Bariatric surgery Feed

Burnin' my butter

Hey! Quickly popping in with a tale o' the tape -- more precisely a printout from the hospital dietitian's fancy Tanita scale today.

I meet with the dietitian every couple months to go over my eating, make any adjustments to my plan, and step on the high-tech scale. I have a pretty high-tech home scale in my Withings/Nokia/Withings Again Body Cardio scale, but this one is hospital grade, so I tend to trust it a bit more. 

I've been kicking butt in fat loss -- my April reading showed that out of the 17 total pounds I lost from February to April, 11.4 pounds was pure fat, 1 pound was total body water, and only 1 pound was fat-free mass. I know that doesn't completely add up, but I'm going by what the printout says. Apparently the more fat you lose, the more accurate the scale readings get.

Today's reading -- from April 10 to June 13 -- showed that out of the 17.8 total pounds I lost, 17 pounds was fat with just under a pound of fat-free mass lost.

All this to say ...

via GIPHY

 I am burnin' the butter, which is a phrase Denise Austin used to say in her exercise videos. I used to cringe when she said it, but now that I am burning actual human butter, I'm kinda digging it.

I have been exercising more (but am totally behind on it this week), but I'm not going nuts or anything. I make sure my meals are protein-forward, but not every meal is stellar.

I mention this because THIS is exactly why I had weight-loss surgery. The times when I could pound off a few pounds I was making myself absolutely NUTS, doing workouts I hated, obsessively and neurotically tracking my food and watching the scale slowly creep down, bounce back up or flatline. Now I can exercise and eat without making myself crazy, and the scale moves down. 

Purple-measuring-tape
My waistline is moving down, too. That's the only measurement I'm taking. At the beginning of the year my waist was around 42 inches. Today it was right around 35, a number that I've kept in my head ever since Dr. Oz used 35 inches as a marker for increased chronic diseases. So you can say I passed a big milestone this week.

Other notes from today

  • She's really happy with my weight loss, even though I intentionally slowed it in May to try out new foods and calorie levels. According to her scale I'm at 203.8, which is tantalizingly close to Onederland.
  • She wants me to increase my daily protein from 60 grams a day to 80 grams, so I'll be throwing protein powder in everything and chugging protein shakes until I can tolerate more solid proteins (STILL having an issue with chicken!).
  • She'd like me to keep my total calories to around 900 a day. I wasn't really sure how much to increase it from the initial 600-ish but I knew I had to once I started exercising. 
  • And I really need to do better with water. According to my Tanita printout, I'm on the low end of the hydration scale, so I'm breaking out the big Hydro Flask again and making sure I drink two of those a day. When you can't eat and drink at the same time it can get frustrating to get both your water and your protein in when your stomach is the size of an egg.

Less than while being more than

Y'know all those motivational platitudes about moving out of your comfort zone, or living life outside of your comfort zone?

FIND YOUR COMFORT ZONE - THEN LEAVE IT!

LIFE BEGINS AT THE END OF YOUR COMFORT ZONE!

GREAT THINGS NEVER CAME FROM COMFORT ZONES!

Etc.

Lemme give you a different way to look at the phrase.

Pretty much all my life I have felt uncomfortable. 

Chosen last at kickball, made to wear the matronly ballet costume because it was bigger than all the other ones, being the youngest kid in the "teen" Weight Watchers meeting.

Being called Gail the Whale.

That's a pretty uncomfortable childhood. 

The discomfort shifted as an adult. 

Having the armrests dig into your hips at a theater, having a theme park employee shove the safety bar into your gut until it clicked, getting stupid "atta girls" from people at the gym because they thought I had never worked out before ("I'm a regular and I can squat you under the table, old man!").

Postponing routine bloodwork because if I give it a couple more months I can turn it all around with extra fish oil and walking and kale.

So I've been out of my comfort zone for quite awhile now, always feeling bigger or slower or lumpier or somehow "less than" while being "more than."

* * *

A couple weeks ago we went to a baseball game and I realized that I could stick my purse next to me on the set. 

Next to me on the seat!

I wasn't hip-checking my neighbor or having the armrests nudge into my sides. I was comfortably sitting in the seat, bumping into nothing and no one.

I didn't feel the dread of intruding on someone else's space. My space was my own.

Comfortable in my comfort zone.

And now, some updates!

2018-weight-loss-tracker-MAY

I deliberately added in more calories and carbs in May because I had been walking around lightheaded all the time, and I didn't like the feeling that I was going to fall over at the gym. I also have been trying and retrying foods to test my tolerance, and chicken and tomatoes are still on the naughty list. I just can't stomach them - literally. But some prepackaged protein shakes are back on the nice list, which is great because I have a lot of them. I had read that your tastes will evolve, and they really have. Stevia-sweetened things are still WAY too "aftertasty," but monkfruit sweetener is kinda nice. Overall, though, I do better with unsweetened stuff or just a touch of the real thing, like honey or agave. 

GAILFebToJuneAllSides2018

Here's my progression from Feb. 1 of this year to June 1. The front view doesn't really show a lot of change in my eyes, but the side view really has me stoked. I'm a lot flatter in the midsection, and my upper arms have deflated a lot (but holy jiggles, Batman! Those things are wobbly!). Total weight dropped from the beginning of the year is 59 pounds. I am around 6 pounds away from Onederland.

And now, a song for the weekend!

 


I think I found a great meal-planning app for my tiny new meals!

This is not a sponsored post. I just really think this is a great app and want you to know about it.

When I first had my weight-loss surgery back in February, and for weeks afterward, I averaged around 600 calories a day, which is TEENY-TINY, but believe it or not, that's the average. 

Now that I am 3 months out and exercising more regularly, 600 calories simply does not work. I discovered that when I started my stint with a personal trainer. I was wobbly, weak and lightheaded, and I knew that I had to get in more calories. 

Over the past couple months I've been working my way up in calories, and now I average around 900 to 1,000 calories a day and my weight loss is still plenty speedy. 

(Did I mention I'm 10 POUNDS AWAY FROM ONEDERLAND??????)

But planning a protein-heavy 1,000-calorie meal plan can be time consuming, and often I just wing it and end up not hitting my protein target.

Another problem I face is that in logging my food in My Fitness Pal, the app freaks out when I attempt to complete my food for the day. It throws up a red-lettered warning if my calorie is too low for its algorithm. 

Eat-this-much-logo
So I don't know where I found this, but clicking around the web yesterday I discovered Eat This Much, which is an automatic meal planner app, which you can use on your phone or on your desktop. 

I can tell it to make me a 1,000-calorie day and it doesn't scold me! I also can tell it what foods to exclude, whether I want to try paleo, Mediterranean, or vegetarian, how much protein I want to get in my day, what size meals I want and how many of them I want. It's really customizable.

It'll generate a day's worth of meals, and if you aren't fond of a meal or a meal component, you can replace it with another one. If you're dining out, you can choose a restaurant meal from its database that'll fit in with your macros. And if you're thrifty, you can direct the app to give you dinner leftovers to eat for lunch or dinner the next day.

Now, I'm only a day into using this app but it looks like it'll help a lot with my meal planning and won't have me lunging for the protein bars and cottage cheese all day. And as you can probably tell, this app is great for anyone on any type of eating plan. 

The plan is free, but there is a premium version that allows you to plan a week in advance and make more modifications. The first two weeks of premium are free. 

Here's a super cute video that explains the program:

And here's a deal!

Any time someone clicks on my link (https://www.eatthismuch.com/a/gogogail) and signs up for a subscription, you AND I will automatically receive $9 in credit. 

Let's dance!

 


The perks of being a weight-loser

If you are a friend or family member of mine, you know I'm a bit of a neat freak. My favorite word is "tidy." I dash around the house from room to room, shouting "TIDY!" when a room is up to snuff. I pretty much do this every morning.

But even a neat freak can slack from time to time, and I felt myself sliding late last year. Everything was stagnant or going in the wrong direction: Water drinking, exercising, housecleaning, spending, going to bed at a decent hour, and -- yes -- weight.

I felt stuck in every area of my life.

Fast-forward to this year. I'm down a little more than 50 pounds since New Year's Day (which still BLOWS MY MIND), and that momentum has spilled over into nearly every facet of my life.

Tidy-shoes
Tidy-shoes
Tidy-shoes

  • The laundry not only gets done, but folded and put away in the same day.
  • The sink (usually) isn't full of dirty dishes.
  • I run the dishwasher and the clean dishes get put away.
  • Tabletops are free of clutter.
  • My magazine pile is down to a short stack instead of unwieldy mountains all over the house.
  • My closet is culled (mostly because I got rid of a bunch of too-big clothes). 

It's something about not being stuck in my weight loss that has jostled loose all sorts of stagnation. 

I've got some other things I'm working on that I hope to update y'all on soon, fingers crossed.


Stuff I love: Clean protein that isn't full of junk

There are around eleventy-billion purveyors of bariatric supplements and foods on the Internet. But as someone who has spent her lifetime eating "diet foods," I don't plan on stocking my pantry with "cookies," and "puddings" and "soups" and other prefab "foods."

Why are these freak-show foods so prevalent? 

Is it because bariatric surgery patients are jonesing for cheesecake and caramel macchiatos? 

mad scientist
This is not how one makes lunch.

I am determined to make my post-op food as clean as I possibly can, and I know that runs counter to some people's reliance on boxed and canned and bottled bariatric foods. So here's my list of clean favorites. First stop:

Premade protein shakes 

Before I even had my surgery in February, I had a couple weeks of a pre-op diet that relied increasingly on protein shakes. We'll get into protein powders in a bit, but the easiest way to down a bunch of protein is to grab a premade protein shake in a cardboard carton. And there are loads of gross ones out there (OK, gross to me). I tried a few varieties of one super popular brand (Premier), and quickly found them way too sweet. I know some people absolutely love them, but after surgery my disdain for sweet stuff got even stronger. It's kinda crazy -- before surgery I didn't really have a sweet tooth per se; it was more of a "food tooth." But after surgery? EVERYTHING is too sweet, especially foods that have artificial sweeteners or stevia. So now I either go without any sweetening or add a little honey, agave or sugar (usually just a teaspoon in my tea). 

Anyway -- the only premade protein shakes I can put up right now (I say that because my tastes are in a constant state of flux) with are Orgain Clean Protein. They have 20 grams of protein and are much cleaner than a lot of brands. There is some stevia, but it's not overkill.

Protein powders: Whey and vegan

I'm narrowing this list to whey and plant-based because I want to keep things simple. I don't mess with soy, and my dietitian told me that whey is the best absorbed protein source. I'm throwing in vegan protein because there are times my pouch is cranky and doesn't want the foamy texture that whey produces.

Man, I have been on a visionquest with protein powders! I made a lot of smoothies before surgery and already had a big collection of protein powders, but all bets were off after surgery. Protein powders that I used to like I now despised. Once again -- too sweet, too much aftertaste. So I was on the hunt for naturally sweetened protein powders that didn't contain stevia.

Whey protein

Chocolate: Whey to Go! Who knew! One of my old, old favorites fit the bill perfectly. I hadn't bought Whey to Go in years, but I checked the label and BINGO! no stevia. It's sweetened with beet sugar and has 9 grams of sugar per serving. It's a little higher in added sugar than my dietitian recommends, but I hadn't been drinking ANY protein shakes, so I'm not sweating the extra few grams of sugar. There's 20 grams of protein and a relatively short list of ingredients.  And it's fairly low cost -- some proteins are ridiculously overpriced (I'm looking at you, Shakeology). The chocolate flavor has a nice depth of flavor, so I haven't had to hit the bag of cocoa powder to amp it up. 

Vanilla: Garden of Life Organic Whey Protein was the first stevia-free whey protein powder I found, probably because it says "no stevia" right on the front label. This protein has 21 grams of organic whey concentrate and 11 grams of sugar, 9 of them added, which is a little high, but again, I'm not sweating it since my overall calorie level is so low for the day. It's really clean tasting, and while it isn't labeled vanilla, there is vanilla in it, so it's like a light vanilla. It's really good mixed with frozen fruit as it lets the fruit really shine through. I made a great smoothie with frozen mango, chilled green tea and a serving of this. 

Plant protein

Chocolate: Apparently Aloha protein powder has reformulated its recipe since the first time I tried it because I really like it now! Sometimes plant-based protein works better for me when my pouch needs something simple. It doesn't tend to foam up as much as whey-based protein powder. Aloha has a nice dark chocolate flavor while only having 4 grams of sugar from coconut sugar. It also uses monkfruit, which doesn't seem as "aftertasty" as stevia. There's 18 grams of protein that comes from pea, pumpkin seed and hemp, and you can buy it online or at Target. 

I don't have any favorite plant-based vanilla protein powders yet, but if I do find one, I'll update this list.

Other proteins: Collagen and Genepro

Collagen is a little controversial because a lot of dietitians don't think collagen peptides are a good protein source, but I use it pretty regularly because it disappears into any liquid hot or cold, and doesn't add any flavor. Many mornings my breakfast will be a cup of tea with a little honey and two scoops of collagen peptides. Hey, even if it isn't the highest quality protein, my cup of tea gives me 18 grams of protein from collagen, which is supposed to be great for your hair, skin, nails and joints, and all of those can use a little help. I haven't tried a lot of collagen brands, so I just stick with Vital Proteins collagen peptides, which you can find nearly all over. It also comes in single-serve packets, which are great for traveling. On our last road trip, I brought a bunch of packets with me and stirred them into coffee, tea and soup. Are there better brands you like? Lemme know in the comments.

Even more controversial is Genepro protein powder. A tiny little scoop -- 1 tablespoon -- purports to give you the equivalent of 30 grams of protein. But many people refuse to believe the claims made by the manufacturer because the serving size is so tiny. It's unflavored, mixes really well into hot or cold liquids and is great if you're low on protein for the day. I just don't know whether I'm getting 30 grams of protein or 15 or what!

I was going to go into vitamins and other things but I'll save those for another day -- this is plenty of food for thought.

 

 


Who is this person? Apparently, it's the new me

I had just gotten done at the gym and needed some Propel, so I swung by a local grocery store. I got my Propel (Yay, it was on sale!), plus a few other things, and loaded up my trunk. As I got in the car, I was facing a Starbucks in the shopping plaza. 

It was nearing noon, so I figured I'd stop in and grab lunch, so I looked at the Starbucks app on my phone to order something to go. 

I scrolled past the entrees, the drinks, the specials and nothing jumped out at me. Remember, I can either drink or eat -- can't do both at the same time anymore because of the surgery. 

Cold brew? Nah. Iced tea. Not feelin' it. Egg white bites? Hmmmm, nah. 

Nothing. Nothing called out to me. 

No starbucks
WHO IS THIS PERSON?!?

Pre-surgery I could always make a successful Starbucks run. There was always something I could find to order. Something always looked or sounded yummy. But now? I just wasn't interested. All I wanted to do was go home, take a shower and drink a Propel. 

In a weird way, I was a little disappointed in my disinterest -- but just a little disappointed. I chose to have surgery that would shut down my constant hunger and overwhelming interest in food, and it worked. A lot of the time I have to almost force myself to eat, especially around dinner. And then when I do find something to eat, I can't eat much. (Thank goodness for unflavored collagen peptides and protein powder -- I put them in lots of things just to get my protein quota for the day.) Last night I had a cup of "Oprah soup" (O That's  Good Creamy Tomato Basil Soup) with a scoop of Genepro whey protein. Fortunately, the protein powder just disappears into the soup, but just to be safe I added a tablespoon of shredded Parmesan. Tiny Tum-Tum was happy.

In other news

From my pre-surgery doctor's appointment to April 30, I'm officially down 50 pounds, which blows my mind.


Countdown to Onederland!

Countdown to onederland

Hey, everyone! I haven't been around here much -- I've been catching up on work that had taken a back seat to getting myself feeling and eating somewhat normal. Some updates:

  • I've been working at the gym twice a week with a trainer because I really, REALLY don't want to lose muscle with all this weight loss. And so far so good: At my 2-month bariatric checkup, out of the 19 pounds I lost from the last time I was at the doctor (6 weeks), 18 of those pounds was fat and only 1 pound was muscle (or technically "fat-free mass") ... which is GREAT! There's really no way to lose 100 percent of your weight in fat; a little muscle loss is to be expected. But my goal is to try and hang onto every pound of fat-free mass that I currently have (which is currently 119.4 pounds) and perhaps gain even more. 
  • Looking more at the printout from the super high-tech Tanita scale at the doctor's office (which is super cool because I love gizmos!), my my target body fat has been adjusted down from 30 percent in February to 25 percent now, and my predicted goal weight went from 172 to 159 pounds. Apparently the scale has a lot of faith in me! Point of reference: I weighed that in college and I THOUGHT I WAS FAT. Yeesh. 
  • My weight loss was fairly slow the past couple weeks because I haven't been working out all that much, and I've been testing my pouch with more calories and different foods. The trial and error can be, frankly, nauseating as I find what foods work and what don't. So far, Tiny Tum-Tum really doesn't like solid animal protein but it does OK with ground-up ones, like ground poultry and even ground beef. I also think that it really doesn't like bread very much, so I should probably knock that off. It loves protein bars, cheese, yogurt and smoothies.
  • I've found myself starting to stay up too late again and wander into the kitchen. But since I have slain the angry polar bear, there's not a whole lot of damage I can do, save for maybe a cheese stick or a quarter of a peeled apple. Still, I need to work on getting to bed earlier and staying away from the kitchen, just to clean up my habits.

But I've officially started my Countdown to Onederland because I'm only 17 pounds away!

(So, yes, that means I'm revealing my weight -- 217.1, as of today. It's been a while since I said how much I weighed.)

And here's a photo update that I did at the beginning of the month -- I'm actually 9 pounds lighter than that now:

Feb to april

 And if you're digging the workout capris in my "before" photo, I'm selling them on Poshmark right now.  They're by Fabletics, size 2X and incredibly comfortable.

The bulk of my too-big stuff usually gets sent to online consignment shop ThredUp because it's a lot easier and the site is desperate for plus-sized clothes, but I thought I'd give Poshmark a try for a few items.

Here is some free money for clothes!

When you join ThredUp through this link, you get $10 to spend on your first order.  I also have a $5 credit for you at Poshmark when you sign up with my username (GOGOGAIL) as your personal invite code on your own device. To earn credit, you will need to enter username GOGOGAIL as the referral  code at the time of registration directly within the Poshmark app.

I've been doing a LOT of closet cleaning, and let's just say my empty hanger collection is now huge. The purging has also extended to my bookcases, and I've been hauling boxes of diet books to the local library. Ain't nobody got time for them!


Why did I decide on gastric bypass surgery?

Il_570xN.763140040_cww0
Yep, that's a gastric bypass plush toy!


Thought I should elaborate on how I came to the decision to get bariatric surgery, because for years I was dead set against it.

  • I thought it was the "easy way out." 
  • I thought it was for people with no willpower.
  • I thought it was super dangerous.

Nope, nope, nope on all counts.

Bariatric surgery is not a magical fix -- believe me, I've seen people get surgery and either lose very little weight or lose a bunch and gain it right back. There's nothing easy about any of that. It takes planning, determination, planning, exercise (and did I mention planning?). You need to make sure you're getting the right nutrients, water, protein, fiber, vitamins and minerals. Thankfully, I'm already a supplement junkie so that won't be a new experience for me. I also have an entire shelf of my pantry devoted to protein powders, so I'm good there. 

As far as the safety, bariatric surgery has come a LONG way over the years, and according to Bariatric Surgery Source, the surgery has a 99.8 percent survival rate. In addition, the 30-day complication rate is 7 percent -- and that includes all complications, be they extremely minor or not. Conversely, the risk of staying obese carries a lot more risk with a host of diseases that are far more common in the obese population. I will take those odds any day.

I initially had chosen VSG, which is short for vertical gastric sleeve surgery. The surgery reduces the size of your stomach around 80 percent, taking it from a football to a banana. But after my docs got a look at my esophagus, the sleeve was off the table for me because it often makes hiatal hernias and reflux worse, and I wasn't going to play fast and loose with possible esophageal cancer. Nope!

So instead of a banana, my stomach with bypass is now an egg. I would have preferred something less extreme, since my BMI was just over the edge of qualifying, but the fact that I could eventually reverse any esophagus damage was more of a deciding factor than anything else.

 


Hey, look - it's me!

So last we talked it was the day before surgery, which occurred last Friday. It's been a week now, I've been home since Sunday and recovery has been OK.

I've learned a lot about coming off morphine, ketone bodies (they SUCK), drinking too much liquid at one time (no bueno) and not drinking enough liquid (also no bueno).

I also learned a new twist on that old fitness meme "Sweat is just your fat crying."

Fat crying

The thing is the size of a paper cut but it's a leaky little sucker. Apparently the fluid looks for the path of least resistance, and right now it's out my belly. 

Super awesome. 

But I felt disgusting before it actually started leaking and now that it is, my belly is feeling less swollen and looking better, too. That same evening that I made my poor, exhausted husband take me to the ER (Valentine's Day, of course!) I also ralphed all the way home. (Thankfully the ER had take-home barf buckets.)

Yesterday I went back to the hospital for a follow-up and learned that the leaking is a fairly common thing, and that the barfing was me trying to power down the protein shakes and broth in one sitting. I was trying so hard to get to 60g of protein I felt like I had to do 20-20-20 at every meal. Well, considering that I have brand new plumbing and a new stomach the size of an egg, that isn't a good idea. So for the past day and a half I've been breaking up the drinks into 4 to 6 ounce portions and doing much better on that. In fact, it's 5 p.m. and I'm nearly at 50g protein -- yay!

I've been pacing back and forth across the house, shooting for a mile a day. That'll gradually increase as I start feeling better (and stop leaking). With the Olympics on, I often cross country ski or speed skate across the house, and the dog thinks I am nuts. 

Now for the freaky fun stuff. 

Since Jan. 18 -- a little less than a month ago -- I'm down nearly 15 pounds. A good portion of that was the pre-op diet but I've been dropping about a pound or so a day this week. There's still some bloating post-surgery (and, of course, the leaking) so once that all settles down I'll be able to get a more accurate picture of my overall weight loss. My body fat percentage has also gone from a ridiculously fluffed-up 52 percent to around 48. 

How do I feel about all this?

via GIPHY

(Nothin' like an MSNBC happy dance.)

 

 

 


Surgery is one week away

For the bariatric surgery of

Yep, that's right. It's happening. All the tests and exams are done (my bloodwork was surprisingly decent!) and insurance has re-approved the surgery.

Why "re-approved"?

I originally chose vertical sleeve gastrectomy, but early on I knew there was a chance I wouldn't be a good candidate because my esophagus is, well ...

via GIPHY

(Actual footage of my throat processing marinara sauce without Prilosec.)

My latest upper endoscopy showed that my hiatal hernia didn't magically close up from the last time we took a peek, and this time my esophagus showed some erosive changes, WHICH IS NOT GOOD. It's called Barrett's esophagus, but mine is in the very early stage with no dysplasia (cell changes). 

My surgeon had said that sleeve surgery can create hiatal hernias over time, and make existing ones worse. 

Well, crap.

There's a very bad thing that can happen if you let your esophagus turn to beef jerky, and basically roux en y bypass surgery can actually reverse the Barrett's. 

Weight loss and GERD relief: Two birds with one stone. Believe me, I've been taking PPIs for a decade, eat super healthy and barely touch alcohol. I just have this stupid hiatal hernia and a flaming pit of acid in my stomach. 

So bypass it is!

Frankly, I'm more concerned with the Barrett's than the size of my ass, so agreeing to change course was a no-brainer for me. My surgeon has done many, many procedures over the years (Cleveland Clinic Florida is a Bariatric Center of Excellence), and he said while the bypass is more involved, recovery is around the same amount of time. 

I'm really looking forward to the improvements in both areas.

Last week, I started the pre-op diet, which was fairly easy -- two protein and veggie meals and one protein shake meal with clear liquids in between. I dropped around 5 pounds. but today was the first day of a liquids-only diet, and damn! I was doing OK with my delightful protein drinks and water until around 4:30 when the hangry polar bear appeared. So I busted open the low-sodium chicken broth, and I swear, it was the best thing ever.

Dinner was probably a little more substantial then I should have eaten -- I found a can of Progresso Organic Tomato Basil Soup in the pantry and stirred in a scoop of unflavored Quest protein powder. That's kind of a smoothie, right? Actually, the soup was a lot higher in sugar than everything I ingested today -- go figure! 

That held me for around an hour and the bear came back, so I just went nuts and ate an Oikos Triple Zero. 

Not perfect but, yeesh, the hunger monster is outta control.