One Month

This post is partly in response to concern from family and friends about how much / or what I am eating during this weight loss journey.  Also, general questions about my surgery and how it is working.  My blog is also going to be a journal of sorts of the transformation, the awakenings – the things that have happened and are continuing to happen on this journey to a healthier life.  And writing is a great way to respond to emotional eating triggers!

That and making little pieces of art:

A tag —

And a thank you card for my surgeon —

To be honest, sometimes the questions about what I am eating make me feel like saying, "mind your own business" – only because it is said NOT being said to me, but to a friend or family member — which just gets them upset.  But the other side of the coin would be when those same friends / family reach out and are genuinely interested in making a change like this for themselves.  A phone call from a friend yesterday was the highlight of my day!  That is why I decided to share my journey in the first place! 

So, I realize that I've put this 'out there' and I need to be a responsible citizen and follow through.

It's been a month since my VSG (vertical sleeve gastrectomy).  At this point I am able to eat 'regular food'.  More on that later.  For more on the surgical weight-loss procedure I chose, read this post.  Later in this post I'll also discuss the different procedures that I did NOT choose, and why.

Where's the Beef?

If my nutrionist and surgeon's office have drilled one thing into my head it is that protein is essential.  You NEED it.  Not having enough will have you losing muscle and potentially having some hair loss around month 4 from what I've read.  It's the ONE thing you need to concentrate on and everything else will pretty much fall into place.  For getting in my protein, I've followed this basic mealplan (protein ONLY being shown below):

• Atkins Dark Royale Chcolate Shake – 15G for breakfast
• 6 slices Oscar Meyer Oven Roasted Turkey – 8G for snack
• Naked Protein Zone Smoothie (found in the produce dept. at grocery stores) 1/2 bottle – 16G for snack (this is my go-to sip sip sip throughout the day and as a meal replacement for LUNCH.
• 3 oz. Salmon, marinated/served with teriyaki sauce – 23G for Dinner.
• 1/2 tbsp. of smooth peanut butter – 2G for Snack

That totals 64G of protein.  Between 65 – 80 is where I need to be from here on out.  That number has been increased every week since my surgery.  So I've been working up to this stage.  I'll discuss the different stages later.

Once I feel more comfortable with other cuts of meat, I'm sure this number will be going up.  After trying out a hamburger at the Boy Scouts event last night – I can tell you that I understand why it has to be 90% cuts or above.  I couldn't even swallow that bite.  I knew my tummy would hate it!  This week I'll be adding egg beaters with reduced fat cheese and greek yogurt to get my number up.

What am I living on?  What my doctor and nutritionist tell me to eat.

I think we've covered the important food aspect.  On to more nutrition!

Read the Label

Throughout this journey, from when I was on the pre-op two week diet to now, I've been using a wonderful nutrition tracker (it's free!) at www.sparkpeople.com.  It takes the guesswork out of what is in your food and you can input your own information on the nutrition labels from your groceries.  There are suggestions, which are helpful for anyone looking to have a more healthly lifestyle.  And once again, FREE!

I'm also very thankful for eating establishments, like Panera, who actually post their nutrition information on their website.  Because I will still go out with my family, and it really helps to scope out a menu before I get to the restaurant – especially at a 'carbolicious' establishment like this one!

I will tell you what I am NOT eating – and that is anything that screams, "I am a CARB".  That is pasta, bread, cereal, chips.  The obvious bad boys of carb land.  I bought a box of Special K Protein – but haven't touched it yet…

My basic nutrition counts on average over the last few weeks have been:

Calories:  698
Fat: 23 grams
Carbs: 73 grams
Protein: 54 grams

Pictures, Please?

I'm not going to take full-body profile shots at this point. Basically dieting never goes from the bottom up, right?  The caboose is always last.  My hands, my ankles and my face are showing it remarkably!  My waist, hips, thighs and arms are shedding inches – but it is a slower transformation.  So it's all about the head shot — but it does tell the story!  You can flip through the thumbnail gallery.  These pictures have not been edited in any way.

 

 

Sharing the Decision

The decision to lose weight is so personal.  You have to make it for yourself.  My decision to go through with this hinged on three things:

• The death of my sister
• The funeral of a friend
• The phone call from a friend

My sister's 50th birthday would have been this coming week.  The pain of that is just too great to share on these pages.  I can refer you back to last year if you want to understand more.  I really can't type more about it right now.

Just a day or so before I got the call from my surgeon's office to say that my insurance had approved me and to schedule the procedure, I got a call from a neighbor that a mutual friend has lost her battle with cancer.  I was supposed to leave town the morning of the funeral, but my car broke down the night before.  I was meant to be there.  Seeing her surviving family and their grief was so painful.  I knew I had to do something, anything to try and spare my family that pain.  There are so few things that you can control in your life.  My weight.  My health.  Those things I could work to control.  This surgery would make it possible for me to enjoy my life more.  To have a fuller life with my children.  To look and feel better, certainly.  To not only have a healthier lifestyle, but a better quality of life.

The loss of these two lives have effected mine utterly.  If I am so blessed to go on from here when others have had their lives cut too short – how could I not take this next step??  This gave me the motivation to move forward.

What am I living on?  The fact is I am living on.

Then there was the phone call.  A friend who told me about this type of surgery called me while whe was out of town.  She had just walked 5 blocks around this lovely town that she had wanted to see – and she hadn't even realized how far she'd gone.  Before surgery, this same friend could hardly make it from parking lot to restaurant without taking several breaks – so terrible was her constant back pain.  She had gone from defining her life to what she couldn't do because of her pain – to blithely walking around without pain and simply enjoying her life.  What a transformation!  It gave me the courage to go forward.

My life was transformed by these three people's lives.  And that is why I made my decision to go through with this.

Over Sharing…

Sometimes when sharing your journey you get a bit of negative feedback.  In personal relationships, when I am face-to-face with people, I consider it a 'don't ask, don't tell' policy.  If somebody asks me, I will tell them anything they want to hear. 

But if it isn't clear to you from what I typed above – nobody can TELL YOU to make a big life decision.  The decision has to come from within.

There are so many facets to a person.  Nobody, doctors included can tell you to lose weight and have it STICK.  It's a personal decision and it won't work if you are doing it solely for someone else, or for an event.  It's a lifestyle change.  Since embarking on this journey I had two recent events that make me cringe…

The first was a lady who was part of a group of walkers at the high school parking lot.  Her companion was chatting with me, because I was obviously SLOW at that point, because it was just a couple of weeks after my surgery and so we got to talking about it.  The first lady overheard the conversation – and her response was dismissive.  She was doing it 'on her own'.  This didn't bother me until much later in the evening when I began to question my choice and whether it was 'cheating' to do it this way?

Isn't that ridiculous??????  I'm grateful.  I'm LUCKY.  But it all comes down to diet and exercise in the end.  More on this later…

The second was a friend that I was chatting with, and she turned around and spoke to another co-worker behind her at the counter and said, "are you listening to this?".  This lady was morbidly obese. 

Does anybody, ever, want to be called to attention like that?  While you may think it kind or helpful – the fact is it is embarrasing and hurtful.  If that lady was listening to us at all it would have been privately – and perhaps it might have inspired her if I was really, really lucky.  Frankly I hadn't even noticed her because we don't know each other.  But until my friend pointed her out like that — it became a NEGATIVE moment.  It's like asking if somebody is pregnant when you don't know them well.  As a comedienne pointed out, "unless the head is crowning, don't ask".  And unless you know someone well, you don't talk about weight loss in public.  It's private one-on-one time.

So if you want to share my story with a friend – I am honored.  But each person has to make this choice for themselves.

The Details

So many people ask WHAT can I eat, and when.  Since all doctors and nutritionists are different, and therefore so are there guidelines.  These are the guidelines that I followed according to my doctors' advice.

Two Weeks Before Surgery – 1,000-calorie low-fat diet.  They would have started me on some kind of Optifast plan, but the call came literally as I was getting ready to leave town, and there was no time to go to the doctor's office.  So they gave me a guideline of what to eat and pretty much if I didn't do it – no surgery.

As I've said in the past, "I can do anything for two weeks."  But in this case, I had incentive as well as a corresponding possibility of losing my surgery date if I didn't stick to the plan.

The reason for the extrememly restrictive pre-op diet is pretty simple – obese people tend to have a condition called fatty infiltration of the liver.  The liver sits right in the way of your surgeon and they have to be able to lift it and get it out of the way while they work.  Imagine it being slimy and slippery… impossible to work around, and even if they tried you could end up with liver damage.  Incentive enough?

I used www.sparkpeople.com to track my food.

Caffeine, carbonated drinks of any kind and alcohol are now off the menu at this point.  Carbonated drinks are gone forever.

48 hours before surgery – Clear liquid diet.  Water, Chicken Broth, No-Sugar Jello, Fruit popsicles.  Nothing after midnight on the day before surgery.

Surgery – In the hospital on Monday morning and surgery around 11am.  In recovery 3-6pm.  Up to the room about 7pm.

Next day – thimbles of water.  I was supposed to have a medicine cup of water every 15 minutes and to keep track of it.

Next day – they brought me a clear liquid diet similar to what I had for the 48 hours before surgery.  I was checked out in the late afternoon.

Basic Post-Op Rules

Eat slowly.  Each meal should take 15-30 minutes.  Drink fluids between meals, either 30 minutes before or 30-45 minutes after. 

• First week – clear liquid diet.  Same as pre-op 48 hours.
• Second week – full liquids.  Added to the items I could have the week before, milk, yogurt (no fruit on the bottom), milk and soup. Aim for 40-60G of protein a day.
• Third week – pureed foods.  Egg Beaters, ricotta cheese, unsweetened applesauce.  You can take lean chicken, turkey (dark meat is best, more moist), and puree the heck out of it.  LOL.  Along with all of the items you could eat on prior weeks as well.  Vegetable and fruit is best delivered by eating Stage 1 baby foods. 65-70G of protein a day.  Take a calcium supplement such as calcium citrate CHEWABLES.
• Fourth week – soft foods.  Black beans, tuna in water, salmon, very well-cooked, peeled vegetables like carrots, avoiding brocolli and all other gassy foods.
• Fifth week – regular foods.  Still be careful with raw vegetables and red meat.  Chew everything well.  Aim for 60-80G of protein a day.

Alphabet Soup

Here's a little bit of information about the different procedures so you can unsterstand what I chose.  Discuss your options with your surgeon.

http://www.lapsf.com/weight-loss-surgeries.html

I chose Vertical Sleeve Gastrectomy because of several reasons:

• It is not mal-absorbtive.  I get all the nutrients that I eat.
• I would be able to take some oral medications in the future, which would not be possible with a Gastric Bypass or Duodenal Switch.
• The procedure removes 80% of my stomach, which solved my two main problems: Always hungry – Never Full.  The portion of the stomach that is removed is the part that produces the hormone, Ghrelin.  No more Ghrelin – no more hunger pangs.  Smaller stomach – and I'm Thanksgiving Dinner-full after a half cup of anything.

Short and Long-Term Gains

This is my one shot.  It isn't a silver bullet!  At my one month appointment I confirmed that:

The first 6 months are when I will lose weight easiest.  Mostly because my metabolism hasn't a clue about what has happened to it.  As long as I stick to the plan my nutrionist and surgeon have given me… which is in essence an Atkins-type diet: high in protein and low in carbs and fat — I will lose weight.

The second 6 monts will require exercise to continue the weight-loss trend.  Adding exercise to the regimen along with sticking to the plan will be key.

The final 6 months will be HARDER to lose weight.  My body will be adjusting my metabolism to its new reality; and therefore I will need to ramp up the exercise in order to continue weight loss.

After 18 months I'll be in the same boat as everybody else.  I will have to continue eating like I do and weight loss will be difficult because I cannot reduce my caloric intake or nutrition levels further.

So I have this one shot.  It isn't like I can ever do this procedure again.  I have to 'Respect the Pouch'.  That's our motto around here these days!

http://www.youtube.com/watch?v=-SesasYdKVI

So that is it!

I hope it has answered any questions you may have.  Thanks for reading this LONG post and for all the support you have given me!