MYST 85 Trevitorial: Success Without Total Effort?

Is he giving 100%
Is he giving 100%

Photo by Vincezo Di Giorgi via StockSnap

“Don’t put in half the effort, unless you are okay with half the results!”

What an excellent motto. I’m happy to say that I wrote it….well, I wrote it after reading it in a LoseIt Community group from another member. (Today’s show is not going to exclusively be about weight loss.)

I’ve mentioned this many times before (and I will continue to for as long as I run this show) but I am very active using the app LoseIt for weight loss. Actually, I am one of seven Ambassadors who work to help provide some guidance to the millions of members, and especially the newer members who may need a bit virtual hand-holding.

But not all guidance is from the Ambassadors. In fact, the amount of help we provide is trivial when compared to the hundreds—no thousands—of posts every day from experienced and successful member who only want to share their ideas and help others find success.

Theordora has been a LoseIt member since May 2015, and already she is an active and enthusiastic supporter of everyone around her. She is still actively working toward her weight loss goal, and so her words of wisdom are from the perspective of someone who still struggles day after day, and who victoriously emerges from the fight each day. Or…sometimes her victory isn’t as obvious, but she never quits and is always a positive influence.

“Don’t put in half the effort, unless you are okay with half the results!”

That applies to everything in life, not just weight loss. I mean, LoseIt is all about counting calories and finding a healthy weight, but for me, it is much more than that. LoseIt is a support system. It is a family of “virtual friends and neighbors” who are always ready to lend a helping hand, a few words of wisdom, or that gentle kick in the butt if needed.

I needed those words today, for a few reasons, none of which having to do with food.

My legs hurt today. Yesterday, I rode 120 miles to an incredibly exciting meeting for our school’s union (I am the local president). I am still not permitted to drive, so my vice-president drove me.) Two hours there. Seven hours sitting, trying to stay awake. Two hours driving home. I arrived home with legs as stiff as possible. And they are not much improved today.

And they hurt. Walking is painful. Sitting is painful. I realize it sounds like I’m whining—and maybe I am—but bear with me, I have a reason. I was feeling sorry for myself. I didn’t want to do anything but sit in my chair with my dog on my lap. I wanted to be at ease. I wanted to rest.

Ozzy

But how will sitting and resting help me fully recover from my knee replacements? (Answer: not at all!) I was acting like my students. They carry their books in their backpacks, but rarely open them, assuming that the knowledge will magically migrate from the printed page to their brains without any effort. Me? I’m hoping that if I rest enough, my strength and flexibility will return without the effort of exercises.

More specifically, without the pain of exercises. Pain hurts, you know?

Mmmmm. How do you think that will work? Tomorrow I see my physical therapist, Nick. He is going to measure my knee flexion. Resting is easier, but do you think that will give me much improvement?

No. All morning I was giving far less than 100%, yet knowing that tomorrow, I would be hoping for 105% improvement.

The same applies to this show. I’ll be honest (as if you don’t already know) but I am struggling with MYST. I still enjoy running a podcast. I enjoy the recording, and the transcribing, and the promoting.

But I am running low on enthusiasm. I’m running low on ideas. I want to have my show, but I am acting as if putting in 50% effort is enough for 100% performance. And we all know, that is not right.

What about you? Are you trying to write a book? If you are, you know that the words don’t magically appear. You need to sit down and write. And write. And then write some more. Is it fun? Probably not every day. (PT isn’t fun, but I still need to do it!) Choosing to walk instead of drive isn’t necessarily fun, and choosing to eat celery and peanut butter isn’t as desirable as a piece of cake, but that needs to be done if you want to change your weight.

The bottom line is this: if you want success, you need to do the work. There is no other way around it. Even if you fire someone to transcribe your notes, you still need to give your assistant the notes. If you don’t do the work, you won’t get the results.

Theodora is right. If you don’t put it 100%, don’t expect 100%. (I am going to use that line when I address my students at the beginning of the semester.) It might hurt. It might be difficult. It might not be what you really want to do right now.

But where do you want to be tomorrow? Our success tomorrow depends upon our decisions and actions today.

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Some links (but not all) within these show notes may be Affiliate Links, meaning that I may receive a small commission when readers click on them and then purchase something. This does not increase your cost at all, but it does help me cover some of the cost associated with this podcast. Thanks!

Music composed and performed by Jason Shaw, courtesy of Audionautix.com

Voiceover courtesy of Matt Young. Matt is a professional voiceover artist. If you have any need of voiceover work, for your podcast, radio spot, or whatever, you can reach Matt by a variety of methods. He is on LinkedIn. On Twitter. And Google+. And you can read his really nice, contemplative blog. Matt was also my guest on MYST 54. Give his story a listen!

MYST 84 Trevitorial: Diet or Exercise?

or photo-1422207175003-e5b7d45ceb7b  or Rainbow-Run-2014-018 Dave Maier

 

Which is it? Diet or Exercise?

When people hear that I once weighed 305 pounds (138kg) and was able to lose—and keep off—125 pounds (57Kg) I still get asked the same question:

“So? What’s your secret?”  As if there is a secret to successful weight loss!

I almost always get the same response to my reply: “Diet and exercise.” It is a little half-frown, a micro-step backwards, and then, “Ohhhhh.” As if that secret wasn’t good enough.

But that is it! Diet: in other words, eating the correct amount of calories and Exercise: moving more to burn more calories. Nothing else. But…there is more to it than that!

This show will focus on the three phases of weight loss, and how “diet and exercise” remains the foundation of successful weight loss even as how “D & E” habits become modified through each phase.

Nothing can stay the same and remain successful. Things always change, even how you lose weight.

And first, I want to thank one of my LoseIt friends, Mike Pfirrman. He posed a question in the LoseIt forum about this topic, and in crafting a response, I realized that I don’t think I’ve ever really addressed this specific topic. So, thank you, Mike! I hope that your question will eventually help many people, even beyond the world of LoseIt!

His question was “If weight loss happens in the kitchen, why am I reading than nine out of ten people who are formerly obese, regain all their weight over a 5 year period if they don’t exercise?”

His question actually addresses not “weight loss” but “weight maintenance”, which requires a different mindset. But I will get into that shortly.

The genesis of his question is that many people come to LoseIt as ask what exercises they need to perform in order to lose weight, and the stock answer is a variation on this: “Weight loss happens in the kitchen. Fitness happens in the gym. Focus on eating correctly, because you can’t out-exercise bad eating habits.”

And I stand by that answer. It is true. Mostly. In this show, I will dissect it more accurately, addressing each weight loss phase.

The first phase is “Early Loss.” Especially when a person has a lot of weight to lose (50 or more pounds) it is not uncommon that not only is the person overweight, but they are also under-active. And their lack of activity is partly due to low/no stamina, painful joints, shortness of breath or other weight-exacerbated conditions that already exist.

Could an overweight person focus on exercise only and lose weight? Certainly. Will they? Unlikely. If a person has been sedentary long enough combined with bad eating habits, becoming consistently active enough to promote significant weight loss is probably not a realistic goal. I will take myself as an example. When was 305 pounds, I struggled to slowly walk a quarter mile (400m) with my dog Ozzy. By the time I reached that point, I was short of breath to the point of being lightheaded. I had no stamina. Physically, I was all I could do to walk that short distance. If someone had told me, “Trevor, the only way to lose weight is to start a P90X routine” my response would have been, “Sure. Right after I eat this container of ice cream.”

No. In that “early loss” phase, we need to focus on something that is equally hard but within the realm of physical possibility. We need to focus on finding a correct diet. And by “diet”, I mean calorie budget. Personally, I do not subscribe to the idea that any one food, food group, or macronutrient is the source of all weight problems. I know that many people have strong beliefs about this. Some promote eating paleo, some promote low fat, some promote gluten free, some suggest no artificial sweeteners, some no processed carbs, some want meal replacement shakes, and so many others.

That isn’t me. I believe that total calories is the problem, and to fix that problem you need to change your total calories consumed. So, with that in mind, and with the help of LoseIt, I found a calorie budget that worked for me. I learned to eat the correct portions (oh, yes, “portion control” is a major component) by weighing and measuring my foods. I logged everything I ate, because how else do you really know what you’ve eaten. And I ate my budget.

And in the first phase of my losing, that worked. I started losing weight and at the same time, I started making portion control and logging a daily habit. I made it part of my routine life. I made it a new habit, a good habit. All because I was focusing on only one thing, day after day.

After the losses had progressed for a few months, I moved into “Continued Loss” phase. I had dropped from 305 to under 275 in about 3 months. It was a nice steady progression and I was about 20% towards my goal. But during that time, I still needed to walk my dog every day. I didn’t do anything special related to exercise. I just walked my dog, but by the time I reached this point, I had started walking longer distances. I was walking up to a mile, sometimes twice a day.

At this point in the weight loss journey, physical activity started to become easier. I started walking more, sometimes even without Ozzy. My losses continued to accumulate. My calorie budget would slowly drop with each logged loss (about 8 calories per pound) but I was still eating the full budget and still losing weight at a fast pace (around 2 pounds a week—I was still 95 pounds from my goal.) But it is during the “Continued Loss” phase that exercise first needs to be addressed.

Remember, as you lose weight, you need fewer calories for survival, which means your budget will drop. Oh, not much at first, but over those first three months, my daily budget had dropped by about 320 calories! That will continue to work for a while, but eventually, especially when you are close to goal, that “budget only” loss plan will give you a budget that is so low as to be unsustainable and unhealthy. The only way losses will continue is by increasing activity.

During the “Continued Loss” phase, you need to gradually increase your activity. This can be simply walking longer and longer distances (as I did) or adding different activities (bicycles, swimming, weight lifting, etc.) You still need to follow your budget, but these new activities will give your losses a bit of a boost because you are now burning even more calories. And when you are close to the goal, you will need to eat those exercise calories because your base budget might be nearing that “too low” zone (below your Basal Metabolic Rate).

Okay, so in “Early Loss”—the first 20-25%, you focus on changing your eating habits, and very slowly add gentle activities.

“Continued Loss” phase keeps the budget focus but brings more exercises to the plan, enhancing your losses and at the same time, building stamina, strength and physical confidence.

The last phase is what Mike was talking about. “Maintenance” is a different aspect of weight loss, and is where most people stumble and fail. If you have solely been using calorie restriction for weight loss, by the time you are at a normal BMI, your calorie budget will be low. Very low. Again, possibly at that unsustainable level. And to continue living on such a restricted budget–continue for the rest of your life, which is how long maintenance lasts—you will probably become one of those “nine of ten” that Mike mentioned.

But if you had successfully made the transition from primarily focusing on your budget to keeping to your budget while increasing your physical activity, you will probably be that one of ten. You will have discovered that sweet spot between activity and budget and when you find that, you are on the smooth ride for success.

That is what I was able to do. Through my losing phases, I increased my activity, which remained almost exclusively walking, to the point where walking 7 miles was nothing. One day (May 10, 2012) I walked over 42000 steps with a 44 pound (20Kg) backpack. That was 18.5 miles (29.6Km), in only 6.5 hours. Yes, I was tired, but not exhausted. I walked 18.5 miles when a year earlier, I couldn’t walk ¼ mile.

My maintenance continued successfully because I kept walking. When I was on the job at the hospital, I added 50-70 flights of stairs a day, to add to my activity. I still ate my budget, and logged all my foods, but now the focus was more on activity (because the food aspect had become a good habit.)

Oh, you noticed I said “my maintenance continued successfully…” using the past tense? Yes, that is correct. My maintenance period ended, and it ended for the same reason Mike’s “nine out of ten” failed. My activity came to a grinding halt. About a year ago, my knees failed to the point where walking any distance was incredibly painful. I was back to that ¼ mile limit, not because I was short of breath, but because my knees, both “bone on bone” would feel like small blast furnaces had been implanted under my knee caps. I could still—had to—walk at the clinical sites, but no stairs, ever. And I only tolerated the walking because I had a cane, strong anti-inflammatories during the day, and strong narcotic pain killers for after work.

And the weight came back. At my peak loss, I was down to 175, and for about 2 years I fluctuated between 175 and 185, which I considered my success zone. And then in the summer of 2014, that ended, and the weight began adding up. I’m now at 205, twenty pounds over the upper border of my success zone. All because I couldn’t drop my budget low enough, and enhanced by the fact that my walking was negligible.

Now that I am fully one month after knee replacements, I foresee a return to my success zone again. It will take until March or April 2016, but I will get back. I now know how to get there, and know what it takes to stay there.

If you are in any of the three phases of weight management, I hope these ideas are helpful. Leave a message in the show notes or use my Speakpipe message system to leave me a 90 second voice mail!

Some links (but not all) within these show notes may be Affiliate Links, meaning that I may receive a small commission when readers click on them and then purchase something. This does not increase your cost at all, but it does help me cover some of the cost associated with this podcast. Thanks!

Music composed and performed by Jason Shaw, courtesy of Audionautix.com

Voiceover courtesy of Matt Young. Matt is a professional voiceover artist. If you have any need of voiceover work, for your podcast, radio spot, or whatever, you can reach Matt by a variety of methods. He is on LinkedIn. On Twitter. And Google+. And you can read his really nice, contemplative blog. Matt was also my guest on MYST 54. Give his story a listen!

MYST 83 Trevitorial: Educated or Experienced?

Where was I? Did I abandon you?

In my last show, I promised that you’d get another episode in the following week, and that while you were listening to it, I’d be in the hospital recovering from my bilateral total knee replacements.

Obviously, that didn’t happen. And the reason it didn’t work are actually a good lesson that I needed to learn. Maybe you will be able to learn from it, too.

This episode will be about my surgery, and I will go into a fair amount of detail, partly to explain why I was absent, and partly to remind myself of exactly what I went through.

In my room, immediately after surgery.
In my room, immediately after surgery.

I made a mistake. Yes, I know. Shocker, but I’m not perfect.

See, I’m a registered nurse with 19 years of experience. I teach at a local college, and I have groups of clinical students at a local hospital every semester. Knee replacements are a common procedure that we see. Consequently, I am familiar with their treatment course. I have been unofficially working with a physical therapist who gave me a number of exercises to speed my progress and I actually did practice those prior to surgery.

I’m also a guy, and as such, I can be blinded by my ego and assumptions. I know how all those patients do after their knee surgeries, and since I am only 51 and in generally good health, not only will I naturally recover faster, but my knowledge of what to expect will give me an added edge. That will allow me to quickly advance through the inpatient recovery period with maximum functionality. I’ll probably be the one patient who is ambulating up and down the halls all day, just exercising my legs and preparing for discharge. And I know how to stay on top of the pain, yet not use too much pain medicine that could fog my brain a little.

Um. Do you have the sense of some foreshadowing in that paragraph? Do you see possibly where my plans might fall apart?

It all started before the surgery, which was Wednesday, May 20 at 7:15am. In anticipation of my convalescence period, I spent the preceding weeks doing as many household tasks as possible, because I knew that I would be very limited for a few weeks. And as the surgery approached, I realized that I didn’t have time to record an episode for Thursday, May 21. With everything I needed to accomplish, I needed to complete items that had a higher priority than the MYST episode. (As much as I need all of you, and appreciate your listenership, I live with my wife and her needs must be met first.)

But that’s okay. I had a plan, and I thought it a pretty good one indeed! My surgery was early in the morning on Wednesday. I knew that I wouldn’t be doing any physical therapy that first day, so my only activity will be resting and keeping up with pain control. I’d be out of surgery by noon, and in my room by 1pm. A few hours napping off the anesthetic, and then I’d be relatively awake and alert. As evening rolled around, my wife would go home (she had to teach the next day) so I’d be alone in my room. A room with wifi. And so in addition to my computer, I also brought my portable microphone, because I was going to record a show “on the road”! Yes, I would record a show from my hospital bed, and get it loaded and ready to publish for all my awesome listeners.

Plan #1: Record on the night of surgery for an interesting point of view. Dead on Arrival.

About the only part of that plan to be accurate was “my wife would go home”. I was never fully awake and alert. I think I have good pain control. I know I was getting pills every 4 hours, and occasional IV morphine (probably relates to me not being awake and alert.)

But I had other issues that night.

For surgery, I chose to have a spinal block. That is where the anesthesiologist injects the anesthetic into my spinal canal, and that deadens everything from about the navel down to the toes. I chose that because it actually provides about 2-6 hours of relief after the surgery, allowing he long acting anesthetic that my surgeon injects into my knees to begin working. I also wanted to avoid a general anesthesia (breathing tube, gas) because there is more nausea and vomiting from that, and that just isn’t fun.

So I went into the surgical suite and the doc injected my spine and I laid down waiting for it to work. Eventually, everything went numb, much like when the dentist numbs your teeth before drilling. You know, he/she will inject some novacaine in just the right spots so you feel almost nothing, just those little bits of pain once in a while. Right?

The surgeon start checking my body parts. I couldn’t feel anything. So he started the first incision. And I can tell you that he begins the incision above my right knee moving down, because I felt that! The anesthesiologist said, “Whoa, we don’t allow you to feel anything!” and he knocked me out hard.

So late that afternoon, I am trying to work off both anesthetics. Very slowly. I wasn’t clear of the after-effect, but I was certainly losing the numbing effects. I got a thirsty (I love ice chips.) Got a little hungry (mmm, orange jello.) Oh, yippee! Passing gas! These are all signs that everything is waking up. And at this point, I was still thinking “Maybe I can still record tonight.” I even stood at the bedside, for about a minute before I almost fainted.

Except one organ refused to wake from its slumber. I won’t go into too many details, but after surgery, a patient needs to prove that they have good kidney function. And they have 8 hours to meet that challenge.

And I failed. And I begged for a one hour extension and was granted it. I pounded water like it was a forbidden food.

And I still failed. And so, I experienced another lesson: straight cath. Yes, where the catheter is inserted into the bladder to drain it. Now, over my 19 years, I’ve done this many times, and each time I told the patient, that this will be uncomfortable but over quickly.

Oh. My. God. What a lie!!!!

I have never had such pain in my life! Now, the good thing is once it reaches the bladder, the pain is instantly gone. Until it is removed. But I will never gain use the words “little uncomfortable” again. Never!

And of course, the eight hour time limit starts all over.  Kept chugging water, and discovered that when you need to use the bathroom, a call light is never answered fast enough. However, my urinal was in reach and, well, let’s just say, I passed that test with flying colors.

By now it is nearing midnight. And I realize that there is no way on earth I was recording anything tonight. I decided to take that off my to-do list and replace it with one thought: “Survive until morning.”

Wednesday arrived and I was feeling pretty good. I had received meds every four hours, and that was working. The lab tech came in and drew some blood. I ate breakfast. Hmm. Maybe I can record today. It will be a day late, but still…

And then physical therapy showed up. And after a few exercises, I was wringing from sweat and fell asleep. Missed my scheduled pain pills. Lunch, with a few walks to the bathroom, and another PT session. More almost uncontrolled slumber. Dinner. Got pain pills, forgot to ask for the IV anti-inflammatory. Walked in the hall after supper, about 200 feet. Felt good, like I accomplished something.

Fell asleep. Until 1am. And the realization that I hadn’t received two doses of the anti-inflammatory (which is only given if I request it) and one missed pain pill schedule put me way behind the pain curve. I was in horrible pain. More pills, IV anti-inflammatory medication, and IV morphine finally brought it under control. Big lesson: take charge of yourself. If you don’t speak up and ask for something, no one will know you need it.

But that pretty much set the tone for the remaining days in the hospital. PT, pain pills, sleep. Over and over. I don’t remember big chunks of my time there. I do remember the times the pain was bad. But mostly, I was always tired.

And there was a good reason for that feeling of tiredness. I donate platelets through the American Red Cross. And for each donation, they always check my hemoglobin level, or the amount of oxygen-carrying iron in my red blood cells. I am always on the high end of normal 15-16g. I found out later on Thursday that when my CBC was checked, my hemoglobin was 9.9! That is way anemic! Now, it was to be expected after having two knees replaced but that explained why I was so exhausted while in the hospital and continue to this day. I’m doing what I can to help it. I am taking iron pills, and eating meals of liver (good thing I like liver) but it will still take a while for my body to replace all those red blood cells. So my profound tiredness will continue for a while.

Plan #2: Record as soon as I get home, because I’ll get back to normal quickly.

Well, that plan was doomed to failure for a few reasons. First, I really had a hard time getting a good level of pain control. It’s hard to focus on anything—creative or passive—when everything hurts. Not the sharp, stabbing pain of the initial incision or catheter placement, but the dull, deep throbbing ache that never went away. I would move from icing my knees, to elevating my legs to reduce the swelling (which was considerable), to gentle walking, to trying to sleep, to taking maximum amounts of pain pills, trying to find a pattern that would give some relief.

And I was still exhausted. Getting cleaned up, dressed and walking to the living room was tiring. When physical therapy started, I was a dripping puddle of sweat, looking for a place to sleep.

And I could not think of anything to talk about. I had no motivational spark inside me.  I thought it was gone. It was like when they opened my knees, something more than blood leaked out. I was just here. I couldn’t imagine beyond myself.

Oh, speaking of blood leaking out, a couple days after leaving the hospital, my legs started to display incredible bruises. From hip to ankle, inside and out, I as bruised. Big, ugly red-black bruises. (Ah, that explains some of my low hemoglobin!) If you go to the show notes at MYST.com/knees you will see some of the pictures. The bruises didn’t hurt, but they were scary-looking!

This was 1 weeks after surgery
This was 1 weeks after surgery
Even my ankles were bruised
Even my ankles were bruised
My first post-op check. I really wanted to peel that off!
My first post-op check. I really wanted to peel that off!

I wrote this script on Wednesday, June 10, exactly 21 days since surgery. That was the first day where I feel as though I can concentrate on something like this. And I still don’t know what to write about, but maybe this will be entertaining and informative enough for you.

This entire experience has been a major growth opportunity. While I really wish that I had never needed the surgery, part of me is glad because now I have a better understanding of my patients, and how they feel about things that seem so minor—to the nurses—but to the patient are very important.

An example was in my first room on the fourth floor, I had an over-bed table and a night stand. And I kept my computer on the nightstand, and other items like my water, and some snacks, on the over-bed table. Both tables were within easy reach. (I wasn’t able to record on my computer, but I was alert enough to put in a movie and watch it, at least for a little while until I fell asleep.) One night, the nurse was “organizing” and she move the nightstand out of my reach. Well, in addition to my computer, that is also where I kept my glasses and my phone and when I woke up in the middle of the night, nothing was where it was supposed to be. It was frustrating. And all because the nurse wanted the room more “organized.” This will help teach my students that patients have such little control over their situation, making arbitrary changes to their room is a bad thing.

On day three, I was moved to the eighth floor, because they were closing the fourth floor due to low census. Okay, that was fine. Except the staff forgot my shaving kit. And they forgot to bring my elevated toilet seat (such a wonderful invention!) I actually had to ask three different people before finally someone brought it up for me. Frustrating. Also on the eighth floor, I had an arrangement with my nurses that I wanted my pain pills every four hours, and they were to wake me if I was sleeping (which I never was—I generally only slept two to three hours at a time while in the hospital.) So, that Friday night, they were due at 9pm.  A half hour or so early, I called the nurse, reminding her that my pain was climbing and that I wanted them as scheduled. She agreed and said she would be in my room at 9pm. Except that when she finally arrived, it turned out to be 9:30. “Oh, I got tied up with another nurse, and it slipped my mind.” Pain control is important. And when you commit to providing a service—pain pills, or anything else—you need to honor that commitment. She didn’t. That bothered me.

So what have I learned?

Even when a person is educated—maybe especially when—that is not the same as experienced.

Education can act as a hindrance to positive performance.

Making plans off of assumptions based on education and not experience is a very bad idea.

And when you make a promise, no one really cares what the excuse is when you don’t meet your obligation.

How does this apply to you?

Let’s say you want to start your own podcast. And you decide to use my mentor’s course (Meron Bareket’s Podcast Starter Kit.) You sign up, watch all the videos, do all the prep work, and everything is running smoothly. You are now educated in podcasting.

But you won’t know what podcasting really is until you record your first shows, submit to iTunes and start getting reviews. That is when you start becoming experienced. (And that form of education never ends.)

As of today, June 12, 2015, things are looking good.
As of today, June 12, 2015, things are looking good. Yes, those are eight inch (20cm) incisions

Some links (but not all) within these show notes may be Affiliate Links, meaning that I may receive a small commission when readers click on them and then purchase something. This does not increase your cost at all, but it does help me cover some of the cost associated with this podcast. Thanks!

Music composed and performed by Jason Shaw, courtesy of Audionautix.com

Voiceover courtesy of Matt Young. Matt is a professional voiceover artist. If you have any need of voiceover work, for your podcast, radio spot, or whatever, you can reach Matt by a variety of methods. He is on LinkedIn. On Twitter. And Google+. And you can read his really nice, contemplative blog. Matt was also my guest on MYST 54. Give his story a listen!