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!


 

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. 

 

Lost and found, Bariatric Betty embraces hard stuff

The fitbit is lost, long live the fitbit!  Yes, I lost my second fitbit, and have been trying to manually calculate my steps and calories burned all week - boy did it have me spoiled!  My clip/holder had broken the week before and I had contacted the customer service for a free replacement.  For that week I was clipping the fitbit directly on to my belt loops, bra straps, etc.  And on that last fateful day - I jogged with my dog after clipping it on, and came home to find it gone.  I traveled my path again twice, trying to find it to no avail.  Fitbit had already given me a replacement once for free - it wasn't reasonable to expect them to do it again.  And then a ray of light - they have a new (cheaper!) fitbit - the Fitbit Zip.  It does everything but counting flights of stairs and sleep monitoring.  That's not bad - I don't even use the sleep monitoring function.  And instead of $99 it's only $59.  OK!

So I sent an email to customer support reporting the loss of my fitbit, and on the next business day... it happened.  "We would be happy to send you a complementary replacement..."  No way.   OK, I will once again rave: Fitbit - BEST CUSTOMER SERVICE EVER.  So here is my unsolicited ad - in addition to the newer cheaper Zip, the Fitbit One (which should be out for the holidays) will have all the initial capabilities as the Fitbit Ultra - but it and the Zip will be able to interact wirelessly with Apple devices and soon select Android devices.  No more base with a cord.  Woo-hoo!  I'm just getting a replacement Ultra, but for those of you who might be considering a splurge (or who want to whisper a wish to Santa) - this will be even more amazing.   Here's a link http://www.fitbit.com/one

OK, so my scale is hovering around the same number it has been on for the past 4 weeks; we are in a stall, Houston, we are in a stall.  But, I'm not worried.  I have continued to lower my Body Fat Percentage a little at a time, so I know I'm replacing fat with muscle.   I also got my test results back from my primary care physician and they were ALL NORMAL.  All my supplements are doing their jobs, no deficiancies, no diabetes, nothing wrong :) 

I'm enjoying my job, I really get a lot out of being an elementary school monitor.  Other than basically functioning as a lifeguard/ babysitter in the lunchroom and playground, I get a chance to impact the lives some of the kids.  The kid who are bored and need a challenge - have you tried running around the track - see how fast you can get around it!  Wow - you went around the whole monkey bars by yourself look how strong you have gotten by trying every day!  Watching the girl who just lost a parent find solace in helping a special needs student.  The student that told me his "heart hurt" and the resulting conversation that ended up with a referral to child protection services.  The daily boo-boos that give me a chance to talk about how amazing and strong the human body is, that it's already working on healing itself while we walk to get a band-aid.  Explaining to the children who are sad or mad that their friend doesn't want to be their friend anymore that even friends can have disagreements - that real friends will forgive each other and play together another day.  Talking about being fair and sportsmanlike, about including others, and watching the kids grow.  It's very rewarding.  In another life I think I would love to be a guidance counselor - but in this one I appreciate the chance to help when I can and refer them to someone better qualified when it's beyond my level.  One of my NSV's (non-scale victories) this week was that I was able to run around the playground track with my 1st graders when they asked me to join them - without breaking a sweat.

Dealing with stress seems to be going better - in addition to talking with my husband, I'm choosing to walk or jog more than any other coping mechanism.  Of course, last night I had a mega-wave of PMS hormones triggering some huge irritability.  It was late, and since I was finding myself getting ticked about things that I could see weren't worth getting upset about, I elected to send myself to bed early.  I just announced that I was worn out, and asked my hubby to take over - which he graciously did.  This morning I explained why, and he actually thanked me! 

Earlier this week I realized I was starting to eat progressively more of the delicious caramel calcium chew supplements than I needed every day.  Not good.  After chatting with a reader who was asking MY advice about staying away from temptation I recognized it for what it was - an addictive behavior.  Enjoying something, turning to craving something, turning to increased consumption/ usage... That might sound extreme labeling to those of you who haven't been morbidly obese, but most of us recognize that are our overeating could be classified as addiction.  So, I threw the caramel supplements out.  Bought boring tablets.  Did I overreact?  Not in this case - I know because 1) late that day I thought about pulling them out of the trash (they were in a sealed bag) and 2) because I craved those caramel supplements for the next three days.  Were they going to make me fat again?  No.  They might have led to kidney stones because of the large doses of calcium - that wouldn't be good.  But it's more the fact that I recognize that I can't allow myself to have something that I'm going to "crave" because it grows out of control too easily with me.  Will I ever let myself have treats again?  Yes, but definitely not in my first year, and then it will be a small amount, rare, and not keeping it in my house.   Eating too much of anything is unhealthy.  Even calcium.

Yes, my head is a constant work-in-progress.  But I didn't get morbidly obese because of stellar mental health, and I am definitely earning my improved health.  By making good choices over and over again, I look forward to it not being so difficult some day.  It's not difficult every day now, and I am so grateful I have my pouch to help me!