I Can Do Hard Things

The following are not my words. Here I'm sharing the wise words of my friend Shari (Jupiter6) from Obesity Help. She shared this message on the OH forums last summer and it's inspired me ever since. 

The phrase, "I can do hard things" has become a mantra for many of us who were there for the original posting of this message.  I CAN do hard things.  And it makes me proud that I understand that about myself and when I'm faced with something hard, I can use those inspirational words to get me through a tough situation.  I have these words printed and hanging on my refrigerator (and bookmarked on my computer and saved to my flash drive and burned into my memory).  

So in case you hadn't read it yet, I wanted to share them with you. I hope they are as powerful for you as they have been for me.

"I've had some success-- I suppose I can admit as much at this point, although it feels weird. So now I get a lot of people who PM asking for advice, or saying they look up to me, and flattering though that is, it's silly, because I pretty much just follow the rules (okay, the ones that make sense) and it all comes out in the wash. So I usually don't have much to add when people ask how you get where I have gotten, there's no great mystery: the reason I have been successful in some ways that others have failed I usually pass off as luck.

But that's not entirely true. I just realized it. There actually *is* one more piece, and because I love ya, I am going to share it with you now. Sounds trifling, but it contains volumes.

Here it is: YOU CAN do hard things.

I know, you're saying, "What's your point?"

Sometimes, when faced with a challenge-- especially if you're a recovering addict as so many of us are, when you approach something difficult, your inner voice says, "Holy crap-- I can't DO that"...and you do an about-face-- you reach for the drug (or Ring Ding) of choice. To feel uncomfortable..and not to comfort yourself, is a hard thing --

but you can do hard things.

When it's late and you're tired, and you know you are supposed to walk, you said you would, and it's looking like it might rain-- it's hard as hell to lace those sneakers up and get out there---

but you can do hard things.

Protein shakes can taste yucky. It's hard to remember all those calcium supplements. It's hard to get 64 oz of water in. It's hard to plan meals, buy expensive and healthy choices, stay out of the cake in the lounge at work--

but you can do hard things.

You don't have to self-medicate. You don't have to eat those chips. You don't have to duck and avoid every unpleasant, difficult challenge in your path. Sometimes, the best bet is to admit their existance..."Yes, hard things, I see you trying to get in my way, but you know what? I CAN DO HARD THINGS!"

Sometimes this means having to survive a host of feelings you never felt before because you never let yourself feel them before-- stress, confusion, anger, rage. You can't numb them out or sand off their edges-- you have to stand right in your space and let them have a go at you-- and grit your teeth, and say to yourself, "Go ahead, get in my way. I'll get through this. I can do hard things."

And you will find that you will survive them. And as you survive them, you will face new ones, standing a little taller, because in time you will eventually understand and rely on the fact that you can do hard things. And eventually the "pass me some Ben and Jerry's--my boss is a jackass" response gives way to something new-- something that sounds more like this:

"Go ahead, Boss, bring it on. I'll have that on your desk by five."
"No thanks, Nancy, it's gorgeous but I really can't have an eclair right now."
"I guess I could just park back there and walk."
"It's only 8 ounces and I don't have to love the stuff, I'll just drink it quickly."
"If I spend ten minutes planning now, I won't be faced with tough choices later."

Post RNY living is no joke. It's not easy. It's not fun. It's not all "Whee, I'm a size 6!" Not everyone takes it as badly as I did, but there were days I *literally* cried because a kid at a store could have a cookie and I couldn't. I felt sorry for myself and holed up in my jammies, burning candles, and chatting here to avoid my fridge.

When I started, I could literally not walk further than my car, which is about 100 feet from my door. I bargained with myself that getting down to maybe 250 pounds would be JUST FINE, I didn't need more than that because the thought to ask more from myself was ridiculous, impossible-- who the hell loses 220 pounds? That's not even humanly possible, seriously!

And I found out the answer to who does that : it's ME. *I* can lose 220 pounds-- I know it because I *did* it . I can get in my supplements. I can learn to accept my new, imperfect body. And with planning and management, I can make a post op life that still provides pleasure, joy and fulfillment.

And I don't do those things because they are easy-- I do them because they're hard, but I *can*. I can do hard things.

And so can you. And you will. So the next time it's all too much (and it is for me too, although less often as I grow), look your RNY challenge-- whatever it is--- boldy in the face and say, "I can do this. I can do hard things."

Then pull out all the stops and grab the brass ring-- it's there for the taking!"

I Met Ron from Biggest Loser Today!

Our Workplace Wellness Program hosted a lecture by Ron Morelli from last season of The Biggest Loser - Season 7. Then after he spoke, I took a couple minutes of his time to chat and get a picture.  I wrote four pages of notes during his talk and wanted to share a few of the important points he made.

My employer is outstanding.  We've got this great Wellness Program that encourages the 4,000-or-so employees on the job, plus retirees and all our families to be healthier and take care of our overall wellness.  One of the programs they offer is the "Lunch-n-Learn" lecture series (which is what today's lecture was). These lectures are held monthly and include topics on a wide variety of topics - next month is about laughter, for instance.  I've also joined the competitive pedometer walking program that begins in a couple weeks - that should be fun!

So anyway... back to Ron...

This is going to be a long post, so I'm going to try and break it up as best I can.  Somehow try to organize my thoughts and do my best not to ramble. Wish me luck!  LOL  I know we, as WLS'ers, are most interested in hearing about Ron's gastric bypass surgery - but honestly he didn't talk about it much.  He did, however, have some very profound things to say about eating, exercise and getting your head screwed on straight.

UPDATES -- First a few updates that I'm sure others are wondering about. Since the show Ron has maintained his weight loss and hovers around 250 pounds (his highest weight ever was 527lbs).  His son Michael, also on the show, has maintained his weight loss as well and is currently attending college at Michigan State University.  His other son, Max, who we saw on the show during family visits, is doing well with his weight loss efforts and has lost over 100 pounds already.

DIETING HISTORY (and RNY) -- He's been obese his whole life.  He weighed 200 pounds at age 9 and was up to 400 in high school.  So he's well versed in dieting. He's done every diet you can think of, had his jaw wired shut, starved himself, did Weight Watchers and Atkins and even spent time at a weight loss hospital a couple times.  Then 14 years ago he had gastric bypass surgery.  He lose a lot of weight very quickly, as expected. But gained much of it back because he had not permanently changed his habits for the way he ate and the way he moved. He didn't gain ALL his weight back though.  Remember, his highest weight was 527 before surgery - which was 13 years before he went on The Biggest Loser where he started out weighing 420 pounds. So yes, there was regain, but not 100% regain as you hear so often rumored around the message boards. Think about it.  He maintained almost a 100lbs loss for 13 years -- as an average, of course, since he freely admits his weight fluctuated widely during that time period.

POUCH SIZE & STOMA -- His stomach pouch is still the "right" size - still pouch-sized.  So we know that a mature RNY pouch is around 6oz to 9oz in size and can hold about 8-12oz of food, so we can assume this is the size of his pouch now, 14 years later.  However, he said that his stoma has stretched (the opening between the pouch and intestines)  - in essence allowing a portion of his small intestine to "act" like a stomach pouch.  I didn't ask - and he didn't go into detail since this wasn't a WLS presentation and I think I was the only other WLS'er in the room - but I don't know if the stoma was fixed or revised at anytime or if he just adapts to that issue with how he eats now.

BEHIND THE SCENES ON THE SHOW -- So before contestants even begin doing the show, they see the doctor, right?  We know that part already.  But what was interesting to me is that the doctor is the one who sets the calorie intake limits for each contestant - not the trainers.   The doctor alters that calorie limit as they lose weight, as needed.  Ron was assigned 2025 calories/day.  His son Michael ate 1850 calories/day. These numbers were based on their RMR (resting metabolic rate) and an estimate of what they would burn in the gym everyday as well as the show's goal for their weekly/daily weight loss numbers. Once their daily calorie intake limits were set, the trainers (Bob and Jillian) set the nutrition balance for those calories based on the expected workout loads. The cool thing about their calorie intake goals is that each contestant decided on their OWN menu - they would make a shopping list and someone would buy their food for them (they apparently didn't have time to go grocery shopping since they were working out or whatever).  Then at meal times, they would cook their own stuff.  Michael would have oatmeal for breakfast and Ron would have eggs, or instance. No personal chefs on the ranch.  I'll cover some food and nutrition stuff later.

BOB & JILLIAN -- Bob is a vegan - not just vegetarian, but full blown vegan.  Did you know that?  I didn't. Ron laughed while telling about how often Bob eats.  "He keeps fruit in his pockets, gym bag, jacket, everywhere - he needs to eat every couple hours."  (I can see why he likes Yoga so much now.)  Jillian eats more variety, but she's all about organic and whole foods.  As for what kind of trainers they are?  Bob's tougher than Jillian.  And all that yelling Jillian does - apparently not a reflection of her personality.  "She's sweet and shy and very quiet. And she's short but solid and is a double black belt in every martial art you can think of."

BODYBUGG & GO WEAR FIT -- Someone today asked about the BodyBugg each contestant wears (similar to my GoWearFit / BodyMedia device) -- Ron loves it and will be renewing his subscription so he can continue to wear it.  Ron would burn about 6,000 calories a day and Michael would burn about 10,500 calories/day. Holy Cow!  Now, off the ranch, Ron maintains a calorie deficit of about 500 calories (rather than 4,000 like when on the show). Ron's quote about the device: "It is an invaluable tool for weight loss and can be very useful for everyone."

FINDING "IT" -- As an expert dieter who has tried them all - I believe him when he said: "Any diet or surgery or jaw wiring trick will work."  But the problem we haven't learned anything from it.  If you get your jaw wired shut, don't eat for 2 months and when the wires come off you go back to eating like you used to - you didn't learn anything.  Whatever method you use to lose weight you have to CHANGE the way you eat forever, CHANGE the way you move forever, CHANGE the way your maintain your habits forever. Those changes, those habits, those realizations that you've been doing it wrong up until now -- those he refers to as "IT".  When IT finally settles in your head and becomes part of your being, the weight will stay off.  If you don't have IT, the weight will return.

THE PAC-MAN EFFECT -- We've heard this before, but I liked the name he gave it. (Actually he'd heard it  from a doctor at an in-patient weight loss hospital he'd been in years ago.)  The fat cells we have when we're about 21 years old are the fat cells we'll always have.  We don't grow more, we don't lose them as we lose weight - fat cells will always be there in our bodies, they expand with more fat or they shrink when we lose fat. But those fat cells are like the little PacMan guy in the video game... always chomping his mouth open and closed looking too be fed.  Fat cells, when they get too skinny, will send signals to our brain demanding more food. Ron's comment was that the wished he'd never been told that because he used it as an excuse to eat more after losing weight ("I need to eat, my fat cells are too skinny.").  But personally, I like knowing this information because it makes me aware that after I lose weight and my fat cells are screaming for food -- that I can safely ignore those screams.  I can be secure in the knowledge that the screams for food I'm hearing is my fat cells bitching and moaning that they want fat.  But you know what?  I worked too freaking hard to make them skinny to just feed them more food, so I'm going to ignore them and be happy about letting them starve!

IT'S HARD -- "All those diets of my past were my attempt at finding the easy way to lose weight." Even if they were hard to do at the time, he was looking for "easy" but never found it.  Losing weight is HARD.  It's a STRUGGLE.  There is no easy way.  It's all hard and you have to work to get what you strive for.  Ron admits: "I hate working out. I hate exercise. It's hard.  But I do it everyday anyway."  The sooner we realize this is hard, the faster we'll learn to face the challenges and plow through it.

FACING FEAR -- "When you've always been fat, the fear of being thin is enormous."

After he said that, I wish I'd had a moment of silence to just take it in. But he kept talking and I kept scribbling notes.  When we're heavy we blame everything that's wrong in our lives on the fat. I can't play tennis because I'm fat.  I can't find a soul mate because I'm fat. I can't keep friends because I'm fat. I can't find a job because I'm fat. So what happens when you're suddenly not fat any longer and all those things are still wrong?  Fat can't fix everything. When you're thin you're still going to suck at tennis. So instead of blaming fat for all the things wrong in your life, you need to realize that you are letting FEAR hold you back from being thin -- because somewhere in our subconscious, we realize that it's not the fat that makes all those things bad in our lives, it's just us.  So when we realize we can't blame the fat anymore, and start fixing the things we want to fix - independent of the fat issue - then we'll finally be allowed to let thin be what it really is.  Just thin.

EXCUSES -- "So what?"  That's the response you need to have when you hear excuses. Ron admits that all his life he was the king of excuses... but at some point you need to change your mindset about excuses and start facing them with "so what!".  My knees hurt so I can't exercise. So what! Exercise anyway.  I'm too tired to cook a healthy dinner.  So what! Cook healthy anyway. It's raining out, I can't do my run today. So what. Run anyway. Don't let excuses stand in the way of your goals.

FOOD & NUTRITION -- On the Biggest Loser ranch all processed food was banned. Well, unless you were a sponsor of the show and had contestants eating your processed food on camera (think Subway) ... but as soon as the camera were turned off, the trainers would yell: "Ok, spit it out!" Yeah... no processed foods allowed, which includes processed deli meats. Remember, Bob's a vegan (and received a jovial phone call from Ron when the "double meat" ads ran) and Jillian eats organic whole foods.  So that's what the contestants eat too.  They focus their meals on nutrient dense foods rather than calorie dense (for instance a salad gives you a large volume of food, but very few calories).  They also focused on whole foods that were lean and healthy. They learned how to eat properly through regular training in the kitchen (it wasn't clear if Bob and Jillian were the only ones doing these trainings or if there were others in the kitchen teaching about how to cook).  Contestants at 3 meals and 2 snacks per day - every 4 hours.  So their daily calorie intake was divided accordingly --- so 2000 calories divided by 4 is 500 which meant 3 meals were 500 calories each and the 2 snacks each got 250 calories. Along with their normal calorie intake they were also drinking 5 quarts of water each day and eliminated all added salt from their diet. Ron also mentioned that to boost flavor on lean meats and fish, they used a lot of Mrs. Dash and other herbs and spices as long as they had no added salt.

THE WORKOUTS -- There were "taping days" and "dark days" on the show.  On taping days we see the teams working together with the trainer in the gym, many times all doing the same workout routine and all being coached (and screamed at) step by step by Bob or Jillian.  That was not the norm.  Most days were "dark days" - meaning the cameras were not on in the gym and the contestants were just there doing their own thing. They could wear whatever workout clothes they wanted to on dark days and they chose to do the exercises they enjoyed the best (or worked best for their own personal goals).  So Ron walked and swam a lot... Michael loved boxing.

WEAKNESSES -- Since we're talking about food, I thought this was worth sharing.  We all have certain food weaknesses, right?  For me it's fresh deli salsa -- not the salsa specifically but the fact that when I buy salsa, tortilla chips mysteriously appear in my shopping cart and I have no control over their appearance. So I don't buy fresh deli salsa - ever.  For Ron, it's peanut butter.  It's simply not allowed in his house.  He used to love peanut butter by the spoonful dipped in whipped cream.  He said it calls to him if it's in the house: "Ron, I'm over here!"  So we need to recognize if we have trigger foods like that and simply eliminate them from our lives.  If you don't have control, then don't put yourself in the position of battling that trigger.

IF YOU EVER GET THE CHANCE -- Ron told us that if we ever get the chance to go grocery shopping with a nutritionist, do it!  He learned so much about understanding food from his shopping trip while on the store (I didn't watch that whole season, so must have missed that episode).  One big thing he learned is that the nutrition label doesn't tell the whole story -- the ingredient list is just as important as the nutrition label.  For instance, a diet soda might have zeros all down the nutrition label... 0 calories, 0 fat, 0 carbs, etc ... but what are those 30 ingredients doing in the ingredient list?  The body knows it's getting those ingredients and depending on what those ingredients are, might freak out and do crazy stuff that scientists haven't figure out yet. So keep the ingredient list in mind when shopping.  Fewer ingredients is better.

JILLIAN'S FOOD ADVICE -- He said this one a couple times, so I'll repeat it.  Jillian says:  "If it doesn't come off a tree or out of the ground... or if it didn't have a mother - don't eat it."

HANDLING HOLIDAYS -- How many holiday or special occasion meals are there in a year?  (Christmas, Thanksgiving, Easter, Birthday, weddings, etc.) Maybe 15?  How many meals are there that are just normal everyday meals? If we eat 3 meals a day and subtract the 15 special meals in a year -- that means we eat 1050 other meals in a year.  15 special days. 350 normal days.  We didn't get morbidly obese from 15 meals a year when we indulge in a special holiday meal.  We grew our way to morbid obesity from the 1050 meals where we didn't make healthy choices and eat only until we were satisfied. So now... if we handle the 1050 normal meals in a healthy way, we don't have to worry about the 15 special meals.  When Easter dinner comes around next weekend, go ahead and eat. But Easter dinner is just dinner.  That doesn't mean Easter breakfast and lunch and snacks and snitches, it means just dinner. And when Monday morning arrives we're not still indulging in Easter dinner, we're back to a normal Monday morning breakfast.

AFTERWARDS -- After his hour-long lecture I made my way to the front of the room for a little chat. I wanted to THANK him for being brave enough to go on The Biggest Loser after having gastric bypass surgery.  Facing regain after WLS is hard and I appreciate his willingness to be open about his past. I also told him I'd had surgery - he smiled and asked how I was doing.  I also asked him if he knew about ObesityHelp.com - he didn't - but I told him that he had his own cheering section on the forums and we talked about his success after each week's show.  I showed him my before-and-after picture (at the bottom of this page) which I keep on my phone as a handy reminder and he congratulated me on my success.  Then I had a gal nearby snap a photo on my camera phone.  He was genuine and patient with all us lookie-loos who needed to have a moment of his time.  A very nice man, for sure.

MY NEW OPINION -- Remember last August when I did a race where Helen and Shannon were participants? (Helen was winner of Season 7.) After chatting with Helen for a few minutes after the race I had a pretty big turn around on my opinion of The Biggest Loser. I used to like the show. But...  The "advice" she gave to me in those few minutes of talking - and the advice I heard her giving to others who were nearby - was not very good advice. In fact, it was pretty dangerous advice for those who want to lose weight in a healthy and safe way. From that point forward I decided to not watch the show and to not promote it as a good weight loss inspiration source.  I still question the tactics of the show -- extreme workouts without enough nutrition to back it up -- but after listening to Ron today, my opinion has changed a bit.  The level of nutritional knowledge Ron had before the show compared to after was significant and when he talks about what the most important part of the show was, he talks about that education in the kitchen. After hearing Ron and his passion for the changes he's made in his life... and finding "IT" ... maybe I don't hate The Biggest Loser as much as I have for the past several months.

~Pam

I ate a kumquat too

My friend Nikki ate a kumquat last week.  She blogged about it.  And even chattered about it while we were talking online.  Which made me realize I'd never eaten a kumquat either... so I ran right out and bought some.

Ok, first of all they were expensive!  Dang!  $3.50 for a tiny container.  But I was curious enough to give it a try.

One other thing you should know about me is that I'm pretty picky about fruit.  For instance, one of the fruits I don't like is melon.  I don't do melon.  Or anything that resembles melon, has the texture of melon or smells like melon. That includes cantaloupe, watermelon and mangoes.  So when Nik mentioned it reminded her of a mango, I was immediately leery.

The verdict?

It was alright.  Definitely in the citrus family with a very tart and slightly bitter flavor.  The smaller sized kumquats were tastier than the larger ones.  In fact the larger kumquats has very large seeds inside that you couldn't eat, but the seeds in the small ones are small enough to eat without noticing.

Ok, so a few were fine to experiment with.  I definitely won't be eating these just plain.  In fact, I've now got most of my $3.50 container left and need to figure out what to do with them.  So I went in search of recipes. There's a Kumquat Growers website with a large recipe section. I've also done a search on RecipeZaar and there are several savory recipes available too.  For instance, Moroccan Chicken Breasts sounds very good.

I'll let you know which recipe I settle on and how the second half of this experiment goes.  Thanks for the inspiration, Nikki!

~Pam

Lactose Intolerance after Gastric Bypass

It is very common after RNY surgery for people to suddenly become lactose intolerance. My sister had RNY 8 years ago - she's lactose intolerant.  My mom had RNY 6 years ago - she's lactose intolerant. So when I had my RNY 2 years ago I fully expected to also be lactose intolerant.  In fact, for the first 4 months after my surgery I was too scared to drink normal milk so I would only use soy milk. But somehow I got lucky and milk and I are friends.

I'm definitely the minority though among the WLS community. Plus, I found out that I already had a second strike against me - my Native American heritage.  So I definitely got lucky in the lactose department. I'd miss my milk for sure.

So you know how I am, right?  I like to know WHY stuff happens.  I was excited when I found this info. I recently stumbled across some information about lactose intolerance that explains to me why the intolerance is so common after RNY.  It has to do with the enzyme that processes milk in our digestive tract and the fact that it's production center is now bypassed. And we know that the first part of the small intestine (first 4 to 5 feet) is bypassed and any enzymes produced in that portion doesn't mix with food until further down in the digestive tract.  So by the time the milk and enzyme mix, the intolerance symptoms have already begun.  Let's let Dr. Joyce explain it:

Lactose intolerance is the inability to digest significant amounts of lactose, the predominant sugar of milk. This inability results from a shortage of the enzyme lactase, which is normally produced by the cells that line the small intestine.  Lactase breaks down milk sugar into simpler forms that can then be absorbed into the bloodstream. When there is not enough lactase to digest the amount of lactose consumed, the results, although not usually dangerous, may be very distressing. Common symptoms include nausea, cramps, bloating, gas, and diarrhea, which begin about 30 minutes to 2 hours after eating or drinking foods containing lactose. 

Some causes of lactose intolerance are well known. For instance, certain digestive diseases and injuries to the small intestine can reduce the amount of enzymes produced.  Between 30 and 50 million Americans are lactose intolerant. Certain ethnic and racial populations are more widely affected than others. As many as 75 percent of all African-Americans and Native Americans and 90 percent of Asian-Americans are lactose intolerant. The condition is least common among persons of northern European descent.

Source: http://www.drjoycerichards.com/digestive-diseases.htm

The Core of your Being

Who are you?  Who are you at the core of your being?  What does that person look like in the mirror - not the physical mirror, but the mirror of your soul.  Do you know?  Have you looked closely enough to recognize your true self and fully understand who you are?

Once we know who we are at the core of our being --- then it will become clear who we are NOT.  What characteristics do not define you and need to be eliminated?  What traits do not coincide with your core identity and need to be changed?  What steps must I take to allow my true self identity to be released and able to shine through?  What specifically will I work on TODAY that gets me closer to my ultimate goal of understanding who I am at the core of my being?

Sometimes it's difficult to distinguish between WHO I am and WHAT I am.  I am not my job. I am not my family (sister, daughter, granddaughter, aunt, cousin, neice).  I am not the roles I play (support group leader, source of information on WLS, student, teacher).  All those things say what I do but do not define who I am. Maybe making a list of what I am and what roles I play will help me better identify what things should not go on my list for self identity.
These are the questions I'm working through right now.  It is something we've discussed in past sessions of Graduate School therapy and dug into more detail last night during the session.

Once we understand fully who we are and what our core identity is, we are better able to face the daily struggles and stresses of life.  It will also help us get to the root cause of our morbid obesity (and avoid letting ourselves return to obesity), understand our disfunctional relationships with food and how to fix that disfunction and also give us the tools we need to battle emotional upheaval in our lives when we're faced with it (at least that's what Dr. W. tells us). 

I'm putting this out here today to not only give you a peek into what we're dealing with in this therapy session and what's happening inside my head these days.  But I'm also sharing this jumble of questions in case you want to work on this project too.  It's going to take time and patience with myself, I know.  But if I attack it in a methodical way, it's like "eating an elephant" - one bite at a time.

~Pam

A Little Tour

As promised... here's a little tour of the new blog design.

• It's so Pretty!  I've adapted a blog template from Our Blog Templates - I like the wider main column so posts can have big pictures and lots of space for my ramblings.  I'm loving the lighter colors too, makes it easier on the eyes than the black background the old version had.
• Stay Connected - I've made it easy for you to stay updated.  Notice the links on the right column for RSS subscription or Email subscription.  If you follow lots of different blogs, I recommend getting a RSS Reader account -- I used Bloglines for years but recently have been trying out Google Reader. If it's easier for you to simply read my blog posts in your email inbox, there's now a way to do that.  Just click on the link --- > over there and sign up for the email service.  
• Twitter - who knew I'd like Twitter!  I'm not very chatting there, but I do read a lot of great stuff from the people I follow.  Click the link under the birdy to follow me.  All blog posts are automatically linked to my Twitter account, so you'll be alerted when a new post is up for reading. 
• Blogroll - I've finally gotten my blogroll rebuilt.  It's on the right column toward the end of the list.  Be sure to visit these folks - they've got lots of great things to talk about. Most are related to WLS, healthy living and nutrition... but you'll find a few other fun blogs in there too, like the Grey's Anatomy writers' blog.
• Favorite Sites - Down in the footer you'll find a list of links to some of my favorite websites.  Some are related to WLS, some aren't.  Be sure to check out Podrunner and Best Workout Music -- two great sites for mp3s to load on your media player for workouts. 
• Labels / Categories -- The label cloud on the right needs work. But keep an eye on that section, I'll be streamlining post labels to make things easier to find. 

Thanks for being here!  You mean a lot to me and I'm so glad I've got readers out there in cyberspace who actually read my ramblings.  Makes me glad I'm not just talking to myself (although, I'd probably still talk to myself even if you weren't here... so your presence just makes me less insane, right?).  

~Pam

Chicken and Veggie Casserole

Last night I threw together a casserole.  I'm eating it for lunch today and it's delicious! I decided to make a huge batch and freeze several servings for lazy cooking days.  The ingredients listed below are what I used, but you're free to substitute or add other ingredients according to your taste. Cut the recipe in half if you don't need a huge batch.

2 lbs chicken (I used frozen boneless skinless chicken breasts)
1/2 cup light Italian salad dressing
2 small zucchini
2 small yellow squash
1 medium onion
2 cups (or so) frozen mixed veggies (broccoli, cauliflower, carrots)
1 8oz package sliced mushrooms
1 cup edamame beans
1 cup frozen spinach
1 can diced tomatoes (I used Rotell)
1 cup black beans
1 can cream of celery soup (or whatever flavor you have)
1 8oz package shredded cheddar cheese
Salt & Pepper
Mrs. Dash seasoning -- or any herb blend you prefer

In large skillet cook the chicken breasts in the Italian salad dressing and season with salt & pepper (I used Lawry's season salt).  You may also need to add a splash of water to the skillet to keep the moisture level high. When these are cooked through remove from skillet and set aside.  While chicken is cooking chop all veggies to similar sized chunks.  When chicken is removed from pan, leave the remaining salad dressing in the pan and add all veggies. Add Mrs. Dash or other spices/herbs to your taste. Cover and let sautee for several minutes.  Cut chicken into bite-sized pieces and add to veggies.  Add cream of celery soup to the veggie/chicken mixture -- mix it in kinda of well, but don't stress about breaking up every little bit of it.  It'll take care of itself in the oven. 

Transfer the skillet contents to a large baking dish.  This makes a LOT, so you might need two baking dishes.  I used a deep 9x13 pan and it was filled to the top.   Add the shredded cheese to the top and pop in the oven.  Bake for about 30 minutes at 350 or until the cheese is bubbly and delicious.

Servings:  About 16 half-cup servings.

I'm So Proud

I'm so proud of Kristy, Jean, Tammie and Nan! 

They all finished the St. Patricks Day 5k Race in Bay City yesterday -- they all did amazingly well too!   Our WLS support group has planned a series of races to do together this year and this was the first on the schedule for us.  I couldn't walk yesterday because I hurt my back and didn't want to aggrevate it, but I was there to cheer them on and snap some photos of them crossing the finish line.

If you are a new WLS patient, look to these ladies for inspiration.  Kristy had RNY  4 years ago and just had a tummy tuck this pat winter.  Jean is almost 2 years post-op from her RNY and RAN this race - doing intervals of run/walk.  Tammie has the Sleeve less than a year ago and Nan just celebrated her 1 year anniversary of her RNY surgery.  They've gone from morbidly obese and unhealthy before WLS -- to a group of athletes who are fit, healthy and enthusiastic about exercise.  They are all amazing and such an inspiration to me.




Their finish times:

Kristy - 50:38
Jean -  39:09
Tammie - 55:56 (her first race!)
Nan - 43:15 (her first race!)

The Future Direction of This Blog

I've got ideas and to-do lists! This semester is done!  So now that I've got some more time, I want to tackle several ideas I have for specific blog posts in the coming weeks ... and also begin to build this blog into what I've alway envisioned it to be.  The future is here and it's time to get to work!

Personally I LOVE to-do lists.  Seeing things in writing helps me focus on what's most important and what needs to be tackled first.  It also helps me break down big, intimidating project into smaller manageable tasks.  And it gets all those whirling thoughts out of my head so I stop stressing about 'em.

Something I've been thinking about for a while now ... and I might regret saying it out loud here because it's going to take a lot of work in the coming months, and saying it out loud makes it real .... I'd like to add a whole bunch of WLS resources, information and other important content to this blog. I want "Journey to a Healthier Me" to be packed with information. So prepared to be buried! (I promise to give it to you slowly and in digestible chunks.)

I have done a LOT of research in the past 3+ years. I never knew I had such a passion for learning new things and digging deep into topics of science and biology and nutrition.  I've shared a lot here and on the forums but usually in small little nuggets to answer one small specific question instead of giving all the information I have on a single topic, I'd just scratch the surface so as not to overwhelm the question. But there's more, lots more... and it needs to be shared.  In fact, I have this sense of obligation that I should share what I've learned for those coming behind me in this WLS journey. Others gave so much to me when I was first learning and I want to pay it forward for others too.  This obligation I feel is not a bad thing ... but it is a  sense that if I've connected all these dots in my head and have all these resources I've amassed, is it ethical to keep it all to myself?  I feel like I've been given this gift of knowledge and it's helped me understand my body so much better... I want others to have that same understanding.  This kind of knowledge is empowering in the face of the changes we'll encounter along the way and helping others feel that same sense of empowerment is important to me.

I have a truckload of resources that I access regularly and it's scattered all over Timbuktu. It sure would be nice to have it all in one spot - for my own sanity. So I'd like to build a place here that's filled with information we all need to know. I am not, by any means, the be all and end all expert ... but I want to share what I know and what I've learned.  The more we know about how our bodies work, I believe the more successful we will be.  You'll notice some of the post ideas below relate to this very thing - understanding how our body works - both pre-op and post-op and understanding why there's a difference since surgery. My goal over the next several months is to fill this blog with that truckload of information -- and to also let this blog become more of a dumping ground for the information and knowledge I have floating around inside my head so I don't have to hunt for links and reports every time I want to refer someone to it.  But don't fret -- you'll still be subjected to my ramblings, whining, recipes and silliness along the way.

I thought maybe you'd like a preview of what's on the idea list for upcoming posts -- in no particular order:

• Digestive Enzymes -- I recently responded to a question on OH about what happens to our digestive enzymes after gastric bypass surgery. (Hint - they don't go away, they continue working.)  It was a pretty good response with a bunch of links, but I want to flesh it out a bit and get these resources up here.
• Nutrition Labels -- What I look for on the label and what things we should (or shouldn't) be concerned about.
• Group Therapy -- An update on some things I've learned in my group therapy sessions. Maybe share some techniques that will help you too.
• Diet Pills after WLS -- (DONE) Just an opinion piece that's still forming in my head. Will probably be a lot of rambling thoughts, we'll see.
• So you want WLS? -- A guide for people who are thinking about WLS and what first steps they need to take.  Not only how to research the surgery types, but what specific things need to be done with your doctor, insurance company, etc. 
• Four Types of WLS -- (DONE) Understanding the four different types of weight loss surgery and a list of resources for doing more research on your own.  RNY, DS, Band, Sleeve. 
• Weight Regain -- What the medical experts say about regaining weight after WLS. What are the statistics and what usually leads to regain?
• Eating on the Run & Meal Planning -- (DONE) Obviously I'm pretty busy, right?  I literally eat almost all of my meals "out" -- 5 of 6 meals are eaten outside my house.  But I eat home cooked food, rarely hitting a restaurant or drive-thru window. I make healthy choices for meals and snacks - but it takes a system, planning and dedication. Being on the run all the time is not a good excuse for eating poorly.  So I'll share some techniques I've adapted over the years on how to make it all work.
• Proof that WLS is Good -- I often hear of folks who can't get WLS because their employer has written an exclusion into their insurance policy.  There are ways to fight this intelligently to convince your employer to make changes in the insurance policy during the next negotiation.  I have resources I want to share about how to start this "fight" -- or discussion with your HR department.
• Support Group Meeting Topics -- (DONE) I've been leading a peer-based WLS support group for about 18 months now and I've accumulated a lot of material for meetings. I want to start building a series of posts about topics I've covered with my group along with downloadable files for the handout materials I've provided to my group. I so often hear of fellow WLR'ers who have horribly ineffective support groups and this might serve as a resource for other group leaders for ideas. (I'll build a new table of contents for this information, similar to the Recipe Index above.)

I know I have a bunch of really smart readers here.  I mean... smarter-than-me type of readers and also folks who have had a different journey than me and have experienced different things along the way.  I want to hear from you more!  (Sorry, don't mean to beg for comments.)  Most of the stuff I talk about here is one-sided... it only shows MY experiences.  Yours will be different.  I think we can all benefit from hearing what each other deals with and what strategies helped that someone else hasn't heard of before or thought to try.  For instance when I talk about nutrition labels I'm going to give you MY perspective - it's not the only way though and I'd love to hear what YOU look for on labels first, second, third.  So get ready.  I'm going to ask for your opinions a lot more in the future.  I know who you are.  I might even signal you out if you don't pipe up on your own.  You've been warned.  LOL!

Ok, so that covers the content items that have been milling around in my head (it always feels good to write those whirling thoughts down so they become a plan instead of just whirling thoughts). I've also got some housekeeping stuff around here that needs my attention. Not house-housekeeping... I'm talking blog-housekeeping.  A few weeks ago when I redesigned my blog I neglected a couple important tasks. But also now that it's so pretty around here, I want to do more cool stuff. So here's a few things on the plan:  

• Tell you About the New Stuff -- (done) This one will be coming very soon (in the next day or two).  There are some new things around here you might not have noticed and I'll be giving you the grand tour. 
• Reformatting Posts -- (done) I've discovered a couple old posts that were formatted with white text... UhOh! not good with a white background I have not.  So need to dig through the old stuff and make sure everything is readable. (If you find one of these "white" posts, send me a message so I can get that one done. In the meantime, to read that information, you'll need to highlight the page with your mouse-- where you "think" the text should be.  That will make the text visit while it's highlighted.)
• Blogroll -- (done) Still need to rebuild my blogroll. It got lost in the redesign - but needed major updating anyway. There's a placeholder for it at the bottom of the page (scroll all the way down), but when I'm done with the whole list, I suspect it's going to need a bigger spot. There are some amazing websites out there that I read regularly and I want to share them with you.
• File Hosting -- (DONE) Right now I'm using Scribd to host files I want you to be able to download. I don't like that you have to register with the site to grab the file. It's a great site and has lots of cool stuff from people all over the world... but I want a solution that's more user friendly.  Which means files will be hosted on my website and linked from there -- just that it'll take some time to transfer stuff and get new stuff uploaded. Visit my website Resource Page for other downloads.
• Updating Files -- A few of my downloadable files need updating with new information.  The Protein Book has a new rendition -- this is always changing as I learn new stuff (which is often).  And the multi-vitamin comparison spreadsheet needs updating because there's some new products on the market and some I didn't know about when I created the spreadsheet. 
• Recipes -- As I was writing the post last night about Freezer Meals, I realized that I don't have recipes up for all the stuff I eat regularly.  Like that beef stew I mentioned pulling out of the freezer - I thought it was posted here, but apparently it's not, so I couldn't link you to the recipe.  And now that I've got the Recipe Index, it's a great motivator to fill it up with new goodies!
• Make Stuff Prettier -- This coming semester I'm learning another program in the Creative Suite 4 family - InDesign - which is more about document layout and desktop publishing. I'd like to use what I learn to re-do several of my files to make them more consistent in look and feel and easier for me to update as I add new info. For instance, The RNY Rules - those articles were converted from various blog posts from the past years and I'd like to redesign them to make them look more like magazine articles with graphics and such.  And the Protein Book - oh my - managing a 160-page document in MS Word is a very bad idea, it needs serious help (and it needs a new title, so I'm taking suggestions on that). I wonder if my professor would let me use these re-designs as projects for class?
• Checking Links -- Older posts have links to older data that need to be updated with newer links.  (Like the Preparing for Surgery post has links to my old protein samples list that's on my OH Profile, but not everyone has access to OH, so that's a dead link to some people.)

Wow!  That list is much longer than I realized. I think I should be scared! Looks like I have a lot of work lined up for me in the next several weeks and months.  If you've got other things you'd like to learn about or want me to ramble on about (you know I'm good at rambling), just let me know and I"ll add it to the list.  I'll come back here and check off things as I get them done - it's going to take a while, but as least I've put it out here, which means I can't get out of it now!  

~Pam

Freezer Meals.

Today I pulled some meals out of the freezer.  On Sundays I usually cook a big batch of something yummy that I pack up for lunches all week.  Sometimes those dishes feed me for longer than 5 lunches (cooking too much food is a family trait, I blame my mother).  So of course by the time I get done eating the same thing for 5 days in a row, I'm not usually thrilled with the prospect of eating it for another 3 or 4 days to use up what I've got leftover.  So I'll package up the leftovers into individual serving size containers and stash them in the freezer for a day when I need a quick meal and don't have anything prepped.

The main problem is that I rarely have something prepared for meals ahead of time.  It's much more likely that I'm facing a pile of leftovers that need to be added to the freezer stash.  

But this past weekend I didn't cook.  I simply ran out of time and didn't get around to throwing anything together.  So I rummaged through the freezer to see what I could find.  Lo and behold!  I found treasure!  I had some chicken zucchini casserole stuff (mystery casserole?) for lunch today and couldn't believe how delicious it was!  OMG!  So I got home tonight and went looking for more mystery casserole.  I found another bowl so I'm set for lunch tomorrow.  But guess what I'll probably be cooking this weekend for lunches next week?  

I also found a container of homemade beef stew and more protein ice cream than I knew I had.  A month or so ago, I pulled out some leftover Southwest Chicken and turned it into Tortilla Soup, which was delicious. Plus I discovered I've got a bunch of frozen fruit I'd forgotten about - so protein smoothies are on deck too.  

Want some recipes of things that freeze well?  Here's a few links from the Recipe Index

• Christine's Southwest Chicken
• Empty-the-Fridge Casserole
• Creamy Chicken and Mushrooms
• Crazy Beef Casserole
• Wendy's Chili - The Homemade Version

As for the chicken zucchini casserole I had for lunch today.  I don't know what the recipe was.  It was loosely based on Eggface's Double Dip Casserole -- but different stuff.  Mine had chicken, zucchini, black beans, diced tomatoes, edamame and who knows what else (that's all I could identify clearly).  

I think I'll venture into my freezer more often.  

~Pam

I love dead grass

My lawn is a mess.  Dead grass, soggy sod, mud puddles along the curb and patches of lawn displaced from shoveling and plowing.  I've got fallen branches and sticks from the big oak tree and even some litter along the back fence line from months of accumulation.

It's a beautiful site.  And I'm loving every minute of it.

Really.  I'm not even being sarcastic or anything.  I love this time of year.  Just moments after the last of the big snow piles have melted and everything smells musty and damp and slightly decaying.  It is in these tiny moments when we realize that it's not all dead... it's the moment before everything wakes up from a long winter slumber. And soon - very soon - the flowers will pop their heads out from the dirt and announce that Spring really is here.

So yes, I love dead grass. Because it's not really dead - it was just sleeping under the snow.

Easy Oatmeal

This past fall when I was in Florida on vacation, I learned a new way to make oatmeal from my friend.  I guess it's not all that earth-shattering, but it has become my new way of cooking it. Instead of the normal stove-top method, I now do it in the microwave.  And once you have your basic bowl of oatmeal, you can add stuff to it mid-way through cooking.  Here's how:

Easy Oatmeal

• 1/2 cup Quaker Old Fashioned Oats
• couple dashes salt
• water
• "Other Stuff" (optional)

Choose a bowl that you think might be too big.  I use a large soup bowl.  You want room for the water to bubble without going over the edges.  Add oats and salt to the bowl, then add enough water to cover the oats (about 1 cup or so?).  Cook on high in microwave for 1 minute.

You'll cook this for another 30-60 seconds, so determine if you have the right amount of water.  Too much, pour some off.  Not enough, add a little bit.  If you don't want to add anything to your oatmeal, just cook it again for 30-60 seconds or until it's done.  If you want additives, go to the next step before cooking.

ADD STUFF -- this is the point where you'll add stuff to your oatmeal.  A tablespoon of peanut butter.  A handful of frozen or fresh berries (blackberries is my current favorite).  Cinnamon. Splenda. SF Maple Syrup. Protein Powder.  Whatever you have a taste for, add it now.  Stir it in.

Cook on high for 30-60 seconds.  Done!  I usually add a bit of Splenda Brown Sugar and a splash of milk before I enjoy it.

Follow up with Dr. Diet Pills

Yep, that's what I'm calling him nowadays. Even though he's an endocrinologist, he doesn't seem to be doing anything that endocrinologist-y.  Maybe I'm missing something, but it seems his first line of defense is to prescribe a diet pill as treatment.  So yeah, he's the "diet pill doctor" now.

So today I had the 1 month follow up with Dr. T.  As I suspected... he was thrilled with the "4lbs loss" (which is what I registered on his scale and based on my weigh-ins at his office).  And as you may suspect, that kinda pissed me off.  Which is stupid on my part because, c'mon... it's 4 pounds.  Pounds I couldn't lose in any other way, so why am I having such a hard time accepting pounds lost with a pill?  Still working on that one.

At our initial appointment a month ago I got the distinct impression that the doc doubted my compliance.  Ummm... not a good move on his part, huh?  You all know how much data I have and how much I love my charts and lists.  So I kicked it up a notch this past month and became a bit obsessive with the data.  I recorded my food everyday on FitDay and uploaded my GoWearFit data everyday.  Then I also created a little notebook that I carried around with me and transferred those number into a handwritten log.  And in that log I also recorded my meals, exercise, fluid intake, vitamin doses, calorie deficit and also notes about what I did that day.  It drove me a little batty - I don't like writing stuff down in long hand or having to prove myself to anyone.

So I kept good logs this month and for my appointment today I printed all my reports (daily, weekly and monthly) in case I got questioned on my compliance again.  And I got the question, of course.  So I kindly told him I'd brought him a copy of my food logs and asked if he's like to see it and handed over a packet of about 50 pages of data.  Ha!  I can't say for sure, but I think his jaw dropped.  LOL! I explained how I weigh and measure all the food I eat, how I plan my meals on a weekly basis and strive for certain percentages of nutrition and then how I record that info in my online food journal.  I told him about the GoWear Fit and how clinical trials showed it is accurate within 5% of other clinically approved methods of recording calories burned and was a medically accepted device.  To which he asked for the name of it again and wanted the website and information about where to buy one and how it work.  :: grin ::  He kept the pile of my reports and expect he'll probably check out BodyMedia.

Ok.... so I know you're waiting for the report about what happened.

He wants me to continue on Adipex. And also wanted to start me on Metformin to deal with any residual affects of PCOS and insulin resistance.  I thought I was ready for that recommendation.  I mean.... I expected him to be thrilled with the results and to want me to keep using the drugs because it was this big joyous success. But I guess I wasn't as prepared as I thought I was because I started to cry.  Just more emotional crap creeping up.  He asked me why I was crying and I told him the truth -- that being on a diet pills feels like I'm a failure and that I can't do it on my own and that anything I lose doesn't count.  He looked pretty confused and caught off guard, I think.  But he recovered soon enough and assured me that if this is what works, then we should continue until it stops working - then we'll explore what is going to work next.  Ok. Fine. Again.

Still haven't decided on the Metformin.  Need to look into that a bit more.  Kind of worried about how it will affect the hypoglycemia issue.  So I'll decide on that after some research and learn more about what it's suppose to do. (BTW - I was on Metformin for a while years ago after first being diagnosed with PCOS, but couldn't bear the side effects of upset stomach and general yuckiness.)

Ok, so the Adipex Rx has been filled.  I'll start this round tomorrow morning.  I've got two months on this round and a follow up with Dr. Diet Pills again in May. I'll keep you updated on how things go -- not with weekly updates like I have in this first month, but yes, regularly.

I have some thoughts on the use of diet pills after gastric bypass surgery that I'll share with you.  My thoughts today are not what they were a year ago.  I'm still not convinced this is the right thing - for me or anyone else. Once I get those thoughts a bit more in order, I'll share them here.

~Pam

My Nature Trail

When the temp hits 50 and the sun begins to shine - even if it's still early March - Michiganders rejoice and celebrate. We start believing it might actually be springtime or something. Oh sure... We know it is likely that we'll get another snowfall but we celebrate spring anyway.

So this afternoon I stopped at my favorite nature trail for a workout. 3 miles is good for the body and soul. Todays walk was less about the workout and more about mental health. Just a bit of time to commune with nature and get my thoughts in order.

My fingers are fozen and my nose is running so I guess it's not quite spring yet, but it sure feels good to be outside. I stopped at a bench to write this so I'll sign off for now and finish the last 1/4 mile back to the car.

Pam

-- Sent from my Palm Pre

OK Fine. Lesson Learned

My class load this semester was at full-time level - 12 credit hours.  Add an intense weekly group therapy session and emotional stress brought on by my battle with the scale plus the physical affects of the Adipex. Plus still leading the support group and doing my normal work schedule.  I remember saying to someone before this semester even started, "It's just 10 weeks. You can do anything for 10 weeks, right?"  Wrong!  All that craziness adds up to a very tired Pam.

But unfortunately, it's not just "tired" anymore ... it's turned into "sick" now. 

Last week I was battling a major headache that had me down for a couple days.  I still wasn't focusing well over the weekend and then Monday I got up with a sore throat and what feels like the beginning of an ear infection.  I've also got this sneezing thing going on. It happens sometimes -- basically I just start sneezing and can't stop and no medications will touch it.  Just a steady stream of sneezing for hours (it drives my co-workers nuts!).  This time around it started at midnight on Tuesday and is still hanging around tonight (Wednesday at 9pm).  My body is fighting back.  I've pushed it too hard for too many weeks in a row and it's telling me to stop.  I can't stop yet - finals week next week - but I am finally getting the message that I pushed too hard this time. I'll do what I can in the next 7 days to take care of myself and not push too hard.

A few weeks ago when I was registering for classes for the Spring semester everyone who cared about me told me to cut it back to two classes this time instead of three.  So I did.  Just two classes next semester.  Except I wasn't convinced.  Up until a couple days ago I was still contemplating signing up for that third classes - it was still open and it would have been an easy class (speech) and I kept checking the schedule to make sure it was still available.  Yes, I really was going to sign up for that third class against the advice of some very smart people.

Today I was sitting at work feeling like crap when I realized my body was forcing me to slow down whether I wanted to or not.  OK fine.  Lesson learned.  Slow down, Pam!  I won't register for that third class next semester.  And I'm going to do a better job of saying no and focus more on taking better care of myself.

~Pam

Week 3 on Adipex

Technically I'm at about 3.75 weeks -- sorry I'm late.  But essentially week 3 on the new drug (Adipex is a diet pill) was pretty unremarkable. I've got 3 pills left in the Rx and I see the doctor on Friday for a follow up, which means I'll be off the pill for 2 days before I see the doc. So here's the roundup:

WEIGHT -- Last week I reported I was 189.6.  This week I'm about the same.  Somewhere between 188.5 and 190 seems to be where the scale has settled most days this week.  So I'm going to leave the official number at 189.6 and continue to call it a 3-pound loss.  (For reference - most people who report on forums and reviews claim to lose about 10 to 20 pounds in the first month.)

DRY MOUTH -- the dry mouth side effect is starting to get on my nerves.  It seems the only thing that resolves it is chewing gum.  I'm still getting my fluids in (averaging 75oz to 85oz/day) but it just doesn't seem to quench my thirst.

SLEEPING -- I went a couple days without eating a banana and ended up with a sleepless night mid-week.  Next day I had a banana and slept like a baby that night. Dr. W (my psych who specialize in neuro-psych) was the one who originally suggested eating a banana to see if my potassium levels were out of whack because of the drug.  I didn't have my levels tested at a lab, but eating a banana seems to keep things balanced for me. I guess I could switch it up with an avocado once in a while since those are packed with potassium too.

FIDGETING -- the first week or two I was restless and energized - and not in a good way.  That seems to have leveled off this past week and I don't notice it as much.  However, I seem to have much better stamina when it comes to putting in long hours in the day.  For instance last weekend I did about 11 hours of school work straight through and finally went to bed around 3am - and was back up and wide awake at 8am for more homework.  So there must be increased energy coming from somewhere, but at least it doesn't feel like I'm on speed anymore.

EATING -- the nausea has completely gone away, thankfully.  And I'm eating pretty close to normal.  Averaging about 1100-1300 calories a day.  However, I've noticed a disturbing trend of missing dinner.  I eat an afternoon snack around 4:30 and on class nights I'll eat a small snack during break (pb crackers or protein bar) then a small snack when I get home (hot cocoa or slice of turkey) just before bed.  But on non-school nights the afternoon snack seems to hold me through until late at night when I suddenly realize that I didn't eat dinner.  This relates to how the drug works, I'm sure - it attacks the hypothalamus which is the hunger center of the brain.  More below.

EXERCISE -- I've made an effort this week to move more - not that I've got any extra time in my hectic schedule, just that I've decided to neglect some obligations in favor of others. So a couple homework assignments didn't get done and I'll just sacrifice a better grade.  Not sure if it was a driving desire to exercise or the fact that the sun was shining and I was tired of the long dreary gray winter days and just wanted to be outside.  It's easier to squeeze in a workout when the weather is nice and you can actually go outside.  Soon this semester will be over and the snow will be melted and I can do regular workouts on my favorite nature trail.

WHAT'S NEXT -- I have a follow up appointment with Dr. T. on Friday afternoon, so I'll post here to give an update on that.  Adipex is recommended for short term use (4- 12 weeks) so I'm anticipating that my Rx will not be renewed.  Which is fine with me since it doesn't seem to be doing anything significant for my weight loss.  Interestingly, in my mind the lack of success with weight loss on this pill seems to prove even further (in my mind) that something is wrong with my body .... or it's at a set point that it doesn't want to budge from.  If something medically is really wrong, I want to know what it is.  But I'm also nearing the end of my patience with the process so I'm not sure how much more I'm willing to push for answers.  I guess I'll know more after Friday.

Below is a general summary of some of the research I've done in the past couple weeks.  It is in no way exhaustive  -- I really focused my reading on how the pill works within my body and then dug deeper into the reasons behind the specific side effects I experienced.

THE RESEARCH -- So finally after the crazy sleep deprivation and constant nausea and emotional upheaval cleared I was able to go back and do some more research on the drug itself and what was causing those issues.   Yes, I'd done some research beforehand, but I realize now that I didn't fully know what I was getting myself into and didn't know which research to look for.  Now I know.

Wikipedia has a pretty good section on Phentermine (which is the name of the medication in Adepix).  Of course the best part of Wikipedia is the reference section at the bottom which gives you the real information and clinical studies, etc.  Here's what I've figured out about the drug as it relates to what I've experienced:

Phentermine works on the hypothalamus of the brain -- this is the part of your brain that controls a whole bunch of stuff that goes on in the body.  Yes, hunger is one of those things - but if you screw with one thing you're going to be affecting all of the others too.  The hypothalamus controls body temperature, hunger, thirst, fatigue, and circadian cycles (our internal human clock which helps to regulate sleep) as well as affecting the endocrine system and governing emotional behavior.

The hypothalamus also regulates the initiation of the fight-or-flight response to received threats to our survival.  The fight-or-flight response is meant for short-term reactions to immediate threats, so the body is in hyper-arousal mode with all systems at attention to deal with that one immediate threat.   While the body is in high-alert mode, the appetite is reduced and other body responses are heightened.  Adreline and noradreline is released which causes the heart rate to increase, triggering the release of glucose for energy and increased blood flow from muscles. The body also shuts down the blood flow to the digestive system to speed all energy and resources to skeletal muscles for fighting and rational thought is weakened in favor of survival instincts. Adipex causes the release of the neurotransmitters that signal the body to go into fight or flight mode.  This is thought to result in the restlessness, fidgeting and anxious feelings of the drug.

Ok, so what about the banana thing?  So the theory is that the extreme thirst and dry mouth issue is a result of what the drug is doing to my hypothalamus. And because of the increased fluid intake it's causing increased potty breaks, which then contributes to a depletion of electrolytes (potassium being one of them).  Electrolytes (sodium, chloride, potassium, calcium, etc.) also play a large role in nervous system transmission and the hypothalamus has a very large nerve center in the brain which sends signals for proper function throughout the body. So, does unbalanced electrolytes cause problems with nerve communication or is nerve communication from Adipex impaired in the hypothalamus which in turn creates an imbalance in electrolytes?  I don't know.  But somehow the bananas are making side effects better for me ... so something is going on there.

One final note.  Remember Dr. W... the neuro-psychologist who studies the brain's function and has worked with bariatric patients for over 25 years ... he warned me this past week in therapy class that after stopping any diet pill that affects the hypothalamus to be careful about appetite.  Appetite can return at 150% of it's original strength before starting the drug and can often become uncontrollable.  Yeah, this scares me.  Before I started Adipex I had no problems at all with appetite or controlling my food intake.  It'd be nice if I just go back to that same level.  I'm hoping it'll be alright when I stop taking the pills.  Maybe just knowing its a possibility will help me to control it... if it becomes an issue.

~Pam

The Recipe Index

I have created a central list of all the recipes I've posted here over the years.  Once I got them all into one place I was amazed at how many there are!  You can find the Recipe Index at the top of this page, just below the title header .... see that series of tabs?

- Home - My Story - Popular Posts - Recipe Index - RNY Rules - Pam's Other Websites -

I've sorted the recipes into categories and will update the link list as I continue to concoct new recipes ideas. When you click on a recipe in the list, it'll take you directly to the blog post where it was originally written.

• Protein Shakes and Drinks
• Protein Treats
• Beverages
• Appetizers
• Breakfast
• Soups and Stews
• Side Dishes
• Main Dish / Entree`
• Dessert
• Bonus Stuff

As I was going through and putting in all the links I was surprised at how many things I'd totally forgotten about.  So many yummy sounding, delicious tasting recipes I've neglected all these months.  I'll be cooking something off the list this weekend, just have to decide which recipe to use. 

Have fun!
~Pam

Techniques to Manage Emotional Eating

Emotional eating -- it's a battle we'll fight every day for the rest of our lives. Weight loss surgery doesn't fix it, losing weight doesn't fix it - it's a habit we have to sort out on a mental and emotional level. So learning techniques to combat emotional eating is the key to being successful with long term weight loss. Here are some things my psych has taught us in support groups and group therapy sessions that might help:

• Know that it's OK to have emotions. The sooner we realize that emotions are perfectly natural and a part of who we are, the better. When we have an emotion we don't like or enjoy, we don't need to bury it, or squash it, or try to get rid of it -- that's what we've been trying to do when we eat to sooth our emotions. Instead try this: Sit quietly for a moment and acknowledge your emotions. If you're angry, then be angry. If you're sad, then be sad. If you're happy, then be happy. You don't need food to acknowledge those emotions, you just need to recognize the feeling, accept it and move on with your day. It takes practice and it's not fun or easy sometimes ... afterall, this technique means we actually have to face the crap we've been running from all these years. 
• Say out loud "I'm not hungry, I'm emotional." Thinking it to yourself doesn't work... you have to say it out loud, hear it spoken and acknowledge that the action you're about to take is emotional-based and not hunger-based.
• Know your emotional triggers. (upset, sad, happy, stress) and which trigger is the most prone to get out of control the fastest. And also think about which emotion has the least affect on your eating. For me I'm most prone to emotionally eat when I'm angry and least likely to eat when I'm stressed. Write it down.  Make a list and take the time to explore the reasons behind why certain emotions make you eat but others don't.  This is a process, so don't rush it.  Work in small chunks and keep coming back to this list to continue exploring your emotions on paper.  Thinking about it is fine, but writing it down makes those thoughts real so it's important to literally use pen and paper in this exercise.
• Make of list of your trigger foods -- what do you turn to when you are emotionally eating? (ie: sweets, salty snacks, alcohol over-doing healthy foods?)  You might think you already know this stuff... but making a conscious effort to think about each thing, write it down and have a list can help you recognize it when it's happening. For instance one emotion might trigger certain types of food but a different emotion might make you reach for a different type of food.  But exploring the details of it is important so you know what battles you have to fight when the emtion creeps up.  So when the next emotional instance comes up you'll be able to more readily recognize what's happening before it happens and you can put a stop to it. 
• Find an alternative activity. If you eat when you're bored, find a hobby that occupies your hands (knitting, scrapbooking, gardening). If you eat when you're happy, figure out how to release that joyous energy in a positive way (turn the radio up loud and dance around the house with the kids). If you eat when you're angry, find a way to get the aggression out (kickboxing, weight lifting, scrubbing toilets). Make sure you have that list of things written down too. So when you're in the midst of an emotional rant you don't have to be responsible for thinking clearly to find something to release the emotions... just refer to the list and pick something. 
• As GI Joe says... KNOWING is half the battle. As you work through this process there will be times when you know you're eating for emotional reasons rather than hunger.  And we all know that many times emotions are much more powerful than our logical brain - so sometimes we win against the emotions and sometimes the emotions win.  But knowing that you're in the midst of an emotional eating binge is an important step.  Remember back when you didn't think twice about eating for whatever reason you felt like eating?  But now you're more aware of your body and you're more aware of how your emotions can trigger food obsessions.  This is a huge leap from where you started.  So think of it as one more baby step in the right direction.  Over time, we'll grow stronger and more able to deal with these decisions of handling our emotions in a healthier way.
• Mistakes happen. No matter how hard we try emotional eating is going to happen. When it does, don't let guilt plague you and make it even worse. We're not allowed to indulge in guilt-eating to make up for the emotional-eating! Instead, acknowledge that you made a mistake, forgive yourself and move on. Don't dwell on it. Just make the very next step, the very next meal or snack... the right choice.  

What NOT to do to control emotional eating.  So often I hear people give advice to just replace the "bad food" with a healthier choice.  So instead of having a slab of chocolate cake when you're feeling sad, have a salad instaed.  The problem with this advice is that it doesn't really address the emotions involved.  You're still buring your saddness in food, just that it's a salad instead of cake.  The cycle continues.  And eventually you'll turn back to the cake because let's face it, salad is not very comforting in times of sorrow.  So it's important to address the EMOTIONS involved and how we manage our emotionis -- once we are able to live with the emotion and stop trying to bury it or hide it, our behaviors will reflect this healthier mental state.

~Pam