Over Anticipating Results

I've said this before but I always end up feeling let down from the scale related goals I set for myself. It's been better than other weight loss attempts, but I can't say it's all motivation and willpower. (Thank you Sleevie!)

My first goal passed this past weekend. I took a business trip and wanted to be 220. I ended up at 222.8 which isn't bad but the truth to making a ton of goals ahead of time is that if you miss one goal it's only going to be more difficult to catch up.

One of the things I've found with surgery is patience that I didn't have before. Perhaps this is me maturing, but I have a hunch it's more that I know the surgery will make me successful. I have to work at it but in the months out from surgery it's fairly difficult to not do well.

It's my fear of this complacent mindset that has kept me going the past few weeks to break out of my norm and start adopting healthy habits and challenge myself. I sort of see it as a race between New Me an Old Me to see who is strongest.

I think we can all agree that once you start sneaking things on a fitness or nutrition plan is the beginning of the end. What may be a small setback for most people can lead to self hatred and bad decisions on a grand scale for others (ie ME!)

I Have a Hole In My Life (Not In My Stomach)

Are you genuinely hungry for food or are you looking for a hobby?

Ever since surgery I've felt like I've had a lot of time on my hands. I had a solid week off work after surgery and while juggling getting in nutrients was time consuming I really wished there was something else to entertain myself

Before surgery I always felt that the constant eating was trying to fill a hole I had in my life. I wasn't happy with who I was and had a feeling of dispair, change seemed so difficult. I turned to food and because of my uneven sugar levels got into a bad habit of making bad decisions when it came to what I was putting into my body.

When I look back at the time I spent focusing on food I can see how the surgery has made me a better employee, daughter, sister, aunt, and friend.

I no longer think about food non-stop in the way I did before surgery. Now I make sure I am getting the nourishment I need and plan what I take with me around that. When I run errands I run errands, I don't plan on what I'm doing when based on fast food options. It's a life changer.

Personally, I try to be artistic really hard but it's just not in the cards for me. Photography is my outlet. It helps me slow things down and notice the smaller things. I may not be the best, but it keeps me busy. This blog is another outlet and I've been spotty with fitness as of late but the gym will be another source of energy and positive reinforcement so I can reach my goal.


So to anyone who is looking to lose weight, regardless of whether you are a WLS patient or not, I implore you to see if there's something missing in your life. If you are, what is it? What might help you fill what's missing? Will food help you in the long run? Will eating your trigger food make you feel better than a workout?

Support Groups: The Key To Success

I have Kaiser Permanente health insurance which is unique in the industry where it acts as the insurance company and the doctor's offices. As a part of my pre-op education I completed a 24 week educational course. Post-operatively there are support groups to reinforce positive behaviors and to give patients the feeling of togetherness.

I went to my first session last week and was impressed. There ended up being 4 other people there and the social worker in the Options program. We spent the first half talking about addiction which was the topic of the evening and the second half was opened up to general questions and comments regarding post-op life.

The surgically altered pouches ranged in age from a few weeks (me!) to three years. As someone fresh out it was encouraging to see people 1-3 years out because they look so normal. You would never know they struggled with their weight for decades. Looking at it from the other side, I'm sure it's a refresher to look at people like me to see where they used to be and how their current lifestyle has changed their lives.

Alternative Support Avenues
Different surgeons and hospitals have their own support groups. To find one in your area please contact your surgeon's office because there may also be surgical support groups for the general public, as well.

If you do not have access to an in-person support group or you do not want to attend one then the internet has a wealth of information. There is a larger volume of people offering support and advice can be more forthcoming and prompt compared to a surgeon's office where they haven't had the surgery. Of course, every surgeon is different so make sure you follow your protocol and contact a physician with any serious matters.

Every forum is different so you may need to try multiple ones until you find home. Some that I have found include:

• www.bariatrictv.com
• www.thinnertimesforum.com
• www.obesityhelp.com
• www.verticalsleevetalk.com

In addition, I've also been able to connect to fellow patients via Twitter. To find people you can search for keywords. Using the hashtag symbol (#) can also narrow down your searching, as well.

Other informational sources include YouTube, podcasts (I highly recommend Bariatric TV), blogs, and books.

Some blogs I frequent include:

• The World According to Eggface
• Bariatric Foodie
• Chef Woody
• Bariatric Eating (great recipe resource!)

Got a BodyMedia Fit!

Those of you who follow me on Twitter (twitter.com/futrfitmeg) know that I won a contest BodyMedia put on for Mother's Day. While my mom technically won the BodyMedia Fit, she is contemplating taking my Bodybugg instead since I'll most likely be entering her information anyways. After playing around with the BodyMedia's interface I'm hoping I get the new toy!


I posted a video on my YouTube Channel (www.youtube.com/futrfitmeg) comparing the differences between BodyMedia's BodyMediaFit and the Bodybugg. Neither model I compare has bluetooth wireless technology.

With hands on experience with both devices I really like the BodyMedia Fit, even though it's the same hardware the interface is more intuitive and user friendly. I also love that it has mobile apps for Android and Apple. Having a Spring Android Device the tech g33k in me loves the ID pack o'widgets, as well. 

www.bodymedia.com
www.bodybugg.com

Sushi and My Sleeve

Since I have had fears that I had stretched my sleeve and it was irreparably damaged I decided to go with firmer soft foods today.

I love sushi. I used to go to sushi and down roll after roll of rice and shrimp tempura. My favorite roll is a rainbow roll wrapped in soy paper instead of rice. I could probably eat a dozen of those if I had the funds when I was pre-op.

Today I ate 3 pieces of one roll and am so stuffed I cannot believe it. Just one of life's little miracles.

Non-Number Related Goals

Even though my last post included my number related goals doesn't mean that I discount how I feel or what changes weight loss, no matter the number, has on my day-to-day functioning. 

Above is the signature I am currently using on the WLS forums. I of course have other goals, but some of my non-scale related goals are:

1. To be able to comfortably cross my legs
2. Stand up on my feet for long periods of time
3. To shop at normal stores (and not have to go to the back of the rack)
4. Fly without fear (and extra room in my seat)
5. Be cute on Halloween (okay, slutty)
6. Feel like I'm in my 20s!
7. Look forward to reunions

Achieving these things will help me transform into the person I know is waiting inside, but more on that later. 

Hefty Goals

 

With so many failed weight loss attempts and knowledge that weight fluctuations are normal I am hesitant to post my weight related goals. However, I couldn't resist when I was looking at the spreadsheet I use to track my weight and all of the things I have planned for the year.

I understand I will have stalls and have ups and downs, but I'm looking forward to a year where I am bound to come fairly close to my goals!

Heard From My Surgeon

I also heard from my surgeon yesterday evening. He said that starting on soft foods when I did was fine. He let me know that tuna may be on the soft foods list but I may want to wait until the next phase (fish) to consume it because it can be dry. I'll go ahead and start that when I finish the tuna that came in my tuna wrap I had for lunch yesterday.

He did say I can have baby shrimp so I am looking forward to buying some this week to eat. Overall I think I may be a bit dehydrated and that may be giving me hunger pangs. I'm getting in about 40 oz of water and 10 oz of protein shake so I'm nowhere near the 80-100 oz I drank before surgery.

Today I had about 10 oz of protein shake, a cup of French Onion Soup (4 oz at lunch, 4 oz at dinner), a teaspoon of spinach souffle, and a tablespoon of tuna which is just about 300 calories. Not exactly like I'm gorging myself. I don't stuff myself so I'm just giving myself blind faith that everything is okay and I am normal :)

Infected Incision Sites

Yep, the incision sites are getting a little infected. I went to Urgent Care yesterday after work and got an oral antibiotic. The doctor there said I can keep using Benadryl. I also still think part of it could be skin irritation.

I started antibiotics today and the sites are essentially cool to the touch and haven't itched as much. Goes to show that you know your body and you have to trust instincts.

I also couldn't believe that there were so few Google Images of infected laproscopic incisions! If anyone has any problems let me know and I can send you pics of what mine looked like. Otherwise, I don't want to ruin your appetites.

Post-Op Fears

I am extremely thankful that I have been on the online forums for so long since I've read hundreds of posts from people who think they are broken or have ruined everything. The primary reason I am glad to have seen these posts is that I have found it to be a constant fear for me post-operatively.

I realize it probably only means I am healing, but cold chills went down my spine last week when I went from being stuffed with a half of a Jello cup to being able to eat the whole thing in less than 20 minutes. I know that is a good thing, I need to be able to eat my protein and get the nutrients I need from food to be healthy. However, it was scary to be feeling hungry still at that point. And I think I am also starting to get hungry.

It's not the tear-your-head-off-if-I-don't-get-a-burger-right-now kind of hunger but I do feel it more now that I am 2 weeks out.

Other panics I've had this week include the bruise that showed up Wednesday night and now some redness around my incision sites (I'm starting to ice them now and that seems to be making it better).

I also had a tiff with my surgeon's nurse because I was following the protocol they gave me back in November. I was told soft foods could start last Sunday and the tuna sat fine in my belly but I called in to make sure it was okay and she basically said I could have ruined eveything. She also sort of laughed at my concern over my bruise. We aren't off to a great start. She basically said to only eat soft foods like soup for another month until I see the doctor and then backtracked on what soft food was even though it's all listed as the same thing in the manual. Never heard from the doctor and I called to follow-up with him...

I come from a long line of worriers, while I would prefer we were warriors I think that the worries are encouraging a healthy caution when it comes to surgery.

Post-Operative WLS Lower Abdominal Bruising

Woke up and noticed this bruise for the first time on my lower left abdomen for the first time. I'm sure it's been there for a few days but  has gone unnoticed since I mainly look at my incision sites.

This discovery obviously caused a bit of alarm. Looking online it seems that it's probably from the heparin shots they gave me in my belly at the hospital but I'm double checking with my surgeon today. This is also the side I use to get out of bed and I've woken up sleeping on this side so I'm sure everything's fine. Will update the post when I know more.

Update: talked to my surgeons staff and she sort of giggled at me like I should obviously assume it was ok which makes me question the staff. However, I take it as a good sign that maybe she is asked this many times and everything is ok. Waiting on a call from my surgeon regarding a food matter from yesterday so we shall see

Food Porn

No not that kind of porn, though I am too scared to Google the term to see what fetish sites I might find.<-- The Blogger Analytics should also be interesting ;)

Whenever I start a weight loss journey (yes there have been many) I start watching Food Network and now Cooking Channel quite a bit. (I also love Sam the Cooking Guy!) My family thinks I'm tortuing myself but the fact is that I get really into trying to cook when I want to regain my health. I'm admittedly not skilled in the kitchen, but there's no doubt that professional chefs have honed their craft and their art form is beautiful. 

When I watch cooking shows I look at the passion on the host's face, their knife skills, techniques, what ingredients go together, etc. I can't wait until I can eat and prepare more of the things I see.

Image: http://goo.gl/JzaSA

Artifical Sweeteners and Food Additives

Thank you to Jamie Oliver and his Food Revolution team! A few weeks ago with surgery ahead of me I stocked up on products touted on the weight loss surgery (WLS) forums. As with any "diet" or weight loss protocol most people use sugar free products. This is in part due to the fact that gastric bypass patients may "dump" if they have too much sugar.

After the first season of Jamie Oliver's Food Revolution (on ABC) I tried to implement fresher ingredients and watching the first 2 episodes in the last 2 days has reinforced that principle. The first season he made an example of chicken byproducts, in the season premier of Season 2 he described pink slime which concerns the processing of beef...trash.

But back to natural products. A few days after surgery I made the decision to purchase full sugar products. Obviously immediate post-op foods are not healthy or natural - Jello Cups, puddings, etc. However, I decided if I need to eat that type of products for the first 2 weeks that I am not eating enough volume to justify the use of artificial sweetener.

A couple days out from using the artificially sweetened products I feel better. I notice that much of the gas that I thought I had was actually my body rejecting the additives. One of the things that attracted me to surgery is that it encourages the intake of animal proteins and healthy carbohydrates. I will be able to eat bad things eventually, without a doubt. However, I had surgery to become a better healthier person which a balanced nutritious diet will help me obtain.


www.twitter.com/foodrevteam
www.twitter.com/jamieoliver
http://www.jamieoliver.com/us/foundation/jamies-food-revolution/home
http://abc.go.com/shows/jamie-olivers-food-revolution/about-the-show

My Hospital Experience

Surgery Tuesday went very well. I didn't know what to expect since I've never had surgery but my mom gave a fairly accurate portrayal of what was to come.

I was very impressed with the hospital and it's staff. They kept me for 3 days which sounded like a long time but ended up being perfect. When I was to have my surgery done with Kaiser they were going to kick me out the day after and I can't imagine trying to make the car ride home feeling like I did the day after.

The hospital has a Very Special Person program which allows significant others or family members to stay with you in your room overnight or past visiting hours. I was fortunate enough to have a private room so my mom could be my VSP. She ended up staying at my sister's but she could stay later and still used the cot to rest on when she was visiting.

Tuesday April 12th (Surgery Day)
I woke up at 2:30am to use my antibacterial scrub and get on the road to San Diego. I did my best to nap knew I'd have plenty of time for rest in the coming days so I did my best to listen to my mom's experience with her multiple surgeries over the years.

We were supposed to be at the hospital no later than 5:00am but got there more like 4:30am so we sat in the car for a bit and talked. We headed in around 4:50 behind a woman and her husband, the woman was to have surgery at the same time as me. We got to the surgery check-in and found it empty so we waited to be called in.

My mom was right about many things, once I went back they weighed me, let me go to the bathroom one last time, and told me to change into a hospital gown, socks, and thin leg coverings to protect my legs from the compression garments I would have to wear post-op.

As I suspected it took the nurse a few tries to find my dehydrated veins, I stopped counting around 4 tries but we finally found a good spot in my left hand which helped me make sure I didn't rip anything out in the coming days.

Once they had the IV drip in my parents were called back and we briefly saw my surgeon and the anesthesiologist. I still wasn't nervous at this point. Actually if anyone asked me what I was feeling I was going to be honest and say hungry! I was even joking with my mom that they were monitoring my heart beat because whenever my grandmother goes to the ER she tells us it was serious because they put something on her finger.

When they were ready to take me back a nurse wheeled me in and it was like a big ride to the OR. I saw he was wearing a Bodybugg and was amazed when this lean and fit nurse told me he had undergone gastric bypass 3 years ago.

Once in the OR they moved me to the operating table and they started putting me into anesthesia and I barely remember anything more.

I woke up in recovery with reminders from the staff to breathe when I would hear beeping from the monitors behind me.  One man named John had a lot of difficulty with this because I kept on hearing the nurses yelling reminders at him. I was fairly out of it at this point but remember I was in a bit of pain and confused but gladly accepted anti-nausea and pain medications when asked if I needed them.

I next woke up when I was getting to my room. Scripps Mercy has a program that allows a Very Special Person to stay in the room with you which also grants you a private room. Score one for me. I woke up and my parents were there and I was going in and out. I was hooked up to a pain pump and from my mom's advice became well acquainted with it. I know my sister came and we visited but I really was not entertaining for my family that first day. I also had leg compression garments on that basically massaged the blood around in my legs to avoid blood clots. It was like being at Brookstone with good drugs.

Luckily I was fairly mobile, I was woozy on my feet but made a few laps around the ward which was marked as 1/16 of a mile. It is important to get on your feet after surgery so even though I didn't feel like it I made a couple of attempts to move around. To keep my mouth moist they gave me lemon flavored swabs.

My sister and her girls came by to pick my mom up and I showed them everything medical. My 8 yr old niece is very interested in medical things right now so she took an interest in what was going on. 

That night my night nurse needed to change my pain pump at midnight. I knew that it only administers medicine at specific doses over a certain time but she made me feel like a junkie. I'm sure she was trying to determine if I needed anything stronger but she insinuated that the amount of meds I had gone through would have been appropriate for a bed ridden open procedure.

This was the only service issue I had at the hospital, I would press the call button and nobody would come in. I was unhooking myself to go walk and go to the bathroom but by my last spin around I was so dizzy and nauseous I sort of laid halfway in the bed until someone came to check my vitals.


Wednesday April 13th
I started to ween myself off of my pain pump and overnight and in the early morning got very nauseous. I was afraid it was from the lack of pain meds but after going to the support group they hold on weekdays there I realized it was from the anesthesia and the pain meds were blocking the nausea. I immediately started hitting the green button on my pump as often as possible and put myself to sleep most of the time.

I was literally dry heaving when physical therapy was talking to me about the support group meeting and have to credit my mom for dragging my butt to the session. The coin it as a exercise class which is true but it was great to see people felt as awful as I did and hear the people who had surgery on Monday tell me that was them the day before. I literally puked in a washcloth on my way back to my room. 

I wasn't hungry in the least but savored the ice chips they gave me. The instructions was 1 oz per hour which I fell short of. Amazing to think that I did liquids Monday and ate nothing on Tuesday!

I spent much of Wednesday in and out of consciousness but was feeling better by the evening when my sister, her husband, and the girls stopped by.

By then I had a routine where I would put myself to sleep after my mom left at 8:30pm and then I would wake up around 11pm for a round of walking. It was hard to keep count but I tried to do about a mile every time I did a round. The night staff would be cluttering the hallways but not many people would be walking around that time of night. I would then start to knock myself out again and they would take my vitals around midnight.

By Wednesday night I was unhooking and rehooking myself up to the machinery myself unless my mom was with me. I was a model patient.


Thursday April 14th
By Thursday everything was routine. I always had new nurses but everyone was very friendly after that first night. I only used my pain pump a few times to knock myself out but read, played on my iPad, and watched TV most of the day. I even snuck out to take a walk while my mom was napping.

I also got to take a shower which was heaven. I wish I had had my own products but it was great nonetheless.

The support group was great, I could do more of the moves (look up non-stripper chair dancing exercises and you get the drift). I then got to be the reassuring face encouraging the Wednesday surgery patients on.

When I was walking the halls there were actually 3 ladies making their rounds that had not been at the meetings but had surgery the same day as me. I actually had not seen them up and walking around either which seemed strange to me.

They have me Hawaiian Punch and chicken broth to drink which I was told to drink an once of every hour. The Hawaiian Punch didn't really make sense since it's loaded with sugar but it tasted good. The broth was okay but they have me a huge cup of it and I drank it cold except for the first "dose" I had. In all I probably had 4 oz of broth and 4 oz of punch.


Friday April 15th
Happy discharge day to me! This was the day when I sad F-It and started hitting my pain pump to enjoy the naps before my dad came to get me. They gave me Jello and it was okay. I felt great but was afraid I wouldn't be able to fall asleep once I got home.

 I also got kudos for attending a third exercise class.

On the way home we stopped at the grocery store and picked up some puddings and soft foods. I was really craving chocolate but was put on clear liquids through Saturday. Instead I had a sugar free popsicle as soon as I got home. My mom made me some broth and I ate about 3-4 oz of that as well.

I actually slept well at home. I propped myself up and was able to fall asleep at night without a problem.


Saturday April 16th
I took it easy on Saturday and worked on the computer some, caught up on some TV, and tried to move around. I was tempted to try a chocolate protein shake but I don't want to push my limits or risk my new sleeved stomach so I decided to wait.

Against my better judgment I weighed myself and it appears I have lost 12 pounds since surgery!


Sunday April 17th.
I ran errands with my parents today to San Clemente and Home Depot and still had energy afterwards. I drank a few ounces of protein shake in the morning and was completely stuffed when I had 60% of a pudding cup for lunch. At this point I'm buying more full sugar or no sugar added products, sugar free is great for people who may dump with the bypass but I don't want to become reliant on unnatural sweeteners which really aren't good for your body anyways.

I finished the pudding cup and had some more protein shake for dinner. 

I took an afternoon nap and watched TV the rest of the evening.


Afterthoughts
I have no regrets regarding surgery. When I get hunger pains they usually go away on their own or are easily solved. I do, however, get a panic at those moments and when I sometimes wake up on my side in pain during the night I have damaged the staples. I think they must be more resilient than that, but I went through a lot to get surgery and want to do what I can to honor it.

At this point I'm not pushing the soft foods I can have because I don't want to grow tired of them. Instead, I'm relishing my pudding cups and protein shakes knowing that soups, eggs, and tuna are all possibilities. 

I have 5 incision sites that are very small. They were actually covered by band-aids post-op and my surgeon removed them on Friday. Now there are strips of surgical tape holding them in place but they are beginning to fall off. They are almost more like zits than open wounds which is very exciting.

At the hospital my sugar levels were all over the place. I was pleased that my fasting glucose was 93 on Monday and before surgery it had dropped to 78 from the clear liquids. I've run as high as 105 and 99 is technically the cut off for having Type 2 Diabetes as opposed to being pre-diabetic.

They pumped some sugar in my IV during surgery so my levels were dropping from 150 back down to the 90s during my hospital stay. As of now I am off of my metformin which is a big relief to me.

Surgery Tomorrow

Even though it's 2 years in the making it seems like surgery has crept up on me. Despite the frustration and everything I have had to do to get to this point, it's finally coming together. It's very surreal really.

I spent all of last week working a highly stressful conference. It was my intention to do all liquids but that idea quickly went out the door. However, thanks in large part to room service not having potato skins, I made it through the week and even lost 3 pounds.

I went to Kaiser and had my labs drawn this morning, shopped for robes and slippers at Target and Kohl's and made it to San Diego for my pre-op appointment.

The nurse gave me my spirometer and surgical scrub and it's all becoming a reality.

I was on all clear liquids today, I ate 3 chicken bullion cubes worth of soup, 3 sugar free Jello cups (strawberry), and 3 tablespoons of milk of magnesia. I guess I know my lucky number now!

I thought I might perhaps be nervous for surgery but to be honest I'm still exhausted from my trip and this has been a long time coming. I can only look forward to what the future holds.

Obesity: The New Smoking

A while ago I retweeted something a friend regarding an article written for The LA Times had written about obesity being the new smoking and I think that is a very interesting analogy.

The actual article was in regards to health and how obesity can cause cancer, but I am interest in exploring the social stigma of obesity and smoking. Research dating back decades has shown that excess weight and smoking are both bad for you. So why do people still smoke and why is there an obesity EPIDEMIC?

I admit it, even at 250 pounds I judge fat people. I also judge people I see sucking on their cancer sticks, especially ones I know sat through all of the same education I did growing up. This as I belly up to fattening foods. So my question is: Is an overweight person eating fattening foods the new smoking? Is one worse than the other?

An overweight person and someone with a nicotine addiction may pity one another for their dependencies, but are they so different? They both say that they can give up their vice, yet most diets fail and cigarette companies are still in business. They are also both marketed to youth. For fast food it may elicit memories of going to McDonalds with your family when you were little, for cigarettes it may embody teenage rebellion or the feeling people got from that rebellion years later. The common denominator is that research indicates both fattening foods and cigarettes are addicting and both threaten the health of the planet.

There's no doubt in my mind that a single cigarette does more harm than a single burger. There's something called second hand smoke and a burger isn't slowly killing a person leading a balanced lifestyle. However, this article has me thinking again before I shake my head at smokers.



Source: http://www.latimes.com/health/la-he-cancer-obesity-20110307,0,2785774.story

Before & After Photos

Well I only have before photos. Lots of them. Actually at all different weights. Anyways, nothing frustrates me more than seeing a bad before photo. Yes, I know we don't all look our "best" before we lose weight but c'mon people! I know people don't feel their best when they're heavy but it's so frustrating when the before pic is a blurry shot of someone eating KFC.

Here are my tips to a good before shot:

1. Smile! Even if you have to fake it just keep grinning!
2. Look into the camera, it's not a mugshot
3. Take it in front of a door frame or the refrigerator - anything that will help you gauge size and cropping so your pics aren't all zoomed into different proportions
4. Angles are key - make sure you get them from all sides and make sure you do it every time. 
5. Get someone to take them for you or get a tripod. A lot of mine were sideways from trying to use a dinky tripod so I got a taller one and really like the shots I have now
6. Why not a before VIDEO? Talk about yourself, your life, why you want to lose weight, how you feel, etc.
7. Try wearing a variety of clothes - ones you feel great in now, ones you don't fit into well, dresses, pants, workout clothes
8. Take note of what you're wearing in the photos - i.e. what size and brand of jeans?

So What Is Weight Loss Surgery?

There are many misconceptions about bariatric surgery, also known as weight loss surgery or WLS, that I would like to address. I was guilty of believing many untruths or quasi-realities of weight loss surgery that is often documented.

There have been many incarnations of WLS over the years but there are only 3 major surgeries used today. Bariatric surgeries can be classified into 3 types:

1. Malabsorptive. These procedures reroute or remove the digestive process which means that vitamins and calories are not fully absorbed by the body
2. Restrictive. These procedures reduce the size of the stomach
3. Combination. Some surgeries combine malabsorption and restriction

There Are Three Major Types of WLS performed today...

RNY Gastric Bypass Surgery
 RNY is the most well known type of bariatric surgery practiced today. RNY gained  attention when Carnie Wilson allowed her surgery to be streamed online. Even though she helped spark interest in WLS, Ms. Wilson is not necessarily the poster girl for WLS. Many celebrities such as Al Roker, Sharon Osborne, Roseanne Barr, and Randy Jackson have also undergone the procedure.


This form of WLS is both malabsorptive and restrictive. It divides the stomach into a smaller upper and larger lower pouch to give patients a feeling of satiety (restrictive) and also rearranges the small intestine (malabsorptive). The larger part of the stomach which is bypassed is also the center of the hunger hormone (grehlin) production.

Before educating myself I was not aware that the intestines absorb calories and nutrients. Since some of the intestines are being bypassed this has its pros and cons. While not all calories are absorbed, not all vitamins and minerals are either. Furthermore, the bypass itself can cause patients to get sick, or "dump", easily when they consume certain levels of fat and sugar and this effect can last forever.

I was also surprised to learn that the bypass is very effective in essentially curing Type 2 diabetes. Many patients have instantaneous drops in their blood sugar count before they even leave the hospital. Other WLS surgeries aid in eliminating diabetes but it is more from losing weight and lifestyle changes.

There are many years of research to show that RNY is a solid procedure and is still the most common weight loss surgery performed.


Gastric Banding
Although this procedure is often referred to as the lap band, lap band is actually a brand of gastric band. Results for this surgery are mixed depending on the amount of weight people want to lose and their dependency on food as a drug.

The band is an actual device that gets put around the stomach to create a small restrictive pouch to give the people the feeling of fullness.

This surgery definitely has its success stories, but studies are showing that it may have a lower success rate than other types of WLS. With RNY many patients who intake mass amounts of calories will get sick. However, people with food addictions can intake large amounts of calories by eating calorie dense liquids and soft foods such as milk shakes and mashed potatoes.  This is why I think studies are coming back showing that people who are only obese or overweight can benefit from being banded while morbidly or super morbidly obese patients have a lower success rate.

Please now reference the image above. There are many less than credible doctors performing the surgery on anyone willing to pay which affects the statistics. The way that gastric banding is marketed it feeds the negative connotations of WLS in a way by making it look like an easy solution for everyone.


Vertical Sleeve Gastrectomy (VSG)
I chose VSG after a lot of research and consideration and am extremely happy with my decision. Considered a newer surgery in the US but has growing popularity both domestically and internationally. Many surgeons believe it may be the future of WLS.

VSG started off as the first phase of a duodenal switch. It was used as a stepping stone to make surgery less risky for extremely overweight patients.The switch is still used by some doctors but the procedure is waning in popularity partly due to the results physicians saw in their patients who received the VSG.

Vertical Sleeve Gastrectomy is a restrictive surgery that involves removing the part of the stomach that produces grehlin. The result leaves a tube shaped sleeve composed of the more muscular part of the stomach that is resistant to stretching.

Why I Chose VSG

I call gastric banding the gateway surgery because it's what a lot of people seem to consider at first. On paper it is appealing because there's no cutting involved and it seems fairly non-invasive. The band has reaped incredible results, but it has drawbacks which include slower weight loss.

I almost immediately switched my focus to having an RNY and was very secure in my decision. I wanted immediate results and liked that cheating was very difficult and could be very painful.

I decided on VSG because there is a lower risk of malnutrition in the long run and I am confident that overall weight loss will be about even with RNY even if the pace of loss isn't as rapid. I am fortunate that my insurance company pays for VSG since many insurers still consider VSG to be experimental.

Patient Education

Most reputable bariatric programs require pre and/or post-op education and many insurance companies also require some sort of pre-op diet program to show commitment to losing weight and a lifestyle change. With Kaiser they essentially are my surgeon AND insurer because they have developed the program with the surgery group they contract out to. I needed to lose 10% of my original weight and complete a 6 month program about surgery and post-WLS life.

It sounds trite, but knowledge is truly power and patients need to empower themselves to change their lives. Part of the reason why many fail to lose the weight or regain has to do with whether or not they have truly adopted a healthy lifestyle. WLS is not for everyone and it's up to you to make the choice to have surgery.

Risk of Complications

Like with any type of surgery WLS does run risk of death or injury in the short and long term. There could be leaks along incision lines, intestines can tangle, you may be more prone to hernias, you could form a blood clot, etc.

The way that I look at this is that right now I'm not living the life I'm imagining in my head and people don't see me for who I feel like I am on the outside. Yes I have a career that I love, I have family, I have friends - but there's still something missing.

If you read other blogs or go on different forums you will see many people talk about quality of life. Not only does WLS help give you years back, it also raises your quality of life by helping you gain your health back. My unhealthy behavior has given me high cholesterol, PCOS, a fatty liver, and has increased my risk of stroke or a heart attack.

Bariatric surgery is not a cure all solution or "the easy way out". In order to get approved you have to jump through bureaucratic hoops, lose weight on your own, and go to classes. There are people who have surgery that shouldn't just as there are surgeons performing surgeries on anyone with money.

At the end of the day WLS is a tool just like a Bodybugg or Weight Watchers. How you decide to use the tool is up to you and will directly affect the results you yield.
For anyone looking for more information please visit asmbs.org/. I also highly recommend Bariatric TV to anyone interested in learning more about the ups and downs of WLS. Their podcasts are hilarious and they touch on many things WLS patients and their loved ones face pre and post surgery.

Source: http://www.webmd.com/diet/weight-loss-surgery/surgery-for-you

My Journey to Weight Loss Surgery (VSG)

Being overweight my entire life I didn't seriously consider weight loss surgery (WLS) until February 2009. My mom had mentioned it over the years and I always thought it was too extreme. It wasn't that I thought it was, "the easy way out," like many people do. It was more of the fact that I knew how much would be asked of me and thought I could lose the weight on my own.

The turning point wen I first considered WLS was when my mom brought a packet of information home from the hospital. I admit I was like most people and didn't fully grasp what weight loss surgery was, I was thinking Carnie Wilson and stomach stapling.

After reading the packet of information I was open to gastric banding and called to attend an informational session at a local surgeon's office. I was actually so determined about lap band that I remember trying to arrange everything while I was out of town. I have Kaiser so I was calling them to check on coverage and their people didn't even know what bariatrics were, I scheduled the informational session, I was busy and determined.

I usually research things thoroughly but barely had a chance to while I was away. I went to the informational session and fell in love with the program, the surgeons, and after receiving more information decided I was all for the RNY Gastric Bypass. I went home and scoured the internet for all I could find.

Long story short, Kaiser does cover WLS but since it is a self-managing HMO you need to go through them. I had my heart set on the local surgeon, but couldn't get financing. So here's my story with Kaiser...

• February 2009. Was told there was no bariatrics program
• March 30th. Received first inkling that there was a bariatrics program but not minimum qualifications
• April 9th. Called Kaiser, got bounced around to multiple locations and was told they didn't know what bariatrics was. Finally given number to head of Options program for Orange County
• April 5th. Spoke to head of Options and scheduled the pre-Options seminars
• May 14th. Attended bariatrics seminar
• May 18th. Attended weight loss seminar
• July - December. Participated in Options
• January 7th. Consult with  KP surgeon and scheduled surgery
• March 24th. Surgery date

 So why am I just now getting surgery? Kaiser switched from using an outside surgery group in San Diego (Pacific Bariatric) to bring everything in house with general surgeons. The Kaiser surgeons all went to great schools, but I just didn't like how my surgeon didn't make eye contact, talked down to me, and performs other surgeries on a regular basis.

At the time I was losing weight on my own and felt optimistic about my chances, as well. I was quite honest regarding my post UKC struggles to maintain my momentum. After I stopped toing to the workouts daily I started "refeeding" myself food items I had banned from my diet and my I started regaining inches and pounds. (Early on it was just inches because of eating gluten, but that's another entry).

In Fall I hit a low and was frustrated with how short I had fallen from expectations. I started this weight loss journey almost 2 years ago now and watching shows like Biggest Loser feel almost entitled to instantaneous results. Of course I know that my wavering determination is a factor, but it is a privilege to be on Biggest Loser and it is a tremendous aid.

Kaiser has since stopped doing WLS in house because they got back logged and are now using Pacific Bariatric again. Although I felt very comfortable with the first surgery group I chose and think about the what ifs every time I pass their exit on the 73, I feel I am in great hands with Pacific Bariatric. I went in for a round of consults the second week of November and saw the surgeon, internist, and psychiatrist.

They had originally told me I could expect a February surgery date but given the holiday I was given a mid-March date. Since I have a mandatory travel trip the first week of April I had to postpone surgery until April 12th when I get back.

I know that I will continue to catch a lot of crap about getting weight loss surgery, but I hope by sharing my story and decision I can better educate people. I still have friends and family that while supportive stand by preconceived truths or what is out there in the media. I know that this is the decision for me and I've never prescribed myself to living a life any other way.

Bust A Move With Kinect

The focus of my affection in December was my XBOX 360. I actually just got it in December which was a huge improvement from my regular XBOX. As you may or may not know, Microsoft rolled out the Kinect in November.

The Kinect is technically a peripheral that connects to the 360. There's a lot of comparisons flying around between the Kinect, the Wii, Motion Eye, and the Move which Playstation rolled out in the winter, as well.

To break it down, the Wii was ahead of it's time and revolutionized gaming. Different companies have tried to expand motion control over the past few years but nothing has found mainstream success. Kinect scans your body, no controller necessary. This makes it more interactive than the Wii because you can use (and score points) using your legs. Move uses a camera and a controller to track your movements which gets points for extra tracking, but then you are bogged down with buying extra controllers and by holding the controllers. To me, Kinect is a very natural process, it seems to recognize my movements and I can focus my uncoordinated body on the screen.

The biggest complaint by far is the playing field involved. I have this set up in my bedroom and I have about 7 feet inbetween the bed and TV and it was barely enough room to play. If you want to have 2 players then you need an even larger space. I raised the Kinect above the TV and that seems to have given me about an extra foot.

I love playing this thing and yes I do get winded. Kinect comes with Kinect Adventures which allows you to play a few mini games which are interersting. One thing I didn't mention about Kinect earlier is that the camera senses your position in the room so activities such as the bubble popping game allow you to move forward and backwards which is pretty incredible.

There are other games coming, of course with motion based gaming the fitness and sports games come first. There is a Women/Men's Health game called Your Shape Evolved, there's a Biggest Loser game, and there's an EA Sports game amongst many other games that don't have high ratings online. The game that's probably gotten the most buzz is Dance Central which I haven't played but I hear is incredible. There will probably be other games coming out that aren't fitness oriented but for now that's what's on the line up.

I had a friend in high school that would play Dance Dance Revolution as her exercise. While using these products for weight loss as your sole source of exercise may not get you far, they are fun ways to break up your day and are a great solution for people in a rut or stuck inside because of the weather. If you can motivate yourself to turn on the TV and do the programs then it will get you sweating and maybe even possibly sore.

Bodybugg

Some of you have asked me what a Bodybugg is from my tweets. Well, it's a magical device that you put on your arm and it measures your calorie burn via skin temperature and movement.

I believe it's on its 3rd model, I had the first one and now have the second one. I first saw the device on The Biggest Loser and didn't know what it was until I finally started hitting my local 24 Hour Fitness (sponsor of BL). Being a proud tech geek I knew I had to have one.

The device seems to be more accurate than a pedometer - I know that sometimes a pedometer would say I had walked a half mile before I even left the house. If anything, I've found I have to really pump my arms for steps to register which is why it doesn't measure kettlebells or spin class / cycling well.

This thing is so great I think I can also see when I'm in REM sleep. I typically average 1.5 calories per minute completely sedentary and certain times at night it drops to 1.2 calories. Definitely good information and makes nerd-me squee with delight.

The current version will actually sync to your smartphone via bluetooth which is quite an upgrade. Actually, I know for sure they have an Android (<3) app and an iPhone/iPod Touch/iPad application to download. There's also a web interface you can purcahse for a monthly fee and it will let you input foods and recipes to determine your calorie intake. Also in the web app you can see how many calories you burned (and when), your overall calorie surplus or deficit, and your steps and physical activity for the day with corresponding times. The nurition portion also breaks down your calorie consumption by carbs, fat, and protein and also shows where your consumption falls for the RDI of many things. As a Weight Watcher my biggest pet peeve with this is that it only shows carbs, fat, and protein for individual line items which makes it difficult to determine how much fiber was in each individual thing you consumed. The same unit is also produced by BodyMedia with a different web app. I don't have the unit or subscription but the interface seems sleeker and it also analyzes your sleep. Jenny Craig seems to have a partnership with them to bring it to select members which I also think it pretty awesome.

Now I'm going to girl out on you here, I think the Bodymedia interface looks really pretty - it's obviously marketed more towards women whereas the Bodybugg is marketed towards fitness people. Ok, done with that part... But seriosuly, if I were to upgrade to the newer model I think I might try out the BodyMedia one.

So is this for you? I say yes if you have the money to buy it, are active or are looking to be active, and if you love technology. The bottom line is whether you're going to wear it and sync it. Even when I'm being naughty with my eating it's good to see my calorie surplus laid out for me on the screen. This is ultimately a tool, it definitely won't take the weight off of you by itself but it puts out a lot of valuable information for you to analyze your day and see where you may be able to add in more activity.

Capture a Feeling...

I touched on this in my last post, but I really wish there was a true way of capturing my feelings that was powerful enough to remind me the next time I'm thinking of acting on my impulses.

Case in point, when I go to sushi I focus on how good it sounds and have a euphoric feeling when I start eating it. However, my feelings start to spiral into guilt and shame when I think of the money and calories I have expended for a fleeting event (and trust me, when I eat sushi it's an event!) that makes me feel so low. (Thank you carbs).

To help capture this feeling, I have tried journaling, but when I'm making rash decisions I don't really go back and read how awful things made me feel, all of my previous experiences are thrown out the window.

Looking at pictures can help, but it also seems to spur a hopelessness feeling in me that eggs me on in my poor decisions. I haven't tried video yet, but I think I might try that next time.

Just like emotions are formed based off of many factors, maybe my ultimate aid will be a combination of self-worth, will power, and these verbal and written documentation of my feelings.

Free Running

Apparently I'm a few years behind, but I'm a fan of parkour, well actually free running. In my defense, I just didn't know there was a name to the level of bad assery in movies as diverse as Casino Royale and Paul Blart: Mall Cop. And even though I love The Office, my fellas didn't quite have it.

For those who don't know, parkour is is a movement/discipline based on efficiently traversing the environment which includes jumping, climbing, rolling, swinging, and scaling. Many parkour enthusiasts, also called traceurs, are also free runners.

Free running takes many elements of parkour, but adds stunts. Unlike traceurs, free runners are interested in creative and aesthetic touches that can go against the efficient nature of parkour.

I actually came across this community watching American Ninja Warrior on G4TV. (Thank the heavens for the premium cable package I upgraded to in the summer!) American Ninja Warrior is an offshoot of Sasuke, a competitive game show in Japan. G4 is also launching a new show next week called Jump City which features some of the athletes from American Ninja Warrior.

A couple of my favorites from American Ninja Warrior were Levi Meeuwenberg (gotta love a fellow Michigander) and Brian Orosco and they are on Team Tempest which will be featured in Jump City. I'm really excited to see what all of the teams can do

So why am I writing about this on my weight loss blog? Because it's pretty freaking amazing. As someone supremely uncoordinated, it is inspiring to see what people can do with their bodies. I love how much talent, practice, and passion is necessary to pull off the moves and salute anyone who can do it. Watching the videos of these athletes I am touched by the artistry and dedication it takes for them to excel. Even though I can't do a somersault, it motivates me to make a difference in my life.

And anyone who knows a kid being teased for doing gymnastics needs to check out the videos on YouTube because these ladies and gentlemen are no joke.


Picture source: waveformless.blogspot.com

Birthday

So I'm another year older...well technically just a day older. What a difference a year does and doesn't make...

There's nothing like a major holiday or milestone that gets me thinking of the what if, has been, and never was moments of my life. I attribute many of these to my weight, but who's ultimately in charge of THAT?

Last year I literally went straight from a session with my UKC cohorts about our struggles to TGI Fridays for potato skins and a burger. A couple of years before I remember going to Weight Watchers to weigh in and doing the same thing.

This year I went crazy. Like really crazy. I ate breakfast at the grill in my office building, went out to lunch with my co-workers, went to happy hour, and then went to Dave and Busters.

Where has all of this gotten me? More importantly, why do I do this and how do I stop? I always wish I could capture the feeling of shame and regret that follows the euphoric feeling of eating. But more to come on that later...

Subway

There's no doubt that Subway is healthy...compared to other items in the American diet. I'm far from a nutritionist, but whether I'm counting calories, points, carbs, or protein Subway falls short for me. Personally, protein not only fills my belly, it satisfies me. I lerve me some sandwiches, but I can truly eat a 12" turkey and feel unsatieted afterward.

Some of you may have seen my tweet last week. I had not planned my meals so I stopped in at Subway and got a 6" breakfast flatbread. While I was there I figured I should pick up a healthy lunch and got a 12" turkey swearing to myself that I would only eat half.

Well, I ate all of the flatbread by 8:30am and polished off the footlong at noon and was ravenous all day. THEN, I went to enter everything into my BodyBugg web app and was surprised to see I had eaten 470 calories for breakfast and 640 calories for lunch for a combined carbohydrate intake of 132. Holy white bread, Batman!

Lesson learned, lesson learned. I know that having Subway twice a day is an extreme, but I know there are people out there who think they can eat anything from Subway and be the next Jared.

I implore everyone to go to Subway's website and read about their nutrition (http://www.subway.com/applications/NutritionInfo/index.aspx). Don't just look at calories or nutrients, look at the actual ingredients. Did you know that the wheat bread there actually has HFCS? Did you know the steak and meatball sandwiches had THAT many calories? Just some food for thought. (Oh come on, you knew that tagline was coming!)

I like Subway and it's a fast alternative to unhealthy options. No joke the Subway I went to was in 100 foot radius of a Del Taco, chinese restaurant, bagel shop, Thai place, and a pizza place. However, I am now more informed and will plan ahead for what I can and should have.

Body Composition with DEXA Scans

After seeing it on The Biggest Loser, I wanted to have a DEXA Scan done on myself to evaluate how much fat and muscle I truly had.

I had no idea how few places actually did this. I only found one in my area. A DEXA scan is primarily used to check bone density, but some practices use it to measure body composition, as well.

Anyone out there saying their scale measures this for them, prepare to have your mind blown. Whether you are using a scale or one of the handheld grip devices, the unit's energy waves only penetrate about half of your body depending on your size. Please bear in mind this is standard stock stuff, nothing too fancy or expensive.

Now for me, it didn't end up making that much of a difference, I think that may be attributed to my short stature and the fact that most of my fat is in my belly. However, if you carry your muscle or fat primarily in your legs or arms, these devices may give you unreliable information.

I've had DEXA scans done twice. Unfortunately the results weren't drastically different, but I know one day they will be. Actually, I can't say I have a 100% accurate reading because my technician was talking on her cell phone and didn't realize that parts of my body were hanging out of bounds each time. (Yes, part of this is because I am large)

So do you have to be afraid to do this test? Not really. I went to an integrative medical clinic and they do it there. If you aren't familiar with integrative medicine, it is a concept where doctors who are primarily MDs integrate alternative therapies into their everyday practices. These doctors are very health conscious and actually study electromagnetic waves and the body so if they tell you it's low grade risk then you're good to go.

When they did the scan I kept my street clothes and just laid down. I totally felt like I was a document being scanned into a computer, which I guess was fairly accurate. To avoid movement they did confine my legs together, but otherwise the scanner hovers about a foot overhead and moves down and then up your body so you aren't enclosed. In less than 10 minutes you are ready to go.



A couple of weeks later I receive a full report in the mail that is fairly easy to explain. Not only does it give you an overall reading, it gives you a region reading so you can also see if your body is symmetrical. This can be of benefit if you have had a sports injury so you know what you need to do to balance your body.

For me, the scan itself wasn't very expensive, but I had to pay an initial visit fee with the doctor which was expensive.

There are other options out there, the Bod Pod is supposed to be accurate, but it cannot accommodate everyone. There's also the tried and true hydrostatic testing otherwise known as going in the "dunk tank".

For now, I can't wait until I fit in the line guides and know I have an accurate measurement. Furthermore, I can't wait to see my body composition change and as a techie am excited to be able track my progress.

Has anyone else tried this or other types of testing? What do you think?

Weight Watchers

History
I have been a Weight Watcher off and on since 8th Grade. I joined with my mom pretty much every year up until my senior year when I joined with friends.

At that time I remember I was ravenous - I had postponed both of my gym classes until the last part of my senior year and I would run a mile 3 times a week and it was frustrating because it seemed like my time never improved and the skinny girls would hide behind this "shield" on the other side of the track or other overweight people would run 3 laps and I would be the only one clocking in at 14 minutes.

I didn't really join WW in college, I think my mom and I had tried to give it a go but it never stuck for more than a month. We were onto fad type diets like meal replacement shakes by then.

Frustrations
As someone who even in 8th grade had significant weight to lose, my frustration with Weight Watchers was when I would have leaders who lost 15 pounds and hit goal. This was a barrier to communication and proper help in many ways. First, they had never been fat and didn't know what it was like. Secondly, they didn't have food co-dependency or the lack of self control that accompanies.

Case A: In past incarnations of the program you figured out your daily points range by factoring in the first two digits of your weight. My last leader saw I wasn't writing anything down in Orientation and couldn't fathom that I can add 5 numbers in my head and demanded I tell them how many points I got. I politely replied that I didn't want to tell everyone my weight. It's these types of things that make me self conscious at WW. Oh yeah, also when I'm in a group of people that are in their weight range looking to slim up for cruises.

My best leader was when I lived in Las Vegas. She was young, vivacious, had lost 80 pounds, and loved life. To top it off she was 4 months pregnant and you couldn't even tell. She was living the lifestyle.

My final beef with Weight Watchers was that with the points system it was easy to choose processed foods over clean foods because they were the same points. This definitely wasn't helped when WW started coming out with their own product lines, but everyone has to make money and their stuff is tasty.

Points Plus
So this brings us to present day. I joined WW and this is my second week. I have to applaud them for their eTools system, which gets better every time I join, and for the monthly pass because it keeps me invested in the program for at least a month. (Though I'm really not sure who goes to multiple meetings a week...)

In November Weight Watchers rolled out their new Points Plus Plan which is really just an alliterative way of saying New Points. With this program you analyze your fat, fiber, protein, and carbohydrates to evaluate points as opposed to the calories, fat, and fiber of yesteryear. They have also now made all fruits zero points. The reason I like this is it encourages cleaner eating by showing that an apple, even if it is a few points, is better than a bag of chips.

They've probably had this for a while, it's been 2 years since I was in WW, but they also have iPhone and Blackberry apps which are great. However, I can't wait for them to do something for my Android. It just isn't socially acceptable to whip your iPad out in public casually, even in Orange County, and you can't use a slide ruler anymore.

So is Weight Watchers for everyone? No, but no weight loss plan is. What I like about Weight Watchers is it gives you the option of what to eat. If you want a Lean Cuisine, eat a Lean Cuisine. If you want birthday cake, just budget it in. I also like the accountability of having a group meeting and weigh in to go to. They celebrate every little thing at Weight Watchers and it seems trivial but the 5 pound star stickers and the other things they give out do make you feel good.

Anecdote
Okay so I just thought this was funny, my mom joined me at WW this week and she was so upset that she is 170 and 5'8". I know right, cry me a freaking river! But anyways, there were two women in line behind us who started talking because they were both joining and recognized each other from previous attempts. My mom got up on the scale and they said she had gained 6.6 pounds since 2009 and the ladies were scoffing about how 3 pounds a year isn't that bad. Needless to say, that made my mom's night. It's all about perspective. Your weight is going to fluctuate, the problem my mom has had is that her health is on a decline and while she doesn't eat anything terrible like I tend to, she doesn't eat particularly healthy either so it's also about how you feel on the inside.