Weighty Matters

One thing that I’ve been working on for the last few months is what my daily food plan should look like. It is difficult to decide how many calories are too many or how many grams of protein and carbs I should aim for every day. Different people in the group that I’ve joined have different nutritional goals. I’m just trying to figure out what is right for me, what will help me achieve my goals.

I’m taking in all of the information. I know mathematically that I need to use 3600 calories more than I take in in order to lose a pound. However, there are so many other factors including my age, body chemistry, frame, genetics, metabolism, overall physical condition, and so on.

It took a while for me to accept this, but I realize that in order to lose weight, I can shoot for about 1000 calories of food a day but I also need to focus on what combinations of food make up those calories. One of the things I heard in this group is to focus on protein and produce. Basically, as much as I have resisted the idea in the past, in order to lose weight I really have to cut out most wheat flour products most of the time, other “white” carbs like white potatoes, white rice and pasta, and pretty much all refined sugar stuff.

Okay, that last category should be a no-brainer. Cookies, cake, breakfast pastries, donuts – well, they do not a successful weight reduction plan make.

What I’ve also learned is that even so called “healthier” carbs brought to my diet from beans and legumes and some produce, as well as sugar in fruit, need to be ingested in small amounts or only occasionally.

Fruit might be produce but I won’t be successful eating it three times a day.

Overall, I’m shooting for 900-1000 calories a day with 80-100g of quality protein, 50-75g of healthy carbs, 80 plus ounces of water.

For the most part, I’m making the adjustments to hit these goals more easily than I expected. My determination is at this time much stronger than my resistance. I so badly want to get 60 pounds off and would like to get as many of them gone before my knee surgery. I’m even more strongly motivated now than I was. I guess for a long time I was sort of passive and just going along eating what I wanted instead of keeping my focus.

It’s still a struggle. Constant vigilance is still necessary to battle the ever present eating disorder. I’m not perfect but I’m much better than before. I have faith that I’m going to be able to sustain the effort and be successful.

Today, January 25th, is the fifth anniversary of my weight loss surgery. It’s hard to believe that so much time has gone by!

Because the last six months in particular have been mostly a discouraging struggle with some regain of weight, I’m probably not feeling quite as overjoyed as I could be. I’m sort of bummed that I’m sitting 60 pounds from goal weight and that I still haven’t hit that magic number after five years.

Then I stop, give myself a mental shake and remind myself just how far I’ve come.

I’ve lost 136 pounds from my top weight and, even with the regain I experienced I’m maintaining a weight loss equal to the total body weight of many of my friends and family members. (Okay, I have a LOT of friends and family who weigh even less than 136 pounds.)

Before my surgery, I had Type II diabetes and was on a prescription to lower my blood sugar. I was on a beta blocker and a second medication for high blood pressure, plus yet another prescription for high cholesterol.  Now, I’m not on any of those meds and not dealing with those conditions.

At age 59, even carrying too much excess poundage, I am much more physically fit than ever in my life. If I was this fit when I was an active kid, I sure don’t remember. It’s common for me to do a 45 minute intense rowing workout with my heart at 90% plus maximum rate and stick with it, mixed in with strength-building exercises and other “fun” stuff. (Today we held wall sits for 90 seconds. Ever do a wall sit. Oh, go try it, just for fun. Put your feet shoulder width apart about a foot or so from a wall, back against the wall and go into the sitting position with your thighs parallel to the floor. See how long you can hold that position before your legs start to burn.  Really, we’ll wait. 🙂  )

Okay, I’m just kidding, unless you want to give your upper legs a quick workout. I just described it because I’m proud of the fact that I can do that and other exercises.  Like planks and sit ups and a number of other things that I couldn’t do before. I still ride my bike outside too, which I wouldn’t have attempted before the surgery.

In the last five years, because of the weight loss and better fitness, I’ve experienced some wonderful adventures during great vacations. The summer before my surgery when I went to Alaska, I could barely walk a couple of blocks before I would feel my heart pound and gasp for air.  Plus, my entire body hurt.

In the last five years, I’ve been to Hawaii twice where I’ve snorkeled, done snuba, hiked down, across and out of a crater and other cool sites.  I’ve even ziplined.

I’ve gone on a couple of cruises which gave me the opportunity to take long kayak trips, more snorkeling, help race in a sailboat, do hour long line dance lessons and other fun things.

Last August, I spent 10 days in Brazil on a rustic river boat exploring the Amazon. Each day we stepped from the boat into large canoes and then sometimes climbed out of them up river banks. On one memorable day we jumped off them into an enchanted lake and I then had the upper body strength to boost myself up out of the water and back into the canoe.

Before my arthritic knee started to get worse, I even participated in some 5K walks.

By losing so much weight, I’ve enjoyed a countless variety of NSVs – non-scale victories.  Just being able to walk without gasping is a joy. So is fitting comfortably in an airplane seat – even the middle seat – and also being able to buckle the seat belt. Speaking of fitting in seats, one of my closest friends and I spent two days at Universal Studios two years ago. I’d avoided theme parks and rides since 1998 because I just knew I’d be humiliated when I couldn’t close the safety bar. At Universal, we rode all but one of the rides and I never had an issue. I was elated!

Even at home, my life is so much fuller and more able. From Tai Chi to Zumba classes, to the simple activity of functioning better on any given day, I can do so much more – and so much more comfortably.

Emotionally, the last five years have been happier, more joyful, and less dragged down by the constant impact of being a Super Obese person.  Do I still have challenges connected with the never-cured disease of an eating disorder? Yes, and sometimes I can get down. I’m only human and that’s nothing unusual.  Nobody is happy-happy-joy-joy 24/7/365. But there again, things are so much better and healthier. My spirit is lighter.

So, five years out from surgery, life is very grand indeed. I have more adventures I want to take, among them other things like Brazil that I would never have attempted at 386 pounds. I am geared up to get back on the losing track so that I can finally lose the remaining weight and get to goal.

I am so, so happy that I finally had the surgery five years ago. Doing so restored my health and has helped me reclaim my life. Happy Surgiversary to me!

In the early days post-wls, it was easier to tune into hunger and satiety. My stomach had recently been cut to a third of its size, there were foods I couldn’t tolerate and the area that produced the hunger hormone had been removed. I was rarely hungry to start with and didn’t want much to eat or drink.

Gradually, that changed. My stomach sleeve is still restricted but it has stretched a bit, I’m sure. As I got further away from the surgery and recovery period, I would have done myself a great service if I’d really tuned into my hunger and satiety levels. Instead, I often still just ate until I was a few bites past comfortable.

I’m really working hard on developing my mindfulness around my eating. I did work last fall on exchanging a habit for a new one. Eating mindlessly, particularly while watching television or working on my computer was the habit that I wanted to let go of while I cultivated more awareness at the time of eating.

After the surgery and full liquids period when I started to eat solid food, it was suggested that I eat six times a day – three meals and three smaller snacks – so I could get in the proper amount of protein and other nutrients. I kept up that pattern out of habit. I believe now that I trained my body to eat by the clock instead of really noticing and eating according to true hunger cues.

So, I’m trying to retrain myself. I still pack the snacks to have during the day, but if I’m not truly hungry at 10 a.m., which was my regular mid-morning snack time, then I don’t eat. I wait until I’m actually hungry – but not starving – at lunch time and eat that meal. Same thing in the afternoon. I check in with myself to see if I really want food at 3 p.m. Sometimes I do; sometimes I don’t. Keeping up with my daily water intake often helps. Dehydration can masquerade as hunger.

At my actual meals, I prepare and serve myself appropriate portions, still focusing on protein and produce. However, I pay attention instead of letting myself be distracted by external things. I’ve noticed that there have been meals when I was satisfied and comfortably full before everything on my plate was consumed. I could just wait a few minutes and eat some more, but instead I’m trying to stop, pick up my plate and put the remaining food away instead of eating it.

Understanding my own hunger and satiety keeps me on track, that’s for sure!

I’ve treated myself to an easy, lazy, Sunday. It’s not that I’m sacked out on the couch doing nothing, but I didn’t pack a 100 things into the day either. I slept until 8 a.m. and then spent a leisurely morning with breakfast, the newspaper, and some morning news shows. I’ve been fascinated about coverage of the various Women’s Marches across the country and around the world.

I helped my elderly neighbor with a problem on her cell phone and then invested time in taking care of myself and my recovery. This means that I really thought about the week ahead and my food needs so that I could think about meals and make that important shopping list. These steps are critical to me maintaining a successful effort and sustaining abstinence from compulsive eating and counter-productive food choices.  I also realize that following this process alleviates stress. When I make the plans ahead of time, I then don’t spend a lot of additional time thinking about food, wondering what to eat and when and fussing about the choices. I definitely notice a difference in my attitude and emotions. I’m much more relaxed.

I got everything I needed from the supermarket. With that chore out the way, I did some Tai Chi, and am now sort of chilling before doing another chore or two. I’m soon going to start a bathroom remodeling project, so it would be good to start storing some extra towels and things to clear out the room that’s going to be torn apart. Eventually I’ll also do laundry.

There’s a lot of benefit to a day that isn’t overscheduled. There’s time to get things done and time to relax too. We all need that some days. I hope you’re having one too.

My day started with Tai Chi class. When we did a full set at the end of class, I felt so balanced and stable, even when balancing on my right knee. Over the last two years, that knee’s condition has worsened. It isn’t as strong and it is less stable, which really contributes to my decision to get it replaced in March. I can’t wait to get it done, complete my rehabilitation and move forward with greater strength and a lot less pain.

After class, I went to Key West with a couple of co-workers/friends to join the Woman’s March. Yes, even here in the laid back Florida Keys, we wanted to rally and have our voices heard.  I’m not going to get all political; that’s not the purpose of the blog. Plus, frankly, I’m tired of talking about it, or hearing about it, all of the time.

All I will say was that the rally was peaceful and uplifting. It was a true boost to the spirit. We walked up Duval Street, pretty  much Key West’s best known street, from on end to the other, carrying signs, waving at people, and occasionally chanting positive messages. There’s been an overload of negativity lately, so being part of this experience was simply an amazing antidote.

I was a little young to be truly active in the peace and anti-war rallies of the 60s. I remember marching and shouting against the Vietnam War in some little protest once in our home area but it was seriously a small affair.  Another time, when my friends and I were around 11 or 12 we picketed City Hall over a proposed ordinance to stop letting dogs go on the beach in the off season. We walked around with signs and dogs, including a small one in a wagon filled with sand.  My family’s dogs were at my grandparents, so I actually borrowed my next-door-neighbors’ dog. I’m not sure if we actually influenced the city government to not pass that ordinance, but I’m sure we entertained the City employees and the local police with our earnestness and signs. Someone called and told my parents. (We had not pre-informed our folks of our intentions.) Dad could barely keep a straight face when he asked me about it that night. Great memory!

I can tell you that civil marches and activism were easier on my body back then. Duval Street is about a mile and a quarter in length, plus we logged additional distance going from a parking lot to the starting point, then stood for an hour before the march began. Duval Street isn’t that wide and there were a lot of participants so we filled the street. (Hoping to get a credible estimate of the number of marchers. Edited to add: Event organizers say we were 3200 strong. That’s a big number for a relatively small town!) The pace was leisurely, but Woman’s Stroll just doesn’t have the same impact as March. Still, it’s a good indication of how bad my knee has gotten that the pace and distance really affected me. By the time we finished, I was feeling the burn as my knee throbbed and felt swollen. I was more than happy when my friends suggested we catch a cab back to the car rather than log another mile on our feet.

We went out for an early dinner after the event and then came home. As soon as I entered the house, I apologized to Nat because there was no way I was taking him out for a walk. He was happy to go out in the yard as long as I served him his dinner right after. After mixing up his bowl, I quickly swallowed two OTC pain relievers , grabbed an ice pack and sat on the couch with my leg elevated. It feels much better than it did a few hours ago, and the residual throbbing will pass.

After so many years of sedentary life pre-weight loss surgery, and then the last five years of becoming more fit and enjoying so many physical activities, I don’t like these reminders that I am hampered in any way. I think the thought of my knee getting worse and worse – to the point where I’d have to start giving up more activities, is what really pushed me over the edge to making the surgery decision. I don’t ever want to get to the point where I start to think, “No, I can’t do that.” Now and forever when something comes up that I want to participate in, I always want my answer to be, “Yes I can!”

We’ve all heard it: Drink 8 to 10 glasses of water a day. For most weight loss surgery (WLS) patients, the daily water intake recommendation is between 64 and 100 ounces a day. However, there are also other challenges, such as not drinking water with meals or, in some cases, not closer than 30 minutes before a meal. After a meal, good luck if you can get any water into the restricted stomach space.

I like water, but it has always been a challenge for me to get in the recommended amounts on a daily basis. The women who run the group I’m connected to post weekly challenges for us. Last week, the challenge was achieving adequate hydration every day.  For many days I improved my water intake but didn’t reach the goal I’d set for myself – 80 ounces minimum a day. I do better on days that include a rowing workout because I’ll go through 20 ounces during the workout or immediately after.

A book of daily writings for WLS peeps offered some suggestions a few days ago. The book suggested creating strategies for how I could improve my water intake. Oh, before I forget, most doctors that I’ve heard of count water or decaffeinated tea without anything added. Anything else doesn’t count to the total goal. A few other doctors apparently count any fluid.

Anyway, after reading that entry, I thought and thought about what worked for me and what might work even more effectively. I knew if I kept a glass filled with water on my desk, I was more likely to regularly sip on it while working. So, I decided that having a larger glass might naturally lead to me drinking more, plus I’d have to make fewer trips to refill.

A few days ago when shopping at the supermarket, I passed the small section of refillable water bottles and glasses. I spotted the perfect new plastic glass.  It holds 32 ounces, has a handle and a lid for a tight seal (a necessity in an office environment that includes curious cats), plus a reuseable, washable straw.  I laughed when I saw that it was appropriately called The Bubba. I grabbed that glass and added it to my cart in a heartbeat.

Let me tell you that The Bubba has become my best tool in my determined effort to achieve proper hydration.  With its help, I’ve absorbed between 92 and 100 ounces of water each day for the last two days.

I truly have noticed that all of this hydration brings benefits. It makes my muscles feel good, particularly when I’ve done intense workouts. It flushes out my system which is an asset when working on losing weight. I also see and feel less puffiness in my joints.  I also don’t experience the 3 p.m. sleepiness that happens your brain isn’t hydrated enough.

Being a WLS patient is a lot of work with many different things to remember. Setting myself up for success with planning and The Bubba makes it a little simpler as I strive to reach my daily hydration goals.

The food plan that I’m following these days is high on protein and low on carbohydrates. Even in the low carbohydrates, I’m mostly abstaining from eating flour-based products, potatoes, rice and refined sugar products. I still eat fruit but not more than once a day and not every day at that. For variety, I sometimes get protein in beans and legumes.  I have goals for myself each day in terms of total calories, number of grams of protein, number of grams of carbs. Mostly, however, you can sum up my food emphasis on P & P – protein and produce.

P & P keeps it relatively simple, but it doesn’t have to be boring or flavorless. Was I trying Plated.com back in June before I went on my blogging hiatus? If not, we’ll save that for another blog post, but if you haven’t heard of Plated.com, it’s one of the services that sends you all of the ingredients and recipes/instructions on making the meal. I don’t use it every week, but it’s a great time saver. It has also taught me to try new things, cook meals I’ve never tried before, and taste new flavor combinations.

Over the last five years I tried to cultivate an attitude of “Sure I’ll try it” when it comes to healthier alternatives in meals. Well, and healthier choices overall.  In the course of this endeavor I have become a huge fan of the humble cauliflower. In the past, the only way I wanted to eat cauliflower, and that “wanted” was a stretch, was if it was steamed and then covered with cheese sauce. I thought it a boring vegetable without much flavor. To some extent that “not much flavor” part is true, but cauliflower turns out to be a great foundation for a lot of dishes that rock their yumminess.

First I started with a basic mashed cauli – something I’d first seen friends do on the South Beach Diet. Steam the veggie and, after it was cooked and drained, mash or puree it with some butter or olive oil and season it. It really did turn out to be a great substitute for mashed potatoes. I got into roasting veggies of all kinds, and cauli was an excellent edition with some olive oil and fresh herbs drizzled on it.

A few months ago, I was craving baked macaroni and cheese.  I decided to see if I could make a version using cauliflower instead of macaroni.  I’m here to tell you that I succeeded with tasty results. If you try it, just make sure to drain the cauliflower really really well before adding it to the cheesy sauce mixture and baking it.

Tonight I tried something I’ve wanted to try for a long time. I’ve been hearing a lot about cauliflower “rice”. This is really just cauliflower pulsed in a food processor until it’s turned into rice-sized pieces. I love risotto. It is one of my favorite side dishes and, with very little urging, I could make a meal out of it with no other accompaniment.  I actually did that once in, of all places, Venice, Italy. I was there as part of a tour. At one of the dinners arranged for us, the appetizer was octopus and the entree was liver with risotto on the side. I don’t eat things that swim and the very thought of liver makes my stomach curdle. So, I ate a double-serving of risotto and was perfectly happy.

Some years ago, I think it was pre-WLS, I took a cooking class and learned how to make risotto myself and I’ve refined my dish by picking up tips from cooking shows.

Sadly, it’s a dish that I’ve denied myself in the last five years, except for a few extremely rare times. Given my love of this particular food, you can see why the prospect of being able to substitute a vegetable for the starchy rise would appeal to me.  My supermarket only recently started carrying cauliflower rice. I could have made it myself, of course, but spotting the package with everything already shredded gave me extra motivation and I grabbed a bag.

Traditional risotto takes a good 45 minutes to cook as you slowly add liquid in thirds and stir until each addition is absorbed. I wasn’t sure exactly how to cook the dish with cauliflower so I did the best thing I could think of – I Googled for some recipes.

I am here to tell you that the resulting dish was absolutely delicious! Seriously delish, like I would serve it to guests. I input the ingredients into my food tracking app and was pleasantly surprised that even with some cream, cheese, pancetta and peas, the nutrient counts for protein and carbs are completely workable. I had no trouble eating a serving tonight and knowing that it was inline with my daily nutrition goals. Put another star in the cauliflower column for versatility and taste.

While I won’t make risotto all of the time, it’s helpful to know that I can choose a healthier, more veggie-based version of a dish that I love and enjoy eating. Like everything else on my daily food plan, it’s important me to incorporate this in balance with other things, but it’s completely doable. If you need to get more vegetables into your daily menus, I highly recommend you experiment with getting creative with cauliflower!

After five years, I’d sort of forgotten how much preparation work is necessary before surgery. Granted, I had to do more things before having weight loss surgery than I do for the knee replacement, but there are still several tests I need to have done. I also have to schedule a pre-surgery registration appointment and a rehabilitation orientation. I’ve already had the CT scan that the surgeon needed so that my custom knee implant can be built.

The surgeon’s office issued detailed instructions, including the phone numbers I needed to call. I’m pretty impressed by their operation, although there are a couple of flaws.  The instructions tell me that their office recommends that I have the pre-surgery tests done five to six weeks ahead of the operation and that they need to have the results in their hands a week prior.  That sounds cut and dried, right? Well, almost. A few sentences down from that recommendation is the information that the lab tests are only good for 30 days.I think they need to double-check their own math because five to six weeks = 35-42 days.

I called my primary care physician to schedule the appointment for my labs. The scheduler suggested two weeks before my surgery for the tests and then 10 days before for my appointment with the doctor to get the medical clearance. Worried that we might be cutting it close on that “surgeon wants the results and the clearance letter a week prior”, I made the scheduler confirm twice that everything would be done and reports received on time.

The other two appointments – pre-surgery registration and rehab orientation – have to be done in Miami where I’m having the operation. Thankfully, I was able to schedule these for the same day so that I don’t have to take two days off from work to drive up, have an appointment, and drive home.

Do I sound like I’m whining? I don’t mean to. Honestly, I completely understand why all of the lab tests are necessary. It would be a very bad thing to be harboring an infection or some other medical condition I didn’t know about when I go into the hospital to have my knee opened up.

This is more my “bottom liner, get things done” tendency. I resisted the very idea of having the surgery for so long, but now that I’m committed, I want to have every last thing scheduled, organized and in place. Not only is this necessary to make sure things stay on track, but it will actually reduce the potential for stress as the surgery date approaches.

I can’t believe that I have gone seven months and not blogged. I am so sorry.  As I look at comments, I am deeply appreciative that you checked up on me. Again, I’m sorry.

I really didn’t mean to be gone so long. I thought it would be a short break and then I’d think about blogging and not feel like I had anything of any interest to say. Other times, I’d think that I really should check in because I missed all of you, but I’d feel overwhelmed or overtired from the day and think, “Tomorrow.”  Lots of tomorrows followed one right after the other.

Looking back, I’ve had a lot of days when I felt all of those things and more – that I had nothing of interest to say, that I was overwhelmed, that I was exhausted. It’s been crazy for me at work and for most of the last seven months I’ve been a department of one doing all of the responsibilities that are normally handled by me and another person. No surprise that by the time I finished in the evenings, I couldn’t muster the energy to write. To be honest, I had a lot of nights where I’d fall asleep on the couch, right in the middle of a television show I wanted to watch.

Honestly, I think the thing that really held me back was not knowing what to blog about. Frankly, I was in a really bad place with my food and eating, and I was constantly struggling with my eating disorder.  Emotionally, I was on a roller coaster. Physically, I felt like crap as I kept putting on weight, losing it, then putting it back with a little extra.  I guess I thought that all of my blog posts would be bummers.

Not that all of the last seven months have been horrid. No, far from it. I took an awesome trip to Brazil and the Amazon forests in August. I’ve continued to work on my workouts and Tai Chi. I’ve had some fun times with friends and family.

Still, I let so much of my emotional state get wrapped up in my eating disorder or success at dealing with it and all that stuff.

Here’s the bottom line, I regained 50 pounds of the 182 I initially lost. I don’t know if I ever typed that reality before. I kept trying different things and approaches but my disease keep getting the better of me. I started to get really frightened that I wouldn’t be able to stop and I would become one of the bariatric surgery patients who ended up regaining every pound. Did I say frightened? Hell, I was terrified!

Fortunately, right when I needed it, I got an email from a company of two women who have created a business offers programs and support to people who have had weight loss surgery. (Both principals have lap bands.) I checked out their website and an upcoming six week web-based class designed to help people get back on track. I signed up and it really helped me settle my head and emotions.  From that, I joined their year-long online group that does a weekly weigh-in but encourages lots of sharing and posting via a closed Facebook group.  The women also create weekly challenges and suggestions.

Just in a couple of weeks (that group started January 3rd), I’ve begun to settle even more and, more importantly to me, I have learned a lot. The key learning is how much I don’t know about long term strategies and suggestions for weight loss surgery patients. I am now getting some concrete, workable suggestions on how many grams of protein to aim for a day, what range to keep my daily carbs in, how much water I should drink, etc.

There are other practical tools on exchanging habits, goal-setting, fitness, and the like.  All of these things have been huge gifts and just what I needed to hear, learn and implement in my life.  I now am no longer backsliding and terrified that I will regain all of my weight. I am confident in my ability to stay emotionally even, eat healthy, stay on plan, and lose weight. I’m staying consistent with my fitness goals too.

All of these things would be important overall in my life. They are particularly and acutely important right now. One of the other aspects of my life that I’ve had to face is that the condition of my right knee has deteriorated from two years ago. I have more pain, less strength and less stability and it is affecting my life much more than it used to.

I had been fighting the inevitable. The only way to improve my condition is to have knee replacement surgery. I resisted this solution like the most obdurate woman alive. It took some gentle questions from my brother for me to dig into the why of my resistance. It came down to the fact that there will be a period of about four weeks when I will be unable to drive. I hated the thought of losing my independence for so long.

It took awhile, but I’ve resolved the resistance.  I consulted a really good orthopedic surgeon, scheduled a surgery date (March 15th) and have everything in motion to get this done. The sooner I have the operation, the sooner I can rehab and recover.

The surgery date is also extra motivating for me to focus on my food plan. I intend to lose as much weight as possible before my operation while I continue with my fitness commitment. These steps will aid my recovery process.

So, this pretty much summarizes where I’ve been, where I am today, and what I’m looking ahead to in the near future. Another goal is to once more return to blogging here. Hopefully, I won’t bore you while I’m working through the process.

How are all of you?