Ouch! Doing so well, and then a detour

Yesterday my natural grace and coordination led to a badly sprained ankle.  As in, I can't bear ANY weight on it right now.  I went to the hospital to have an x-ray done and they said nothing is broken.  I'm surprised, but thrilled.  It doesn't hurt to badly right now as long as nothing touches it and I don't put any weight on it or move it.  It's in an aircast splint and I'm on crutches.  No weight bearing for three days, and then only as pain allows for the next couple weeks.  Like I want to push that one!  I can only take tylenol for pain because of the restrictions post-bypass, but as long as I'm resting, that's fine.

While I'm THRILLED it's not broken, I'm still sad that this has gotten in my way temporarily.  I have been doing really well since my last post, going to the rec and jogging and walking frequently.  I was on my way there yesterday when a step in the garage foiled my plans.  My eating is much better as well.  I've seen just a bit of change on the scale, but I'm reminding myself that by increasing my cardio, I'm also gaining muscle again.  Best measure - I'm feeling a lot better about myself.

I will be getting a LOT of upper body/ core work with the crutches for the next couple weeks.  I'm hoping after a couple of days I might be able to swim (with the aircast on).  I'll probably also try to get to the arm machines (you know, the ones that look like you're pedaling a bicycle with your hands).  My fitbit numbers are going to take quite a hit.

Logistics around my house are going to be hard.  My boys (11 and 13) depend on me way too much.  They are used to me making every meal, and most snacks.  I warned them yesterday that they are going to have to make their own food for at least the next few days, and help make mine - I just can't carry anything when I'm non-weight bearing on crutches.  They sounded very supportive and understanding, but reality will hit today, I'm sure.

I also can't walk the dogs - so they will have to take that over as well.  Laundry - well, luckily my 13 y.o. son owes me two loads!  He's a sneakerhead (collects and trades sneakers - it's weird, but think baseball cards).  Normally my boys can earn $1 for doing a load (washing, drying, and carrying upstairs, but yesterday my husband came up with something BRILLIANT.  Justin wanted to go to a shoe store and we made him sign a contract that each time we take him to a shoe store he owes us 2 loads of laundry.  He went to one yesterday, so I have two freebie loads waiting in the wings!  Woo-hoo!

Luckily I had just made up a batch of my sauteed julienned zucchini & onions, with veggie crumbles and spaghetti sauce on top, so it just needs to be heated up with mozzarella on top for my dinner for the next 3 nights.  I've got a bunch of lentils with caramelized onions cooked in the fridge, so put a little cheddar and greek yogurt on that and my lunch is prepared for the next week.  Scrambled eggs I'm good for today, and tomorrow I can either have my husband make them for me or make them while sitting on a stool in the kitchen and just have everyone get everything for me.

It's my left ankle, so I can theoretically drive, although I won't be doing much of that.  It will help that I can take my kids up to the pool at the rec and just sit on a lounge chair with my leg(s) up.  Summer break = cabin fever, and while I can entertain myself (with the computer, books, and some knitting on a loom), my kids will start bouncing off the walls and/ or bugging each other.  The dogs are also a bit freaked out by crutches and aircast, not to mention that I'm not the one walking them.  They'll get used to it.

They said to plan on the aircast and modified activity for at least 2 weeks, and the aircast for more vigorous activity for 2 months after that.  So, when I feel up to jogging again, I'll have to find a way to get a shoe over this thing.  Still, it's not a cast, and I will keep reminding myself it could be SO much worse.

On the other front, I've turned in my applications for grad school - a Masters of Education - School Counseling.  I'm waiting for my recommendation letters to get turned in, but everything else is in.  I hope to enroll for Spring 2015, and probably won't hear until October if I've been accepted anywhere.  I also found that as a part-time student with a low undergrad GPA from 22 years ago, there won't be any financial aid for now.  That stinks, but I can scrape to pay for one class at a time for the first year, and then I'll have a nice high GPA to submit for scholarships.  Eventually I'll have to go full-time, and then I'll be eligible for a G.A. (graduate assistant) position which can cover most of the tuition.  Hopefully I'll be able to land one - usually only about 10% of students do.  And there will be loans.  But, it will all be with it - and grad school will not be the hardest thing I've done by a long shot!!!

Hello darkness, my old friend... and heading back to the light

It's been a few months since I blogged, and for all the new WLS friends out there, when I go radio silent that usually means I'm struggling.  At 2 1/2 years post-op and having surpassed my goal, I'm dealing with some weight regain.  6 pounds from my set-point, 9 pounds from my all-time low.

How did that happen?  I stopped jogging, maybe only doing it once a month.  Still getting in lots of steps, but doing less cardio has a consequence. I started grazing - mostly eating things I shouldn't (carbs) or don't need to (peanut butter), and mostly when I'm preparing food for others, but not always.

Why?  Stress and old habits.  There have been lots of stressors - but we all have them, and mine weren't particularly horrible (nobody died, nobody lost their job, my husband is very lovable).  I came off my 5 day pouch test feeling great, and that lasted a couple of weeks.  Then we had the stress of my father-in-law's health declining some more and the resulting anxiety that brought upon my husband.  And getting my son prepared for some very difficult testing - in that last month I baked like a fiend to reduce my stress, but instead of giving it all away I nibbled at some of it (just in small enough doses not to dump, like any addict learns to avoid the crash).   The testing went well, and all of the stress was worth it, BTW, but I HAVE to remember I have other coping mechanisms I should use.

Then I started looking into a new direction for myself - a new career, starting with a Master's program in School Counseling.  It's very exciting, and it set off a roller coaster of emotions.  The principal and guidance counselor I work with think it's a great idea and will write recommendations for me - Whee!  Up I go... Finding out my undergrad GPA was even lower than I remembered - crap.  Taking a practice GRE was painful but assured me that I could meet the requirements with room to spare - yay!  Realizing that the idea of my going back to school part-time was freaking out my husband and increasing his anxiety and depression - ouch.  Talking that through with him over our anniversary and having that reverse into his full (albeit still typically anxious) support - whew.  Realizing I could take the 1 hour MAT instead of the 4 1/2 hour GRE was good, and then when I took it and got stellar results was WONDERFUL.  Now my applications are turned in, and I'm just waiting - for the recommendations to get turned in, the transcripts to arrive, and the decisions to get made at the two different programs... and waiting is hard. I'm settling in for about 2 months of it.

Last week I started with the mental tweaking.  I changed my Facebook profile pic to the one of me about to do the triathalon I did in March.  I needed the daily reminder of what I can accomplish.  I reconnected with some old friends that I haven't visited in a while.

The last two days I have been making better choices.  I've eaten clean, surpassed my step goal, and yesterday I jogged 25 minutes and felt good.  I've reminded myself that I can manage my stress in healthy ways now.  Now I just have to re-establish the habit.  The scale hasn't started moving back down yet, but it will.  And when I'm thinking about baking, I'm back to asking myself - are you wanting to bake for a good reason, or because you want to eat the cookie dough?

I also found a new fun way to enjoy my jogging (especially good when our weather has been so stormy).  I've been taking my Kindle Fire to the gym and setting it up on the treadmill so I can watch movies/ shows while I work out and my kids play.  It's a great distraction, and yesterday I was actually looking forward to it so I could finish the movie I started the other day.  Anything that works, baby.

I'm feeling like I'm training for a race, but unlike my 5ks or triathalons, this one is the ultra-marathon of life.  I need to build up my endurance, because there is always stuff to endure.  Starting something new is exciting, but the challenges will come and I have to be strong enough to meet them.  To prepare myself physically and mentally.  To know when to ask for help and support.  To keep my priorities in order.

The journey goes on, one step and one day at a time.  It's easier on days I get a good sleep.  And more fun some days than others.  But I have the tools, and I can do this for the rest of my life.  We stumble, we fall down, but we pick ourselves up and get back up stronger and wiser.  All the other WLS vets out there - if you are struggling you are not alone.  If you are doing well - share!  We could all use reminders of success for inspiration.  

Results of my first 5-day Pouch Test

I started my 5-Day pouch test a week ago, on the first evening of Passover.  For those who aren't familiar with the concept, the pouch test condenses the eating restrictions given to us as WLS post-ops into 5 days. Instead of being on liquids (mostly protein shakes) for two weeks, I was on them for two days.  Then instead of being on pureed/ super soft foods for 2 weeks, I was on them for the next 2 days.  The fifth day I returned to my normal post-WLS diet.  My surgeon said he has no problem with people doing the 5 day pounch test occasionally.  Of course, all WLS patients should check with their programs before they change their eating habits, even temporarily.

The reason for people doing the pouch test are two fold.  It is called a pouch "test" because after RNY/ Gastic Bypass post-ops have been over a year or two out, many start eating more food.  This can lead to pouch and stoma stretching, which starts to defeat the purpose of having such a baby-sized tummy (helping us get full quicker and stay full longer, also slowing digestion so that we can absorb as much of the nutrients as possible with our jejunum being bypassed).  Much like starting to eat after being very ill from the flu or other GI illness, after being on fluids for a while, you "feel" the food in your stomach more, and can become re-sensitized to cues of being satisfied before you over-eat.  This way you know that your pouch and stoma size are still working appropriately.

The second reason deals with the main problem most of us have - our heads.  Being restricted to protein shakes and the like forces us off the carbs that sneak back in to our diets.  Anyone who has tried to dramatically restrict flour, sugar, and other carbs from their diet knows that the first couple days are the hardest, but then you don't crave them as much after that.  It's both a physical and mental detox in some ways.  Being on protein shakes reminds us that we no longer choose what to eat based on taste - we choose it based on fuel our body needs.  Believe me, nobody would choose whey protein shakes for the taste.

Day 1: I drank 3 Syntrax Nectar Fuzzy Navel protein shakes over the first 24 hours.  While I am more tired than normal, the first thing I didn't anticipate was the return of the chills due to my greatly decreased caloric intake.  While I only eat about 1200-1300 calories on a given day, this took me down to about 750.  I also planned to use the Syntrax vanilla shakes to make the fake "Shamrock Shakes" recipe from the helpful website www.theworldaccordingtoeggface.com that I enjoyed as a post-op.   However, I was so cold I couldn't stand to make an iced drink, so I tried heating it up instead.  Ugh.  Predictably gross.  So, I used another packet of the vanilla to make some protein pudding (sugar free) with skim milk.  I had another 12 grams of protein from the pudding that first day.  First psychological observation: I don't feel hungry AT ALL.  If I'm going to feel hungry while getting all my protein in, it's when I'm only drinking the protein so it isn't staying in my stomach for long.  That means that if I'm getting in my protein when I'm eating my regular diet, any "hunger" I feel isn't real.  It's head hunger (feeling like you should be eating due to habit, emotional eating cues, etc).  Since I always get my protein in, ALL of my "hunger" sensations are fake/ unreliable.  Wow.

Day 2: I again drank the 3 Fuzzy Navel protein shakes and had some sugar-free protein pudding.  Note to others - Jello Sugar Free Lemon Pudding mix worked well.  I was down a couple of pounds already, which was not surprising.  No hunger, still.  Something I noticed more was that I was needing to watch myself very carefully to make sure I wasn't licking my fingers or taking a taste of something that I was preparing for the rest of the family.  I remember doing that a lot the first few weeks post-op.  Now I realize how much I have been licking off the spoons and knives, not to mention taking a bite of pasta to check if it's done, etc.

Day 3: I began my puree/ super soft foods with ricotta cheese mixed with some garlic salt, spaghetti sauce, and some mozzarella melted on top.  Ahhhh, the joy of savory flavors after two days of sweet is wonderful!  I'm down another pound, and still cold most of the time.  I had another eye-opening experience.  Last night I had a dream that I used to have frequently as a recent post-op.  In it, I find myself finishing off some cereal/ other non-bariatric friendly food that my kids have left over.  Then I wake up thinking I have really done that and feel awful.  As I realize it was just a dream, I feel a sense of relief and joy.  I am doing it.  I AM resetting my brain to it's original post-op state.  This is working.  I also enjoyed some runny scrambled eggs.

Day 4: No additional weight loss today.  Eating my runny scrambled eggs I realize that I'm perfectly satisfied with them.  For over a year I have been eating my scrambled eggs with sliced tomatoes, garlic salt, and melted mozzarella on top.  Those things are unnecessary for me to feel satisfied, and just add more calories, sodium, and fat than just another egg worth of egg beaters.  I'm no longer as cold.  Real food starts again tomorrow, and I'm looking forward to it, although I'll just stick with the plain scrambled egg beaters for breakfast.

Day 5: Down another 1/2 pound.  I'm back to my regular foods.  Lentils and onions with greek yogurt and cheddar cheese, sauteed julienned zucchini with vegetarian "meat" sauce and mozzarella, scrambled egg beaters.  Everything tastes great.  I'm eating a little less than I used to (my dogs are getting more leftovers).  I feel recommitted and renewed.  I am DEFINITELY going to make this an annual thing - probably on my surgiversary from now on.

Two days later, and my weight is still down, even though I'm eating regular foods.  What I'm not doing is licking spoons, tasting my kids food, etc (all stuff I shouldn't have been doing).  I'm not feeling very tempted by cravings, either.  For me this pouch test did exactly what I was hoping it would - reset my mind and help me reconnect with my commitment to staying healthy.  I didn't think my pouch or stoma had stretched, and feel confident that it won't if I keep following the rules.

Happy Earth Day!

Lots of pics! Starting my first 5-day pouch test/ My 2nd Surgiversary/ My 2nd Triathalon

I haven't posted a new entry in a long time!  I started this one in February and finally am posting in April.  I think that I have been have a lot of negative old-way-of-thinking thoughts - things like "I'll write a post when I have something cool to write about".  But, that's not why I started this blog.  I started it to motivate myself.  I started it to explore what was going on in my head on this journey.  And I've learned that you can't wait for life to hand something to you, you have to go out and make things happen.  So, I did my second triathalon in spite of the negative self-talk that was spinning around in my head, and it helped turn me back around.  Without further ado, here's a long delayed update.

I can't believe I've just celebrated my second surgiversary!  It seems to have gone so quickly, but at the same time it feels like I've been living this new life forever (and that's a good thing).  I celebrated with my family, and having a date night with my husband :)  And, I decided to splurge and bought myself a Fitbit Flex.

This year has been harder than the first - when they say that honeymoon period ends and it gets harder, they're right!  Your cravings come back stronger - that head hunger that you've been battling is still there AND you actually can tolerate more food (and probably more carbs without dumping, but I'm trying not to find that out).  My weight has fluctuated a lot more in the last year.  I was at 142.8 the morning of my surgiversary, which is 0.2 pounds less than I was on my 1st surgiversary and seems to be a stable point (also below my original goal of 150 so it feels great).  However, I have been lighter (down to 140.6) and I have been heavier (up to 148).  What has changed?  1) I'm not jogging right now, although I just signed up for my favorite 5k - The Color Run in May!  2) Part has been the weather/ deep freeze in Ohio and getting a tiny little dog that can't handle the speed and distance of jogging, and part has been dealing with the physical symptoms of pelvic organ prolapse.  But, part of it is 3) being lazy, being at my goal, and not trying as hard.  I have lost some muscle tone, although my size has stayed pretty much the same.  This is due to decreased intake to balance the decrease in calories burned.

My eating has stayed very good for the most part. I usually eat the exact same breakfast, lunch, and dinner every day.  It is boring, but it helps me remember that I'm eating for fuel not fun and it makes sure that I'm eating things my pouch tolerates well.  Being vegetarian and post-WLS, there aren't that many appropriate entrees that my pouch tolerates. Sometimes I find myself eating something I shouldn't as I'm preparing food for my boys (a bite or two of pasta, a pretzel, etc).  And, when I see the scale heading up north of 144 I have a "eat CLEAN d*** it!" moment.  Sure enough, as soon as I start catching myself, the scale starts to head back down.  I have also recently started rewarding myself with my favorite water flavoring drops (Dasani pineapple coconut) in my evening water if I have done a good job staying clean for the day.  That's been a good incentive.

My labs have continued to come back wonderful.  My hemoglobin A1C (blood glucose over an extended period of time) = 5.1  Anything 6 or below is considered normal for non-diabetics, and below 7 is normal for diabetics, so I am definitely still in remission and plan on keeping it that way.  Getting rid of my diabetes was my #1 motivation for having the surgery, and I was blessed to be part of the 75% to go into remission.  It doesn't mean it can't come back though - so I must remain vigilant.

In general I feel great - lots of energy, lower needed doses of anti-depressants, enjoying my job and (most of the time) my kids.  I love having the feeling of control over my health.  It used to feel like my weight controlled me.  Now it feels like I can us my brain to control my health - although it still has moments of poor judgement.  It's very empowering.

I've got the Color Run 5k coming up! I'm going to do a refresher course of Couch 2 5k to get my race legs on.

I just completed my second indoor triathalon, and that felt great.  I almost bailed on it - I haven't been jogging and didn't know the date for it until 2 weeks before hand.  I was worried that I haven't been jogging, and didn't want to injure myself.  But you know what - that was all negative thinking.  The fact is, nobody was going to force me to jog if I wasn't able to.  Nobody was going to make me finish it if I didn't want to.  Plenty of people just walk the track instead of jogging.  In other words, I needed to stop making excuses and just do my best.

I had a little bug a week before hand, and my husband was very nervous about me doing the race, but I reassured him I was back to normal and wouldn't push too hard.  To me, I realized that I can not let myself make excuses that allow me to be sedentary.  Races are motivating for me, and I enjoy the social aspects.

Here are some pics from the day:

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Last year I won the gold medal for my age group - but that was only because I was THE ONLY WOMAN 40-49!!!  I enjoyed the medal, don't get me wrong, but I would rather lose and have competition.  This year my age group was the most competitive - I had 4 other women in my age group!  I'm proud to say I came in second!

So this is a great reminder to all of us not to let our own self doubts, or negative self-talk stop us from trying to do our best.  Did I run as far in 20 minutes as last year?  No, but it was very close.  And, it turns out I was able to swim, bike, and run farther than a lot of other people so I got a medal!  Most of all, I got a reminder that I am fit, and have good abilities from my daily living, even without really training.

As a psychological reboot, I'm starting my first ever 5-day pouch test tonight with the beginning of Passover.  The idea of a 5-day pouch test is that you re-boot your mind and your pouch sensitivity by reproducing the eating plan you went through right after surgery, only compressed to 5 days.  For the first 2 days, you drink fluids only.  Protein shakes, water, crystal light... The third and fourth day you eat pureed soft foods.  And the fifth day you eat regular food again.  It's to help you remember how to use your pouch as a tool, to think of food as fuel, and reconnect you to your commitment that you've made.  I had been thinking of doing it every year on my surgiversary but a family crisis made that difficult this year.  So I thought that Passover would be a good time - after all, I should be unleavened all year round, but the idea of making a sacrifice, much as people do for lent, seemed to align with the concepts of Passover.  Pushing through, doing what you need to do, walking towards freedom and your future, finding strength and renewing faith...  I'll let you know how it goes!

Naked girls, Head Hunger, and Ups and Downs

I haven't written for a while - I've felt like I've been treading water a lot since graduation.  Not specifically with my weight loss, just juggling a lot of family things.  Anyway, the news blackout ends today thanks to my 10 year old son!

My son has apraxia (a motor planning disorder) and aphasia (a language disorder that makes it hard to find/ understand common words sometimes).  I mention this because when he wants to discuss something, it's often something that he's been thinking about for a while and trying to figure out how to say it.  As a result, he comes up with some thoughts you wouldn't expect to hear from a 10 year old, and today was one of those days. 

I was driving him to a birthday party and Miley Cyrus was singing "Wrecking Ball" on the radio.  For those of you lucky enough not to know this, Miley is a 21 year old former Disney star who is desperately trying to shake the Disney-good-girl image and swung naked on a wrecking ball for video for this song.  So, out of nowhere, my son starts this conversation.

Him: "Mom, you know, I think Miley is pushing it too far."
Me: *Chuckle* "Yeah, I think you're right."
Him: "I mean, she's just pushing it to far.  I have a hypothesis. You know, boys like to see naked girls."
Me: "Okay"
Him: "But I think, really, that truly boys want to see girls not."
Me: "Oh, you mean not naked?  That they would like to see them with clothes on."
Him: "Yeah.  That's better.  It's kind of like with you, Mom.  Your brain tells you that you want to eat some frosting.  But you really don't because you know it will make you feel bad.  And it's kind of like that for boys."

Yup, my 10 year old just summed up Head Hunger and hypothesized that it's the same as boys thinking they want to see naked girls.

Oh, and he explained that they were talking about hypotheses at school, but that he had already learned it from watching The Big Bang Theory.  That's my boy.

So what's been going on otherwise.  Well, one thing that hasn't been going on is my jogging.  I'm still getting in 10,000 to 15,000 steps a day, but I haven't jogged more than a couple minutes in a few months.  I haven't signed up for any 5ks for about 6 months.  So is it being lazy?  Yes, that's part of it.  I haven't been motivated to pick up the pace much. 

I do have a couple valid excuses that make it easier to justify walking.  One is our new rescue dog who is 5 pounds and part Chihuahua.  He just can't run fast/ far.  It took a while to build up his endurance to even being able to walk over a mile.  Now that it's freezing out, he also can't be outside for long.

Sharing some personal health and potential TMI (feel free to skip to the next paragraph) - another is my rectocele problem.  Apparently I'm now experiencing pelvic organ prolapse, which means that things aren't suspended in my pelvis the way they used to be.  Sometimes that causes pressure that is a little uncomfortable, and is continuing to cause some difficulties in voiding bowel movements.  In addition to that, it causes occasional incontinence, which is often brought on by bouncing (like jogging).  Now there is a way around this - I can do my best to void ahead of time and not drink a lot before jogging, and wear a pad or something to catch leakage... I've talked to my doctor and she says she's ready to refer me to a surgeon anytime, but that it won't cause any harm for me to wait as long as none of my internal parts start permanently protruding externally, and it's not causing me actual pain.  Neither of those things are happening.  I know I will have to have the surgery at some point, but I'm just not looking forward to it, so I'm postponing it for now.

So what affect is this decrease in activity intensity having?  My weight remains stable, but I have lost some muscle tone.  That means I must have also gained a couple pounds of fat in exchange, but I'm not bothered by it.  I'm wearing the same sizes, and I use my weight stability as a measure.  I've been baking like a fiend for the holidays, and for 99% of the time I have done remarkably well in not tasting the things I bake.  I have more temptations with everyday things in the house, but tend to see any change in my daily weigh-in as a reminder to "Eat Clean, D**n It!".  I have decreased my daily intake to match my lower calorie burning.  Seems to be working, but if I started to see creep on the scale, it would definitely be a motivator.  Maybe I will start swimming laps again... no bouncing there!

I have been feeling an overwhelming sense  of gratitude most days - gratitude that I'm healthy, that I have the energy my family needs from me, that my family is safe and happy and whole.  As we come into the holidays I'm reminded of people who don't have these things.  The anniversary of the Sandy Hook shooting is another reminder.  I decided to do the 26 Acts of Kindness again this year, inspired by the Sandy Hook families.  I'm getting the whole family involved, having them help think of things we can do other than waiting for opportunities to present themselves.  I don't just want to buy something or donate money, I want to do things that make somebody's life a little easier or bring them a smile.  I also think it helps keep us focused on others during this season of rampant consumerism.  Don't think I'm preaching or trying to be an inspiration, I've got a closet full of Santa's surprises that I'll be paying the bill for this month.  I'm just trying to balance that out a little :)

I hope all of you will find smiles of your own, and hopefully getting to spend some quality time with the ones you love this month.  I hope you all had a Happy Hanukkah, have a Merry Christmas, and a Happy New Year!
 

Graduation Pics, inspirations, rants, & warnings

 

Last Friday I graduated from the St. Vincent Sisters of Charity Bariatric Center.  It is a ceremony they hold once a year (although they skipped last year) for people who have reached their goal and are more than a year post-op.  It was a great excuse to get dressed up and have a night out with my husband - and it was AMAZING to be with all of these other successful people who have so much in common with me.  Walking across the stage, with my before/ after pictures and successes being shown on power point, my hand being shook and handed a rose and certificate.  It was a wonderful recognition from people who help the obese become healthy, and from my fellow patients.  Speaking of fellow graduates...

The 62 of us who graduated lost over 7,200 pounds combined, which equals over 25,000,000 (yup, that's MILLION) calories burnt and not consumed.

22 of us used to be diabetic, and only 4 still are.

We used to take a combined 374 pills daily.  We now take 170.

One woman at my table has lost 240 pounds in the past 16 months!  Holey cow.  She was also diagnosed with ovarian cancer, and has just finished radiation after her radical hysterectomy.  She is very hopeful that the chemo will put her into remission, and shared that the oncologists said they wouldn't have been as hopeful if she hadn't lost the weight - because she wouldn't have been able to tolerate the treatments.  I know that the surgery has extended my life and quality of life by getting rid of my diabetes and other risk factors.  But in her case, literally months after her loss, she found that she could get lifesaving treatment that wouldn't have been possible otherwise. 

Seeing my Personal Care Coordinator, Diane Harris, was wonderful as always.  My surgeon has left the practice, and I have struggled with whether to follow him.  Seeing Diane reminded me that she and the other support staff are a large part of the team effort that have helped me this far, and I will likely stay at St. Vincent.  Here's me hugging her to death!

 

My husband was there to support me, as he has been through the whole thing.  We even got a chance to dance a bit.  One of the physician assistant's stiletto heels took the skin off one of my toes, but I didn't let it stop me from enjoying the evening.  Here's me and my rock.

and for a reality check, here's me with my family before surgery, 103 pounds heavier

 

So, parts of the graduation were frustrating and puzzling for me.  First - it was a dinner.  A dinner, for bariatric patients who try to avoid food-based social gatherings.  Well, at least the food would be bariatric friendly, right?  Sort of.  The first things we were served were typical catering fare - a salad and a bread basket (although the bread was flat and crisp bread, which some bariatric patients can eat a little of - not many, but some).  Salad tends to be tricky for WLS patients - lettuce is notorious for getting caught in our stomas, because it's difficult to chew it into small enough pieces.  We also are told rule #1 is Always eat your protein first - so being given bread and vegetables before our entrée was against THE RULES.  OK, well, there were probably another 75 people there who weren't patients, so they could enjoy it.  Would it have killed them to put some cheese on the salad, though? The entrees were were either salmon with squash or for vegetarians like us (many WLS become vegetarian post-op because meat and fish prove too hard to digest) we had a portabello mushroom with melted cheese, roasted tomato, and beans.  That was pretty yummy, although it was still lower in protein than I would normally eat for a meal. 

 

I made it through the dinner without anything getting stuck, which is always an anxious concern of mine.  Although, being in a room of fellow patients, I knew if it happened nobody would look at me funny if I had to make a hasty exit to the restroom.  Then they came around with coffee and tea - another no-no for WLS patients, we can't drink with our food, or for an hour after we eat.  But, again, there were non-WLS people there, and they haven't trained themselves to not drink, so that was understandable. Here's the thing though - I saw several patients at my table drinking tea and coffee!  What?  You're here for following the rules and being successful so you break the rules???   But then they brought out dessert!  Dessert.  Really?  And not some bariatric friendly ricotta-stuffed strawberries - oh, no.  Cheesecake.  OK, that was just cruel.  In a funny twist, they place one in front of me, but not my husband.  The ovarian cancer survivor and I both gave him our pieces, and frankly I avoided looking to see if any of the other patients were indulging.  I didn't want it to seem like I was going to judge others for their decision, so I just talked to my hubby while he enjoyed it and ignored the rest.  The fact is we are all tempted to take a taste of something now and then - even if we might dump.  I try to be strong not only because of dumping, but because if I have some grain or sugar I'm likely to crave it for days.  Honestly, it would have bothered me less to see WLS patients tasting the cheesecake than drinking after eating - that washes the whole meal out of our pouches and then it isn't digested well and makes us hungry again. Still can't believe some of them did that.

 

We danced, talked, had our pictures taken and waited for the raffle drawing of an Ipad Mini and Fitbit Flex (ooooh, I wanted the flex!).  What a night!

 

I also got great news earlier that day.  My mammogram came back clear.  I had gotten scanned two weeks prior and been told to expect a call - between my breasts having changed so drastically since my only other scan (8 years ago) and the fact that the new digital scans pick up things that weren't visible on the old films...  I've been spending the last two weeks worrying.  I was greatly reassured by other WLS patients that they often get calls to come back because of the way their breast tissue has atrophied looks strange on the scans, which helped keep me from panicking.  Part of the reason it took so long was because my previous films were taken out of town.  At least now they will have them locally for the future.  WLS people - be prepared for mammogram scares!  That was something I never read about in all of my pre-op prep. 

 

RANT WARNING..... (this is nothing new info wise, just me venting)

 

I am still working hard to make good food choices, and staying active.  Maintaining my weight loss is VERY important to me.  I continue to dislike eating out/ away from home, and have started to get more push-back from my mom on that.  When I told her I was surprised the graduation was a dinner she said "Well, maybe it will help you get over eating out..."  Uh, right.  Part of the reason I don't like to eat out is that eating out vegetarian can be a little bit of a challenge, but eating out bariatric-friendly vegetarian can be VERY HARD.  And even when appropriate food is available, the way it is prepared greatly varies how it will be tolerated.  Even in the best of circumstances, there are times when eating (even at home, my regular diet) results in severe GI distress.  My mom, who originally said that she wouldn't mind if we wanted to stop having traditional Thanksgiving meals together and just get together afterwards, now lays guilt trips on me for not eating at her place.  Sigh.  No Mom, it's not that I don't want to be with you.  It's that I would rather eat at home.  I don't go eat at my friend's homes either.  And the rare times I eat out - it's usually with you.  When I'm at home I have the most control not only over the food, but the fact that I can run to my OWN bathroom if I need to, and lay down on my OWN bed if my stomach hurts later.  This doesn't happen very often anymore, but about once a week I have at least some indigestion.  That's often enough.  It happened Saturday night even though I ate at home, and I had to miss 1/3 of a play while I was in the bathroom.  It's worth it everyday when I am healthy and happy, but eating is NOT a fun social activity for me any more, it is a deliberate, planned, and strategized necessity.  No, I don't mind you eating in front of me.  What I mind is you continuing to invited me to eat out/ over at your place and then not understanding when I decline and say we will meet you after the meal. 



 

Did I mention I get frustrated?  :)  This journey has been and continues to be a rewarding challenge, some days it's easier to focus on the rewards, so days it's hard to see past the challenges. Seeing all my fellow WLS patients and their successes was very inspiring and made me think about how far I've come.  It's not easy, but it's worth it.  I have a free album credit on Snapfish - I think I'm going to use it to make an album of my journey from pre-surgery to graduation!

Surprises! On the scale, with labs, and an unbelievable itch!

The last week has been full of surprises.  Some were good, others not so much.  Last Wednesday I went for my annual physical, where they also draw my labs for the bariatric center.  For my non-WLS friends, because we no long absorb vitamins and minerals well (in addition to taking supplements) we have to have our blood checked for Iron, Folate, Calcium, Vitamin D, Thiamine, Copper, Zinc, and B-12 as well as getting a complete blood count, lipid panel, thyroid panel, and blood glucose level.  They drew 6 tubes of blood, went over my list of the labs I needed, and wondered why they hadn't seen me on a billboard advertising for my bariatric surgeon.  Awwww!  Some compliments never get old. 

The next day I got a call apologizing, but telling me they needed to take more blood.  They hadn't frozen some of the tubes immediately that should have been frozen, so they needed more blood.  Sigh.  OK, no problem, it is a complicated lab order.  The next morning my kids and I went in (we had the day off school for Yom Kippur - Happy New Year everyone who celebrates it) and they drew 6 more. 

Today, 6 days later, I got a call from them again.  Apparently, when the lab courier came to pick up the labs, he put ALL of my tubes in his freezer (not just the frozen ones).  So, they were all frozen when they got to the lab, and they weren't able to run the tests on the ones that weren't supposed to be frozen.  They apologized, and suggested that they send me a script to get them drawn and go directly to the labs to have them drawn to prevent another courier problem.  They don't know if the ones that were supposed to be frozen were run.  Sigh deja vu!  They will send the script to me, and we will try again.  I was actually hoping my results might be in the mail today.  Guess NOT.

On a positive note, I hit another all time low on the scale on Monday, and it blew me away.  139.8!  Under 140?!?  Incredible.  Unbelievable.  Whoa.  OK, so it's now back to 141, but I broke a barrier that I NEVER IN MY WILDEST DREAMS thought was possible.  My initial goal was to get to 160.  Then I hit the 150s and was really happy.  Then I broke into the 140s and I was over-the-moon dream-come-true happy.  I don't imagine I will be going down much further, I seemed to be very steady around 141 - 143 for the last 8 or 9 months - but then I've hit new lows several times in the last month or so.  I'm back at work, so I'm getting more steps in each day - that is helping for sure.  Who knows?  I'm just happy I'm not gaining anything back. 

Here's the bad surprise with returning to work.  I've got a rash.  A really itchy not-fun rash.  For non-WLS friends, we have a lot of extra skin after we lose 100+ pounds.  Some people have so much skin that it causes skin infections, and can interfere with walking, voiding, and sexual functioning.  Imagine a flap of skin that hangs down like an apron from your waist getting in the way of things and trapping bacteria and other fun things between it and the skin that is underneath it.  Yuck.  Having lost 103 pounds, I didn't seem to be having any problems with the excess skin (other than it making some muffin top and other flaps that my son thinks are funny to play with).  I didn't expect to have problems, mostly that happens with people who lose a lot more than I have.  Many WLS people get the extra skin removed ( it's called a panniculectomy, which is about 1/2 of what most people would call a "tummy tuck").  Between the risks, the cost, and the recovery I always said I wouldn't be getting one unless there was a real medical necessity.  Then I went back to work at my lowest ever weight (in 90 degree weather, walking around constantly)...  Hello, itch.  I've got a rash/ skin infection underneath the flap of excess skin hanging from my waist.  I'm treating it with the same anti-fungal medicine that you use for athlete's foot or yeast infections.  It helps with the itching a bit, but it hasn't gone away.  If it's still here much longer, I'll have to see my primary care doctor for something stronger.  And, that will start a trail of documentation.  If I have recurrent infections, my insurance may decide to cover a panniculectomy for me.  I don't want one.  The risk of major surgery, the 6 weeks of restricted activity in recovery, and the 20% of the cost I would still have to pay are three good reasons not to get it which wipe out the positive of being rid of the flaps.  However, if this rash is something I have to deal with on an ongoing basis, I will consider it.  Go away, itch!

Back to the positive!  I got to go visit some old friends briefly over the weekend, many of whom hadn't seen me for over a year (some not since before surgery).  It was really fun getting to have quick visits with them, and I would be lying if I didn't admit that I really enjoyed seeing their reactions to seeing me in my new healthy body.  Bonus.  I am so blessed to have such great family and friends, my home, my job and my health.

Today, 9/11, I'm counting my blessings.  Thank you for all those blessings, and may the hungry, homeless, out of work, and victims of violence find such blessings in the next year.  May I make the right choices to stay healthy, and be able to support others who need help.  May I learn from my mistakes and help my children avoid them.  May I find patience on the hard days, and give of myself on the good ones.  Thank you first responders, for risking your lives to save so many of ours.  Thank you to the members of the armed forces who serve their country - may you receive the support you deserve from us and our country.  Thank you to the teachers who are shaping our tomorrow. 

Truths! Birthdays, Graduation, and pics

I'm really trying to stay honest, and embrace the truth even when it hurts.  Here's my latest confession - I love butter/ margarine.  This is embarrassing - but I've loved it since I was a child.  My mom tells about me climbing out of my highchair and onto the thanksgiving table to sit down and chew on a stick of butter at my grandmother's while everybody was in the kitchen when I was 15 months old.  I used to stick my finger into the tub of margarine and scoop out a little once in a while as a kid.  As I grew up I grew out of it - or should I say changed things I liked to eat that weren't good for me. 

Since my surgery, really in the last couple months, I have rediscovered my taste for margarine.  That sounds gross doesn't it?  I think part of it is craving fat - which even with a tablespoon or two of margarine a day my consumption stays low (yes, I have been logging it).  That melt-in-your mouth feeling is part of it.  There lies a truth - if it melts in your mouth, it's liquid calories - a BIG NO-NO and major rule breaking.  So, just like I had to make a big change when I realized I was starting to compulsively eat popcorn, I'm going to have to make a big change here.  No more buying tubs of margarine.  I will buy sticks of butter, which I have no craving for, whatsoever.  Logical?  Of course not - it's a crazy psych thing.  Oh the webs our tricky brains weave.  I can use sticks of butter for everything cooking-wise that I use tubs for, and not be tempted.  Yesterday I threw out the tub that was in my fridge.  Wonder what the next thing is my brain will try to tempt me with...

On to a more positive truth - I got my new driver's license!  The truth part is that I actually put my REAL weight on the license for the first time in my life.  Not even my lowest weight, but the pound higher that I was on the day I renewed it.  I thought I needed to renew it by my birthday but it turns out I didn't have to renew it until next year.  Yeah, it was written right on the license, I know... But I decided to renew it early because I don't look like my license anymore.  And I'm 50 pounds lighter than the LIE I had on my old license.  But I took pictures of my old and new license (with all the potential identity theft info blocked out) for memories sake (and this blog). 

 

OK, so that's my old license.  I listed my weight at 190, which was 53 less than I weighed at my highest.  When the picture was taken I might have been 235.  I remember being relatively happy with the picture, because it only showed two chins.  I spent a lot of time on my hair and makeup that day, too. 

... and here's my new one!  I LOVE looking at those two pictures next to each other.  An added bonus is that people will actually believe it's my I.D. when I am asked to show it :) 

I still think that they should just have a digital scale built into the floor at the license bureau.  That way when you step up for your turn it would automatically weigh you and the they wouldn't have to ask your weight.  It's embarrassing for the average person to say their weight out loud to someone, and mortifying for the obese.  Plus, it's not like most people tell the truth!  Heaven forbid something had happened to me two years ago and they found my body.  I can see them saying "Oh, this probably isn't her, she's much heavier than the person we're looking for..." 

My birthday is in two days, and my mom offered to come spend the morning with me for a "girl's day" - something we used to do when I was little, and have tried to make time for occasionally now that I'm a grownup.  I asked my boys (10 and 13) for the birthday present of them watching themselves (without killing and bugging each other) for a few hours for my birthday present.  My mom is going to come and go on a nice long walk with me and my dogs.  Then she's going to come with me to a jewelry store.  All of my rings are WAY to big.  I'm guessing I'm wearing a 6 1/2 now - my old rings are 8 1/2.  I don't feel the need to spend the money to resize everything, but I've been wrapping medical tape around my wedding band and engagement ring for over a year now and want to get that done!  I'm thinking about instead of having several rings resized I would look at combining stones into a new setting.  I have no idea how much that will be, but want to explore options and get a sense of how much money I will have to save up.  Then we might go to a bookstore and browse...aaaah, the luxury of doing that without having the kids interrupt me twenty times.

I got an email this morning inviting me to my Center for Bariatric Surgery graduation!  In our program, if you have met your goal and kept it off for over a year, you are invited to that year's graduation party.  It's a formal event at a really nice hotel, and will be happening in October.  The only sad thing is that my surgeon has left the practice.  So I'm sad that when I walk across the stage with a slide show of my before and after pcitures I won't get to shake Dr. Ben-Meir's hand.  :( But, I'm really excited to be in the graduating class of 2013.  I need to start looking for an AWESOME dress.  Oh, and saving up for it, too. 

New swimsuit Pic, and could Bariatric Betty be losing more??? Obsessing about weight.

I may be losing more weight, at 17 months post-op.  It is boggling my mind.  For the last 8 months my weight has been stable for the most part.  I went well past my goal and hit a one day low of 140.6 (my goal was to be in the 150s, and dream weight was to be in the 140s).  My weight then seemed to stabilize at 142 and except for my flirtation with some compulsive popcorn consumption adding 5 pounds temporarily, it has stayed there.  A couple days after I stopped eating popcorn and I was already back down to 145.  Another month later and I was down to 143.  Last month I was back to 142 and happy, lesson learned.

I usually weigh myself daily knowing that fluctuations happen, and not taking the number to seriously.  I can be up to 144 pounds depending on how much salt and carbs I have had in the past day, as well as where I am in my cycle.  One of the funniest things I have found is that the day before my cycle, I actually drop 1 to 2 pounds for a period of a day or two.  And all these years I thought I gained weight when I was PMS-ing!  So last week I had already had my PMS drop and seen 141 pounds.  Then my cycle started and I was back to 142.  A couple days later, and I was 140.6 - Hey, long time no see!  Weird, this would not be when I would expect to see my all-time low again.  Imagine my surprise on Friday when I weighed myself and saw 140.4!

OK, I know this is silly, it's 0.2 pounds lower than my previous low.  And the numbers shouldn't have such a big impact on me.  There is a lot of fluctuation and I wouldn't be mad for going up 0.2 pounds, so why did it cause this illogical feeling of glee that I had a new low??? 

I weighed myself several times and got the same reading.  Then I checked my body composition meter, and it has stayed stable.  I haven't been running much with the heat, more walking and swimming, so I thought maybe I had lost muscle.  But if my body fat percentage is about the same, then if I lost muscle I also lost some fat.  Hmmmm. 

Then I thought about the last couple months.  Other than cutting out the popcorn I have decreased my intake a little because of the decrease in running/ burning calories.  Maybe my body isn't at it's new set-point?  Maybe there is room for some more loss?  I don't know.  My doctors say I'm at a healthy weight, I feel healthy and happy.  I don't need to lose any more weight.  On the other hand, I am at the top of the healthy range, so it wouldn't hurt me if I lost a bit more. 

Meanwhile, my new bathing suit came I from Lands End.  I tried ordering tankini seperates to help with the fact that my lower half is a very different size that my upper half.  The lower half is a high-waisted control top skirt, so it smooths out some of the folds and flaps nicely.  If you are self conscious about your middle, I highly recommend it.  The top is their D-cup underwire, which actually contains the girls, saggy and prone to floating as they are.  Again, recommended by me for endowed post-ops.  Here's the pic.

 

 

 

In comparison, here is a picture of me pre-op in a bathing suit (25 pounds already lost) and then about 9 months post op, already pretty close to my goal (but maybe not final) weight. 

Now it's a couple of days later and I'm hovering around 140.6 - 141.0.  So, what does this all mean?  It means that maybe I shouldn't just worry about not gaining.  It means that maybe I will lose more, and I should be open to that.  Either way, I'm going to keep working my program, following the rules.  1) No drinking with meals or for one hour after.  2) Eat protein first, trying to get in 20 grams at each meal.  3) No liquid calories (alcohol, milk, ice cream, soup, etc.) and 4) Eat meals within 20 minutes, no grazing and only eat until I'm full. 

Where am I headed?  Forward, never back.  I have bad days, I give in to old habits occasionally.  I am not perfect and never will be.  I commit to staying healthy, to making the best choices I can.  It requires a lot of time and energy to keep my new lifestyle, but it is worth it.  To all my friends and family who support me and my unusual needs - I thank you.  I couldn't do this without you.  To all the WLS friends out there who read my blog, we're in this together.  You inspire me. 

Bariatric Betty's Summertime, and the living is sometimes too easy

Ahhhh, summer.  I'm off work (since I work at an elementary school), and my boys are home.  No homework or tests to deal with - just daily reading to keep them from regressing over the summer.  Only thing is, they think that I should be providing FUN!!!! all day every day.  Um, no, that's what summer CAMP is for, which both of you declined to attend repeatedly.  So now you have be bored at home with me! 

My day starts making breakfast for everyone, unless it's one of the days my 12 year old has gotten up early and hungry and has made his own.  I don't eat for about an hour after I wake up so I have time to drink my first 24 ounces of liquid for the day.  I see my husband off to work with the lunch I've packed and eat my breakfast.  Then the kids and I go over the plans for the day.  That starts out with a reminder that they each need to read 1/2 hour.  The complaints start then, and sometimes last for hours. I walk/ jog the dog, do a load of dishes and remind my 12 year old he needs to run a load of laundry.  I get in my second 24 ounces before lunch, and another 24 before dinner.  We usually go somewhere in the afternoon, and eat early.  Since the boys are both playing baseball this summer, we often have 3-4 hours of overlapping baseball games in the evening.  My sweet husband eats a dinner I bring at the community park where the games are being played at least once a week because the games start before he can even get home from work.  Sometimes the games go until after 10pm!

I spend at least a chunk of time every couple days cooking large amounts of my staple foods so that they are ready for daily consumption.  I scramble 6 days of egg beaters at a time - that doesn't take that long.  When I sauté my 5-6 days of onions and julienned zucchini (think non-noodle spaghetti) it takes a bit longer.  When I make up a pot of my lentils with carmelized onions it's over an hour, but that will last me for a couple of weeks.  I am also cooking for a family of friends once a week who have a mom recovering from a serious illness.  It's been fun finding things that are vegetarian that her family enjoys - my family has had such a predictable diet for years that it's taken me out of my comfort zone a bit - but it has also increased the quality of meals my own family is getting.  Eggplant parmesean has entered our regular rotation, as has fried tofu.  The other night I made fried rice with broccoli, pea pods, carrots, peas, water chestnuts, asparagus, and eggs that was a hit.  It's weird that I can't enjoy most of these things myself - they don't have enough protein or sit well in my pouch (with the exception of un-fried tofu) but it does feel good to see everybody eating well.

I do try to plan at least one fun thing a day for the kids, whether it's going to our local rec center/ pool, going to a movie, going to the local waterpark where we have season passes, etc.  We won't do anything like that until they have done their reading, however, and on some days that means it's afternoon before we get to go.  Like today.  It was 2pm before my 10 year old finally finished his reading.  He spent all morning complaining about how he didn't want to read, and he wanted to go do SOMETHING.  No matter how many times I explained "You do your reading, and I will take you somewhere, you get to decide how soon that happens..." the whining WOULDN'T stop.  Augh.  I took my dog for a longer walk just for the peace and quiet. 

Speaking of walking the dog, that's my only predictable exercise right now.  I miss my job!  It's nice to be able to have other options during the middle of the day during break, but I miss working with the kids, talking with other grownups, and most of all the 5000 steps I would walk while I was working. 

Thank goodness for my fitbit pedometer.  If I didn't wear it every day then my exercise would be pitiful right now.  It's a great motivator - because I HATE not hitting at least 10,000 steps a day.  During the school year I average about 15,000.  But now I average around 11,000.  I actually have to work for those, too.  When we go to the park I walk circles around the playground.  When my kids have a baseball game I pace back and forth for the second half of the game.  When we're camping out at the rec for a long time, I walk a couple miles on the track. 

I don't enjoy running in real heat, so I'm not jogging much right now.  I have decreased my food intake a bit to take into account that I'm not burning as many calories right now, and that seems to be working well because I'm staying at goal.  The daily struggles with making good food choices is harder some days than others - although I haven't had a crazy obsession (like the pie crust) for a while, thank goodness.  I usually stay away from white carbs because I find they trigger cravings for me and I don't need the extra stress. 

My house continues to be a disaster zone, but most days I feel like I am getting the level of cleanliness incrementally better.  My focus has been on getting the boys to help clean up their own messes (definitely works in progress) and keeping counter-tops and kitchen/ dining room tables at least partially clear.  At the moment my 12 year old has his basketball shoes on top of my papers on the kitchen table, and my 10 year old feels that since he has set up his lego building area on half of the dining room table for the last 6 months, I am being unreasonable to think that should change.  Baby steps.  This last week I tackled the outside mess - pulling up 7 bags of thistle and other assorted weeds that had started looking like trees. 

Speaking of trees, the other night a severe thunderstorm took down half of a 30 foot tree in our front yard.  Besides being stunned, everybody is fine.  Mostly I am overwhelmed with gratitude that the tree didn't fall on the house and that we weren't home when it happened - because my car is usually parked right where it fell.  It didn't even knock over our basketball hoop!  It was definitely one of those moments that I felt someone was watching over us. 

I am so grateful for the every-day blessings my family enjoys.  Our health and our home top amongst them.  But it's up to us to maintain both of those things if we want to keep them as blessings.  My sons arguing for more snacks and less work can be tiring, but I try to remind myself that I am teaching them life lessons - and that if I want them to value those things as highly as I do, they need to see our commitment to them every day.  It's easier to think of it that way when the whining isn't happening.  There will definitely be times when the overwhelming thought in my head is "Do it because I SAID SO!" although I try to be calmer in explain the importance of the issue at hand.  And there are times that I tell them "You've worn me down.  I am taking a break.  Be nice to each other and work on xyz while I go lay down for a bit/ take a walk/ run to the store."  It's lovely that they are old enough that I can do that now. 

I remain incredibly thankful for not only the support of my family on this journey, but my local support group.  The other night we had a meeting, and as I was walking out the door to attend we discovered that while my 10 year old had been "bored" he had used scissors to scratch and poke on our black leather couch.  Augh!  I went on to the meeting and vented, and we all agreed that the "old" us would have then eaten a large amount of junk food to handle the frustration.  Now my son is responsible for cleaning off said couch and his own favorite chair every night to help him learn to respect our things more.  His response "For how long?"  Our answer "Until we decide to ADD more chores.  This will be your responsibility, period." 

I am also thankful for all of the health professionals that have helped me get to where I am, and where our family is going.  I found out a couple of weeks ago that my surgeon and his team are leaving St. Vincent and it really feels like a loss.  I will have to work with new people for my follow-up.  But, they gave me my pouch/ tool and a good foundation to work with.  I will miss you Drs. Ben-Meir and Salomone!  I am also so glad we found a great family psychologist to work through issues with our sons, and have found a wonderful rheumatologist for my husband.  Never underestimate what have access to good healthcare can mean for your family.  I wish everyone had it this good!


 

Bariatric Betty tackles Self Hate and Sabotage

Last Friday I stopped at our local Sears/ Lands End store to try on some tops.  I'm still building up my wardrobe at my goal size - my clothes from last summer are two sizes too big.  I have become a big fan of getting clothes second hand, but also hit the sales racks at places like Talbot's Outlet, Lands End, and of course Target and other places as well when I need something. 

I picked up several Medium Petite (still boggles my mind) tops and went to the dressing room.  Walking in there was a woman trying on a winter jacket (Lands End has GREAT deals on winter clothing right now) and I commented "Cute jacket!".  She replied "Not on a fat woman like me, maybe on somebody like you."  My heart fell.  I hate to hear people being cruel and calling people names, but one of the worst is when they are hateful towards themselves.  I couldn't just let it pass.  Here's a chunk of the conversation that followed:

"You shouldn't be so hard on yourself"
"No, it's true!"
"You know, a year ago I had bariatric surgery to lose over a hundred pounds, and I know it's really hard to lose weight.  Beating yourself up isn't going to make it easier."
(pause) "Wow, you lost 100 pounds!  You look great.  You would never know."
"Yeah, I feel great, too.  But for decades I tried Weight Watchers, Nutrisystem, and all sorts of diets.  When you find something that works for you, you will lose weight.  For me it took surgery to get it all off - otherwise I just kept losing the same 30 pounds.  Until then, you should give yourself credit for doing the best you can."
"I guess.  It all came on after I had my kids - I was never heavy before then...."

I felt so bad - here she was berating herself to a stranger in a public changing room.  I said a supportive comment and ended up hearing her whole weight loss history.  Of course, I shared mine first (heaven knows I like to share happy stuff with everyone) - but can you imagine how much she needed to talk to someone sympathetic that she was willing to talk about something that made her ashamed and mad with a total stranger?  She was perfectly willing to say mean things to herself, and I'm sure has heard cruel comments from others.  The sense that fat people deserve to be made fun of or be the targets of snide comments - or the even more twisted thought process that targeting them might make them more likely to lose weight and be healthy - it's RIDICULOUS.

Here's a link to an interview on the Today Show that showed up yesterday after I started writing this blog. http://www.today.com/health/my-butt-so-huge-fat-talk-common-harmful-6C10109738   It talks about how women hurt their self-esteem and that of others by participating in negative self-talk or negative comparisons to others.  What many may think is trying to help support a friend unhappy with their body, i.e. "Oh, no - my hips are SO much bigger than yours!" is not helping.  It is leading into an almost competitive cycle of trying to make others feel better at your own expense - where the original unhappy person then feels the need to point out that her "flaws" are even BIGGER.  So instead, talk positive.  About yourselves, about others.  When your friend says "My muffin top is turning into a whole CAKE top!", say "I think you look beautiful" - not "my muffin top just filed for it's own zip code".  When you are frustrated that your own physical fitness goals aren't showing up the way you would like,  i.e. "Why can I now see some ribs outlined but still have a jelly belly???" think "I have worked hard, I feel better, and I look better.  I can't control where my body decides to lose fat, but I can make the most of the parts I'm proud of."

Now, fast forward to yesterday, when I tried on a new pair of shorts with an older shirt.  I didn't think they necessarily worked together, so I asked my husband.  He agreed.  I tried a different shirt, and he tried to explain that my top is so curvy, but the bottom half is so straight, and the original combo just seemed to over-exaggerate it.  He was right, I have a large chest and then very little hips or butt.  So I needed an outfit that created a little more balance.  I had unrolled the legs on the short to about a 10" inseam, but originally they were rolled to about a 7" inseam.  I rolled them back up and with the new shirt felt better.  Still, I looked in the mirror several times yesterday morning, and ended up asking my 12 year old son what he thought.  Warning Sign Alert - if you have to ask your 12 year old son for fashion advice, it's a sign you are feeling a little insecure!  The following is a recap:

"Justin, does this outfit look OK?"
"Ummm, that depends... where are you going to wear it?"
(internal alarm, uh-oh, what the heck?  Maybe my tucked-in shirt is showing my extra-skin flaps too much???) "To work"
"Oh, then it's fine."
(???) "OK, just wondering , where WOULDN'T it be a OK to wear it?"
"Ummm, to drop me off with my friends"
"OK, I promise I won't be upset, but I want to know what makes you uncomfortable about your friends seeing me like this." (Oh boy, I hope this doesn't hurt too much)
"Well, Mom, could you wear jeans or something?  I'm not used to seeing your knees, it just seems weird..."

LOL.  Yes, my son wasn't embarrassed by my flaps of skin, or my large chest - he felt that my shorts falling just above my kneecaps was embarrassing!  Watch out - I'm a hootchie mama!  Looking back, I shouldn't be surprised, he told me that if any of his friends wear shorts that don't come below their knees some of the guys at school call them "bootie shorts".  It gets even more funny when you know that I wear skirts above my knee (about the same length as the shorts yesterday), but that doesn't bother him.  But shorts that showed the ENTIRE KNEECAP???? Gasp.

We can be our own worst enemy.  Don't give in to the negative trash talk in your own head.  It makes it easier to do it again, and easier to believe that others are thinking/ saying even worse. 

Speaking of our own worst enemy - I caught myself before I sabotaged myself yesterday.  Yay for the catch, boo for the constant vigilance required.  I have been making meals for a friend once a week - she's been very ill for several months, and a couple of us bring meals a couple times a week to take some of the pressure off the family.  This week I offered to bring "Breakfast for Dinner" - French toast casserole, quiche, and a carrot/ yogurt/ craisin salad.  They have a severe peanut allergy in the family, so it's important to read and re-read the labels.  I started being concerned about the quiche crust.  In the past, I have found it a little tricky to find ready-made pie crusts that don't have lard.  And now I would have to find one without any peanut oil/ exposure to nuts in the factory.   Hmmm.  I started thinking about making my own crust.  OK, that's simple.  Then I remembered how much I like to nibble on pie crust dough.  Yeah, I know, weird.  I don't know why it tastes good to me, but it does.  And then I found myself thinking about nibbling on pie crust dough probably 50 times over 24 hours.  Not exaggerating.  And about how I should probably make a little extra to make sure I had enough dough - but knowing it was really so I could eat some but still have enough.  Yikes.  So I started thinking about going back to finding a pre-made crust.  But they usually come in two packs.  I would have a whole extra pie crust.  Extra pie crust, mmmmmm.  Seriously?  Then here comes my AHA moment.  Wait, I can use that whole extra pie crust to make another quiche for another meal for them.  So I can't break off a piece and eat it, because I will need it for the next week!  Restraint engaged - logic wins!  It was that hard.  You never know where your brain will take you on these weird cravings/ food addiction trips.  Every day is a journey, where we have to make the choices that will keep us healthy.  Some days are easy down-hill paths, other days we have to climb the mountain in the way. 

On a positive note - I saw a wonderful friend this weekend who hadn't seen me for over a year.  She has seen my pics on facebook, and knew all about the surgery, but it was still a shock for her.  I loved getting to visit with her and her family, and of course the complements felt wonderful.  Mostly though, I loved seeing our kids together.  Except for maybe when two of our sons demonstrated their "feedbag method" of eating a bag of popcorn.  Gross. 

Getting ready for summer break to start next week - and it turns out I registered for another 5k I forgot about.  Now I have to figure out if I can do it with the kid's baseball schedules.... 





 

The Honeymoon's Over - Bariatric Betty's Uphill Climb

How many of you have heard someone actually call getting weight loss surgery "the easy way out"?  WLS patients wince every time we hear it, and many of us will actually address the ignorant person who says it.  Chris Christie just "came out" about having lap band surgery 2 months ago, and I can't blame him for keeping it quiet so long.  The judgment that so many people make about someone having weight loss surgery can be vicious.  And that's on top of the judgment people have already made about those of us who are morbidly obese.

In an interview Christ Christie gave with Brian Williams, he recounts his conversation with his doctor when he asked if he should really get the surgery.  He said his doctor said "If you came into my office with cancer and I knew that there was a 40 minute surgery that would give you a 90% chance of a cure, should you get it?"  Here's the thing - the surgery IS simple for most of us. 

The surgery itself (without complications) can have you in and out of the hospital in a couple of days, put Type 2 Diabetes into remission immediately, and start a rapid weight loss that can lead to a healthy weight and lifestyle.  But, what the typical person doesn't understand is that the real work starts before surgery, and continues for the rest of our lives. 

One of the WLS patients on a Facebook support group was preparing for her surgery with a multiple week liquid diet that the surgeon prescribed.  Weight loss just before surgery will shrink a fatty liver and reduce risks of complications.  A week before surgery she had a small bowl of oatmeal, just wanting something "solid" one more time before surgery and the post-op weeks of liquids and then pureed diet restrictions.  Worried that this might put her in danger during surgery, her husband put a call into the surgeon.  The surgeon cancelled the surgery - NOT because of the oatmeal causing any risks - it wouldn't.  Because the woman feeling such a strong need to eat something she had been told she couldn't have (even though it was a healthy food) indicated that she might not be ready for the lifetime commitment to dietary restrictions that a successful WLS patient must have.  She has to meet with a social worker now, and who knows how long her surgery will delayed until she is really mentally ready.

What happens if we don't make those right choices after surgery?  The obvious result - that we won't lose the weight we need to lose, or will quickly gain it back.  Yes, people go through the surgery and then sabotage themselves soon after - whether pureeing the unhealthy food they crave so they can eat it again (cheeseburgers, french fries, etc) or by consuming liquid calories - a big NO in the rules for post-ops.  Eating ice cream, drinking milkshakes, drinking alcohol - they are all forbidden (although some doctors will say you can have a small amount of alcohol occasionally after 1 year post-op). 

What are other outcomes of bad post-op choices?  If your Type 2 diabetes went into remission and you go off plan and gain the weight back, it will come back WITH AN ATTITUDE.  There is a high risk of alcohol abuse/ alcoholism, even if the patient was never a drinker before.  A patient who had RNY bypass will now absorb more of the alcohol quicker than a typical person.  They will get a bigger buzz/ drunker and it will happen more quickly with less alcohol.  Given that many of us were "using" food in an addictive manner, it isn't hard to imagine that we would look to fill that need in other ways.  Increases in alcohol use, drug abuse, compulsive gambling and other addictive behaviors have all been seen in post-ops.  Big hard rule - whatever your problems were before surgery, they will still be here after surgery.  So you have to work on the underlying issues every day, and continue to face up to them.

My honeymoon period (usually seen as the first 12-15 months post-op when you aren't hungry) is over.  I get hungry now.  I also still get "head hunger" - where I crave something but my body doesn't need the nutrition -  that never went away, I just became better at identifying it.  I have found myself eating things for the wrong reasons before and caught myself before it showed up on the scale.  My caramel calcium chews - that I started eating twice as much of as I should - a nice way to get kidney stones!  Threw them out after a week.  The cashews I had gotten to eat as a protein packed snack occasionally - but found myself snacking on multiple times a day (at 200 calories a pop!).  Got them out of the house and kept them out for over 2 months until I was sure I could see them and not be tempted.  The glaze on the peppermint candy cane cookies that I licked off my fingers and then started scooping off the drip tray - I confessed to my husband that I had a real weakness there and he said that the next time I want to make them for the holidays, he and the kids will do the glazing for me. 

This last one snuck up on me.  I was eating homemade popcorn in the evening once in a while if I was hungry, making a big bowl for the family and having a serving size myself.  Then my serving size grew.  Then I was making it every night.  I still didn't realize I was in trouble until I saw the scale change.  I gained 3 pounds.  From popcorn.  Do you realize how much (unbuttered) popcorn I must have been eating?  OK, that's not the only reason I gained weight - I had been doing more walking than jogging.  While I am still very active (12,000 - 14,000 average steps a day) I went from jogging 3-4 times a week to jogging 3 times a month.  Add to that the salt I put on the popcorn, and Voila!  3 more pounds. 

Don't get me wrong, it isn't unreasonable to expect a little regain.  18 - 24 months out the average patient gains 5 - 10% of their weight back, mostly because their stomach has expanded enough that they can eat more/ get hungry again.  Some people never have any regain - and I really want to be one of them.  I told my husband I needed to "go off" popcorn for the forseeable future and from then on whenever my son requests it he says "Mommy's not going to make it, you can make a small amount just for yourself and throw out whatever you don't eat".  Awesome hubby, isn't he?  Sure enough, just 3 days after no popcorn, and my weight was already back down 2 pounds just getting the excess salt out of my system.  I also started jogging twice a week again.

The scary thing is how I didn't realize my new night-time snack was a problem until it showed up on the scale.  First of all - I shouldn't need a snack every night!  First thing I should do if I think I'm hungry is drink, because I'm probably just thirsty.   And if I am hungry, most of the time it should be satisfied by protein.  And I had gotten lazy with my exercise.  I feel embarrassed to have fallen off the wagon - lured back into an addictive eating pattern (eating more, more often).  It will take conscious choices and deliberate actions for me to stay healthy.  I must stay more active than the average person, and I can't think I can snack like an average person.  "Within moderation" is a loaded phrase and WAY too subjective for me.  In the case of popcorn, I've decided it means 2 cups of popcorn once every 3-4 weeks, max.  It means get out of the freakin' house in the evening, when I start to have the head hunger, so I am distracted from it.  Luckily, I've got my kids baseball and soccer practices and games to help with that! 

Finally, to end on a good note - I had a BLAST doing the Akron Color Vibe Run 2013.  I ran 5k in 30 minutes flat - my new best time.  That might have been because it was cross-country - up slopes, down slopes, across the gravel, sliding on the wet grass, splashing through the puddles.  There was NO BOREDOM there, on the contrary - I was terrified I was going to fall and take some layers of skin off, so that adrenaline probably helped my time.  Also, four times along the run we were liberally doused with colored cornstarch, which made it really fun.  Here are some pics (the tutu is a common accessory in these races)

 

If you want to try a fun 5k, I highly suggest Color Vibe and The Color Run!  Lots of fun for the whole family - one of my sons ran it with me, and the other is seen above tossing a lot of magenta cornstarch!

So, to sum up my original thought, getting weight loss surgery may be simple for most of us, but being a WLS patient for life is not.  Running a 5k feels simple now - it's a short amount of time, and a reasonable amount of effort for that time and you're done.  Making the right choices all day every day, pushing yourself to stay active, reminding yourself to stay away from your triggers and deal with your issues instead of eating to deaden them - that's the hard part.  It's part of the reason I eat the same things almost every day - it removes the temptation.  It's like an alcoholic realizing that it might never be a good idea to eat in a bar if there is another option.  Unlike the alcoholic, we can't just stop eating.  We have to choose to eat healthy things that won't trigger overeating, which can rule out a lot of things for each of us.  We have to choose the proteins that will fill us and meet our new body's needs.  We have to avoid the carbs that are likely to make us ill/ get dumping syndrome.  And we need to take our supplements regularly to make up for the vitamins and minerals we can't get absorbed through our food.  And when we do that, we are healthy.  That's how I plan to stay.