The Importance of Protein

At my recent appointment with my nutritionist, we talked about the fact that I am not getting enough protein.  I am supposed to get at least 65 grams of protein per day and I am averaging less than half that.  Malnutrition is always a possibility after gastric bypass, and I knew that going in, but I don't think I fully understood what would happen were I to be malnourished.  

Because let's face it:  I think I'm invincible.

But then I went on vacation and noticed that my hair was coming out by the handful in the shower and there were strands of espresso hair covering the bathroom floor.  It's disturbing.  I'm fortunate, though.  I've always had an abundance of super thick hair, so despite the heavy loss, it's not noticeable on my scalp, i.e. I don't look like my hair is thinning.

Despite the appearance, I decided it was time to get back on the bandwagon.  I haven't been eating properly (and it's not just the lack of protein).  I hadn't been exercising.  I don't drink enough low-calorie beverages (or really, any beverages for that matter).  And my weight loss is stagnating because of it (and yeah, the tequila didn't help, either).

So last night, I stopped into GNC and picked up unflavored whey protein powder.  At 110 calories and 21 grams of protein per scoop, this will give me a great boost.  Today, after some experimentation, I determined that a half scoop to my normal serving of oatmeal was the right combination.  I added the half scoop to a packet of HMR hot cereal (with apples and currants - yum!) for a breakfast that has 265 calories and a whopping 21 grams of protein.  It's actually so filling that after 30 minutes, I still have a significant amount left to finish.


I also picked up a complete multivitamin because we discovered that the chewables I purchased were not, in fact, complete.  Sure, they had the vitamins I needed, but not the minerals, so that was exacerbating the situation.  There wasn't much selection and I don't like horse pills, so I only purchased a 4-pack.  We'll see if I like them once I get them down.


I thought it was some fluke that I felt like exercising earlier this week, but apparently not.  This morning I woke up with a burning desire to walk/jog the two mile loop at Breakheart Reservation.  It was such a beautiful morning (temps in the high 50s/low 60s, full of sunshine) and I had a great time, much to my surprise.

Losing Weight, Losing Track

It seems it's been a month since I've had anything to post here.  Well, that's not entirely true.  Of course, I've continued to lose weight and in fact, the week before I left for vacation (or like a week ago, basically), I'd finally gotten below the 200 mark.  It felt amazing to be able to say that before I went to my family reunion, especially because the last time I was here was only for a day or two and was way back in 2007 and prior to that, it'd been when I was a teenager. 

I'm hovering between a 40-43 pound loss at the moment (in three months) and I'm starting to realize that I really do need to start exercising now.  Not because the fact that I'm not is hindering my weight loss (it's not) but because as I'm losing the weight, I'm finding that I'm not appreciating the previously firm (while fat) parts.

I found out that the guy who used to teach the Zumba classes I was attending a while back, actually bought the studio and is now running it himself.  For $28/month I can attend one Zumba and one Yoga class per week.  So I'm thinking of starting out with that and then maybe adding hip hop at Springstep or maybe joining a rowing league in the spring.  All I know is that I've got to do something.

I've packed up four bags of clothing to give away and I'm sure that I will have more once I finish unpacking from the trip.  I know of at least two jean skirts, a dress and some tshirts that are now too big.  I've been collecting clothes from other people as well and supplementing with small purchases from Target and Marshalls to just get me through to the next smallest size.  I've gone from a size 20 to a 14 and went from a XXL to a L.  I have clothes in my closet now (since I've been collecting them) that are 6 to 16.  I never knew what that felt like.  I always thought it was stupid to hold onto things that will never fit you again, but in my case, they just don't fit me yet.

I wasn't eating consistently while I was on vacation.  I didn't have a big choice in what I ate because we all (about 25 of us at times) ate together for most of our meals and there were a lot of things I'd normally eat (say, like oatmeal) that we didn't have in the house.  I got sick two nights in a row at dinner because I'd had pork (against my better judgment).  And of course, I was drinking tequila, so I will probably not see any losses on the scale for the next week or so.

I did try to be a little active while I was gone - walking the beach and swimming laps in the indoor pool - and that all probably just offset all of the unhealthy foods I was eating plus the booze.  My first meal upon getting home?  Rice (brown) and beans (pink). 

This week while we were away, it finally hit me that I'm losing a lot of hair.  I know this is because I'm not getting enough protein and because I need to replace my daily multivitamin for a complete multivitamin.  On the upside, I've got more than enough to spare, but I really do need to make sure that I'm getting enough of the proper nutrition.  They all warned me this could happen, so I'm not terribly surprised by it.

Official weigh-ins begin again on Wednesday!

Week 9 Results

Wow, I've had an exhausting weekend!  I logged about 600 miles on my car driving between Boston-NYC-Provincetown, MA-Boston, but it was a great time and I wouldn't have had it any other way.  Even if that means I'm completely sleep deprived.

As of this morning, I am down 36 pounds! 

Man, I can't wait to get down to that nice round 4-0 number.  Soon, soon, I know.

Now that Labor Day has passed, it's officially boot season.  This makes me so happy!  What doesn't make me happy is that with this weight loss, I now need to find both a new fall jacket and a winter one as well.  I'm going to hold off on the winter one for now, but have to start looking with some seriousness for something to wear in the fall.

Also, I have to wrap my brain around sizing and what I am/am not anymore.  I got caught in a rain storm yesterday in P-town and jumped into a store to buy a hoodie.  XL was swimming on me, and of course it was my first inclination.  I bought a L but it too wasn't really a good fit either.  C'est la vie!

Week 8 Results!

It's 6:35 AM on Thursday morning.  I'm humming Cross the Line and I'm running through the list of things I still need to pack in advance of our trip to NYC this weekend for Electric Zoo (a musical festival for electronic music junkies).  Of course, I realized I hadn't checked in for week 8 yet, so here goes.

I am officially down 33 pounds!

I've decided that rather than continuing to post weekly on Facebook, I'll save my friends the ad nauseum updates and instead post every 10 pounds or so.  I'll continue updating here weekly and if I were even techy, I'd figure out how to do a table in HTML so I could post my weekly weigh-ins on one page.  But I'm not.  And I'm not going to post it if it's not readable anyway.

According to my surgeon, I'm on track.  Look, there's no way I was going to lose 30 pounds a month when my starting weight was just over the qualifying amount.  So 33 pounds in two months is right on target.  He says I will probably lose another 15-20 in the next month and then it will start to taper off; down to 8-10 for the following three months and then 5-8 after that for the rest of the first year.  So, my desire to be down 60 pounds by Christmas, is, according to his estimates, reasonable.

I've been having some pain to the left of my belly button and when I told him about it, he jabbed me in the precise spot it hurt.  Apparently the nerve endings are starting to come back to the area where I have internal stitches/staples, so this is common. I may feel like this for a few months.  He wants me to practice good posture (remember those lessons with a book on your head?), continue wearing the binder (which I need to order a new one online since the ones in the drugstores are made for people with exceptionally short torsos) and do core exercises.


Otherwise, I'm healing normally - despite the fact that I've still got a little crust at the opening of my incision.  That may take another week or two to fully close.


Now, I'm off for the Very Long Weekend of crazy DJs, dancing for 10+ hours a day and little-to-no sleep.

Miscellany

Now that Hurrican Irene has passed us on the East Coast and I'm not laying on the couch like a soggy noodle thanks to both dentistry and crazy air pressure that made me nauseous all weekend, I can share a few more things with you.

I went thrifting this weekend.  Inspired by a friend (who also has a pretty amazing blog you should follow), I spent about an hour at the local Salvation Army tearing through their women's section  like nobody's business.  I snagged a black and silver tank top, a plain black tank top, a Banana Republic tank (good for work), two pairs of Ashley Stewart jean skirts and a black velvet blazer that's perfect for Fall.  All in, I spent $37.39.  Not too shabby!

Last night, I sat down with a pair of scissors and a seam ripper and tore apart one of the denim skirts.  It was about 4" too long to be anything by dowdy.  I cut it back and patiently sat around shredding the hemline.  When that was done, I went to town deconstructing two t-shirts I'd had made up especially for our trip to Electric Zoo next weekend).  I cut a wide, boat neck and created some slashes in the back of the first one.  The second one, I turned into a tank with slashes in the side of the shirt that I plan to double weave, but just haven't gotten around to yet.  Because the third one fits perfectly, I'm not doing anything to it. 

Packing for this event is always tough, but is made even more tough this year due to the fact that we're attending two after parties.  So in addition to having to pack three sets of clothes that will be comfortable dancing outside for twelve hours a day, I also need to pack at least two outfits for the after party.  This normally would mean I'd sit in my bedroom and try on everything and cry because nothing looks right.  But this year, I've got options!  I've got skinny jeans and tanks and Airwalks and skirts and all sorts of things to fall back on.  It's actually fun thinking about this instead of being stressed about what to wear!  What's not fun is spending time thinking about how little sleep I'll be getting.

In other news, I was craving corn chowder last night.  I don't know why, but sometimes I get these odd cravings.  I can say that they're not like pre-op when I craved sugar and sweets, so hey, that's a plus.  Anyway, I found this amazing Ina Garten recipe that if I could eat more than 4-5 oz. at a time would be deadly.  But since I can only have a little, I figured I'd give it a shot.  It was delicious!  Of course, now I have enough corn chowder to last me through winter (and I only made half the recipe, friends).

A few last things that have helped me since I've been post-op:

• Dinner Rolls.  Yep, dinner rolls.  Since I can't tolerate a lot of bread since my bypass, I found these little babies to be the perfect size for a PB&J, or tomato & mozzarella sandwich.  We found a bag of 48 at Costco for a few bucks and I've frozen them and just take one out and defrost it when I want it.
• Hint water.  I finally found something I can drink that doesn't have fake sugar (or any sugar, for that matter) but still adds some flavor!  Getting my fluids in is finally not a problem!  I'm about to start ordering this by the case from Amazon (no joke!) because I can only find a few of the flavors in my local grocery store.  I might also stop being a lazy ass and just make my own.
• I've stopped looking at breakfast as eggs, oatmeal and cereal and instead have adopted a more Mediterranean style with cheese, fruit, pita and hummus.  I found this amazing lemon hummus at the grocery store this week, but before that, I'd pack individual servings of Sabra hummus that I picked up at BJs.

Shoe Love and Other Miscellany

In an effort to get my house in shape (which in turn is also sort of a metaphor for my attempt to get my LIFE in shape), I realized I was going to have to part with the bag o’shoes that no longer fit or that were so far gone that not even the cobbler (because yes, we still call them that in the great Commonwealth of Massachusetts) wouldn’t be able to resurrect them.

I said goodbye to three pairs of beloved boots and at least 9 pairs of heels and flats.  Many of the heels had the nails coming through.  Some had soles that were falling off.  But many of them, and in fact, my primary reason for needing to do this, is that since my surgery and subsequent 30 pound loss in 7 weeks (you didn’t think I’d leave my weekly progress out of this post, did you?), my feet have shrunk a half size.

Huh?

Yeah, I’m not kidding.

I was in a shoe store the other day looking for a pair of shoes to wear to a music festival I’m attending in NYC next weekend and when I tried on my usual 7’s, they were too big.  6’s were too small, but the 6.5’s were just right.  I thought it may have just been the brand, because like clothes, all shoes are cut differently.  But no, my feet have actually shrunk a half size.

The good news in all of this, though, is that now that we’re approaching Fall, I needed some new shoes anyway to get through the season and the upcoming Winter.  So this culling just created more room for me to replace them. And in other news, I’ve been checking out some boots online.  For most of my life I’ve had to order them from plus-size specialty stores because my calves are too large.  But it now appears that they’re small enough for me to buy them from DSW where is where I get most of my best deals.

Other than my feet shrinking, I’ve gone through every article of clothing I own and now have three bags of clothes to donate.  I’m on the cusp of needing some new work pants because my old ones are starting to fall off and of course they don’t have belt loops.  I’m hoping to hold off until Winter to buy new pants because Fall is another extension of dress season for me.

I’m not going to hit my target of losing 41 pounds before the music festival next week.  I mean losing another 11 pounds in the next week would be ludicrous, but I’m okay with this.  I think that my imagination got carried away by the crazy losses in the first month.  I mean, losing 24 of those 30 pounds in the first month does a little job on your brain in the process.  Now I know to expect an 8-10 pound loss per month going forward.  That means that by Christmas, I could be down as much as 60 pounds total.  How amazing that would be!

MacGyver!

"MacGyver – (v) 1. To use ingenuity to fix or remedy a problem using only the tools available at hand. 2. To jury-rig.

We have a lot to thank Angus MacGyver for. This mild-mannered and mulleted TV action-adventure character showed us how to solve everyday problems with a combination of ingenuity and readily available materials. Like burning through an armoured door with nothing but handlebars and a flare, for example." Cycle Chick

This morning, I found it necessary to MacGyver a tourniquet-like device to stop the ozzing of one mostly healed abdominal wound with only a paper towel, some scotch tape and a prayer. This wouldn't be necessary if I'd either invest in more Tagaderm patches or you know, find Band-Aids.   It also wouldn't be necessary if it weren't summer and I didn't insist on wearing white shirts.

But since I didn't and I do, I found myself in quite the predicament this morning.

So far, that scotch tape is holding up pretty well.

All Over the Place

The image above pretty much sums up where I've been for the last few weeks.  I've had quite a lot of distractions at work and I've done some traveling so I've been beyond scatter-brained.

A friend sent me a sly little note telling me how much they were looking forward to my next blog update and I'm sure that's part of the reason I've been staying away.  No, not because I'm being urged to write or that people look forward to it, but that I find that I've fallen into the Blogger's Trap:  that place where you only write if there's something YOU think is interesting to say. 

I mean, honestly, how many times I can write about the following without you getting bored out of your mind or totally disgusted:

• Vomit - the verb and the noun
• Daily postings about losing weight (Look, I had gastric bypass, if I didn't lose weight then that would be news!)
• The everyday phenomena that occurs when you stumble upon something that reminds you that you are indeed smaller
• The strange things that start to happen to your body as you lose weight
• The fun of recovering from major abdominal surgery and life with weeping wounds and serious scars
• And of course, what bariatric surgery blog would be complete without the constant reminders of how absolutely amazing you look now that you've started to drop the weight.  I mean, how could they not have noticed what a pretty face I have, but... (Yeah, the chubbies in the room know precisely what I'm talking about here)

That's about summed up my life in the last six weeks since my surgery, but since some of you seem to be itching to know the details, I'll provide them.  Just don't say that I didn't warn you that it'd be graphic.  You have been duly warned.

I'll start with what I'm sure you all want to know most:  I've lost 27 pounds in the 6 weeks since my surgery.  Because I'm not exercising, it's slowed to about 2 pounds per week just based on my food intake.  I intend to exercise, but I continue to make excuses for why I'm not doing it.  Those excuses include:  I don't have the money for a gym; I hate working out to begin with; working out is torture; I look ridiculous in workout clothes; and my all-time favorite:  I know I have a free gym in my building, but I really want to take some sort of aerobics class and I don't want to do it alone.  Whine Whine Whine.  It's on my to-do list, okay?  Sue me.

I've had a few instances where I've vomited.  This is not because my surgeon is a dunce or because it's just What Gastric Bypass Patients Do.  It's entirely because there have been times where I simply haven't followed the rules.  One time it was because I ate too fast (because I didn't plan properly and was over-hungry).  Another time it's because I ate a piece of my anniversary cake despite the warnings to stay away from sweets.  Last night it was because although I knew better than to eat the breaded and fried mozzarella stick, I ate it anyway.  I've discovered that when they say not to eat fried foods, they mean it.  They also mean it when they tell you to stay away from bread.  And I've discovered - the hard way - that I can no longer tolerate sour foods like pickles.  I can only have olives in moderation before the gag reflex kicks in, and by moderation I mean like one or two.

Want to know what's fun (and a sure sign you're losing weight)?  Walking through the city and discovering that your underwear have completely fallen off your ass.  No, really.  Imagine you're just sitting at a baseball game and as soon as you get up to leave, you start to feel the creep of your underwear sliding off your ass and by the time you get home, they're around your knees and you're just grateful you chose to wear pants.  This has happened a few times in various scenarios and let me tell you, I've decided I need to buy some new ones.

Imagine trying on your favorite pair of shoes and having them flop off the back of your feet (despite not being flip flops) because bizarrely enough, your feet have shrunk or narrowed or something.  This is another current dilemma.  Although the fact that summer is almost over gives me a great excuse to buy some new Fall shoes.  No complaints there.  DSW, here I come!

How about your body doing things involuntarily that you didn't agree to?  I don't remember agreeing to belch like 50 times in a row or to get the hiccups whenever I eat or to get a runny nose when I'm right on the cusp of overeating.  I don't remember telling my uterus to kick into gear and get rid of the PCOS and get me back on a monthly schedule.  I don't remember what the acne was like during that TTOTM, but now I've got clear reminders all over my face.  It's like I'm back in high school.  Time to re-up the Proactive.

But what's really fun about being post-op is watching people try to figure it out.  I can't tell you how many "Aren't you hungry?"s I've gotten or "You look great!  Did you cut your hair?"s I've received.  And yes, yes, I did cut my hair but that's not the reason my face looks thinner, thank you very much.  It's not the reason I walk through the halls holding my pants up or why it looks like I have a whole new wardrobe (as clothes that haven't fit me in a year are starting to be too big).

I thought I'd be okay with being an open book about the why, but as it turns out, I find it incredibly awkward to tell a stranger that I really did enjoy the food, but I simply can't eat anymore.  Or why I bring a bento box filled with snacks that I have to eat every 2-3 hours.  Or why you may see me wear something once and a week later it's in my ever-growing donation pile because it's now too big.   Or why it looks like I'm playing with my food when I'm cutting it up into the tiniest little pieces.  Or why my necklaces all look too long now and my rings don't fit me right anymore.  Or why the smallest tasting menu you've ever seen was the perfect size for me.  Or why every new tendon I discover is like your first time playing with sparklers - scary and completely thrilling at the same time. 

Or why losing weight may actually be changing who I am.  And how utterly terrified I am of that being true.

 

Progress

It's officially been 4 weeks since my surgery and I am down 24 pounds in that time.  What feels incredibly strange is the consistency with which the weight continues to drop off.  When you've tried every diet under the sun, and you hit that plateau around 20 pounds, you start to expect that you'll never lose more than that and so it become pointless to try.  But even now, when I'm not exercising and no longer being extremely cautious about what I'm eating, the weight continues to come off.

With that said, I know that if I continue to lose large amounts of weight without doing any kind of exercise to help (a) speed it up and (b) tone up my body, I'm not going to like what I'm left with.  So, I found a personal trainer and we have our first workout tonight.  I'm really excited about this.  I had a trainer a few years ago and found it incredibly helpful.  First of all, the elliptical isn't going to change your body, especially when you have this much weight to lose.  I was doing 2 workouts a day for 45-60 minutes on the elliptical back then and the scale wasn't budging.  But as soon as my trainer switched up my routine and had me doing compound exercises, boot camp style workouts, plyometrics and got me out of the gym - my entire body changed quickly.  

Clearly, that's what I'm hoping for here as well.  The plan is to work with the trainer 2 days a week to start.  I'm sure she'll give me instruction on what to do the other 2-3 days a week that I should be working out that I'm not with her.

I've been really successful in terms of what I'm able to eat, however I'm pretty sure that's because I'm fearless when it comes to food.  I've met people who are extremely cautious with their pouch and don't try foods because they've been scared off of them.  Now that I'm back to eating real food again, I have zero interest in protein shakes or smoothies.  I never liked them before surgery and I didn't expect that surgery would be the magic bullet that would suddenly change that; so I don't bother forcing myself to eat them.

Breakfast is usually either a scrambled egg or oatmeal (either sweet - with fruit; or savory).  Lunch is either a half sandwich I've packed from home, leftovers from another night's meal or whatever looks good at the company cafeteria.  Yesterday, for instance, they had a chicken salad with grapes and almonds, so I ordered a scoop of that without any bread and it was delicious.  Yes, I got some puzzled looks and the obvious, "You sure you don't want some lettuce or tomato with that?" but I'd rather only take what I can eat than wasting the rest of it because I can't.  Dinner has taken on a life of its own.  I've had chicken, steak, pasta, veggies - all with success.  I try not to eat much bread because it fills me up too quickly, but last night I had cheese tortellini with peas and 1/2 cup was just enough for me - which is crazy because before surgery I'd have eaten half the package.

One area that I should probably exhibit more caution is with sweets.  So first of all, I've lost my cravings for them and I can't tolerate things that are too sweet now - this includes all of those fake sugary drinks like Crystal Light, by the way.  However, we brought home an amazing cake for our anniversary from one of our favorite bakers and even though I didn't crave the cake, I thought I could have a small piece (we're talking a paper thin slice of a 4" cake, so not much at all) and be okay with it.  Well, the other day when I tried it, it was fine.  Last night?  Not so much.  I spent the night nauseous, wishing I could vomit to make the feeling go away.  So, this is a lesson that I should just stay away from them altogether.  Then I won't have to worry about whether or not this will be the time I can tolerate something.

Point taken!

One of the things that came up with my Life Manager (this is an inside joke whereby I basically told her she shouldn't be a Life Coach, but rather a Life Manager where she just makes all of the decisions and we just have to go along with them) this week was to begin finding and engaging in activities that hit on my core values.  So, one of the things I came up with was to participate in a 5K.  I haven't jogged in oh, five years or so, but now seemed as good a time as any to get back into it.  I found a race up in Newbury, MA and am going to register for it this week so I can start prepping for it.  Sure, 3.1 miles isn't a huge deal but to a person who only a month ago couldn't get up a flight of stairs without significant knee pain, it's everything.

In other, related, news:

• I fit into the seats at Fenway Park!  No more squeezing in and essentially being stuck as my hips held me hostage in the seats.
• I ran (not walked, not limped, not pulled) up 4 flights of stairs on the T this week without any knee pain!
• I bought some dresses in a size Large, thinking they'd be the right size in the Fall...but they fit me now!
• My skin has improved and apparently I have the glow of a pregnant woman.  No, there will be no little ones running around any time soon.

Journaling the Journey

I used to think that food journaling was a tedious task and that it didn't help me stay on track.  That may have been true prior to my surgery, but these days, it's one of the most critical pieces to my continued success.  For starters, because I can't just crack open an entree and eat the whole thing, it means I save a lot of time in having to log things because I've already got the other half of said entree on another page from the day before or whatever.  But more importantly, I find that when I look back at how I used to track things, I was being so complex!  That's why it was so tedious!

These days, I keep a very simple journal in my purse at all times and I simply list the time, the items I ate, the calories and the protein.  That's it.  All I really need to know is whether I am eating at consistent times throughout the day and make sure that I'm getting some variety since post-op it's easy to fall victim to malnutrition. 

Perhaps at some point I'll be better at photographing what I'm doing since the visuals may help, but for now, here's a peek into the last few days' worth of my pouch:

Tuesday

• 8:00 AM - 2 oz. cottage cheese with 3 stone wheat crackers
• 11:00 AM - 2 oz. chicken salad with 2 stone wheat crackers
• 12:30 PM - 1 Colby Jack cheese stick
• 3:00 PM - 1 sesame torte with artichoke hummus
• 6:30 PM - 1/2 cup chicken chili with 5 saltines
• 8:00 PM - Jamba Juice yogurt and sorbet bar
• Total calories:  815; Total protein:  48 grams

Wednesday

• 8:00 AM - 1 egg, scrambled with Laughing Cow chipotle cheese and 1/2 sandwich thin, toasted
• 10:00 AM - 1/2 banana with 1 TBsp peanut butter
• 12:00 PM - 4 oz. chicken breast, grilled
• 3:00 PM - 1 mini Babybel cheese with 5 saltines
• 8:00 PM - 2 cheese ravioli in a bolognese sauce
• Total calories:  787; Total protein:  64.2 grams

 Thursday

• 6:30 AM - 2 oz. cottage cheese with 3 stone wheat crackers
• 10:00 AM - 1/2 banana with 1 TBsp peanut butter
• 2:00 PM - 3 pieces vegetarian sushi
• 5:00 PM - 1 oz. mixed nuts, raw and unsalted
• 8:00 PM - 2 oz. chicken salad with 2 stone wheat crackers
• Total calories:  791; Total protein:  41 grams

I now find writing everything down a bit cathartic.  What I need to get better at doing, especially as I'm gearing up to go back to work is planning what I'm going to eat.  I think one way I'm going to do this to write down the next day's plan in pencil and check off in pen where I've actually followed it so I can see where/when/why I've deviated.

I guess all of this is to say that with not a lot of effort, you can start to take control over the thing that used to control you.  I went to the support group last night and for the first time was able to sit on the post-op side and let me tell you, it was like a two way mirror back to myself when I was sitting there.  A lot of the things that people on the post-op side would say sounded like a dream:  "You won't be hungry"; "People will have to remind you to eat"; "You won't crave sweets", etc.  But now that I'm on that side, I see just how true it is.

A friend who is dieting told me she finds it difficult to stick to 1,200 calories a day.  She also has a normal sized stomach.  I found that impossible pre-op.  In fact, I used to have trouble sticking to 1,600-1,800 a day which was my target.  But now, even 1,000 calories seems like too much to me. I simply can't eat that much unless I'm eating the wrong foods (i.e. high in fat/sugar, low protein, high carbs, etc.)  

I realize it won't always be this way.  That at some point, I will be able to eat a plate of food and that I can stretch my stomach again if I'm not careful.  But this time, immediately post-op, where I can really focus on what 'full' feels like, how much is enough and getting into the habit of simply listening to my body tell me what it needs, is invaluable.
 
For those of you playing along at home, I am down 22 pounds in 2.5 weeks.  I am a pound away from shifting from 'morbidly obese' to merely 'obese'.  I am fitting back into the clothes I'd grown out of pre-surgery.  I chopped off my hair yesterday because I could.  I've gone from tight 1X clothes to comfortable XLs and the L's are making an appearance and while some of them even fit, I'm going to give it another 15 pounds or so before I wear them anywhere.

The next thing on my to do list is to sign up for a local 5K in the fall so I have something to work towards on the exercise front.  Who's in?



 

Progress

Surgery Morning - 7/6/11                                                July 17, 2011 (Down 19.6 pounds)


In this particular post, I think it's important to show what I hadn't even noticed until my husband took this second photo today before we headed out.  I wasn't actually posing; I was waiting while he checked this other camera to make sure it worked before we headed out to Rockport, MA for the afternoon.  That's my I'm an Impatient Bitch stance.

When we got home and I was downloading photos from the camera, I came across this one and decided to compare it against the one from just prior to my surgery.  It's only been two weeks so I didn't expect there to be much of a difference yet, but, well...the proof is in the photos.

The shorts I'm wearing today haven't fit me since I bought them in April and I suspect that by next week they'll be too large in the waist as they were a bit loose this morning.  In the last 11 days, I've lost 19.6 pounds - far more than anyone led me to believe I'd lose in even the first month since my BMI was at the low end of the range to qualify for the surgery in the first place.

My days are starting to become more 'normal' now even though I'm just under the two week post-op mark.  This week, I've added eggs, cottage cheese, shredded chicken, crackers, various cheeses (ricotta, boursin, Laughing Cow cheeses and feta) and veggies (tomato and cukes raw, potatoes, carrots).  I'm able to space out my meals to every 2.5-3 hours or so and I've gone out to restaurants twice - the first time ordering chicken and rice soup and today, I ordered a Greek salad but only ate the tomatoes, cukes, olives and feta cheese.

A typical breakfast is an egg (either scrambled with 1 oz. of cheese or hard-boiled and made into an egg salad with a tiny bit of low fat mayo, mustard and paprika).  If I make it into an egg salad, I'll put it on two crackers.  That's all I can have right now before I'm full.  Around mid-morning I'll have a mini Babybel cheese as a snack.  Lunch has been shredded chicken salad (sometimes with BBQ sauce, sometimes with a little mayo and some relish) on a few crackers.  Dinner is more of the same, though last night I had a half of a Boca veggie burger on a half a sandwich thin and that was enough.

I am averaging less than 800 calories a day right now, but by next week when I can start to add back in more protein, veggies and starches, my target is 1,000 a day.  In addition to eating less, I am moving more.  I'm walking at least 30 minutes a day - usually more - and even on days when I'm stuck at home throughout the rest of my medical leave, I just put on some music and dance for a while at a time.

When they say that weight loss surgery is a tool, and only that, they're right.  I've still got to make the right choices when I'm eating and I've still got to move and get this body active.

The Real Deal - Week 1

I thought that having had other surgeries would have prepared me for what I was getting myself into.  But honestly, I now think that nothing other than a comparison to a C-section is a real look into what the first week has been.  And I've never had a C-section, but the pain described by the people I've met who've had them pretty accurately describes what my first week has been.

Surgery Day - Wednesday

On surgery day, I was nervous, but also excited (silly me!).  I kissed my husband goodbye before I was knocked out and wheeled to the OR.  When I awoke in the PACU, I felt no pain.  I was surrounded by a flurry of people and all was well.  I was eventually moved to ICU and my husband came by to check in on me.  I was so out of it that it didn't make sense for him to stay.  But eventually, I started to really "come to" and I realized how uncomfortable I was without anything to even rinse my dry mouth with. 

Later in the evening, I asked for something to swab my mouth with and my nurse took that as a sign I must be feeling better, so rather than getting what I asked for, I instead got to stand up out of bed for what felt like an eternity.  Oh, and I never got that swab.  I did get a mouthful out to one of the nurses though when she told me that the "worst of it is over now."  Oh no...I may have been medicated, but I still spat out, "Don't you dare tell me the worst of it is over until you're where I am right now!" 

I ended up texting my husband, who called his mother, who immediately came over with his sister to see me and straighten things out with the nurses and the surgeon.  I am so thankful she was there because she talked to them about my anxiety levels (Ativan!) and that I needed to continue resting and not be aggravated (Trazodone!).  After they left, I slept very very well.

Day One - Thursday

On Day One, I made it out of my bed and around the ICU floor with the Physical Therapist twice.  When I got back to my room, I opted for the recliner rather than the bed.  I had a lot of pain, so I was laying on the PCA (the only pain meds you're given with this hospital is through a self-controlled PCA pump that you can hit every 6 minutes).  I was nice and toasty and fell back in the chair, asleep, when I was roused by what felt like the entire floor jerking me up, making me stand, smacking my back and telling me to breathe.  "Okayyyyyyyyyyyy," I yelled out dramatically, "I'm breathing!!!!!!!!"  

All the while that they're frantic, I'm listening to them discuss How This Could Have Happened; my not breathing and getting my oxygen levels to coma-inducing levels, that is.  Someone blamed the nurse for not plugging the oxygen back into the wall.  Another blamed me for hitting the pain pump so many times, "You effin' told me I could hit the button every six minutes and I wouldn't overdose.  If you don't want me hitting it that often then maybe YOU should change how often I can hit it or what dose it doles out!"  They told me to stop yelling and cursing and well, you don't tell a fire ant to cut it out after you've stepped in their ant pile.  I had a few choice words for the staff and lo and behold, they found me a room ASAP on the post-ICU floor.  Go me!  Self-advocacy is really a bitch, especially when you're medicated because then people don't find you credible.
 

Day Two - Friday

I did much better on Day Two in the main part of the hospital with the nurses that are specially trained to work with my surgeon's patients.  I had much more responsibility for using the Incentive Spirometer (to keep pneumonia at bay) and getting myself up and around to walk the halls.  I was finally allowed to have more than just clear liquids - upgrading to protein shakes and tomato soup felt like a dream - a fairytale land where these things were like liquid gold being poured down your throat every few hours.

A friend showed up unexpectedly to keep me company and it was so nice to finally have someone to talk to during the day and to spill the floor's secrets.  My catheter (whoever says they don't like a Foley is lying, I promise you that) was removed and I had to use the restroom on my own.  I also had to give myself my own sponge bath - not like the ones I was given gratis in ICU.  But I did all of this and they released me to go home.

Day Three - Saturday

On Day Three, I want to die.  I was home, which was nice, but if I just could've died, I would've been happy.  I can hardly walk on my own.  I can't do anything for myself.  I can't rearrange my pillows, go to the bathroom by myself, or even get up and prepare anything for myself.  How do single people do this?

Day Four - Sunday

I still want to die, but maybe I am just overreacting.  My parents sent me flowers delivered by a tiny Asian lady and I swear the flowers are as tall as she is.  I'm not racist, but the meds are really doing a number on my vision.  I am still Team Vicodin's number one player.

We discover (well, first we discover that I don't have any shame) that all of the walking helped reawaken my digestive system.  I won't go into detail, but I will tell you this:  I wish someone other than my mother warned me about this particular bit of nastiness.  If you don't have someone you really, really trust, hire yourself a nurse 'cause honey, you aren't going to be able to clean the back door.  No really, I mean it.  I'm not exaggerating.  Unless you're some weirdo with really long arms and a short torso, you're in danger here.  You know we never fully believe what our mothers say, so it would've been nice to have this little bit of nastiness reinforced elsewhere.  It wasn't and OMG IT WAS TRUE!


I have a crying fit because I'm appalled that I cannot care for myself.  If this is what it's going to be like to get old, I may sign up for the Kevorkian Special.

Day Five - Monday

My friend who visited me in the hospital promised me she'd come over to help me a few days this week and her company really lifts my spirits.  We talk for hours about things not related to weight or the surgery and it completely takes my mind off the fact that I hadn't had any Vicodin today.

As we get ready to take a shower, my husband notices that my dressing has a lot of pooled blood in it.  I discover that it's warm and squishy and I almost pass out.  I have another crying fit and insist he takes me to the ER to get it checked out.  The surgeon calls us on the way in and tells us he's onsite so he'll see me there.  Turns out it was just "leakage" - a  fine word that basically means mix a lot of water with just a little blood and this is what oozes out of your incision.  Apparently, you're supposed to want this to happen so that the blood doesn't pool under the incision.  They get me cleaned up and tell me what to do going forward and send me on my way.  Before we left, I had a motivational chat with the surgeon that set me on the right path.  He also made my day when he told me I could add cottage and ricotta cheeses to my daily routine now.

Day Six - Tuesday

I am back to checking my Crackberry, but finding it actually relaxing to not be so engaged in work right now.  I can't imagine having the pressure to be back in the office quickly after something like this and for once, I finally appreciate all of the urgings of my bosses and co-workers that I really take all the time I need and come back strong.


My friend comes back to visit and this time we take a trip to Walgreens for some essentials and walk a bit around my apartment complex.  I am now able to shower by myself (at first, even standing that long and with assistance was really hard due to nausea).  I can even almost fully dress myself but still need help with the abdominal binder.  When my husband gets home, he wants to cool off in the pool.  I'm in a purple dress, about knee-length and I decide that while I can't go in, it would be nice to sit with my feet in the water.  While I'm there, I meet a woman who had gastric bypass 16 years ago and who gave me a ton of encouragement and advice.


Sometimes, when I feel afraid to tell people what I had done (calling it 'stomach surgery' versus what it really is), it's times like these where I'm glad I chose the brave path.  I am finding much more support and encouragement than I'd expected.  I am no failure and this is not an easy path by any means.

Food Shopping

One of the things I'm hearing a lot of as I speed closer to my surgery date (4 days, but who is counting?!?) is that we should prepare our fridge so when we come home, there's less thinking we have to do.  The food choices become automated by already having the correct ones there for you.


For the next few days, I'm going to enjoy the things I know I'll have some trouble with later - like sweets (see, at least I'm admitting it!) and we're going to a brunch (buffet!) tomorrow as well.  But Monday (yes, I'm aware it's a holiday) and Tuesday are really about prepping for the surgery and to help give my body at least a few days to rid itself of the horrors of the last 33.57 years, I'm planning to be on all liquids.


I will not be able to eat anything after midnight on Tuesday as my surgery is scheduled for 7:30 AM on Wednesday morning.  They've already warned me that I won't be allowed to eat or drink anything Wednesday at all (with the exception of a few ice chips if my mouth is too dry).  By Thursday I will be on clear liquids only - broth, sugar free jello, etc. and on Friday I will be able to start on other liquids - non-clear soups like a tomato bisque, pudding, protein shakes.  When I come home, I'll be on these types of liquids for the first week, then I can start to incorporate soft foods - eggs, cottage cheese, yogurt - for the second week.  In the third week, I can start to introduce small amounts of pureed vegetables and small amounts of lean protein.


To prepare for this, we went to BJs and stocked up on:

• Eggs (2 dozen)
• Skim milk (1 gallon)
• Jamba Juice Fruit Boost (Low-cal fruit cups that are fortified with additional vitamins and minerals)
• 100-cal Cottage Cheese doubles
• Colby Jack cheese sticks (60 calories each)
• Carnation Instant Breakfast (30 packs)
• Calcium + Vitamin D chewables
• Multivitamin chewables
• Water Pods (those little 11 oz. water bottles)
• Jamba Juice Fruit Sorbet and Yogurt bars 

I had a lot of anxiety this week around things like will I remember how many ounces of food I can have at a time? and How am I really going to get as much protein as they want me to get when I can't eat as much as I used to?  



I'm not going to lie, I've been extremely stressed out and an emo nightmare.  They say that the emotions straighten themselves out after a few months.  I hope my husband has the patience to wait that long!

Setting Expectations

I've been reading a lot...and while you probably can't tell from this blog which may seem abandoned (but I assure you is not), I've been learning a lot about what to expect in the days, weeks, months and years post-surgery.  Not just about what life will be like - counting grams of proteins, taking miniscule bites, avoiding buffets like the plague - but about the things people wish others had told them before they were wheeled into the operating room.

So, on a lark, I decided to write about what I've set myself up to expect.  I probably have a strange sense of humor (fine, yeah, I do), but I think it will be funny and interesting to come back here, to this moment, and find out if I was on target or if I really had as little a clue as just about anyone else standing where I am at the moment.

1. I'm pretty sure that some of my relationships are going to change.  I'm not just talking food here, people.  I mean relationships with friends and family where interactions that were primarily based around food and the act of eating probably won't be as much fun for me anymore.  Marathon sessions at the buffet won't be an option and I'm sure I won't be popular when fat people complain about their weight because, ya know, there are options - and this one may not be right for you, but it just might be.
2. I'm both excited and nervous about what's underneath all of this junk in my trunk.  You ever clean out the junk in your actual trunk and discover things that you'd forgotten were there?  How exciting when you pull out that old band t-shirt that slipped into the spare tire well!  But what about when you're cleaning it out and find that greasy rag from the time you sprung a leak and now it's moldy and gross and you don't want to touch it but it's right in front of your face and now you've got to do something with it?  Not so much fun anymore.  'Fat' has been something that has insulated me - not just from the cold weather - but maybe even from myself.  While I'm excited to see what's beneath there, it's also a scary place because what if I discover that I don't actually like myself and now I've got nothing with which to cover that up?
3. I wonder if I'm prepared for the shift in the way society will perceive me.  I may not be able to get away with starting so many of my diatribes with, "Well, I'm not what society deems to be attractive, so I don't have that problem."  I wonder if more doors will open for me, and if they do, will that change me or will I appreciate the boost that I believe thin women get.  There have been scientific studies that infer that overweight women are viewed as slow, unintelligent, less talented - even though that isn't how we really are, it's just how people perceive us.  How will I deal with having to set the labels aside and learn to graciously acknowledge the shift in perception while working hard to change it?
4. Celebrate the small, incremental changes too.  It's not all about skydiving in San Diego or hiking the entire Appalachian Trail.  Am I really prepared for how good it's going to feel to walk up a flight of stairs without both of my knees about to buckle?  Am I prepared to see my feet and not just take the compliments on my shoes at face value?  Am I ready to stop hearing, "You have such a beautiful face, but..."?
5. It's okay if I really do not like yoga.  I don't have to.  But I should at least try to remember what it's like to contort my body in such ways.  Will I regret not continuing with gymnastics?  Or will I remember why I didn't continue doing cartwheels in the first place?
6. Despite not being hungry in the first few weeks or months, it won't always be that way.  And eventually, I will feel hungry and I will also be able to eat.  Not like I do now, but still, a lot more than I can immediately post-op.  I've got to establish good habits now so that I can continue to lose the weight when I won't have the help of not feeling hungry.
7. When people tell you how "easy" it is for you, just smile and walk away.  Lots of people think that gastric bypass is the easy way out.  Let them continue thinking whatever they want, because no amount of trying to educate them is going to make them change their minds.  When they're ready, they'll search for the answers themselves.  Let them see how "easy" it is if they decide to do it for themselves - all of the appointments, preparing, remembering all of the rules, setting up your support system, getting into exercise and eating routines, the actual experience of the surgery and all of the post-op pain...and on and on and on.
8. It's going to take time to remember that I'm not as fat as I used to be.  I'll feel like I really succeeded when I stop going to plus size departments by instinct.
9. Resist the urge to measure success by the successes of others.  I won't lose weight at the same rate as everyone else.  So I should count my losses as my own and not worry about how I'm stacking up against everyone else.
10. Save now for any cosmetic surgeries you may need or want down the line.  Don't let 'not having the money' deter you from being able to be fully happy and comfortable in your own skin (and in less of it!).

My surgery is officially scheduled for next Wednesday.  All of my clearances were received.  The insurance company didn't delay in approving me.  I've had my pulmonary functions tests, met with the anesthesiologist, picked up my post-op prescriptions and am literally getting my house in order before I'm admitted next week.

On the Path

(c) Stuart McClymont

When I was younger, I had a friend who wore the same size clothes as her mother.  It seemed like she had an endless wardrobe because it was, essentially, doubled.  I don't remember, in the two years we knew each other in high school, her ever wearing the same thing twice in the same way.

This was a completely foreign concept for me.  Sharing clothes with your mother.

When it comes to weight, I have the type of genetics that hardly leaves anyone envious.  Let's face it, I'm genetically prone to gain weight and keep it on.  This isn't something that just came out of the blue, but one that crept up a little each day and when paired with an inactive lifestyle and a propensity towards drowning my sorrows in food, leads to a perpetual cycle of weight issues.  I'm not alone.

In photos, I begin to identify our shapes as nearly identical.  More than merely round, we are built in much the same way.  More than that, my feet touch the path in much the same places; this is partly why I know that gastric bypass - while a challenge - is the right choice for me.

I watched my mother struggle with her weight and I've watched her successfully lose hundreds of pounds on the seemingly endless dieting Ferris Wheel - up and down, down and up.  Now, after so long, I am seeing her win this battle, pound by pound.  It's amazing, watching what emerges - a collarbone, muscular and striated legs, a change in the shape of her face - and literally seeing what lies ahead for me.  Yes, my feet are firmly planted on this path which she has walked before me.

In my entire life, it is only now - weeks before my surgery - that my mother is a smaller size than I am.  We chat, with excitement, about what changes will come next.  What the next size will be.  What else may be revealed.  I tease her that she should take good care of her clothes because I'll be wearing them next.

It may seem small - even trivial, to some - this bonding we're experiencing.  But for me, right now, it is everything.

They say you cannot know where you're going until you know where you have been.  She is a reflection not only where I have been, but who I am and what I can become.  She is hope.  She is strength.  She is courage.  She is beating the odds.  

I spent a long time being resentful and angry when people would call me by her name.  "I am me!" I'd exclaim, exasperated.  In truth, I am fortunate that people make that mistake.  I finally understand, after all these years, just how much a compliment it is.

20 Things

 
As I get ever closer to my scheduled surgery date, I've started to think about all of the things I want to do when I'm thinner.  For the most part, I don't let being fat stop me from doing things I want to do (ask me about ziplining in Jamaica one of these days!) but there are definitely some things I just can't do.  Maybe this list will inspire you to get up, get out and get going on your own journey.

Note:  Although this list is numbered, this isn't really in any preferential order.

1. Hike the White Mountains (NH is really beautiful)
2. Finally learn to ski or snowboard
3. Wear a 2-piece (not necessarily a bikini)
4. Swim with dolphins
5. Be an extra in a film
6. Attend a live taping of a show
7. Go white water rafting (OMG this is so fun!)
8. Get certified (to scuba dive, silly!)
9. Volunteer overseas for a week doing something physical like improving homes or helping with an agriculture project
10. Purchase a piece of custom-made clothing
11. Learn to kayak
12. Take a rowing class (ya know, on the Charles)
13. Relax in a natural hot spring
14. Trek the Inca Trail to Machu Picchu
15. Wear skinny jeans that are actually skinny
16. Wear a dress in summer and not worry about a terrible case of Chub Rub
17. Stop holding onto clothes that will fit me "someday" and make that day "today"
18. Cancel my Lane Bryant credit card
19. Play basketball with my husband
20. Buy a pair of stilettos

Let them eat cake

I wasn't going to write about this.  I certainly wasn't going to say, in public, that I'd gained eleven pounds between my initial appointment with the surgeon and my appointment with the dietician six weeks later.  Yes, you read that right:  11 pounds gained in 6 weeks.  That's some championship-level eating right there.  So, how did it happen?

When the surgeon asked me that question, he wasn't pleased.  He most certainly wasn't happy with the response, either.

Half of that time, I was traveling for business.  I was attending conferences and meetings all day (from 7AM-10PM usually) and the other half, I was too tired to cook, so most of our meals were from fast food joints, take out and delivery.  It sort of became the running joke in our house about where to go for dinner.  I mean, c'mon, there's only so much KFCTacoBellKelly'sRoastBeefBostonMarket a person can eat, right?

So, there you have it.  My confession.

As I said, the surgeon wasn't pleased with the answers I gave him.  "Let me guess," he asked rhetorically, "when you went dowstairs for the buffet breakfast every morning, you walked right past the fruit, oatmeal and cottage cheese and went straight for the eggs, bacon, sausage and bagels."

"That's not entirely true," I said, truthfully, "I did put a few pieces of fruit on my plate before I hit the eggs, bacon, sausage and bagels."

He was not amused.  "You have a wiring issue in your brain.  I'd bet that if you see someone else eating it or you smell the food, you can't resist it, even if you're full and you don't actually want it."

Light bulb!  "Yes!  That's exactly what it's like!"  It's like someone finally telling you that hey, yeah, you're fat, but it's not entirely your fault.  It's a relief to know that it's not just my lack of willpower or disdain for the treadmill that has made me fat and kept me this way - there's a biological reason as well.  It's not just the arthritis in my knee and ankle, my slow metabolism, my IBS, PCOS, glucose intolerance or any other number of things wrong with me.  There's a larger underlying issue that isn't going to be resolved by beating myself up about it.

And after some tears - of joy and shame - we agreed on a date.  July 6th.  My Independence Day.   I am working as hard as I can to do what I need to do to make that date a reality.  In the week between seeing the dietician and my follow up with the surgeon, I lost three of the 11 pounds I'd gained.  He'd like to see me lose 5-7 more in the next month before I see him again. 

To do that, I've stuck strictly to the dietician's recommendations.  I set up alarms on my calendar to remind me to eat and when to drink. I eat by the clock, even if I'm not hungry, because that's what I'll need to do post-surgery as well.  I've been walking more.  I'm not setting aside gym time, but I am walking around my work campus much more and taking an extra walk during lunch time when I can get in another mile or so (and when the weather cooperates).

I've also scheduled the next psych appointment, dietician appointment and called my primary to send over additional documentation to the surgeon.  Sometimes it feels like getting prepared for this is a full-time job.  I should have the psych clearance after my next appointment (awaiting a call back to schedule), the dietician's clearance after my next visit on June 13th, pulmonologist clearance is being written up now (even though the sleep study results are still another week or two away from being complete) and then the final hurdle will be getting the surgeon's final sign-off and the insurance clearance.

Exciting times!

Let the Countdown Begin!

I can't write as much as I'd actually like to right now because I have some other things I need to work on tonight, but...

I met with the surgeon tonight and my tentative date for my surgery is July 6th!

I have quite a lot I still need to get done in the next month before my next follow up with the surgeon:

• Lose 5-7 more pounds on my own
• May support group
• Dietician clearance
• Psych clearance
• Pulmonary clearance
• Physician's notes from my Primary Doc
• Final approval from the insurance company

Rock-a-Bye Baby

What a difference ten days makes!  In that time, I've come and gone on another business trip (which means I ate and drank way more than I should have), met with the dietician, met with the pulmonologist, stood up my surgeon and had a sleep test done.

I'm not busy!  Who's busy?!

I met with the dietician earlier this week and I have to say that while I did not really connect to her on a personal level, I took notes anyway and asked clarifying questions about some of the rules I will need to follow (and actually implement now).  Some of the fun stuff I've mentioned before, but am now living:

• No mixing of food and beverages.  This has been a challenge!  I can't drink anything (even water!) 20 minutes before OR after a meal or snack.  It will stretch the pouch and push food through faster, making me hungrier, so this is a habit I need to get down.
• No carbonated beverages.  Ever. The dietician explained that carbonation will stretch the pouch and that the carbonation will not really have anywhere to go once it's inside you.  She told a fun (well, fun if you have MY sense of humor) story about a woman who drank some soda and then foamed at the mouth.  Doesn't really sound worth it if you ask me.  This is going to be a challenge for me since I'm a big soda drinker. Having weaned myself off regular soda, I'd learned to enjoy the diet stuff.  But now, think about it, that means no more sparkling water or CHAMPAGNE!  One of my favorite adult beverages of all time will now be relegated to the Do Not Touch list (along with dirty socks and a host of other things).
• Eat every 3.5-4 hours.  Start the clock as soon as you wake up by eating something within the first 1-2 hours.  This isn't that difficult for me since no matter what time I eat at night, I tend to wake up famished.  I've been incorporating a low-fat cheese stick (I'm currently obsessed with monterey jack) either before I leave the house or on my commute into work.  I make sure to either pack or buy enough snacks to keep me going between meals as well. 
• Eat S-L-O-W!  This is a toughie for me since I practically inhale my food.  Each bite is supposed to be dime-sized and chewed 6-8 times.  Meals should take at least 20 minutes to finish (and for me, they never do).
• Count Calories.  Pre-surgery I should aim for 1600-1800 per day.  Post-surgery, I should expect to have between 800-1000 a day.

To be honest, following the "rules" above, I've managed to keep my calorie count where it's supposed to be for the last few days since we met - on the lower end of the range, even.  Stretching my meals out really does help me get that full feeling that used to be so evasive.

After all of that fun, I met with the pulmonologist who could totally have a career in stand up if this whole doctor thing doesn't work out for him.  He, along with my surgeon, suspect sleep apnea.  Since the connection between a lack of sleep and overeating is well documented in scientific circles (no really, it's not JUST my excuse), it was important for them to test me to determine whether or not I have sleep apnea or some other sleep disorder.

I was able to get an appointment for the next evening, so I headed there after work (since my appointment with appointment with the surgeon was moved earlier as he had a conflict and then I was running late).  The pulmonologist took me over to the sleep study suite so I could check out the rooms.  It was like one minute you're in a hospital and the next, you've been whisked away to a hotel room.  Except that before you can go to sleep, they connect you to a gazillion wires, strap belts around you to monitor your breathing and stick some tubes in your nose.  Fun, right?!?!?

Not so much.  I'm not sure how they expect people to pass this test in the first place.  It's almost like it's designed for people to fail.  For starters, they want you to try sleeping on your back most of the night.  Blech.  You're strapped to all of these wires (which are thin, don't get me wrong, it's not like sleeping on bundling cables), but the kicker is really the tubes in the nose.  I have enough trouble breathing, thank you very much!

Since it takes two to three weeks for the results to be analyzed, I don't have much information yet.  I did not meet the criteria for the insurance company to cover the cost of the CPAP machine, but that doesn't mean I don't have sleep apnea either.  Apparently I did wake up quite frequently throughout the night so all of these years I've been complaining about being sleep deprived, I wasn't kidding.  Oh yeah, and don't share a hotel room with me because despite my protests over the last decade, I snore.

In other news, I am now scheduled to follow up with the surgeon on Monday, so stay tuned!  I hear that my next three clearances should be coming quickly which means then it's just up to the surgeon to clear me and get my date confirmed!



Slow Down, Chowhound!

In my quest to lose weight, get healthier and prepare for Life After Surgery, I actually timed myself at breakfast yesterday.  My grandmother, God love her, said something along the lines of making pancakes on Sundays and since we were visiting, she wanted to make them.  Now, not only do I not ever really pass up an opportunity for food, I certainly don't pass up a chance for Grandma's Cooking.

I had the good luck of getting the first batch of three pancakes.  I carefully doled out one tablespoon of Olivo spread (half the calories of butter!) and lightly drizzled the Aunt Jemimah Lite syrup over my triple stack of flapjacks.  'You never did use a lot of syrup," my grandmother commented from the stove.

Then, I checked the clock.  8:55 AM.

With Grandma still manning the griddle and my Grandfather poring over the NY Daily News, I sat there with my plate of pancakes and made a conscious effort to not inhale them.  First, I cut the stack in half.  I looked at them, curiously, then I started cutting all around the crispy edges and taking miniscule bites and then just chewing, chewing, chewing, chewing, chewing until my jaw ached.

At 9:00 AM I'd finished the first half.  Five minutes?  It felt like forever.  I dragged out the second half of the pancakes until 9:13 AM.  It felt like torture.  There was a Corningware full of extra pancakes right in front of me and it had just taken me eighteen minutes to eat three pancakes.  For the sake of comparison, let me just say that in eighteen minutes I probably could have eaten at least six or seven, not just three.  I allowed myself one more and made it take me another seven minutes to finish.  By that point, I was actually full.  Not stuffed, but definitely satisfied.  This is interesting because I don't think I've ever only eaten 4 of my Grandmother's pancakes. 

Maybe there is some truth to slow eating.  But regardless, slow eating is something I am going to have to train myself to do because once I have the surgery, I will not physically be able to inhale my food like I'm used to doing without there being negative consequences.

Which got me thinking about the Slow Food Movement.  If you take the politics out of it, this boils down to eating whole, local foods that are organically grown and taking the time to prepare and enjoy them.  It also brought me right back to Michael Pollan and his "In Defense of Food", the premise of which is: "Eat food.  Not too much.  Mostly plants."  The idea that we should go back to eating the types of things our grandparents (and since I'm so lucky to still have mine, I'd even go back a generation further and say, my great-grandparents!) would recognize, and nothing else.

I've always had excuses as to why I can't shop at farmer's markets or buy only organic produce.  Yes, it's more expensive than buying the stuff that's been sprayed with pesticides and God only knows what else.  But at the end of the day, if we were eating the quantities of food we were meant to eat; eating slower so we actually allowed ourselves to feel full and not pushing our plates away with the signal that it's empty; and eating whole, real foods...we wouldn't be in the predicament we're in.

Now, I am not pointing fingers or telling people how to live their lives.  I most certainly couldn't do this if I wasn't planning to have surgery to physically restrict how much I can eat.  I also don't think I could do this if I had a large family or a spouse who ate really large meals.  The truth is that I can do my part here and that every small effort can lead to bigger changes down the line.