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!

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.