Weight Loss

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Saturday, April 28, 2007

On Lap Band Time

Things are slow with the band here. I had a fill 2 weeks ago and can't wait for my next one. I can't believe my surgeon left!!! Grrr. I hope Dr Jan will be a little...assertive...with my band and give me another good size fill. I don't want to say "aggressive" because I don't want to do too much and get set back by barfing or reflux or end up with a slip later...but I know I have a lot of room to go with this band and I want to get going already.

I'm hanging on the 13 lb loss. I'm restless. I work out regularly and make good choices about 85% of the time. I've been in charge at work for the last couple of days and do well except when people leave food at the desk, which happens A LOT. The desk in the middle of the nurses station is Grand Central for sharing food, and the food sits right by my computer. Today I had to ask people to put it in another room so I'm not sitting by it all the time. I mean, come on!! How's a girl going to avoid french fries and cookies when they are sitting six inches from her?!? geez.

I have nothing to add. Lap band time is different and slow. I can't wait for that magic moment when I have restriction and things can get started.

Saturday, April 21, 2007

Assessment

I've had my first fill in for a few days and do notice a very subtle difference in how much I am comfortable eating. I don't know if it is real or my imagination. But, I've lost a couple of pounds. That's not bad.

In the past 5 1/2 weeks I have strived to follow all the rules I have been given at various stages of this process. Here is how I think I am doing at this point:

Good
  1. eating enough protein
  2. eating small portions
  3. making quality food choices
  4. taking my vitamins
  5. exercising
  6. chewing thoroughly

Needs Improvement

  1. drinking enough water
  2. eating 3 meals and a snack
  3. paying attention to eating only
  4. not eating in front of the computer
  5. eating very slowly

It could be worse, definitely. But the issue with sitting at the table to eat meals is going to be a struggle. I usually eat alone, and I just get so bored eating a meal by myself. I can't stand it. I can't be content to "chew" and "enjoy" my food and pay attention to the eating and getting full. That will be a problem when I have real restriction and I need to be careful with small, well chewed bites eaten slowly to prevent getting stuck or barfing. I need to read or something. Lately I've been trying to compromise by reading and paying attention simultanously to what I am eating and how I'm feeling. That seems to be fine, but I don't know if it is good enough and if I will lapse into distracted eating again over time.

All of this will be put to the test with my next fill, I'm sure.

Thursday, April 19, 2007

First Fill

Yesterday was my 1 month post op appointment (it was actually 5 weeks since Dr Hong was out of town when I was supposed to see him last week) and I got my first fill. He gave me 1.5cc since my band was very loose. Yesterday was liquids, today mushies. Tomorrow back to food. I won't know until tomorrow if I have any restriction with this fill. It seems like liquids go down a little more slowly, but that might be my imagination.

I called to make my next appointment for 1 month from now, and the receptionist told me Dr Hong is moving! WTF? He is moving back to Canada at the end of the month. I am sad about that, and a little surprised that he didn't tell me yesterday, especially since we talked about me moving to Spokane in January. So I have seen Dr Hong for the last time, unless something comes up in the next few weeks.

I am finally down a couple more pounds, but I don't count on that staying that way until I have at least another fill. I'm doing well at the gym, though. I guess I can start weights and abs again since it's been 5 weeks since surgery---I forgot to ask at my appointment.

Wednesday, April 11, 2007

Is this Dieting?--part 2

Today I was supposed to have appointments with my surgeon and my nutritionist. Somehow, the message from my surgeon's office telling me that he would not be in today did not reach me. Not only was he not in, but I got there when they went to lunch. They close for an hour and switch to an answering service. I had to wait an hour for them to tell me that my appointment was cancelled. Bleh.

I thought about cancelling with the nutritionist, but decided to see her anyway. It was an additional hour's wait, but I was already there. We both agreed that I would need fewer than the generally recommended 1200 cal per day to lose, based on my record keeping, and that I probably won't be able to achieve that without some restriction. She thinks he might give me a fill before 6 weeks. I rescheduled my appointment for next Weds, which will be just over 5 weeks post op. HOPEFULLY he will fill my band and I can get this thing rolling.

Then tonight I went to my first support group meeting at the hospital. It was an interesting experience...a lot of the information I got was the same stuff we talk about online on OH.com. It was the little tidbits of info that will probably have me coming back again. The group leader, Dale, spoke a lot about "releasing the ghrelins" (hormones that stimulate hunger feelings), enough that it made me think of releasing The Hounds, which made me laugh a little. It's catchy, it sticks with you. I was struck by how much the people who have been banded for any significant length of time wanted to talk about what they knew, and how much of that differed from what the group leader said. In other words, people are doing the wrong things and spouting it to other people, and they were reluctant to listen to any suggestion that it might be better to do things a different way. Bandsters are a chatty, moderately informed group who often forget that they too are still learning--not just these Bandsters, but most I have had contact with, in my observations. One guy brought up the idea of having to "avoid certain foods forever" because they are just triggers. Dale disputed this idea, talking about what he called the "abstinance violation" phenomenon, which is just the basic idea that if you make certain foods forbidden and then you eat them, you set yourself up to give up and binge. I agree with this idea, and the thought that "dieting" is not sustainable in the long term. Rather than avoiding these "trigger" foods, we should be trying to learn how to deal with them and eat them in a moderate way, occasionally. It seems to me that many people who seek weight loss surgery resign themselves to the idea that they will just have to diet for the rest of their lives. They've given up on the idea that they can eat moderate amounts of anything, and as long as they usually choose healthy foods, can indulge in the occasional "treat" as long as it is a controlled portion and they just do it occasionally.

I was also struck by people talking about how when they had proper restriction, their cravings for certain foods--any foods, in some cases--disappeared. One woman talked about being too tight for a long time, and vomiting for months, but not saying anything because she was losing lots of weight. She ultimately had to have her band unfilled for a few months because of all the inflammation all that vomiting had caused, and she ended up regaining 35 lbs. She had also exacerbated a hernia and had to have a new band placed. She said that once she was unfilled, all those food cravings came back just like before. It is unclear whether this phenomenon is entirely psychological or if it is a hormonally mediated thing; probably a combination of both, but restricting the stomach results in restricting foods, and when you choose the right foods, those ghrelins go down and you supposedly lose those cravings. How cool is that? (As long as you aren't barfing, that is.)

One woman reported having been stuck 47 times for one fill (how is that possible?) and ending up with punctured tubing proximal to the port, which had to be replaced surgically. Again, no restriction for months while waiting for that to be diagnosed, fixed, and healed. That would suck. I'll keep that in mind when my surgeon wants to let his fellow do my fills.

So, is this dieting? It seems the answer is No. I do not plan on going back on diets, although that may change when I hit a plateau in my weight loss. The point here is to stop doing all the damage that yoyo dieting has done over the years, and start learning to eat smaller portions of a variety of foods, and maintain weight with the help of the band. So my post-support group scoop of gelato at Mio Gelato on NW 23rd? I have no guilt about that.

Monday, April 9, 2007

Real Food

Tomorrow is the start of post op week 4, and I can officially start eating Real Food. Unofficially, I have on occasion eaten very soft "Real Food" while being very careful to chew chew chew. But I've kept very close to my soft-puree foods for the last 2 weeks, like I am supposed to. My first post op appointment is on Weds with the surgeon and the nutritionist.

I am supposed to keep food records for the 3 days prior to my nutritionist appointment. Aside from Easter dinner, I've eaten pretty much the same things every day:

Breakfast:
  • Protein shake (this keeps me full for about 3 hours so I have continued to use them, although I didn't this morning)

Lunch:

  • 4oz. pureed tuna salad
  • 4oz. chopped broccoli topped with 1/2 tbsp asiago cheese

Snack:

  • 1/3 c. pureed refried beans, with 1tbsp. shredded cheese and salsa
  • or 1 c. yogurt
  • maybe 1/2 c. applesauce or pureed canned pears (in juice)

Dinner:

  • more tuna salad
  • maybe a V8
  • more broccoli
  • 1 SF pudding cup with 1 tbsp cool whip lite

I think I'm missing a few things here. It ends up being around 1200 calories, which is supposed to be the right amount for me to lose weight, but I'm just holding. I was very depressed for a few days, thinking that I was supposed to eat this much when my band is filled and I wouldn't lose any weight. But I think I actually need closer to 1000 cal to lose weight consistently. I don't normally eat a lot anyway and I gain weight with that, so I think my body is just very efficient with the calories I give it. If this is true, the band is perfect for me, because I can't eat that little without feeling like I am starving all the time.

I read in my book from the surgeon's office that they usually do a first fill at 6 weeks, which is the generally agreed-upon time to start filling. Earlier seems to interrupt the healing of the stomach and can lead to future slips. (A slip means the band slips lower onto the stomach, which is usually something that has to be surgically fixed and sometimes results in having to remove the band entirely.) So, that is only 2 weeks away! I hope it doesn't take too long to get this thing rolling. I'm ready.

Monday, April 2, 2007

Consequence Free

I guess now that I'm getting closer to going back to work (I'm back for real on Weds) I am slacking off a bit on the blogging. Or perhaps I don't have as much to say now. Not a lot happening on the weight loss front...just waiting for some restriction. I lost 13 lbs and gained back 3, and now I'm holding steady there. I am really trying to get in my water but it's very hard for some reason. It seems like every day I get to about noon...or 2...or later and realize that I haven't gotten very much water yet. The big challenge for me is the water right now.

Without restriction I feel...like before. The only way I can tell I had surgery is by my healing incisions. I DID have one experience this weekend eating breakfast where I experienced a "soft stop" signal (it might have actually been the "hard stop") and had to stop eating. Usually I get sort of semi-full, which is fine. But trying to make the full mental switch to a new way of life without any physical signals is just dieting.

I can't decide...is this dieting, or a new way of life? How do you approach eating after WLS? It seems the lap band community online is divided on this. Some people even go on diets after their band is "up and running" so to speak...on Atkins or WW or some such. WTF? Personally, I think the point is to eat like a normal healthy person, and not be on a diet. I get that it's frustrating when your weight loss slows down, and I'm sure there will be a bit of a mental challenge when I get there myself. But I guess I'm hoping that the restriction will fill in where my relatively healthy eating habits aren't able to. That, and not keeping ice cream in the house. :)