A YEAR OF LOSS - NOW MAINTENANCE

I am now a year from the start of my weight loss.   Last year I was on my pre-op liquid only diet for the
week leading up to my BPD-DS weight loss surgery. I was asked to lose 20 pounds in the month between the time I scheduled my surgery and when it occurred - and I did it.  A lot of people said why did I need surgery if I could lose 20 pounds in a month?  Clearly people who were not aware of just how many times I had lost that 20 pounds (or 80 pounds) and gained it back!!

I reached my goal to lose 130 pounds last month.  I am working on a maintenance diet now - I lost a few pounds and gained a few - so I guess I am doing it right.  My latest labs are just coming back and I see I still need to work on my supplements and protein intake - that's why we keep up with the labs every 3 months.  Even though I can eat more, my body is still adjusting to these changes and I need to keep my awareness up with regard to what it needs to remain healthy.

I made a mistake in switching to a different potassium supplement - the quality must not have been good because my potassium really dropped down, even though I was taking it every day.  I went right out and got the one my doctor prescribed.

I am still struggling with my protein intake.  The same old song.  I feel like I eat all day long and still can't get enough grams of protein in.  I am going to have to get more creative.

If I get too heavy on the carb side of the food pyramid,  my body certainly reminds me.  No just the gassy kind of reminder, but I get diarrhea, too.  I don't mean to get gross, but simply to inform as I know there are people wanting to get the real picture of this whole life changing surgery.  While I can carefully and selectively eat carbs - there is a consequence of going too far!

 I am happy to say that I get to enjoy a few cocktails when we go out.  Wine is hard on my stomach and I can't drink enough of it to get tipsy - but a good martini goes down easily and has yet to give me grief!

I have been getting to the gym less which is not ideal.  I need to get back  to  weight workouts.  I know that building muscle is important and will make me feel and look better, too.

We ride bikes every weekend and I can tell I am stronger and faster as time goes by.  We also started taking dance lessons - Western Swing dancing to be specific.  Two nights a week we are dancing for a couple of hours.  Fun, good exercise and another great activity for us to do together.

So that's the physical side of things - more on the emotional side coming up.

GOAL

I have mentioned that I have been close to my original weight loss goal for or some time.  My weight has been fluctuating and hovering just above that goal number but this weekend I got on the scale and found I had reached it.  Goooaaaalll!

When I was on vacation my sister was having me try clothes on from her closet - a new experience for me.  She gave me some capri pants and I wore her swimsuit for a couple of days.  Mine is still a big old plus size one.  swim suits are just so expensive and I didn't want to invest in one until I am at a stable size... We also tried on clothes at a consignment shop and I bought a few things in smaller sizes than I ever thought I would wear.  Pretty cool.

 I am now actively working to keep my weight at the current level.  Not just because my husband is calling me bony butt (we both miss my former JLo-ness) but because I think I have lost enough.  I have a lot of extra skin and a pretty major poochy lower stomach which can all be covered effectively with clothing.  I don't want to go further and get beyond my current "issues."  My sister is very into me getting plastic surgery to remove the excess skin (and weight) but it isn't something I am interested in spending money on in the foreseeable future.

I also can't keep buying new clothes!  I mean, I like shopping and buying clothes, I always have.  But now I want to buy clothes which will last in my wardrobe.  I  have too many things I have bought and worn a few times and now find are too big.  I am looking for a local consignment store (with a better attitude than than the ones in my town which are very snobby) and hope to make some trades with my too big clothes.

This week will be 10 months since weight loss surgery.  I continue to increase my capacity to eat but still have to be careful not to eat too fast or too much. I still count my protein every single day and aim for 100 grams.  I am vigilant about taking my vitamins.  I am exercising.

I had my first real cookie last week and had no problem with the carbs backfiring on me.  That will not be an everyday occurrence but it is nice to know I can indulge now and then with no major ill effects.  I am also enjoying a cocktail or two most weekends and used some Advil this weekend with no stomach upset.  So the things I was promised would heal and become more "normal" have happened.

Now I am adding more fruits, vegetables and whole grains back into my diet.  When I was in Idaho I bought some Huckleberry Jam at the Farmer's Market and have been using it on my peanut butter sandwiches - heaven! So sad it is almost gone...

9 MONTH "SURGAVERSARY"

Today it is 9 months since I had my BPD-DS weight loss surgery.  I have lost 126 pounds and am 4 pounds from my original goal.  I think back to the day I went to Mexico and remember being excited - not nervous at all.  I was sure this was the right thing to do then and so grateful that I had the opportunity to have it done. (Thanks Christina.)

Tom and I went for a bike ride last Sunday and as we were leaving a neighbor I don't often see came over and asked if I was "disappearing". Like many others she asked how I was doing it and I said diet and exercise.  I feel right saying that - I am dieting and exercising.  The surgery was a tool.  My tiny stomach makes me eat less and I am very careful about what I eat.  I am more open with some people about the procedure and answer direct questions more factually - but for most people I simply say I don't eat much and that is the truth.

I occasionally want to say something to obese women I see, especially the ones out and about with their kids.  This has been such a liberation for me and I wish I could confer it on others.  I don't say anything to these women but I wish I could find a way to let them know the value of this, and if their insurance would cover it (unlike mine) urge them to consider it.  I wish I had been able to have it done years ago.

It is not easy.  There is no easy.  But as difficult as things are sometimes and as restrictive as my diet can be, I am so happy that I had the surgery.

A BARIATRIC SURGEON SPEAKS OUT - NOT THE EASY WAY OUT

I just read this great article written by a Bariatric Surgeon.  He is tired of people commenting about his profession - that he is an "enabler" for lazy, unmotivated fat people taking the "easy way" out of obesity.

He lists not only the difficulties of losing weight and maintaining that loss, the hoops people have to jump through to even get surgery and the fact that the AMA this year has declared obesity a disease and not just the cause of other diseases.

As a life long exerciser, a healthy eater and someone with knowledge of nutrition and of my own psychological issues - I can attest that it is not just a matter of eating less and exercising more.  Yes, for many people there is an issue with eating poorly and not exercising.  For many more of us it is far beyond that simple formula.  No one can really explain all the factors involved but the medical researchers are gaining awareness of the multiplicity of factors which affect different people.

Just as some people can smoke cigarettes all their lives and not get lung cancer, some people live long lives on a high fat diet and others drop dead in their 30's following a spartan diet and running marathons.  None of it is simple.

I had wanted to try weight loss surgery for over 10 years before I was given the opportunity.  As soon as I was aware of the Duodenal Switch I knew it was the solution for me.  I have never been a volume eater.  I have generally been a healthy eater - yes I have binged like pretty much anyone, for the most part I have been eating a high protein, low carb diet for 15 years so I knew I could maintain the dietary requirements.  When people "fail" following weight loss surgery and gain weight, it is probably because they didn't learn enough or know themselves well enough to commit to what it takes to be successful.

The surgery is a tool, not the final solution to the problem.  After all, we still have to eat!

8 MONTHS POST BPD-DS WEIGHT LOSS SURGERY

I am just past the 8 month mark following my surgery.  I have lost 120 pounds.  I bought a size 12 Land's End dress last week.  I haven't worn a 12 in over 20 years!

I am fairly settled in to my routine.  I gave a good system for keeping track of my vitamins and supplements.  I get all of them in pretty much every day. 

I also have a good routine for my protein requirements.  I have a small breakfast before work, usually something added to Greek Yogurt (5-10 g).  Then on the drive to work I get a protein drink started and finish it at my desk (30g). I munch on a protein bar during the morning (20-30g).  I am especially happy I found Quest Bars because they have such a great variety of flavors. (I am so very sick of fake chocolate and peanut butter flavored stuff.)

Lunch can be a challenge because I am usually pretty full from the drink and bar; so I have something small like some almonds and cheese or leftovers (5-10g).  Then another snack at my desk later in the afternoon, like protein chips, sunflower seeds or more nuts (5-12g). 

Dinner varies a lot.  If my protein is on the high side I relax and don't worry about stuffing something down.  Today I needed another boost so I made my taco salad mostly  ground beef beans and avocado. I'll probably have another protein bar or drink this evening to get to my 90 grams of protein.

I do find that the evening is hard for me, my stomach is much more fussy at the end of the day so I find I graze a bit in order to find what feels right going down. Also I notice by evening, my stomach will not tolerate a lot of food.  We went out the other night and all I could eat was  3 shrimp.  Then I  waited a couple of hours and had 2 more from my "doggie bag."

My family is concerned that I am not eating veggies and fruits - I do eat a few bites of salad greens, broccoli, spinach or other veggies most days.  I indulge my love of fruit more often eating berries and grapefruit every day.  This week I have had some watermelon and peaches, too.

Sometimes I wonder if I will be able to keep up with the protein requirements in the long haul - I hope that my stomach capacity will grow so I can get more of my protein from food rather than supplemental drinks and bars.  For the time being I am very mindful and just do what it takes!

102 POUNDS LOST



100 pounds of fat - kinda gross shown this way...

 Finally made it past the 100 pound mark - have I talked enough about it? Sorry.  These numbers start carrying so much importance.  When I was young and trying to look hot my best I always thought 125 was a magic number.  I made it and maintained it for only a few weeks and, surprise!, nothing magical happened.  The scale moved back to my more comfortable 130 and that was where I continued to work hard to stay.

Now my goal is to be at 150.  I think I can do that by summer based on the rate of weight loss I am currently experiencing.

I know 150 sounds like a lot.  I was present when someone I know was weighed at 150 and I gave her a little cheer.  She looked at me like I was crazy!  I explained that was my goal weight.  She understood but still acted like I was undershooting by a lot.

This weekend was a weird one.  I had two meals which were of my normal tiny portions but felt sick after.  Sunday I mostly snacked all day because I felt hungry but couldn't eat more than a few bites at a time.  I made an effort to get my vitamins in this weekend, but didn't make my protein requirements (meaning I was under 90-120g.)  Today, Monday, I am already feeling better and have gotten 50g before noon! 

Day by day.

5 MONTHS POST - OP BPS-DS WEIGHT LOSS SURGERY

Or maybe some sugar free protein ice cream...

I am now at the 5 month mark and have lost so much more weight than I expected in this time frame.  I am down nearly 100 pounds already. I really didn't expect this.  My weight this month has been slower to come off - in fact it bounces up and down a bit but I think I will make it to the 100 pound mark by the end of the month or at most the first week of April.
I am going to the gym 3-4 times a week and have been going on weekend bike rides.  I am walking most weekdays at lunch for 10-20 minutes.  Hurray Spring weather.

I have been bad about logging my food for the last few weeks - but good about my vitamins and water.  The potassium supplement is still awful and I have missed it a few days here and there due to my desire to avoid gagging memory lapses.  I will do my next set of labs in late April.

I am experiencing hair loss.  I noticed about a month ago that the hair loss was creeping up.  I had a hair cut and my stylist confirmed it.  I am lucky that it is pretty evenly distributed and not leaving bald spots.  I take the appropriate supplements and will continue to use Nioxin shampoo - it is just part of the deal for over half of us who have weight loss surgery.

I calculated my BMI and I am very close to moving out of the "obese" category and into the "overweight" one.  I suspect I will never get into the normal range but that's okay with me - the trainer at my gym is borderline "obese" according to BMI and I wouldn't mind looking like her one bit!

TYPICAL DAYS

 I mentioned in my last post that I would list a typical day or two of eating at 4 months post op.

I start each day with about 1/4 cup of grape juice with my potassium supplement mixed in.  Then I usually have a protein hot chocolate and a protein bar.  I make my own and I have an assortment of them from different companies. I try to make sure they are at least 10 g of protein. So usually my breakfast is between 20-30 g protein.

This is what the taro one looked like!

Mid-morning I have a snack, right now I am enjoying Trader Joes Protein Banana Muffins - 7 g protein but 22 g carbs, so I don't eat them too often! Otherwise I might have some sunflower seeds, nuts or finish my protein bar from breakfast.

Lunch is when I get the most variety and opportunity to experiment.  Costco had a good price on Bay Shrimp so I bought a few pounds and portioned them into baggies and put them in the freezer.  If I take one out the night before, it is thawed enough to add some chopped celery, mayo and seasonings.  I have been putting it in a container with 1/2 avocado and it makes a great lunch with some Wonderslim crackers - 19 g protein. I also look for soups with higher protein and add the protein pretzels or crackers to up my intake.

The other day my boss took me to lunch at a Dim Sum place (I managed to get a customer to finally pay off a $10,000. bill he had owned since last April!) I had almost 4 pieces of Dim Sum.  I am terrible about the names, but one was shrimp in a translucent wrapper, two were minced shrimp and pork dumplings and one was taro with something in the middle.  It was great and I was thrilled that I could eat so much.  I suspect the "wrappers" added up carb wise - but what the heck.  It was a treat!

In the afternoon I sometimes have a protein bar/chips depending on how much I ate for lunch and when I managed to take a lunch break.

Dinner, for some reason, is the meal that I have trouble with.  By the end of the day I am hungry but my stomach is easily upset.  I usually have a small portion of chicken and few bites of veggies.  One recent dinner I added about 1/4 of a potato skin (potatoes scooped out but with butter and salt!)  I have been trying out a lot of recipes from low carb cookbooks to expand my dinner menus. If my protein isn't adding up to 90-120 g for the day, I have a protein drink or another protein hot chocolate.

For a treat, I love to have my red grapefruit sections.  The other night I was wanting something different so I melted some semi-sweet chocolate chips and put roasted almonds in the melted chocolate, spread them out on wax paper to harden and broke them into pieces.  A few of these nuts is a nice treat with hot tea at the end of the day.

3 MONTHS POST OP WEIGHT LOSS SURGERY

I finally hit the 3 months mark this week.  I don't know why it feels like such a milestone, but it does.  I guess it is the point where most post-op's feel more settled in, get the labs done and the mystery of how the body is handling things is illuminated.

I feel settled in some ways, but my bowels are still a daily question.  I have been trying to decide if I am lactose intolerant and can't determine an answer.  I have yet to determine the issues behind the days I am in the bathroom repeatedly vs. the more normal days.

I managed to eat two bites of beef stew meat* but then last night some roasted chicken upset my stomach.  I can only eat a couple of bites of egg and many foods still set off my gag reflex.  One day I can eat smoked salmon with a little cream cheese and the next day I can't.  I did have a couple of salads this week - it was so great to have that fresh, clean crunch again.  The salads may have been behind the gastric distress - but they were worth it! So each day is still an adventure.

The small amounts I can eat also pose issues.  I made a batch of "protein pancakes" on Sunday.  The entire  batch is a serving - 6 little pancakes.  I could eat 2.  So the breakfast I had hoped would be 19 grams of protein was only 6.

I finally got my special order potassium supplement from the pharmacy and started it on Friday.  It is just awful stuff.  "Fruit flavored" stuff to mix into water or whatever and it is sour and gross.  I experimented with adding it to different things this weekend with little success.  It is going to be a hard thing to take every single day...

But I am focused on the pleasures.  My grapefruit, more salads, a little pile of sunflower seeds I munch at my desk.  Not to mention that I am down 78 pounds.  My closet is pretty empty and I can't even believe the stuff in there fits me - it all looks so small!



* I make all kinds of things for my husband's dinner, including beef which is not yet advised post-op.  I tasted a couple of bites for tenderness...

A COMPLIMENT?

I went to a meeting last night for the new business I am starting.  I saved a seat for my friend and was keeping an eye out for her arrival.

I missed seeing her come in the door but saw her approach from the other direction.  Apparently she didn't recognise me when she came in.  I asked her if I really looked so different - she gave me an "are you kidding me?" look.

It is hard to see it in ourselves.  I certainly see it in my clothes,  most of which are hanging off me or new.  I feel it when I am putting lotion on after a shower; seems like every week I feel new bones emerging.  I even noticed that my behind hurt after a long drive - that big ole' cushion is missing!

But to look so different that someone who has known me for 10 years had trouble picking me out in a crowd?  Wow.

GIVE IT A REST

It's been a bumpy ride for the past month.  My healing stomach is not happy about most things I put in it and suddenly the day before Thanksgiving it decided it didn't want ANYTHING in it.

Doctors advice - just give it a rest.  So 24 hours with nothing - yes, on Thanksgiving - and then sips of tea and juice for 24 hours then try some chicken broth.  So far those 3 things are the only things that don't make my stomach cramp.  But I keep trying clear and blended soft things.  Am I worried about my lack of protein and nutrition in general?  Yes.  Can I do anything about the state of my stomach?  No. Got to give it time.

If I believed in a higher power that wished to teach me a lesson, I would say this is one of humility.  I went into this with an attitude that I would just sail through the recovery steps.  Clearly not happening!  So I must back myself off my expectations and do what I can. There is no point in forcing anything in this process and if I am the oddball that can't eat an egg or tolerate protein drinks 4+ weeks out, I need to find what I can tolerate and eat until then.

What I am doing is walking more, and using some small hand weights for upper body strength training.  I am working pretty much full time again. 

HOLA!

I am here in Mexicali Mexico, sitting in a very nice hotel room with CNN on the TV so I can watch the debate!

I flew to San Diego this morning from San Francisco - it was pouring rain, the first of the season.  It created some challenges, but I made it to the flight on time.  I was worried that things were off to a bad start when my credit card was turned down at the check-in counter.  (Of course I only brought one with me so I am going to have to call the bank when I have cell service,)  I got on board and found the flight full except for the seat next to me - hurrah.  I could put the divider up and be comfy without upsetting someone with taking up more than my fair share of space...

I had my pre-op tests at the hospital, met the 2 surgeons and got the news that I could eat dinner.  I was shocked!  They seemed a bit surprised I was sent a liquid diet to follow this week.  Oh, well.

So I had 1/2 a very tasty hamburger with mushrooms and 4 french fries.  Whoo hoo.

These are some photos of the hotel:

 Pretty tile in the bathroom.

 This is what they brought for turndown!

I will probably be out of it for a day or two before I report in from the hospital, and I promise not to take pictures of my incisions!!