Thursday, April 26, 2012

Bariatric Betty and the Truth about School Lunches

So I've been enjoying (most of) my work as a school monitor.  It definitely gives me a better insight as to what happens in elementary school these days.  The stresses kids face - lots of rules, bullying, social skill struggles, learning difficulties, et al.  It has also given me an upclose look at what goes on in school lunchrooms.  It's not pretty. 

The entree/ protein source sometimes has less protein than you would like.  For instance, macaroni & cheese - not high protein, but very high in carbs and fat.  Likewise cheese quesadillas.  Chicken fries, popcorn chicken, chicken in any chosen shaped heavily breaded and baked, but still greasy.  Turkey and mashed potatoes - sounds good on paper, but I have to tell you that the turkey cubes in semi-clear gravy scooped over a scoop of mashed potatoes looked (and smelled) like dog food.  Definitely doesn't resemble any turkey I've ever seen served in a home.  I think the subs (roast beef, turkey, etc) look a bit healthier - although the amount of bread/ protein ratio is low.

In my school district, as in many others, school lunches are not cooked, they are warmed.  They are canned, pre-cooked and frozen, and preserved to death.  My sons love broccoli, and I wondered why they used to wrinkle their noses when I would say "Oh, they're having broccoli for lunch today".  Now I know why.  When they say your child is getting steamed broccoli, they mean steamed broccoli stems.  You know, the part you cut off when you serve the "little trees" to your kids.  I was walking around the tables and started counting how many times I actually saw a floret on a try.  1 in 6.  Otherwise, all stems.  And the lucky ones who got a floret only got one.  Plus all of the broccoli was that lovely grey-green that looks oh-so-appetizing.  Needless to say, it doesn't get eaten. 

Doesn't get eaten?  OK, you're not shocked, because our kids don't usually CHOOSE to eat vegetables.  And most of them don't CHOOSE to eat them at school.  Cooked carrots?  In the trash.  Ditto peas, green beans, etc.  They will eat almost any form of potato (as long as it's not covered in the gravy).  But at least they get fruit, right?  Sure - they get canned peaches, canned pears, fruit cocktail, diced pineapple, sometimes their fruit choice is sherbet or fresh fruit.  Want to guess what they choose?  Right, sherbet.  Want to guess how much of the rest of the fruit gets eaten?  Almost none.

Then there is the grain portion of our meal.  Don't be confused - some of the proteins have grains already, but then we add corn muffins, rolls, blueberry muffins - or a new one that surprised me: "Pop Tart Crisps".  Little Pop Tart pastry pieces, without the fruit filling inside, but with the frosting and sprinkles. 

So the schools have made a real effort to make healthy choices available to kids, but for the most part they are a la carte items - you have to pay extra.  String cheese, yogurt, and fresh fruit are available every day where I work - but the fresh fruit is only oranges.  Most of the kids won't get them because they get frustrated with the peels.  I usually see maybe one or 2 kids a day get the yogurt or string cheese. 

So what do I see happening with most school lunches?  The kids drink about half of their milk or water bottle, eat 50-75% of their entree, and throw the rest away.  And then they ask if they can get snack.  Then they run to the ice cream freezer to get popsicles and ice cream.

Do I think we need to hire people to stand over the kids and force them to eat healthy?  No.  But I do think parents should be aware of what their kids are eating and NOT eating at school. 

Here's the part I think is saddest.  When I do see kids making an effort to eat their fruits and vegetables, it's usually the heavy kids.  They've heard what we've been saying; that they need to eat healthier.  And they're hungrier.  And they eat the overcooked broccoli stems and grimace.  But is it helping them in the long run?  Because they are learning that vegetables taste gross for the most part.  And the fruit they're getting is in syrup, so their blood sugar is going to be super elevated and then plummet, making them hungry again sooner. 

Some days they have extra entrees available for an additional price.  Popcorn chicken, mac & cheese, or quesadillas.  There will be a rush up there to get some more or the popular choices.  But just the other day I was shocked to see the mac & cheese being served in 2 cup bowls.  They literally got two additional servings after eating the first one.  Add to that the blueberry muffin they ate, and the some of the kids ate 4-5 servings of grains in 1 sitting. 

My kids pack their lunches - not because I have been worried about what they're eating but because it's their preference.  We are a vegetarian family, and they didn't like having to figure out if there was meat in their options.  Do they get ice cream and popsicles?  Probably more often than I would like.  Do I sometimes feel guilty because I didn't pack a vegetable that day?  Often.  And do I see kids with packed lunches skipping the healthy stuff they had packed for them?  Frequently.

Here's my list of what healthy choices I see actually being consumed in packed lunches:  Grapes, strawberries (with the tops cut off), bananas, string cheese, crackers and cheese, carrots, and yogurt, pasta salads with cut up meat and veggies.  Most of the peanut butter and jelly doesn't get eaten.  Most of the cold cut sandwiches get taken apart and dissected, but not eaten.  My advice - find out what protein sources your kids will eat after it has been sitting in a lunch box for 4 hours.  Pack more finger foods.  Consider getting rigid food storage containers to put their lunch in because they won't eat stuff that looks smashed. 

We can't let our kids grow up with us being "helicopter parents" and making all their choices for them  - then they don't GROW UP, they just get bigger.  But we need to be aware of the choices they have and the choices they are making.

Saturday, April 21, 2012

9 weeks out, Pics, NSVs, and totals

This has been quite a week - I am working 5 days a week as a "monitor" at my son's elementary school.  I work about 2.5 hours a day, and spend the entire time walking (slowly).  That means I no longer struggle to get in 10,000 steps, I usually get in 12,000.  Friday I walked over 18,000!  translation - that's almost 9 miles.  The first day my legs were almost trembling by the end of the day, and I was stiff the next morning.  Now I'm used to it, and doing a little more each weekday.  Weekends I tend to take easy.

I hit a couple milestones this week.  First, I have now lost 30 pounds since surgery, to match the 30 I lost before, for a total of 60 pounds.  The rest were NSVs (non-scale victories).  First I found out that I weigh less than my younger (but taller) brother - and realized that it's probably for the first time in my life.  Then I was telling my husband and found out that I weigh less than him as well!  Then I was thinking about my muscular 11 year old who is almost my height... I could end up weighing about what he does now!  That was weird to think about. 

Next I was trying on an outfit for my son's first communion this weekend and realized it was too big!  And so was the skirt I bought three weeks ago.  So I came up with a new outfit - with my son's approval.  My size 14 pants have started gotten a little looser, but I'm not down another size yet. 

I'm doing much better with eating slowly.  I only have pouch issues about once a week now - and it's usually because I didn't chew something well enough.  Tomato skins continue to be tough to get past the pouch.  I still am not doing any grains, and not much fruits or vegetables - there's not much room in my pouch after protein gets in.  Legumes are an exception - black beans and lentils are frequently on the menu.  I take my supplements daily, and will be having labs at my 3 month appointment to make sure they are doing what they need to do.

After the first communion we had brunch at First Watch.  I ordered an egg and cheese omlette (passed on the potatoes, english muffin, and meat) and ate half of it without trouble.  Yay!  It worked out really well - for the all vegetarians, omnivores, pre-ulcerous, and bariatric patients.  I reccomend it as a bariatric friendly place.

I've been watching the claims that were submitted to my insurance and finding that they have been being paid without too much trouble.  I have an 80/20 plan, so I am responsible for 20% of the approved cost of any treatment/ labs/ hospital stay.  So far, it looks like the estimate of $3000 out of pocket I was given looks fairly on target.  I paid that $3000 in advance, so I'm hoping I might get a small amount back... we'll see. 

I got a lot of complements from people at the church today.  Most of them were lovely, and all were intended that way.  There was one woman who said "Oh my goodness, you look BEAUTIFUL.  Really.  I really think you look BEAUTIFUL!" that had that slight tone of surprise in it that many WLS patients know so well.  Well, she meant it as a complement, so I'm taking it that way.  And I have the two outfits that were too big for today to help me smile for the camera.

Friday, April 13, 2012

Bariatric Betty starts her new job, looks at her progress 8 weeks out

So I started my job as a monitor at the elementary school yesterday, and it's a lot of fun!  I work with Kindergarteners, 1st graders, and 3rd graders.  I knew several kids already from my neighborhood, and from volunteering with 2nd graders for math last year.  The first time I monitored recess I had four little Kindergarten girls taking turns holding my hands and "showing me" all over the playground.  The third grade recess is more along the lines of girl drama, i.e. "She used to be my friend, but now she says she's her best friend, not mine!"  The boys seem to be more rough and tumble at both ages, but then they're back to being friends again. 

I was hoping to have 2nd graders so I could see what happens during my son's recess, but at least I'll get to see him all next year.

My big concern was how my body would handle standing and walking around for 2 1/2 hours non-stop.  It used to be that just an hour or more of that used to cause me to sweat like I was working out.  I've lost almost 60 pounds, so I hoped I would be fine.  I'm happy to say it's literally "no sweat". :)   Not that I don't enjoy sitting down when I'm done - that feels lovely.  But, it doesn't feel like I'm exhausted. 

Yesterday I brought a Quest protein bar which I ate halfway through working, but had a headache by the time I got home.  This time, I ate 1/2 of a Quest bar right before arriving, and then an hour later drank 24 ounces of Crystal Light and had a lunch of lentils and greek yogurt when I got back home - no headache!  The monitor that I'm replacing brought in donuts today to share for her last day, and I watched everyone else eat them without any cravings - Yay!  I love the honeymoon period.  Gotta train that brain. 

I have worn a pedometer both days, and found that I take 4000-5000 steps while working.  Needless to say, I no longer have problems getting in more than 10,000 steps a day! 

So I'm now 8 weeks post-op and really excited with how things are going.  I have lost 58 pounds so far (30 pre-op and 28 post) and my BMI has gone from 42.3 to 32.7!  My next big achievement is a while off - when I lose another 22 pounds I will no longer be considered obese.  Now that my weight loss is slowing a bit, I anticipate that will probably take a couple of months. So, I'm going to be looking forward to celebrating other benchmarks;  going down another size, being able to workout on a day I also work without burning out, feeling more comfortable eating in front of others... 

My son's first communion is 4/21 and we're going to go to brunch at First Watch afterwords.  For those of you who haven't been - First Watch only serves breakfast/ brunch/ lunch.  They have a lot of egg dishes, which is what I'll be sticking to.

My last entry I talked about ordering a dress a size smaller than I currently was for my friend's wedding reception.  The dress came in, and so I tried it on to see how far off I was.  Unfortunately, I got a reminder that just because I'm losing weight does not mean I can wear any style/ cut.  Being unusually top-heavy means I will not be wearing that dress - I would have to lose 4 inches in my bust.  In losing 60 pounds I have lost 3 1/2 inches in my bust - and I'm not planning on losing 60 more.  However, I did find another dress on sale from Lands End that I got at the bargain price of $6.99 that DOES fit and I will probably wear it to the reception, so things all worked out in the end!

Friday, April 6, 2012

Bariatric Betty wrestles with Head Hunger and takes a leap of faith

Head Hunger - the feeling you have when your brain is telling you that you are hungry, but you are not.  You might be thirsty, you might have just seen or smelled something that awakened a craving, or you might have just stumbled upon a trigger that used to cause you to eat (emotional stress, a time of day, a social situation..) 

Real hunger isn't something that my stomach can feel yet - it will probably be 12-18 months post-op before I feel that again.  That's part of why this is called the "honeymoon" period. 

So this week has been enlightening in several ways.  First - head hunger.  I have experienced this numerous times before this week and dealt with it OK; drinking more fluids, sucking on a cashew, distracting myself.  This week I experienced a stronger feeling, about 1 1/2 hours after dinner.  I felt hungry.  Not thirsty, but like I didn't have enough to eat.  So, given that I had eaten 1/3 cup of cooked lentils with a couple tablespoons of greek yogurt for dinner, I thought "OK, I'll get a little more lentils.".  Note - not craving something "bad" - head hunger can be sneaky!  I got another 1/4 cup of lentils and started chewing slowly.  After two bites, the "Uh oh" feeling hit, and I went and threw them up.  Yuck.  I cuddled up with blanket I thought about the other head hunger episodes I've experienced and realized that evening time is a trigger for me.  A couple hours after dinner (about the time the kids start saying "can I have a snack") my head is trying to get me into my old habit of having a snack.  I can distract myself, drink more fluids, etc, but it is still trying to fight me.  Weird talking about your brain as if it's another person.  Anyway, I decided the best thing I can do is put it out there.  My kids (and sweet hubby) are never happy to listen to me get sick - so when I said "Hey guys, I just realized I should NEVER eat after dinner.  It will only make me sick.  Drinking and sugar free popsicles are OK, but no food" they listened and I knew I would be held accountable.  Hah!  Take that sneaky head hunger!

I made need an intervention in the future about my consumption of sugar-free popsicles, but for now I will let it slide.

So, a couple of fun things this week.  I have been struggling with what I will wear to my son's first communion and my best friend's wedding reception.  All of my dresses in my closet are too large.  I went online and found an adorable cotton & silk dress that I thought would work for both, and I was going to order my current size, when I realized that the next size down would be $15 cheaper.  We will discuss my rage issues regarding the overpricing of plus-sized clothing another day.  ;)  Hmmmm.  Given that I'm losing about 2 pounds a week right now and my friend's reception is about 45 days away... I ordered the smaller size.  So, that's my little leap of faith - that I will fit into smaller dress size in 45 days.  At my heaviest I was a size 22 dress, now I'm down to feeling like a 18 is roomy.  And a 16 is on it's way to my house! 

My other fun thing happened yesterday - after getting my hair done my curiosity got the better of me as I passed by a Talbot's outlet store.  Oooooo, nice clothes...  Talbot's is a store I haven't set foot in for over a decade.  Too expensive, and my body wasn't Talbot's size.  But the big posters in the window saying "Additional 75% off already reduced prices" lured me in and boy was I in for a surprise!  First of all - Talbot's has plus sizes!  I don't know when that started - I don't remember seeing plus sizes in other stores in the past - it might be just because it's an outlet store.  But for all of you who might wear plus sizes now - check out Talbot's!   Second of all - I don't NEED to wear the plus sizes!   I fit very nicely into several pairs of shorts and pants (size 14) and actually narrowed down my choices based on what looked BEST.  Huh, enough things that fit that I could say "I prefer the way this one looks to that one."  Best of all - sale prices!  I got a wonderful plum corduroy blazer, two pairs of shorts, and four blouses for under $40.  SWEET. 

My last thought - Passover.  For those of you who don't know me personally, my religous background is confusing and I have not ever formally been a part of any religion or congregation.  However, my faith is very strong and I have found a lot of comfort praying Hebrew prayers and celebrating the high holy days for the last decade.  Someday I might make the step to conversion, but right now I have quite enough converting going on in my body and mind (thank you very much).  My family is very supportive - my husband was raised Catholic but fits more into a Zen-buddist Catholic mindset than anything, and since I didn't have a strong religious background to raise our children in, they have been raised in a similar open-minded, inclusive Catholicism.  So this is the first Passover in quite some time that I'm not participating in a Seder (either my own mini-one or one thrown by friends) and while I'm not having anything leavened/ hametz that is more part of my medical journey than spiritual one.  It feels strange.  And my kids miss the matzah!  One step at a time.  But my prayers are just as strong (or stronger) and I know they are heard.