Weighty Matters

No, I’m not talking about good bras.  🙂   I mean the emotional and physical support from others that have helped me on this journey.

I am extremely fortunate and have received nothing but support from family, friends and co-workers since I first shared that I’d decided to have bariatric surgery.  My brother and sister-in-law immediately said they wanted to fly down and help me in the first days after my operation.  Another good friend made plans to spend 10 days with me after family went home.  My bosses were behind me all the way, telling me that they would support in whatever way I needed and they never once complained about the number of days off I had to take to run to doctor appointments.  My immediate boss had to cover numerous things for me while I was out, but nobody asked if there was any way I could come back to work earlier than planned.

I don’t know how many different conversations I had with friends about the journey leading up to surgery or how many chats we’ve had since.  Everybody is on my side and being active members of my team.

As you know, this hasn’t been the greatest week as my body and systems adjust to the change in diet and I learn more about balancing things.  It’s no secret at work that I’ve felt like crap.  Every day my boss has told me that if I need to, I can absolutely work from home if I’ll feel better.  Today I did just that for the afternoon.  I was able to come home, take some meds to help my system and finally began to see improvement.

It isn’t easy for me to accept help and even harder for me to ask for it.   I’ve lived alone for so long and by nature am self-reliant.  I don’t like needing assistance with things I’m used to doing for myself, but post-surgery there was no choice.  I was frequently tired.  I couldn’t lift or carry anything that weighed more than a gallon of milk.  I wasn’t permitted to drive until I was no longer taking any of the prescribed pain meds.  In those first few days, my brother and sister-in-law ran errands for me, including shopping.  My sister-in-law did my laundry.  Knowing I was limited to broths, she didn’t just buy boxed stock.  She brought home a chicken and veggies and slow cooked them so that the broth would be loaded with flavor after she removed the ingredients that I couldn’t ingest.   If I wanted something to drink, one of them brought it to me.   They accompanied me on my walks, knowing that I didn’t have my full strength.   My brother drove me to do some things before they left, including picking up my dogs from doggy camp.

My friend Marilyn was vigilant in her care and even went so far as to help me clean out the utility closet after we discovered that the dryer vent had come undone and spewed lint all over the place.  By help me I mean she did most of the work while I sat in a chair and wiped lint and dust off things.  She also dragged boxes of books out of my office so that I could sort them.  When it was time for my first post-op doctor’s visit, she drove us up and back to Miami — four hours round-trip.

Now that I’m five weeks post-op and have regained much of my strength and endurance, the emotional support continues to be important.  Friends and family check in with me on a regular basis to ask how I’m doing.  They cheer my progress with me and are understanding and sympathetic about the challenges.

It’s good to be so loved.  I appreciate every single one of them and know that I’m truly blessed.

I also know that not everyone who takes this journey enjoys this kind of unconditional support.  I feel for them and hope that they can find support elsewhere if they don’t receive it from their family and friends.   I also hope that, no matter what, they keep putting one foot in front of the other, marching toward success.   We make this decision and take this step for ourselves.  It’s our futures that are at stake, our health that must be improved and protected.

If nobody in my life had supported me when I started down this road, I still would have done the same thing.  I would have found a way to make it through on my own, but, God, I’m glad that I didn’t have to.

To all of you who have helped me on this endeavor — in person, at work, on the phone and here on the blog — thank you from the bottom of my heart.

It’s a sleepy Sunday morning and I don’t have a lot of deep thoughts and realizations running through my head.  Even so, writing something helps me maintain my focus so I figured I’d recap a few things.

This is my second full day on pureed and soft foods.   I’m really amazed at the shift in how I look at food and eating.  I used to wonder if the portion before me would ever be enough.   This morning I scrambled an egg with some mozarella in it for added protein and hoped that I’d be able to eat the whole thing.  Whole thing — like a single scrambled egg is a lot of food.  It isn’t.  I managed but it took me almost 30 minutes.  All my life I’ve heard the advice that eating slowly is a good practice.  Now it’s the only way I can consume food.

Last night I met friends for dinner.  It’s the first time that I’ve been out for a meal in almost two months.  I wanted very badly to see these friends who were in from out of town for a few days so we picked a local restaurant that I’ve been to before.  I was confident that I could find something on the menu to meet my needs.   I almost opted for the hummus platter when I spotted a newer item — chicken or tuna salad with fruit.  Not very glamorous, but chicken salad is something I can tolerate while in this stage.  When my plate arrived, it held a generous scoop of chicken salad on a bed of greens surrounded by grapes, pineapple and mandarin oranges with three slices of baguette.  I can’t eat bread yet, so I put the slices on another plate.  I can eat fruit if it’s cooked, so I decided right then that I’d take it home and stew it or something later.

My friends and I had a lovely time chatting while we ate.  I took a quarter of a forkful of chicken at a time, put down the fork, and thoroughly chewed before swallowing.  I probably didn’t eat more than two – two and a half ounces all told but it took me as long as it did my friends to eat their entrees and I enjoyed every morsel.  I brought the rest home to eat for lunch today.  Given the amount that remains, it might be lunch and part of dinner.

The experience taught me a lot.  I can eat the way that I need to even in public without a problem.  My friends get it and don’t feel weird eating bigger meals in front of me.  They’re genuinely thrilled for me.  To Go boxes are always available.  My new way of eating in no way diminishes the social benefit of dining out with friends.

Win-win all around!

A lot of people who have had this surgery have shared that they hit a stall or plateau in their weight loss around the third week post-op.  That didn’t happen to me, but I full expect it will at some point.   Even though logically my head will remember that stalls happen and the weight will eventually come off, I anticipate that I will have some negative feelings.  I’m determined to take my measurements once a month and, to measure again if I hit a plateau because I know that even if the scale number doesn’t move, the inches probably still reduce.    It’s important to shore up my defenses so that my attitude remains positive.

Finally today, I am overwhelmed at the everyone’s support for me.  I’ve never met some of you who comment here and know you only from the blogosphere and Bettyverse.  Your input and positive energy means a lot.  I hope you’re getting something in return from your visits, but please know how much I appreciate you — along with the friends I’ve known all or most of my life.    People, both here and in my everyday life have been terrific.  Yesterday I got a call from a man whom I know socially, mostly through his wife who is friends with other friends.  Turns out that he had weight loss surgery over four years ago.  He heard that I’d just gone through it and called to offer support, encouragement and helpful tips.  “You’re in the club now,” he told me.  “If you have any questions or there’s anything you need, keep my number.”  He offered some great advice and, above all, the generous spirit that moved him to call touched me deeply.

Thank you, everyone.  I’m very grateful!

Today’s my first full day of pureed and soft foods after six weeks of liquids.  I woke up excited to taste things other than broths, protein shakes, plain Greek yogurt and juice.  I will admit that I was also apprehensive.  I have a history of binge eating and compulsive overeating.  What if I was so over-the-moon at the idea of cottage cheese that I shoveled it down into my small stomach pouch, only to have my body rebel and bring it right back up again?

Fresh in my mind was the dietitian’s reminder the other night that we really should eat a small amount of something – beginning with protein – every three hours.  At the time, I thought, “Every three hours?  Geezus, I’ll be eating all freaking day.  How’s that going to help me lose weight?”

I needn’t have worried.  I started the day with a single scoop protein shake because it was easy and I don’t mind the taste for breakfast.  (No time to scramble an egg this morning before Tai Chi.)  When I got home from Tai Chi class I knew I needed some protein and I gleefully opened a four ounce container of cottage cheese, ready to luxuriate in the tangy creaminess.

Four half-forkfuls later, I was done.  Seriously done.  I couldn’t stomach one more curd.  I felt full enough that if I’d tried another tiny forkful, I know I would have heaved.

The container wasn’t even half empty.  I now completely get the “eat a little something every three hours”.  The key is that bit about “little something” and the reminder that at every meal or snack, we need to get in the protein first.   Sure, if every three hours a person consumed the equivalent of a McD’s value meal, they’d gain weight at an alarming rate.  Two ounces of food every three hours — not so much.  In fact, now having taken my stomach sleeve on a soft food test run, I see that spacing out the food is the only way that I’m going to be able to consume enough food to satisfy my nutritional needs and remain healthy.

I put down the fork and drove off to pick up my dogs from doggy camp where they’d stayed while I was out of town overnight.  When we returned home I ate another small forkfuls of the cottage cheese and then took in some more fluids.  (Everything in balance.)  I did some chores, cleaned the pool and did some water exercises and just now finally finished the rest of the cottage cheese.  One four-ounce container eaten over three “meals”.

Wow.  I’m pleasantly satisfied, but don’t feel stuffed.  This is a totally opposite way of eating for me and radically different feeling.  In the worst days of my eating disorder when I was completely out of control, I felt like there was never enough food to fill me up.  Of course, I was trying to satiate more than physical hunger, but in the meantime I packed in huge quantities in relatively short periods of time.

This is so different and so incredibly pleasant.  Miniscule meals — yet another new tool for success!

One of my worst old habits is my compulsive behavior over food.  See it, want it, eat it — think about it after, when it’s too late.  On my worst days of binging, I could plow through a pizza — inhale a few entire slices and then keep going back to pick off the cheese and toppings on other slices.  Finish that off with several guzzles of regular soda until I was so full that it’s surprising my body didn’t burst.

I would chow down so quickly that I wasn’t even fully aware of what I was doing and certainly didn’t know whether I was truly hungry for more, more more.

I’m working very hard on changing this destructive eating but I still slip a little here and there.  Last night, I went to the supermarket to buy some of the foods that I’m permitted to have while on this stage of my recovery.  While in the store, I caught the unbelievable, mouth-watering aroma of something wafting from the appetizer/deli/prepared food area.  I swear, it’s like I was compelled to buy just one piece and take it home.  Even though I knew that this was not a good idea and that my system would not tolerate it well, I munched and munched.  It wasn’t a large quantity — large quantities are not possible — but it was a harsh, fattier food that I ate far too rapidly, without thinking about how my stomach would react, or without caring.

Within minutes, I felt my stomach ache as a result.  On top of that, I had very little room for the healthier, protein enriched dinner that I needed.  This was a double screw up on my part.

It was also a valuable lesson.  I’m going to remember how awful I felt and how I had to fight back the nausea.  The next time that I’m tempted to repeat an old compulsive habit, I want to recall the experience and stop myself before I act.

A friend of mine who had gastric bypass surgery a few years ago warned me that I would experience times when my head would tell me I wanted to eat something I shouldn’t, or consume more than I can handle with my smaller stomach.  “Don’t be surprised if you overdo and the food comes right back up again,” she said.  Although this experience didn’t go quite that far, it was on the edge.

“You’ll only do that a couple of times before you retrain yourself.  It’s not worth it,” she added.

She’s so right.  I don’t care how great something tastes in the moment, it isn’t worth the uncomfortable results.  I’m determined to not only kill the old habit, but bury it so deep that it doesn’t come back to get me again.

Today’s my first day back at work full time since surgery.   I came back a few half days last week, but this is major.  Physically I feel great and mentally I needed to be here and actively engaged in my regular responsibilities.

Last night, I realized that I had to prepare myself for the new normal.  This means that I need a good, solid grasp of what I need to have around to fulfill my nutritional needs.  I’m still on “full” liquids so there’s no such thing as not bringing stuff with me to work.  I can’t just run down to the lunch truck and grab a sandwich or hot dog or chicken tenders.  Thankfully, I’d thought ahead and had soup in the house that I could bring with me today.

I’m also staying on top of my fluid intake.  I live in the Florida Keys.  It’s hot down here most of the year.  I am frequently outside with my job.  It is extremely easy to dehydrate.  Once again, if I let that happen, it’s a big problem.  Gone are the days when I can grab a bottle of water and chug it down to replenish my depleted fluids.  Frankly, if I take more than a couple of sips at a time, that water wants to come right back up.  I need to sip, sip, sip and then put down the bottle and wait a moment for all of the liquid to settle.  There’s no room for guzzling.

I filled up the water glass on my desk as soon as I got in this morning.  No matter how busy I get, I reach for the glass and sip regularly.  When the glass is empty, I go right to the cooler and refill.

When I move to pureed foods, I’ll enjoy a greater variety but will still need to make sure that I have foods I can eat readily available.  Pre-planning is the key.  I think I’m going to buy a small plastic box that I can fill with some of the foods I can eat — like cottage cheese, fruity yogurt, and some ready-to-drink protein shakes.  That way, if I ever do forget to bring something from home, I’ll always have what I need around anyway.

This is my new normal.  The sooner I’m accustomed to it, the better.

I love to watch cooking and food shows.  I’ve learned a lot from them, too, like how to make an outstanding risotto from Ann Burrell or the importance of building depth of flavor in every dish.

You’d think this would be pure torture for me right now to watch dish after delicious dish being created and served when I’m still on a full liquid diet.  Instead, I’m doing research.  At some point I will again eat solid foods in drastically smaller portions.  I want to make the most of what foods I eat and find ways to maximize the flavor while cutting down on bad fats and high calories.

Right now, I have a new favorite show.  Bobby Dean’s Not My Mama’s Meals. He’s reinventing his mother Paula’s butter-laden dishs, incorporating different ingredients and cooking methods to make them healthier.   He had me at Greek Yogurt.  Right now, Greek yogurt is one of the foods I’m allowed to eat, but I don’t much like multiple spoonfuls of it plain — like chowing down on sour cream —  and I can’t yet mix in fruit.  So, I’ve experimented with stirring it into my soups to increase the protein count and the creaminess.

I got that idea from Bobby Dean.  It works great, adding texture and flavor.  I’ve been on broths, light cream soups and the like for almost three weeks.  My daily goal is to ingest 60-80 grams of protein.   Anything that adds additional flavor and protein is a keeper.

Just in the few episodes I’ve watched so far, I’ve picked up several other pointers on how to produce a variety of yummy dishes that will be healthier than the old ways I’ve cooked.

One thing that always sucked about diets was deprivation and I don’t mean in the amount of food, but in the taste.   I believe that, when you can only eat a little bit of food, what you eat better be good.  By desire and by design (my reduced capacity stomach), I will eat much less in quantity but ramp up the healthy quality.  That said,  I’m going to make sure that I enjoy every single bite.

Thanks, Bobby Dean, for showing me ways to accomplish these goals!

I touched on “head hunger” yesterday and want to explore the mental and emotional aspects of my life and how they affect my efforts to improve physical health.   I’m very clear that weight loss surgery is only a tool to use in the overall campaign to lose weight and be more fit.  Granted, it’s a great tool.  In addition to physically restricting the amount of food I can eat at any given time, the section of my stomach that was removed included the area that secretes ghrelin, aka the hunger hormone.  I honestly have not felt much physical hunger in the last two and a half weeks.  Granted, in the beginning, the small remaining stomach pouch was swollen so I always felt full, but even since that reduced, I don’t physically feel hungry.  Mentally, I crave food, specifically anything with more substance than milk.

The post-op protocol spells out a slow transition from clear liquids to solid food.  My doctor’s protocol has me spending more time in each transition phase than other plans and I’m doing my best not to whine or quibble.  I was on clear liquids for the first 10 days post-op and then moved up to “full” liquids.  The difference meant mixing protein powder in milk instead of water, strained creamed soups instead of only clear broths, and the ability to eat sugar free pudding and plain greek yogurt.   Doesn’t that list of menu items make your taste buds want to boogie?  I’m to follow this protocol until I see the doctor again on the 24th. At that point I’ll graduate to pureed foods, then to soft foods and then, finally to solids.

People wonder how I can stand the extended liquid diet.  I just keep telling myself that I can do anything for a finite period of time.  God knows I stuck to some extreme diets in the past.  Mentally, I can be extremely tough and disciplined.

I can also go mentally out of control.  The root of my super obesity is in overeating.  For many years I did not realize that compulsive overeating and binge eating are actual disorders and not merely the behavior of a lifelong weak fatty with no will power.   Food has been my drug of choice, my coping mechanism, my way to stuff down feelings, stresses and pain so that they wouldn’t overwhelm me.   Food has also been the stick I’ve used to beat up on myself.  Coming to understand all this about food saved my sanity and may very well have saved my life.

It wasn’t until I was 34 that I actually learned these truths about myself and my relationship with food, even though I’d been overweight to some degree or another since childhood.  I honestly don’t remember a time when I was an appropriate weight.  That’s a topic for another blog.  For all of my life I was convinced that if I could just find the willpower to stick to a diet, I would succeed.  When I didn’t, I chalked it up to me failing again which further contributed to lousy self-esteem.

At 33, I hit rock bottom physically, emotionally, and professionally.   I had recently come out of a horrible work situation but was now in another one loaded with stress. My self-confidence was at an all-time low and I could barely breathe in the day from the tension and my weight.  I was binging like a mad woman.  If I’d been a coke or heroin addict, I’d have died from the overdose.  We can, however, ingest incredible amounts of food in stomachs stretched by gorging.  A possible binge could easily include an entire medium to large pizza, washed down by a two liter bottle of regular soda with a pint of ice cream or entire cake for dessert.  In the middle of the night, I’d wake up from a restless sleep and only half-consciously stumble to the kitchen and eat something.  Often I didn’t remember these food forays until I saw the open wrappers or dirty spoons.

I’d realized that I needed help from a therapist and had begun to see one a few months prior to the melt down.   Thank God for that because I don’t know what I would have done or where I would have turned for help on that fateful day.   I woke up one morning so completely wigged out that I was convinced if I left my apartment something horrible would happen.  I can still remember sitting, shaking, in a chair and picking up the phone to call my therapist.  I left a message begging her to squeeze me in.  She called me back within minutes and assured me that I’d be okay on the drive to her office.  We did a double session and, before it was over, she told me she wanted me to go to an Overeaters Anonymous meeting that night.  She shared her own story and told me she believed that the program would help me get better.

She was right.  I continued to go to program for many years.  I won’t say that I was always perfect in my abstinence from overeating, but mentally I grew to understand the nature of my relationship with food and how I used it for other than nutrition.  I also learned to stop beating myself up and to let go of shame.  Gradually, I reclaimed a healthier personality with restored self-confidence, serenity and genuine happiness.

This lasted almost 20 years but more recently I began to see myself backsliding.  Although I’d never lost all the weight I needed to, I’d kept my obesity at a manageable level.  I know that sounds like a contradiction in terms, but I found ways to make it work.  Age stepped in and eroded my abilities.  The weight I could manage in my 30s became more destructive in my 50s.  It increased the stress and pain in my joints which reduced my mobility.  With reduction in physical capability came the gradual eroding of my serenity and confidence and an increase in my mental pain.  I mentioned before that my range of activities began to narrow and this began to affect me emotionally.

Wow, I’ve traveled quite a way down memory lane with this post, more than originally intended, but now I realize that it’s important to remember the past so I can use it for the future.  You see, lately I’ve had some fear returned.  Several paragraphs ago, I said that the weight loss surgery and my incredibly small stomach pouch (about the size of a small banana) is simply a tool.  Granted, I won’t be able to shove an entire slice of pizza down at one time, let alone a whole pie.  However, if I fall back on food as a coping mechanism, eventually I will stretch the sleeve, stop losing weight, and regain the pounds.  It’s happened to others.

So I’m working on the mind game.  I wish there were OA meetings where I live so I could return to the rooms, but there aren’t.  I need to devise a different way to work a program.  The truth is that I know overeating is an insidious disease.  It does not solve problems, ease stress, comfort pain or do anything positive for me.

The good news is that I’m in a happy place.  I have a wonderful life in a beautiful place.  I have a phenomenal job where I am surrounded by people who are a loving, supportive family in addition to being co-workers.  I also have complete confidence in my abilities and know that I rock my job.  It’s the best of all worlds.  I do not need to medicate with food.  There are other, healthier ways to handle stress or drama when it blows in like a storm on a sunny day.

I need to be vigilant about the mind game of the eating disorder.  It is every bit as important for me to monitor as it is for me to concentrate on the grams of protein and carbs I ingest or the necessary fluids that I drink.   The hammer, saw and drill can’t build anything on their own without the skill and effort of the carpenter.   The sleeve alone can’t save my life.  Only I can — and that’s the most important goal.

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Trying not to weigh myself every day, but it’s hard to resist the scale.  Stepped on the scale this morning and I’m down 36 pounds!

Lots of people make bucket lists — the things that they want to do before they “kick the bucket” and die.  I’ve never made one, nor am I big on creating New Year’s resolutions.

Still, since the decision to have weight loss surgery grew from facing the fact that my obesity was making so many things more difficult or impossible for me to do, I realized that I was starting to think of things I couldn’t wait to try or do once I lost weight.  I began to keep a promise list of the experiences I’m looking forward to in the future.  When I think of something else I write it down and usually call one of my friends and share the new item.

Some of the promises are basic.  I’m looking forward to walking with more ease, no pain, and easy breaths.  Some involve trips.  I want to go to Hawaii.  I want to zip line in Costa Rica.  I also want to take a trip to Disney World and the other theme parks with grown-up friends, walk all around the parks  and go on every ride.  There are at least a dozen other things on my list that range from improvements in my daily life to more elaborate adventures.

The process of imagining the things I want to see and do makes me smile, gives me hope and helps me stay on the path to success with my weight loss journey.  The dreams are bright, shiny and, best of all, absolutely attainable.

I’m already on the way.

Do you have a promise list?  What’s on it?  Is anything keeping you from checking items off of your list?

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Mary Stella