Tuesday, January 22, 2013

11 months post-op with vacation pics

Next month is my first surgiversary!  This month my family went on our annual trip to the Kalahari Resort in Sandusky, Ohio.  I can not even tell you how different this trip was compared to my previous ones... I was almost brought to tears several times.  First, let me show you some pictures from our trip in January 2012  This is actually after I lost 25 pounds pre-op.

I smiled in those pictures only because I knew that these would be my last pre-operative pictures of me in a swim suit.  I didn't want to look at them much then, but I kept them because I knew I would want to compare them to pictures I could take a year later.  Here are the ones from this year.

OK, so the visible difference is huge.  But that's not even the big change.
It started when I we first got there and my sons wanted to do the Flow Rider - a simulated surfing experience.  Surprisingly, I wanted to try to do it, too.  This year I didn't care that I would be the focus of attention as I tried and then wiped out (everybody wipes out).  It's funny when people wipe out, people laugh - and last year I couldn't have handled that.  This year, I went for it.  And yes, I wiped out, but I didn't feel like people were laughing at the obese mom who flipped off the board, they just laughed at the mom who flipped off the board like everyone else.  And that difference felt huge.  I laughed, too!  I felt like a different person.  And after I flipped off I jumped right back on and performed tricks the lifeguard/ teacher showed me.  Here's a sample...
Letting go of the board with one hand to grab my foot - oooooo!

Letting go with both hands to pose... aaaaahhhh!

On this one I actually not only got up on my knees, I was able to sit up without balancing on my hands!  For this I got applause from the crowd and the guards.  Applause!  I'm such a ham... I loved it!

But here's the thing - I loved trying something new and showing off, but they weren't the moments that got me so emotional.  It was when I didn't have to worry about whether I could fit in the inner tube.  And when a guard asked me to sit in front of my son in a raft because the heavier person sits in front - and I got to smile and say "Actually, he's heavier".  Like the moment I realized I don't need to read the weight limits for the rides anymore!  And when I realized that I had so much more energy this year that I had ridden on more slides (and climbed more stairs) in one hour than I had in an entire day last year.  Last year I spent most of the time watching, and taking pictures of everyone else.  This time, I participated.  And I asked other people to take pictures sometimes, so I could be in them!  I could cross floating lilypad bridge by swinging arm over arm (think monkey bars made out of rope) with ease - I even got competitive and beat the person on the other one.

My planning for eating was thrown off by a mistake with the reservation - apparently my mistake.  According to them, the room that we've stayed in the last two years with the full kitchen is not the African Queen Suite, but the Combination Suite.  OK, it just so happens that I've requested the African Queen Suite the last two years and been given the Combination Suite?  Whatever, I know what to ask for next year.  The problem was that with no full kitchen, a lot of my meal planning was thrown off.  My husband stepped in and helped (especially the first night, when I was planning on making a big pasta dinner for everyone else).  After giving up on making pasta in the coffee pot, he figured out how to cook it in the small microwave in little paper bowl - in about 10 batches, that took over an hour!  Most of my own meals I could adjust to cooking in the microwave, but it made me really glad I had packed some Quest protein bars as a backup.  All that obsessive planning came in handy! 

It was a great three day vacation, and this has been a great first year as a post-op.  I can't wait for my 1 year post-op appointment next month!

Sunday, January 13, 2013

Bariatric Betty finds fitbit sale!... and other news

OK, this is not my normal post, but my love of my fitbit Zip as a motivator and tool in exercise in weight loss is borderline obsessive.  This morning my mailbox had the new week's sales at Target and I saw that they are selling the Zip for $49!  That's $10 off, people!

If you are looking for a pedometer or just something to motivate you to be more active, I LOVE THE FITBITS!  They wirelessly upload your steps and other information every time you are within 20 feet of your computer (or in the case of the Zip and the Fitbit one, you can also set your smartphone to sync with them via bluetooth).  The Ultra and Fitbit One are souped up versions of the Zip where they also do sleep tracking and counting flights of stairs.  I love the Zip because 1) it's $40 cheaper 2) comes in bright colors so it's easier to find if you set it down and 3) the grip of the holder is much better - I have yet to have it fall off my clothing, unlike it's predecessors!  They all calculate steps, intensity, distance traveled  and calories burned, and all work with a fabulous website that calculates your metabolic rate and lets you log exercise not easily tracked (biking, swimming, weight training).  Best of all, in my opinion, is that the Fitbit site has partnered with www.myfitnesspal.com so that your activity is automatically uploaded in to my favorite food logging/ diary site.

Logging food and exercise is very important in weight loss, but let's face it, it's not fun.  Anything that reduces the effort involved is golden to me. 

OK, this ends my unsponsored ad for Fitbit.  I received no compensation for this - it was just a combo of my love of deals and this nifty gadget that made me want to post it for my readers.  Back to regular programming.
The last couple weeks have been good.  I'm considering joining a WLS friend for an event in Cleveland called Tackle the Tower.  It's a fundraiser for Ronald McDonald House held at a local upscale mall that is attached to an office tower.  Instead of running a 5k, you run the 38 flights of stairs in the tower.  My concern is my knees, which have always been week and used to pop/ dislocate occasionally in my teens.  They were part of the reason I never jogged/ ran (other than my weight, obviously).  But, as I've seen - things change.  Now I can jog without knee pain as long as I don't run to hard/ fast or too far.  So, I went to our rec center to try the Stair Climber dinosaur machines that look like escalators on steroids. 

Wow.  That kicked my butt.  I've never loved climbing stairs, and my muscles recognized that fact as I completed the 10th "flight".  I started to sweat!  No reactive hypoglycemia this time - I've been back on my regular super-high protein super-low carbs so THAT doesn't happen again.  No, it was a matter of using muscles that I'm not used to using!  I finished climbing 38 flights and stopped, feeling a little achey in my hips and knees.  I waited a few days and did it again, this time doing 40 flights without pain.  I'm still not sure I'm going to Tackle the Tower - climbing up is the hard part, but then you still have to climb back down, and I'm worried that might be too much for my joints...  I'll try it again this week and see how it goes.

My bra size changed again - my whole life I have thought that a "C" cup would be perfect, and imagine my surprise to find that I now fit in (some) "C" cups!  I never wore them before - as a teen I wore a B (skipped A entirely), then went straight to D and then DD.  At my heaviest I was 44DD.  Now I'm a 36C.  Most of my actual breast tissue is gone (it happens in rare circumstances to WLS patients during weight loss), so it's more like I have deflated skin that I stuff in to fill up my bra cups, but hey - once I'm dressed nobody sees those particular battle scars. I'm also hopeful that it reduces my risk of breast cancer, and assume that mammograms will be MUCH easier now.  :)  It's funny, because when I was starving myself to lose weight in high school and was 30 pounds less than I am now it never came off my chest - I stayed a DD.  I didn't have much hope that my cup size would go down.  Now it has.  It has literally lifted a weight off my chest - my back doesn't hurt as much as it used to.  What a blessing!

Next week our family is going to Kalahari - one of the largest indoor waterparks in the world - for our annual weekend visit.  Our school district has a fundraiser that makes the cost reasonable, and allows us to stay in a suite with a full kitchen, which makes eating a LOT easier for me.  I took my "before" bathing suit pictures there last year, and even though I've already posted some "after" ones I look forward to getting new pictures with the family (even if I'm in a swimsuit).

 We're also starting to plan a family trip to Florida - we've been twice before in the past 7 years, and both times we went to Disneyworld and once went to the Kennedy Space Center.  This time we're going to Sea World and Universal Islands of Adventure - one of my sons is into everything water and sea life, and the other loves rides and Harry Potter (almost as much as me).  I found out that Embassy Suites not only had some great deals, but your stay comes with a complimentary cooked-to-order breakfast including eggs and omlettes, so I'll have a bariatric-friendly breakfast each morning.  I'm not as nervous having taken the trip with our extended family to Williamsburg this last summer.  While we won't have the luxury of a kitchen on this trip, I feel confident that I can make do with a bag full of Quest bars - but I'm NOT touching any fruit salad unless I can verify it hasn't been sweetened this time!

I had my first negative experience with straws today.  Many post-ops are warned off drinking with straws because if we swallow too much air it can become very uncomfortable in our pouches.  I've tried it a few times without problem, but for the most part sip out of water bottles.  Today I finished my drink and was still 1/2 hour from home (and a refill) so I got a Light Lemonade at McDonalds.  At first I was fine, but less than a mile from my house I started feeling uncomfortable.  By the time I was pulling into our driveway my pouch was hurting bad enough I was almost crying.  Luckily, just walking around the house dislodged the air bubbles and the pain went away, but it took a few more minutes to figure out what had happened.  Ouch!  But, no damage and another lesson learned. 

A couple of weeks ago I entered a contest with www.tout.com and Zappos where we were supposed to talk about what inspires us - and I talked about my Weight Loss Surgery Support Group.  The contest has ended, and they will be announcing a winner in a couple of weeks, keep your fingers crossed for me!


Saturday, January 5, 2013

Bariatric Betty starts 2013 with Reactive Hypoglycemia

Scary.  That's how I can sum up my first (and hopefully last) experience with Reactive Hypoglycemia.  Reactive Hypoglycemia occurs 1 - 2 hours after a meal and is when your blood sugar plummets.  It's a complication some post-bariatric patients get about a year out from surgery, and apparently I am part of that group.  Non-WLS people can have experience R.H. by eating very high carb unbalanced meals, or by diabetics injecting themselves with too much insulin.  Studies have shown that starting 6 months post-op the pancreas of WLS patients (particularly the gastric bypass patients like myself) have a big increase in insulin reactivity.  One study I read said that the reactivity increases 20 times normal (duadenal switch and gastric sleeve WLS patients had a 6 time increase).   It's part of the same mechanism that reverses our diabetes with surgery, but in overdrive.

So, what happened?  Last night I made homemade black bean soup from a bariatric-friendly recipe, and had a bowl with some cheese sprinkled on top for dinner.  I also ate 1/4 of one serving of a baguette, a rare grain "treat".  I had eaten the black bean soup acouple times before as part of a meal - eating 1/4 of a serving along with 3/4 serving of my favorite lentils/onions/ greek yogurt/ cheddar cheese dinner.  Then about 1 1/2 hours later I went to the gym and hopped on the treadmill, because I hadn't gotten my 10,000 steps in for the day yet and it was TOO COLD to go walking outside.

Looking back, my first clue that something was wrong was that about 20 minutes into the walk I realized I was sweating.  Sweating?  From walking?  Ridiculous - I jog 5ks now, why would walking for 20 minutes make me break out in a sweat?  I decided that the gym must have bumped up the thermostat, and since I was on the top floor I was just getting an extra dose of heat.  I was trying reading while I was walking and I started having trouble reading at about the same time.  Of course, that wasn't how I was thinking of it then - I thought "Wow, suddenly the light reflecting off the screen of my Kindle is making it hard to see the words" and "Huh, I'm losing the thread of this chapter - maybe I shouldn't try reading while walking, I'll just turn it off and watch the TV.  Then I started feeling a little clumsy and irritable.  My brain started to signal "Hey, maybe you've done enough" at about 27 minute, but I thought "Nah, just 3 more minutes..."  By the time the 30 minutes was up I was definitely not feeling great. I felt light-headed, sweaty, and when the machine tried to add an additional 5 minutes of cool down walking I got mad.  I got mad at a treadmill.  Yeah, they should list that among symptoms - if you start to fume at inanimate objects, you might want to check yourself for hypoglycemia. 

Compare this to how I usually feel after a 35 minute jog - warm but not sweaty, sharp, and pleased with myself.

So I went down the stairs carefully because I felt a little dizzy.  "Must have not had enough water..." I thought.  So I drank some and headed into the basketball courts where my kids were playing.  I saw my one son, but didn't see my other son.  Then I realized that the other son was standing next to where my first son was sitting - weird, how did I miss that?  My younger son wanted to stay, so I went to sit down.  Then my older son said he wanted to get home and I agreed.  By this time I had decided that I must not have had enough protein that day.  I had only logged my breakfast so far (15 grams of protein), and had a Quest bar for lunch (20 grams) and I knew that the black bean soup wasn't as protein dense as lentils... yeah, that must be it, I was low on protein.

For my non-WLS readers, most adults only need about 45 grams of protein a day.  Post-bariatric surgery we aim for 60 - 80 grams.  Our bodies metabolise things quite differently, and having to live on great reduced calories requires a large protein load to reassure our bodies that we are not - in fact - starving after having been shipwrecked on a deserted island (in which case our bodies would start to consume it's own muscle tissue in addition to fat, BAD). 

So I called my husband as I started the drive home, explained I was low on protein and not feeling great, that my 12 y.o. was complaining of being lightheaded as well (meanwhile he started telling me from the backseat that he wasn't lightheaded and never said that). My younger son backed me up saying that my older son HAD said he was light-headed, but at this point I realized that I wasn't even sure what he had said any more, because I was feeling confused and irritable.  I SHOULD have realized "That means you shouldn't be driving, dummy!" but I didn't.  Luckily we got home safe and sound.  My hubby was waiting in the driveway with some cheese for me.  I ate half of it and started making some popcorn for my son.  I finished the cheese, had 2 cups of popcorn and went online to log the rest of my food for the day. 

Wow!  I hadn't realized that the disparity between the protein in black beans and lentils were so huge.  I always try to eat between 20-23 grams of protein in a meal, and apparently even with the cheese on top, I had only had 11 grams.  I ate another 1 1/2 ounces of cheese to bring me up to 60 for the day.  My overall calories had been low, too.  Good thing I had eaten some popcorn (I had no idea how good until this morning).  OK, everything looked better.  I signed off and went into the other room to sit with my family while they watched TV.  Within 15 minutes I fell sound asleep.  My husband woke me up and walked me upstairs to bed.  I had horrible dreams about feeling confused and thinking I was having a TIA (mini-stroke).  It wasn't that far off.  My brain was being glucose deprived. 

This morning I woke up feeling much better and something clicked.  Reactive Hypoglycemia.  I went online and reviewed studies and articles until I was sure.  It wasn't just lower protein, it was lower protein mixed with higher carbs (although not enough to make me dump) and then working out (even though it was low intensity) two hours afterwords - which is right about when my blood sugar plummetted.  I rushed through the low level and landed in moderate hypoglycemia and luckily had the popcorn and cheese before it got to severe (which includes seizures, unconsciousness, and potentially death).  If I hadn't eaten the popcorn it might have been worse.

To treat hypoglycemia you eat a small amount of carbs paired with protein (in my case, cheese and popcorn).  Non-WLS people might drink juice or eat a small amount of candy to boost up their blood sugar short term until the protein kicks in, but in gastric bypass patient that will cause a potential dump and a larger blood sugar crash shortly after, putting them in greater danger.  In non-WLS someone might have hypoglycemic symptoms after not eating at all for a long time, or about 1-2 hours after eating a huge amount of carbs (like 120 grams) and no/ low protein.  I ate about 30 grams of carbs, but only 11 grams of protein and BAM!  Lessons learned... whew. 

A big thank you to all my WLS friends who have written and talked about their experiences with R.H. - it was remembering your experiences that helped all of this make sense his morning. 

One fun/ funny experience to share - I was on Zappos' Facebook page and saw joint contest with Delivering Happiness and Tout.com where you shared a 15 second video of what or who inspires you for a chance to win a $500 Zappos gift card.  SWEET. I need new waterproof snowboots, and had been wrestling with whether or not I can afford some nice ones...plus heck - that could be several pieces of new clothing!  So, I made the video about how my Weight Loss Support Group inspires me and posted it, checking the box that said "only you" can view this on your timeline.  Imagine my surprise when my friends started commenting on it!  Great comments, too - saying I was cute, adorable, and my favorite "HHHHOTTT!"  What a great reminder that in our internet world, just because it says something will not be seen doesn't make it TRUE!  I'm so grateful for the support of my family and friends, and grateful that the thing that inspired me wasn't embarrassing or "private" in any way.   Here's hoping I win the gift card!