Forced not to lift for a month, what to do before/after

[800-pound lemur]

Hi Mark!

Stats: 27 y/o, 5'8'', 180 lbs (some fat, but muscle as well, meso/endo type). Used to be very fat, but now attempting to get back in shape (went down from 225 lbs since January).

Story: I've done some lifting in college, at some point even got to a 355 ATG squat for sets of 5. But then I started a full-time job and quit lifting altogether, which is also when fat started creeping up on me.

Now back in the gym, doing SS since March. Currently at a 235 squat, no deloads, doesn't feel like one is going to be necessary for a few more weeks, although it does start to get pretty heavy. Missed my bench today for the first time at 175, pretty badly. 1st set - 5 reps, 2nd set - 2 reps. Upper body pushing was always my weaker side (but I do weighted chin-ups easily with good weight). Going to deload 10% on the bench now. Press is at 135 and feeling fine for now.

Full disclosure: I got gyno since forever, "thanks" to being a fat teenager. And now I'm getting surgery to remove it, cause I'm sick of not being able to take my shirt of at the beach or go to a pool. The MD says I'm not allowed to lift for 30 days post surgery (sounds reasonable). I still have a month to go before it - scheduled for late June.

I realize I'm not quite DTFP due to inadequate nutrition, the first priority was not looking like a ball of fat. I'm loosing fat very well on intermittent fasting, and honestly trying to compensate by loading up on protein and calories in the feeding window. The legs and shoulders are now looking way more "buff" than in March, so I assume I didn't loose that much muscle mass. I feel like I'm getting there in terms of an acceptable bf%, and fully intend to get on a proper food regimen once I restart the program post-surgery.

Questions:

1) Should I be attempting to raise my lifts as much as possible during this 1 month before surgery, or is it pointless since I'm going to loose it while inactive anyway? If that is the case, I would focus on getting rid of max possible amount of fat instead, so that I don't have to worry about it when I restart the program.

2) Where should I start once I get back in the gym? I.e. how much of a deload compared to my pre-surgery numbers? Or maybe just restart from the very beginning?

3) Any advice in terms of nutrition while recovering from surgery?

Thanks a lot!!!

[Mark Rippetoe]

Just to demonstrate that I do still have the patience for questions asked in the absence of having done one's homework. But I've got some time today, and maybe you guys will be reminded to read the board and the books.

You have not read PPST3. You are not very strong. You would have been much better off having had the surgery at 225, instead of losing both fat and muscle.

Has anyone mentioned to you the fact that gynecomastia is almost always the result of test/est ratio imbalance, and has anyone tested your testosterone levels? What were they - we already know they were low -- and are you doing TRT? Gyno is more common in fat guys -- I don't know your previous bodyfat % -- but not all fat guys have boobs. I had adolescent nodules when I was about 14, so I understand the situation, but at 27 something else is still wrong, and surgery will only address the symptoms.

The reason it doesn't feel like you need a deload is that, for a guy with a previous 355x5, 235 is far below where you should be now. IOW, you have been overly conservative with your approach to your numbers and thus have not been DTFP. Thus, the book. I'll bet that when you say "the very beginning" you mean the empty bar. Doing this twice will be Not Doing The Program twice. People, the Program works just fine as it's written, and your customization is not necessary 95% of the time.

You are therefore not training for strength. You are exercising for the sake of appearance, as you state in so many words in your post. You are not only not doing the program with respect to your loading, you are not eating in a way that lends itself to recovery. "Intermittent Fasting" is the California way of saying "I'm not eating breakfast." The "feeding window" is the California way of saying "dinner." Post your macros in your response. And contact Jordan in the Nutrition forum for actual advice on nutrition.

Your surgeon is covering his ass with his bullshit "30 days" recommendation. If you want to lay off of squats and deadlifts for 30 days, fine with me, but I see no point in indulging his advice, unless you just enjoy sitting on your ass. I don't think you do. I just think that you have made some bad decisions that could have been avoided had you prepared yourself with better information.

[Dr.T]

Lemur, can you tell us the exact operation being performed and what workup (imaging, labs) you had? It might be edifying for many of the readers. If it's too private that's fine.

[Will Morris]

I had a surgeon order me to lay off lifting for 8 weeks after having my elbow reconstructed from the ground up. I opted not to follow the surgeon's advice, and I turned out okay.

[Frankie]

It's not too late to back out of the surgery. Jesus, how about just doing the program for a while and seeing what happens and maybe get T levels checked for fun?

[Dr.T]

It's not too late to back out of the surgery. Jesus, how about just doing the program for a while and seeing what happens and maybe get T levels checked for fun?

True gynecomastia will not regress, regardless of hormone levels, except in the pubertal years. The accepted time to wait for regression is 2 years. This lemur is well past that. In many cases, gynecomastia is painful.

I will comment on the recovery time if we figure out what operation he is having. Lemur, another helpful bit of information is the size/ diameter of the breast tissue. Also, is your MD a plastic or general surgeon?

Did Big Poppa Rippy scare off Lemur? Lemurs are easily startled, but they will soon be back, and in greater numbers.

[Tiedemies]

From what I understand, IF-type diets are less detrimental to people who are fat or low-T than it would seem. Unless he is skipping breakfast *daily*.
I had a bout of depression a while ago, along with other problems such as not recovering etc. In retrospect they had very little to do with testosterone levels, but I had them measured and they were a little on the low end of the spectrum; not low enough to warrant treatment. The GP send me to a urologist just to be sure but he also thought that this is probably just something related to my stressful situation. The funny thing about it is, I had them measured again after "kind of" doing the program (at that time I had not read the book) for about three months -- during which I was doing IF for 1-2 days a week. I.e., skipping breakfast and lunch on two days of the week. I was actually not fat at all, rather, I was skinny as hell, though. After getting from virtually zero to about where the OP is now, I think I was squatting about 260lbs, on a linear progression, I had the T measured again. And this time it was on the *high* end of the spectrum.

If the OP would have their T measured now, and if he is lifting at least somewhat according to the program, my guess is his testosterone would probably be more or less normal. I think a lot of low-t men actually are low-t, not because of some "condition", other than being fat slobs or stressed out weasels who don't do much. I know I was. Also, I have a friend who has a bad case of Gyno; he got it whilst getting hugely fat in his 20s (we're both 40 now) when he quit lifting and kept on eating like he was still lifting. His T probably is not or at least was not low; I twisted his arm a few weeks ago, and had him start the program; we are adding 10kg per session on his deadlift now and I am 100% sure if he had his T measured it would not be low, despite his huge gyno.

My point is, I believe testosterone levels react wildly to changes in nutrition, exercise (or rather, training), and mental stress. Fixing those -- and starting from training -- probably should be the first line of conservative treatment for people suspected to have a low T. If you start training hard, change your nutrition to match, your stress is alleviated and probably in many cases the hormonal changes are for the better. Naturally, if this does not help, then probably there is then some underlying condition. YMMV and I am not (that kind of) a doctor, so don't take my word for it. But I would be willing to take on a small wager: If Lemur has his T measured while lifting heavy and eating at least somewhat more towards gaining, the result will not be low. On the ohter hand, his lifts stalling this low *if* he was eating to gain *would* be an indication of some underlying condition.

[Mark Rippetoe]

Our Finnish friend's post is rather full of somewhat unwarranted speculation. My guesses, probablys, and I believes comprise essentially the entire post.

[800-pound lemur]

I've done the tests and my T is completely normal, it's actually in the higher end of the normal range. I don't have hormonal problems now, but I did have them as a teenager, which is when I got the gyno. After a while it solidifies and becomes permanent, it doesn't magically disappear when the hormones get back to normal. After a couple years it can only be removed surgically, which is what I'm doing now.

Dr.T. - I've done all the normal tests, bloodwork/hormones/ultrasound/physical (dat magical feeling when another man fondles your breasts...). The prescribed surgery is subcutaneous mastectomy with pectoral area liposuction. It's substantial size, not your typical "puffed nipples". I'd say an A-sized female cup or something like that lol. The surgeon is a plastic surgeon specializing in gyno, he has loads and loads of successful operations with before/after photos. I made sure of that after hearing all the horror stories of botched operations by general surgeons.

Will - you're a braver man than I am (or maybe crazier). I'd be shit scared to lift heavy after an invasive surgery against the MD's advice. Lifting with two bleeding wounds in my chest is kinda counter-intuitive. Let alone your elbow story. I assume you only did the lower body stuff for a while at least?

Frankie - why would I back out of the surgery? Removing gyno is more important than increasing my strength for me at this point. I believe I will be able to get strong once I recover.

Mark - I fully agree that I've made a lot of stupid decisions. I know that now, but didn't know it then.

Basically I psyched out in January about becoming such a fat slob (and an alcoholic too). Had personal problems as well. I started dieting and doing simple stuff like push-ups at home, and reading up on how to get back in shape. Only in March I stumbled upon the SS and bought the books and got myself into a gym again, have been reading the books since. I've been lifting according to the program, except for the loading - only increasing 5lbs per workout cause I reasoned that since I'm not eating a lot I won't have much recovery potential to progress faster. So I thought I'd do it a bit slower but steady. Stupid, I know (now I do).

The question is, what do I do now - this month before surgery and once I go back to the gym after it. Assuming that I do follow the MD's advice about 30 days of recovery. I will get a second opinion from another MD, but I'd rather err on the safe side than hurt myself going to the gym with surgery wounds not healed properly.

Thanks!!

[Tiedemies]

They are speculations based on what I have read and experienced over the years struggling with some symptoms that are related to low T. They are just that - my guesses - which is to say they are hypothesis I find most plausible given my rather limited experience.

I have no trouble changing the views I have were I to encounter evidence to the contrary. Of the few people -- I am counting four to six - I know who have had their Testosterone measure at low end of the spectrum, all that have subsequently taken to proper training, have had their testosterone levels rise.

This is too few to warrant stronger statements. I think it would be very interesting to know of this guy has a low t or not. I don't *know* but I would not be surprised if it turned out normal given that he's been training a little. Your statement was that we know it's going to be low. You may be right, and you probably have enough experience to say this with authority. I certainly don't have enough to do so.

My testosterone went from borderline to way over average when I started lifting. Personal experience like this seems to make people very sure of themselves, but I try not to jump to conclusions.