, and he will bring the others back.”

Are you one of the 10 that shouldn’t be there, the 80 who are just targets, or are you the one? I may not be the one – I don’t think that anyone can label themselves as such – but I am now confident that I am one of the nine real fighters. I will continue to strive every day to be the one, and to never go back to being one of the 90 ever again.

So come with me, and together we can achieve our goals. Believe in yourself. BE THE ONE!

Sunday, November 14, 2021

Wednesday, November 10, 2021

Unvaccinated Texans 40 times more likely to die of covid than those fully vaccinated in 2021

From the Washington Post

Unvaccinated Texans 40 times more likely to die of covid than those fully vaccinated in 2021, study says
Paulina Firozi1:23 p.m. EST

A medic from the Houston fire department prepares to transport a covid-19 patient to a hospital on Aug. 24. (John Moore/Getty Images)

A vast majority of Texans who have died of covid-19 since the beginning of the year were unvaccinated, according to a grim new Texas health department report released Monday.

The report from the Texas Department of State Health Services examined data from Jan. 15 to Oct. 1 and found that unvaccinated people were much more likely to get infected and die of the coronavirus than those who got their shots.

Of the nearly 29,000 covid-linked fatalities in Texas during that period, more than 85 percent were of unvaccinated individuals. Nearly 7 percent of the deaths were among partially vaccinated people, while nearly 8 percent were fully vaccinated.

The figures highlight just how much more at risk the unvaccinated population has been this year: In all age groups, the state’s unvaccinated were 40 times more likely to die than fully vaccinated people. The study also found that the unvaccinated in all age groups were 45 times more likely to have a coronavirus infection than fully vaccinated people. It also looked closely at data from September and underlined the impact of the highly contagious delta variant, which fueled a surge in Texas, as it did in much of the country.

The report from Texas health officials underscores the risk that cases and death counts would spike among the unvaccinated, echoing the alarms that public health officials have been sounding throughout the year. The report, which Texas health officials say is the first statistical assessment of the real-world effect there of vaccination against the coronavirus, also highlights the impact in a state where Republican leaders have sharpened attacks on public health strategies throughout the pandemic. Last month, Texas Gov. Greg Abbott (R) banned any entity in the state from mandating vaccines for workers or customers.

“This analysis quantifies what we’ve known for months,” Jennifer A. Shuford, the state’s chief epidemiologist, said in a statement. “The COVID-19 vaccines are doing an excellent job of protecting people from getting sick and from dying from COVID-19. Vaccination remains the best way to keep yourself and the people close to you safe from this deadly disease.”

Shuford’s remarks echo statements from other health leaders, including Rochelle Walensky, director of the Centers for Disease Control and Prevention, who has described the nation’s ordeal as “a pandemic of the unvaccinated.”

While Texas is still averaging more than 3,200 new daily infections and almost 110 deaths a day, the state, like the nation overall, has seen case and death totals fall, according to data tracked by The Washington Post.

Nearly 54 percent of the state’s population is fully vaccinated, trailing the national vaccination rate of 58.4 percent.

The state data “shows what we already knew — that the unvaccinated are increasing their risk of severe covid disease and death, and we have the data now to prove this,” said Bhavna Lall, a clinical assistant professor at the University of Houston College of Medicine.

She said she’s troubled by leaders questioning public health mitigation measures and vaccination mandates, particularly in a state that’s had more than 70,000 deaths since the pandemic’s start — one of the highest total death counts in the country.

“By debating mitigation measures, we’re not helping in any way,” she said. “We know what works for decreasing the spread of covid. We know that vaccination works, we know masking works.”


Recent findings from the CDC similarly highlighted risks for the unvaccinated. A CDC study published in September found that people who were not fully vaccinated in the spring and summer were more than 10 times more likely to be hospitalized and 11 times more likely to die of covid-19 than people who were fully vaccinated.

Unvaccinated people were 11 times more likely to die of covid-19, CDC report finds

The new report from Texas also breaks out findings from the weeks between Sept. 4 and Oct. 1, which the health department said researchers wanted to analyze to measure the vaccine’s effectiveness as the delta variant surged in the state.

In that time frame, unvaccinated people were 20 times more likely to experience a covid-associated death than fully vaccinated people, and were 13 times more likely to become infected with the virus than the fully vaccinated.

The Texas data strengthens scientists’ assertions “that vaccines work,” said Rama Thyagarajan, an assistant professor at the University of Texas at Austin’s Dell Medical School.


She noted that the small percentage of fully vaccinated Texans who died probably were “the oldest and sickest of the group.”

The report said 35 percent of deaths were among people 75 years and older, and 25 percent were among those 65 to 74.

While the vaccination against the coronavirus had a strong protective effect for all people, the report notes, the findings varied by age on the protective impact for covid-related deaths. Unvaccinated people in their 40s were 55 times more likely to die of covid-19 in September than fully vaccinated people of the same age. For people age 75 and older, the unvaccinated were 12 times more likely to die than the vaccinated in that time frame.

The report also highlighted the severity of the impact of the delta variant overall. Regardless of vaccination status, the report says, Texans were four to five times more likely to become infected with the coronavirus or to suffer a covid-linked death in August, when the variant was prevalent in the state, than in April, before its presence was widespread.

Lall said it was “sad to see that during the time when delta was surging, we had so many people … dying because they just didn’t get the vaccine.”

She said the latest report from Texas, which shows the protection offered by vaccination, underlines the need to encourage not only more vaccinations but public health measures that can help stop the virus from surging.

“We need to be aware that other parts of the world are surging — Europe has high covid cases right now — and if we don’t get more people vaccinated in America, we’re still at risk,” she said, adding: “No one wants to go through these surges again and again.”