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Sunday, January 10, 2010

Food Addiction

How timely that as I've been thinking more and more about food addiction and its role in my life, I came across this great post by Sparkly Jules. She has a great way of getting across the pervasiveness of food addiction in one's thoughts...check it out.

I went for a run today, and again was shocked that my running felt so sluggish and slow. When I went to enter my 2.8 miles into my running log, I looked back on all the runs I have recorded. I always record my weight as well. It appears that I am the heaviest I have been since I started running almost 2 years ago. So, the sluggishness isn't all in my head.

Everything is just so. much. right now. I'm studying for boards, going to 12 step meetings, trying to figure out my marriage and maybe even improve it, going to therapy, finishing my thesis, and working full time. (Giving free anesthesia...not free for the patients, but I don't get paid.) I'm looking for a job now, one that WILL pay me, when I am done with this and have some credentials. It's been a long 2 years. I understand in my head that everything I have been attempting to do since I have been in school is a lot, and a weight gain is not a surprising affect of trying to do too much and living in too much stress. But knowing this in my head doesn't make the reality easier. I still feel tremendous pressure to lose the weight, and still do all the other things I have been doing all along.

And yet, before I can even become conscious of a surge in stress or unpleasant emotions, before I even notice the emotions, I am eating something that will give my brain a boost of endorphins and glucose, something carb-y, sugar-y, whatever. I've already eaten it before I notice what happened. This is an example of neuroplasticity; a response becomes automated in the brain, and the neural pathways that produce this response become larger and more reinforced. It is exactly what happens to addicts, when they find themselves drinking or using again despite their desire not to, and find themselves doing it before they are conscious of having done it.

The idea that we can overcome these kinds of impulses through sheer willpower seems laughable at times, and indeed research has shown that this is a large part of why diets don't work. Our brain chemistry is smarter than we are. Yet, in learning about addiction I also learn that while we are powerless over addiction (our own or another person's), we are not powerless over our behavior in response to that addiction.

So, I'm working it. I'd like to get my butt into some individual therapy to try to get a handle on the food issues. That's about 3 years too late, but it's not like I can't start now. But then again it feels like yet another thing to add to my already overflowing plate. It's a good idea, if I can make it happen.

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ETA: Here is the text of Jules' post, because sometimes it's just too much to click another link. I really love this post. Be sure to read more of Sparkly Jules' blog if you have time. It's varied and experiential, and well-written, and alternately funny and hopeful and poignant.

What is Food Addiction Like?

I will attempt (donuts) to try and explain what it feels like (waffles) to be a food addict (pancakes). I had a therapist once (danish) who said he'd had it explained to him by previous (cookie) patients that it was (donuts) in some ways sexual in nature. That first bite of (donuts) of food, whatever it might be, was very orgasmic. I told him (waffles) that I agreed; it was, in many ways, a very (pie) sexual experience, one that I felt throughout my (cake) body.

I am as addicted to food (donuts) in the same way that an alcoholic (banana bread) is addicted to alcohol, and a drug addict (ice cream) is addicted to a drug. I have a paternal aunt (pudding) who has been to drug rehab five times over the last (muffins) fifteen years, and she's still not (sourdough bread) sober. Her addiction has a much more unfortunate outcome--she is unable to maintain jobs, (pizelle), relationships, and any sort of stability (cheese won tons) in her life while she is using or drinking. In fact, I've cut off all contact with her until she quits.

As a food addict, the side effects are two-fold: 1. obvious obesity 2. (donuts) poor health, although obesity does not always equal poor health, over time, it will, in one way (chocolate) or the other.

As for exercise, I would love to exercise. I always (cookies) feel better after I do it (toast with jam). In 1979 I broke a vertebrate (pizza) in my back and it has never been the same. I was sixteen. It hurts in varying degrees (cheese) nearly every day. Since I have had the Swine Flu (ham), it's been even worse. I'm not sure what the correlation is there, but that's when the (pie) pain got worse.

I took myself over to the local indoor mall New Year's Eve. I needed some (cinnamon rolls) pantyhose, and there is a Lane Giant there (waffles). Guess what? They no longer carry pantyhose. Although I''m (croissants) glad to hear that because I've always hated pantyhose, I did want a pair for NYE (baguette). So I walked that mall, and my back hurt so badly, that about every 10 minutes I had to sit down to take the pressure off of it so I could keep going (caramel corn).

Add into the (tortillas) mix my bad left knee, which I fell on 12/30/04 and never really had it seriously looked at aside from an (Trader Joe's Gorgonzola Crackers) x-ray. It ain't right, tho, I kin tell ya that. Of course, I could never convince any of my (pie) doctors that it was an injury and not weight related. (Brie.)

I also have diabetic neuropathy in my feet. It was so bad in the fall of 2005, my first semester back in college, that by the time I had (cannoli) walked across campus and then several blocks to the car, I was crying, no, sobbing. Burning, stabbing, shooting pains. I take medication for it that keeps it to a dull (tiramisu) roar, now. That and keeping my BG level. (ha ha ha!)

So, just for a moment, (strawberry shortcake) imagine that you are me. You're carrying 150 extra pounds (a whole person!), you have a bad back that has been exacerbated in some way (donuts) recently, a bad knee and bad (donuts) feet. How motivated are you, really, to get up
off of your duff?

Remember the Schick Center for weight loss and alcoholism (cream puffs)? They used aversion therapy. My GF attended for weight loss. Every time you take a bite of (cupcake) something, they shock you. With booze, they made you drink and drink and drink until you vomited your brains out (donuts).

So when I think about exercising, I think about pain, because I know I'll have it and that's just getting out of (Danish) the chair. So I am averse to exercise due to the constant pain. And yes, it is a vicious (waffles) cycle. Many people who have WLS (weight loss surgery) do not start exercising (donuts) until they have lost a significant amount of (pie) simply due to pain.
I say this not as an excuse, but as an explanation. If I decide to exercise, I have to force myself to do it, even while doing it. I have to stop and (Linzer torte) rest a lot due to back or knee pain. Oh, and then there's the asthma. I need to be careful not to set that off, too.

So you see (pancakes), it just sucks to be me.

Seriously. I'm a food addict. The only person who gets hurt is me. That does not make it any easier, nor does acknowledging that I am a food (pie) addict. (Cinnabon) it's like trying to wean yourself off of crack or meth: it's nearly impossible. And then your body (Danish) works against you by changing up your metabolism (cookies) when you do "diet": 97% of all diets fail with dieters gaining back more weight than they lost. That is a scientific fact.
It's a terrible, horrible, sad place to be. I wouldn't choose this for anyone.
(Donuts).

Addictive personalities also don't change once they discard a harmful (pie) addictive behavior. I've known many recovering alcoholics or drug addicts who replace their substance of choice with coffee, cigarettes, candy or food, or all of the above (donuts). The addictive behavior just moves to a new place. I've seen post-WLS people suddenly become alcoholics, or compulsive shoppers or sex-addicts. It's a b*tch and a half, and I wouldn't wish it on anyone (donuts).
So I hope I've made myself clear (as Jell-O) with the insertions of food items, noticeably carbs. That's what my day is like. Food is constantly (peanut butter cookies) popping into my brain. A visual or auditory trigger can produce thoughts of food as can certain situations, and emotional (donuts) reactions, such as extreme stress or sadness (cake). It's like this for me, every d*mn day (chips).


I'm doing the best that I can here (bearclaw) with what I've got. I'm only human (napoleon).
And I have an ultra-sound scheduled for next Monday to see if there's an alien or something growing in my right side (potato salad).

Thanks for letting me share.

;-D

Wednesday, December 30, 2009

It's Mental

This morning, I am:
  • knitting a blanket
  • sitting at my (old) new kitchen table
  • looking out at 1.5 inches of snowfall (the perfect amount)
  • drinking coffee
  • listening to an old This American Life podcast
This is what vacation looks like for me. It's not bad. It's a bit lonely--I don't see many people during my vacation, but I don't try very hard either. But it's restful, and I am doing some things that I won't be able to do much of for the next 6 months, once studying for boards begins in earnest. I've done a bit of reading, but not as much as I wanted--I ordered about 5 books in anticipation of all this vacation time, but didn't read very much of it.

The kitchen table I finally got yesterday off Craigslist. We have a breakfast nook in our new house, with windows on two sides and a built-in china cupboard. It's right in the entrance from our back door, which is our usual entrance to the house, so I wanted a table big enough to spread my anesthesia books out on to study, but not so big that it would block this entrance. My hubby was really against putting a table in this space, but I really wanted it. I just did. I wanted to be able to sit here with coffee and my books, I wanted to be able to make breakfast and not eat it in the dining room, I wanted to be able to sit and chat with hubby when he was cooking. So I finally found a table that met my requirements. It's not the greatest table but it's not the worst, the price was right and so was the size. And we're both happy with it. I'm really enjoying being able to sit in this spot with some natural light, drink my coffee and have my quiet morning.

We didn't have a white Christmas, which we usually seem to in this part of the state, but we got a little snow last night. Not enough to create any real problems, just enough to look nice. We are supposed to get more this week, but I don't think we are expecting huge amounts. I'm preferring this milder winter to the past two years of major dumpage. For the record, I really don't care for snow. I grew up in an area that rarely got snow, and when it did it was never more than 1". I don't like cold weather or snow. But now I live in Spokane, so snow it is. I'm dealing with it.

I've lost 3 pounds, yippee. Mainly I have been running every other day (even though I usually feel like I am dragging an ox behind me when I do), and not snacking. I am back to "only eat when you are hungry" aka the 3-year-old diet. I realized that I had gotten to the point that I was used to feeling full all the time. My restriction is fine, but I've always been able to eat even after I feel full (with no PB or barfing) and I'm sure this is stretching my stomach. I'm trying to reverse this trend now and actually use my band the way it's supposed to be used. The thing is, I've gained a net of about 5 pounds this year: I started the year at 177, lost to 165 (mainly through stress), then slowly gained to 183. That doesn't seem like too much in the grand scheme of things. But if things continue this way, I will regain back up to my previous weight--it will take time, probably years, but it will happen if I don't do something about my intake. The point of the band is to stop hunger so you can eat less, but I'm not hungry ever, and I'm still eating. That is madness.

So, I had cottage cheese for breakfast, and coffee. I'm not going to be draconian about this. I'm just planning to use the band. Eat a small meal when I am hungry, stop when I am full. Try to get my target amount of protein each day. If I'm not hungry but still feel like eating, I either chew gum or drink water. Pretty simple. Add in exercise, and hopefully get results. If I do this and feel like I'm getting hungry too soon, first I'll evaluate my meals to see if they are suitable to keep me satisfied, then if that doesn't work, go in for a fill.

This is all mental work. The band is a simple device, and it does one simple thing: it makes you feel satisfied after a small amount of food, and keeps you feeling that way for 3-4 hours. It doesn't have any effect on emotional triggers for eating, the desire to have one of those cookies sitting right in front of me, the choice of meal I make when eating out, how well I can resist my hubby offering me food when he is eating and I'm not hungry, my ability to get myself outside to run, or how I see myself in the mirror. All of those other things still matter, and they still have to be addressed. The longer this journey lasts, the harder this gets.

So, nearly 3 years out, there is less and less to write about this "journey." It's not as interesting as losing weight every week as in the first 18 months (your mileage may vary). But this is where that annoying phrase about WLS being only "a tool" comes into play. There are a lot of ways to fail at this, and just assuming that the band will do all the work seems to be the biggest factor in most of them.

Saturday, December 12, 2009

Baby, It's Cold Outside

I'm a rather solitary person by nature. I think it was why I was able to work night shift for 7 years. When I was single, it was easy to stay on my night schedule and do the solitary activities I love, like sewing, beadwork, reading, etc. When I met my husband I was still working nights and I worked them for 2 more years before making the switch back to days. It's much harder working nights when you live with a dayshift person.

All of this is to say that it is in my nature to spend time alone, although I love having a partner now and spending time together. When I get the opportunity to spend time alone, however, it is nice. As happens to most people who get married, that precious alone time becomes less and less frequent.

My husband's brother is in Portland this weekend from New York. I would have liked to see him, but I didn't have it in me to make the 700-plus mile round trip this weekend. It's been a long exhausting year, and so we aren't even planning to travel for Christmas this year, which is rare. I really needed a weekend to do nothing--no school or studying, no traveling long distances. So hubby is in Portland visiting his dear brother, and I am sure they are having a great time together. I would like to be there, but as it happens I have some alone time this weekend instead. It's been a very long time since I have had that.

I've done a lot today already: went to the sale at Joann's Fabric to get a new pair of sewing shears, got things to make a holiday wreath, and then made it and hung it, and now I've just gotten back from a run. This evening I plan on sewing and organizing the basement, and then maybe watching a movie and knitting. I'm not doing one bit of studying!

The running is going slow--I wasn't able to get out there during the week for various reasons. I'm still averaging less than 5 miles a week so far. But running in the cold is better than I anticipated, since I hate being cold. I found today that although my lungs want me to stop, I keep running longer because my legs start to get cold when I walk. Bonus!

I saw something really cool when I ran around the little park by our house. It has a pond, and people were ice skating there. I've never lived somewhere that you could actually ice skate on a pond! It looked like the cover of a Currier & Ives catalog. (Remember those?) Most of the people were preparing for an ice hockey game, but a few people were out there figure skating. It's not a very big pond, but the weather is perfect for it: it's been very cold, single digits at night with highs in the 20s during the day, and so it's been too cold to snow, and there isn't much on the ice to sweep away first. I'm not a cold-weather gal, but I loved seeing people out there skating on a pond. It made it feel very small-town, which happens a lot in Spokane actually.

I hope everyone's Christmas preparations are coming along well. Ours are pretty much done. Normally we go to my brother's house for the holidays, but his wife just gave birth to my first niece this week. As much as I would love to see them, and meet little Kiera, they are very busy with the new baby, and we are too tired to try braving the snowy mountain pass this year. So we are having some friends over for dinner and games and movies on Christmas evening. I'm really looking forward to it. We'll go see my family after the holidays when the mountain driving is a little less stressful.

Monday, December 7, 2009

Return to Form

I took a running break. I intended it to be just a few weeks but it ended up being about 6 weeks. I needed the break mentally more than anything else. Like anything else, if you run for a couple years (21 months) without a significant break, you'll get bored and lazy. At least, I will.

The break did me some good, although I have gained about 5 pounds more. In that interim, we have moved, and had a lot of other stress as well. Thanksgiving came and went. Last week I knew it was time to get out there again: actually, I was so stressed out I didn't feel I had much choice but to go move my legs and exhaust my lungs and think about anything but my life for a while. Today's run was better than last week, and I almost didn't notice that it was 15 degrees outside. The sun was shining and it was lovely. My legs want to do a lot more than my lungs are capable of right now, but hopefully we'll be back in sync soon.

Since we've "fallen back" to standard time since then, it gets dark by 4:30 now, so I decided to invest in a good headlight, as one less reason not to run in the winter. Our neighborhood doesn't have many streetlights, and it's an old neighborhood with sidewalks interrupted by old tree roots. It's treacherous without light. The headlight was a resounding success on my first night-time run--I was amazed at how much I was able to see with just a $25 headlamp.

Now I have some serious weight loss to concern myself with--in late January I was at my lowest weight of 165, and today am back to 181, after staying right around 175 for most of this year. This is significantly higher than I want to be, but despite the holidays being upon us, I think I can tackle this at least somewhat. I'm hoping we don't get tons of snow this year, so I can either run outside or get to the gym without too much trouble.

It was good to take a break, but I'm glad to be back. Weight loss will be a bonus--I need the stress relief and the endorphins. And I intend to take Bloomsday again next spring! It's the weekend before I graduate, but hopefully I won't have so much on my plate that I can't do it.

Thursday, November 19, 2009

A Deep Breath

Sorry for the long time without posting...we are coming up for air now. It's been a crazy week.

We moved last weekend. After 2 weeks of packing, the move was pulled off in one long day with two hired movers. I had a little last-minute mild freak-out because we didn't get moved before the first snow, but the snow we got (the day before the move) was minimal and we didn't get the frozen slick roads on moving day that I feared.

Moving day was more stressful and longer than anticipated, but we got it all done in one day. Yes, some things were broken by one of the movers (an inexperienced, strong guy without much sense of where things he holds extend into space). But it went fairly well, all things considered. It surprised me how much stuff we had managed to pack into our little apartment; easily enough to fill this 1800 square foot house we have moved into.

But! We love the house, so so much. We are renting, because we aren't in a position to buy and because I don't know if we will be able to stay in Spokane when I graduate in less than 6 months. If I get a job here, we'll extend our lease, and we may even have the opportunity to buy this house down the road.

We moved on Saturday, and on Sunday my hubby cleaned the old apartment while I unpacked at the house. He enjoys cleaning and I enjoy packing and unpacking, so it was a pretty good trade-off. The apartment looked GREAT when he was done with it. We should get our deposit back (we might have some knocked off because that mover crashed into a corner and knocked off a big chunk of plaster with a box, but we told the landlords and they may not charge us). I do like the organizing part of moving, but there is definitely a reason that we had not planned on moving again until after I finished school. It's so hard to do homework and study when most of my home is still in boxes. My mind has a hard time focusing when I feel like so much is in disarray.

The other big excitement is that my hubby started a new job on Monday. Yes, we moved AND he started a new job all within 3 days. He's been looking for work for several months now, so this is pretty exciting. Unemployment is hard, especially with both of us unemployed. But I think the time was important for rest and recovery, so while I think he wishes he had found a job a long time ago, I am proud of all the hard work he has done in the interim. It's been stressful, but overall it's been a good thing.

I have no idea how my weight is doing; my scale is still in a box. I usually weigh myself every morning so it's weird to go several days without doing so. There's been no exercise either, since every spare moment has been spent either packing or unpacking. I hope to get back into a healthier routine once we are more settled.

I must say, it is so wonderful to be in our own place and out of our apartment building. The tension with the sociopathic neighbor was so thick, it made being there miserable. He enjoyed doing things like parking just so I couldn't get into my parking space, or playing loud music at 7:30am, stuff like that. I'm way too old to be dealing with crap like that anymore. We spent many months trying to diplomatically handle the situation, first ourselves (mainly hubby) and then through the landlord. Finally, when it was time to resign the lease, and the landlords were starting to look at the option of evicting the neighbor (they preferred to keep us over him), we realized that would be a very long process, and it was the perfect time for us to just get out, before it started to snow so much that no one could move for a few months. So that's what we did. It was a disappointing end to a good relationship with a great landlord, but definitely the right thing for us to do.

So, my mind is full of things related to nesting and unpacking, but I'm pleased to say we are here and we are happy. Happy Thanksgiving to everyone!

Wednesday, November 4, 2009

Good luck moving up, cause I'm moving out...

It's been busy around here. My hubby and I live in an apartment that is the main floor of an old house. We've been having trouble with neighbors. Specifically, our upstairs neighbors have been acting unneighborly. We've been working with them and with our landlord for a few months now, but finally it became apparant that nothing was going to change. I can't study in our home because of the noise, and I am uncomfortable around the hostility and passive-aggressive behavior.

We were about to resign our lease (we've been here 2 years) when we realized that, hey, we can move.

I didn't want to move before I finished school, but suddenly it seemed the best solution. Our landlord toyed with the idea of evicting the upstairs neighbors so that we would stay, but eviction takes time. They wouldn't move voluntarily. And the winter is fast approaching; in about a month, it will probably be unsafe (or actually impossible) to move due to snow. We want to live somewhere where we don't share walls with neighbors anymore (maybe it's more me than hubby). So we decided to move into a house.

The decision came quickly, and the move as well: we are moving in about 12 days. It's not easy to get ready to move while in the thick of the semester, working and going to school. But it's the right thing to do. So it's been very busy here. But, the house we are moving to is just a few blocks away, and it's beautiful. Really, a steal for the amount of rent they are charging us. I can't wait to be out of here and into our new home. We have had great landlords here, and we're sad to be suddenly leaving, but it just doesn't make sense to deal with an untenable situation if we don't have to.

Between moving, working, wrapping up my research project, and studying, I haven't been running in a couple of weeks. And this week I've lost 2 pounds. Go figure. I'm thinking of going for a run today, but we'll see. I'm not stressing about it right now, which is nice, for once.

Thursday, October 22, 2009

Guest Blogger: Hubby

It was an unusually humid evening at Isla Mujeres, Mexico. Isla is a bean-shaped island just off the coast of the Yucatán peninsula, home of Cancun at its most north-eastern tip. My new bride and I were taking a walk, and she casually mentioned to me that she was seriously considering weight-loss surgery of one type or another. She was upset that she was obese, and felt that a surgical procedure could aid her toward the weight and health that she sought fit. I was taken aback.

My initial reaction was a form of confusion. Here was my new bride, my wife, a trained and intellectually-keen medical professional, who was going to “cop out” of hard work including exercise and a calorically-restricted menu? I married my wife knowing that she in fact was indeed overweight, and I never lost the sight of the fact that her weight was more of an issue for her than it was for me. I loved her more than anyone I had ever known, and it seemed odd to me that she was feeling as if I would not accept her given her weight.

That was my own issue, in fact. My wife had never gained a substantial amount of weight in our nascent relationship of a couple of years, and I knew that I was no muscular BMI-perfect “hottie” either. I honestly felt that through a joint regimen of active exercise and healthy diet, that we would both be able to achieve our individual weight loss goals. From my perspective, I knew that I would be able to gain or lose at least twenty pounds or more over a given calendar month, and so I assumed that Gwen would be able to do so also.

My wife later confided in me that in fact she had always battled weight gain in her lifetime, and in fact had even battled bulimia and forms of anorexia. Her mom had provided her morbid templates of unhealthy eating and living, and basically forced her to condition herself to purge her extra calories. Gwen had never been able to sustain a “reasonable” weight level, and her weight had fluctuated considerably since her junior high school days. A decade prior to our marriage, she had a substantial breast reduction, going from an obscene cup size down to a DD or D cup, reflecting about a 2/3 breast weight reduction. Weight and self-image had always been the bane of her existence, and even though she had found someone like myself who honestly loved her despite her obesity, it was still a salient and often daily concern of hers.

I honestly did not know what to think after our vacation. I only wanted the very best for my new wife, but I never really considered surgery for her as an option. Nevertheless, she looked into the surgical options, and came to a determination that a lap-band surgery would be her best choice. She discussed it with me, informing me of the pros and cons of the decision. To me it made sense, knowing that it was a fairly non-invasive approach, and the fact that it was reversible made me feel better. In the Spring of 2007, she underwent WLS surgery to have a lap-band in place. Over the next year, her weight loss was fairly dramatic, as is often the case with those who underwent said surgery. As of today, in late 2009, she has lost all of the predicted pounds she was supposed to have, which amounts to over sixty pounds. She is able to run several miles, and is in the best shape, weight, and health of her life. She is also still a knockout by any measure.

One of the considerations that I have dealt with in this journey is that I wanted to be sure that I did not look at her weight loss results as culminating in a “hot wife” or “thinner, sexier, mate”. However, I would be lying if I were. I was anxious to see what the net effect of the weight loss and healthier regimen would have on her overall physical appearance as well as inner demeanor. When I say “inner demeanor”, I meant her internal “thermostat” as to how she honestly perceives her weight, health, and overall appearance. To date, I know for a fact that she feels better about who she is and how she appears. I also know that my wife feels better about herself in general. A large part of this has to do with the fact that her WLS surgery is only the beginning. She needs to still take care of herself and monitor her nutrition and maintain her weight via exercise and proper association of folks that are similarly congruent in her path of wellness. At this juncture, it can honestly be said that my wife’s lap band is more of a secondary preventative measure, and her attitude toward proper nutrition and exercise, not to mention healthy habits in general, is her first level of defense against obesity and an overall unhealthful lifestyle.

Vanity is always a part of weight loss, whether we consciously acknowledge it or not. In my case, I honestly just wanted my wife to be able to attain a healthy weight and thus a healthy self-image concerning her body and appearance. However, I still have to smile when I think about how Gwen has transformed into a not just an even more gorgeous woman, but one that is dedicated toward a healthier lifestyle in general, regardless of her weight or appearance. This has rubbed off on me as well.

Approximately three months after the lap band surgery, we came across some of our wedding photos that we had hanging in our home on the wall. She remarked how “fat” she looked, with her flabby arms and chubby face. Looking at her at that moment when she said that, I suddenly realized that I could no longer reconcile who I saw when looking at my wife, and who I saw in the pictures of the bride during our wedding day. To be perfectly honest, I never really ever viewed her, in the wedding pictures especially, as “fat” or “obese”. But now, given my wife in front of me, they honestly looked like two very different persons. And yet, I knew that I absolutely loved my wife with all of my heart and intention before and after I married her, regardless of her appearance. The fact that she took her health and appearance so seriously after our marriage only extended the depths of my appreciation and love for her.

In short, weight loss surgery is not just a physical transformation, it is also a personal and inter-relationship transformation. Our western society tells us that we should look and act in a certain way, and when we don’t, an enormous amount of inadequacy and shortcomings tend to plague our personal judgment and self-perception. Many spouses of those who undergo WLS surgery of one type or another are usually eager to see the end result of the effort, which basically amounts to a physical change and appreciation thereof. In my experience, weight loss surgery is only the first step toward a true life transformation, and only seeing the physical results of this effort is seriously short-changing what the reality is. The reality is that it is a life transformation that has much to do with the inner person and their own impression of who they really are, and subsequently a physical transformation that becomes congruent with their inner self-image. I am often reminded of those who undergo sex-change (transgender) operations, and the fact that they must complete and pass a psychological process and examination prior to their physical surgery. In the realm of weight loss surgery, the emotional and psychological change prior and during and especially after the actual surgical procedure is every bit as important as the physical change.


My wife and I often look back at our wedding pictures, and it serves as an important benchmark as to how far she has come regarding her appearance. What is not so evident upon visual observation is how that woman in the wedding dress is in fact not just a thinner, slimmer, sexier, healthier woman…she is also a more integrated and balanced woman. Appearance is over-valued in our culture, but nonetheless it still stands a yardstick as far as how we subjectively determine who is “fat” and who is “not fat”. The fat bias is strong and prevalent, and much of it is unfortunately due to two factors: 1.) the general public’s ignorance as far as body types and healthy physiognomy, and 2.) the inability to perceive ethnic and genetic normalizations and tendencies toward one’s overall appearance and weight. My wife, Gwen, has always felt that she was a much thinner person trapped inside an obese body, and she has since rectified that. Fortunately, she has also come to terms with her overall baseline of health, weight, and appearance and thus can be properly attenuated toward such an ideal. Ironically, as her husband, I have much more work to fulfill toward both of those outcomes, and am thankful that my wife, heavy or not, obese or not, fat or not, chubby or not, has set a wonderfully balanced example for me.

I am so very proud of my wife, in her journey toward a healthier self-realization. It was not just a matter of WLS surgery, but also of hard work, character adjustment, and a fundamental appreciation for who she is as a human being apart from her weight or appearance. I love my wife, and even more so because of not just the work she was willing to do, but her pragmatic understanding that those who are in her life and perceive her as someone important in their lives must look past her physical presence and perceive her far more holistically. WLS surgery did not give her sudden physical acceptance. Her attitude adjustment and constant work in all aspects of her existence is what provides her that, and in turn helps her to know that her physicality and appearance is only a small subset of who she truly is.






(Gwen adds: This photo was taken when we returned from our honeymoon, at a friend's wedding. It was these photos, plus our wedding photos, that convinced me to proceed with WLS. I was appalled at how overweight I had become.)












This photo was taken April 2009 on Capitol Hill in Washington, D.C. Total weight loss 69 pounds.

Back again

It has been some time since I was last able to blog. School is back in full swing, and the stress is somewhat different at this stage of the process, but very palpable. I hit a wall of sorts about 2 weeks ago, when I felt I just couldn't do this for one more moment. Of course, I have to...there are 6 months left before graduation. So, like high school seniors around March, we continue to go through the motions and do what we have to do.

Our days are now mostly clinicals, which I mostly enjoy. 4 days a week we are in the operating room for 8 to 10 hours. In our training, we also happen to generate a lot of billing for the anesthesiologists, but we are not paid because it is part of our training. (This could be an entire blog post itself, but this blog isn't about anesthesia politics, so I'll spare you all.) On Thursdays, we have classes and no clinicals. In our off hours, we study for our classes, start studying for boards next spring, prepare for the next day's cases, and work on our research projects, most of which are wrapping up this semester. Then we have our real lives on top of that. Most of my classmates are parents, all but one are married, and we have the same complicating factors in our lives as everyone else does. It will be nice when we are graduated, have taken boards, and can start earning money for our work again. Mostly due to my school loans, we will be around $100K in debt by the time I graduate.

On the weight front, I haven't made my follow up appointment with Dr P yet, partly because I haven't remembered to do it when they are open, partly because I don't have my November schedule yet, and partly because I want to have more success to show before that happens. It's been a good fill most days. Some days, I'm still super hungry. Other days, I'm not hungry at all. I have had two days of mild heartburn in the past 3 weeks, which is something I am monitoring. If it becomes any more of a problem, I'll have to see the doc about it. Right now I'm about 4 pounds down since my fill. Meh.

I'll be posting a guest blogger post from my husband in just a little bit. He generously offered to write a guest post on WLS from the spouse's perspective. I think when I was spending time on the lap band boards, I heard a bit about marriages ending in divorce after WLS, but not much on the experience of spouses. I hope you enjoy his post.

Friday, October 9, 2009

The Lessons of the Band: 3 1/2 years later

The Click samples have gone out, and hopefully all the winners have received them by now. I was surprised by how hard it was to mail them. We used to have a post office outlet about 3 blocks from our house, but it has closed. We had to pick up a package at the postal hub last weekend, so we thought I could mail the packages from there...but no, the postal hub doesn't accept outgoing packages! WTH?? I finally found a post office that was open at reasonable hours, but it was surprisingly difficult in the age of Google. Anyway, I am glad that they have gone out, and hopefully others like the stuff as much as I do.

I am happy to report that my latest fill seems to be a good one, and seems to be staying put. If I follow my own rules and don't eat unless I am actually physically hungry, I can eat very reasonable portions (small end of normal) and stay satisfied for a long time. And I've lost about 4 pounds. But it still definitely requires me to be mindful of what and when I eat. I have impulses to eat for reasons other than hunger several times a day, and I have to consciously stop and determine if I am physically hungry and if there is something else that would satisfy me more, like doing something fun, talking to someone, or just getting out of the house. In other words, the band still isn't magic, even though I am at probably the best level of "restriction" I've had in 2 years.

I haven't had anything get stuck, or had any reflux, vomiting, or sliming. In other words, still none of the most common problems that people with the band complain of. I still haven't found a food that I physically can't eat because of the band. Some people like to use those things to help with their behavior modification. I can't really speak to that, because I've never experienced it. What I can speak to is my own experience, and that is that at the end of the day, most of this is the same mental work and energy that I experienced when trying to lose weight without the band. Only now I'm not physically hungry, which is exactly what the band is supposed to accomplish.

I knew in my brain that like a lot of other people, I ate for reasons other than hunger. But until my surgery, I didn't really get how significant that was, and you know what? I don't know that I ever would have, without surgery. I used to have a terrible hunger, and I was scared of feeling it. I was terrified that I would be suddenly hungry in a place where I couldn't eat, so I would eat "pre-emptively." Hunger truly was a significant factor in my difficulty losing weight and maintaining weight loss.

But it definitely wasn't all of the battle, or even close. I can see that now, as every evening I come home from a stressful day in the OR and start scavanging for something to eat. If I can get myself to stop and evaluate, usually I find that I'm not hungry, just looking for stress relief or comfort. Sometimes I am actually hungry, and in that case, I go ahead and eat something, but try to make it some sort of protein. If I don't stop and do a self-check first, I can often find myself in the midst of eating quite a bit of food (for a bandster) before I realize what I'm doing. And sometimes, not infrequently, I am conscious of the fact that I crave something specific--usually sweet--without being the least bit hungry. Sometimes I can talk myself out of it or distract myself. Other times, if I've tried for a long time but am still obsessed with it, I will just have it--a small portion--and be done with it. At least then it is a conscious decision, not soothing an impulse.

I hope to get to goal, but even if I get back to where I was at the beginning of the year (11 more pounds) and without the incredible stress that brought me to that point, I will be happy. It is certainly a lot easier to keep my eye on my goal when my hunger is tamped down with a good fill. And it's good to know that even after being "off the wagon" for several months, I can get back to a good fill level and lose again.

Inspiration: Featured Blogger

About 7 years ago (really?!?! it doesn't seem so long ago...) I was living in southern New Mexico as a travelling RN, on a contract. I'd had an interest in beads and beadwork for many, many years, and had always wanted to learn how to make beads. I was doing new things (I had just moved from my home of over a decade, Seattle, to start travelling) and decided to look up a bead artist I had become interested in when I lived in Seattle, Kim Miles. She had moved from Seattle to Taos, New Mexico some years before, and according to her website, she taught beadmaking out of her home studio on a 1-on-1 basis. I emailed her, and before I knew it, I was at her home studio, learning the basic craft of beadmaking from one of the best. And I was lucky, too: not too long after that, she decided to devote herself entirely to her art, and stopped teaching, so I think I was probably one of her last students. Making beads was an art I loved developing (until I started anesthesia school and no longer had time, unfortunately), and it was made possible because of the skills, and more importantly the passion and art, instilled and inspired by Kim.

I've followed her from afar since then, and bought some of her amazing beads (through her online store). She had a blog about her life in Taos, which if you haven't ever been there, is one of the most beautiful places I've ever been to in America. Then, gradually, she and her lovely husband Rick decided that they didn't so much want to be tied to their house in Taos anymore. They started to get wanderlust, the kids were grown and out of the house, and the open road called to them. So this year, Kim and Rick bought a trailer, fixed it up into a little home-away-from-home, rented out their Taos home, and hit the road. She's even got a mini bead studio in the trailer, so she can work whenever or wherever inspiration hits. Their plan: to visit any place their heart drew them to, and find a spot to lay some roots down. Isn't that fabulous?

In a way I have done this, when I started travelling in 2002. But I was single, no kids, and it wasn't too hard to sell my condo, pack the cats into my Jetta, and follow the jobs. Travelling that way is certainly a life-changing experience. But I love the idea of doing it with your mate, after raising kids, having a few businesses, and doing a lot of the other stuff you had wanted to do with your life. Their pictures mostly show them having a grand old time with each other or with friends and family they visit along the way, but I'm sure there's a lot of hard work too, in negotiating how to travel for so long in such close quarters with your spouse. Most marriages might not be able to tolerate it. But then again, maybe more could than we think, if they learn to take themselves less seriously and have fun with it, like Kim and Rick seem to.

Their adventures are an inspiration to me, that you really can find a way to follow your dream, no matter how unconventional others may find it. They look like they are having the time of their lives. Check out Kim's blog if you are interested in their adventures: Taking The Long Way Home.