Monday, August 18, 2008

Reached Goal

Several weeks ago when I saw Melinda last, we talked about my personal weight loss goal. Originally, I had the number of 115 lbs. in my mind. Well, after seeing how I look at 125 lbs. I decided that really, a better goal for me would be 120 lbs. If I didn't actually get to 120, but instead stayed between 122 and 126, that was fine by me. So, I upped my calories in an effort to try and stabilize my weight. I subsequently lost about 4 lbs. within the next week. I haven't had a weight loss that large since the first few months post-op. I let Melinda know and she said not to worry, my weight would stabilize. And it stayed pretty stable the next couple of weeks. This morning, I dropped another 4 lbs. since last week's weigh-in. We ate out (healthily, but still) 3 nights within this past week. I am down to 119.6 lbs. I'm fine with that...and pleased that I actually hit my goal though I wasn't really still striving for it. Now I want to make darn sure I don't keep losing this way. I'm already unhappy with how angular my face looks this thin and I don't want to appear gaunt/unhealthy.

This leaves me with a dilemma of sorts. Do I continue to do what I've been doing, and potentially lose 4 lbs. every 3 weeks or so? Or will it indeed stabilize doing what I'm doing? Should I be taking in MORE calories? I am so scared (to be honest) of getting "below" goal and having the mentality of having a few pounds to "play with." I've been there and done that before...and it's dangerous. I would much prefer to just continue the way I am...which means eating healthy, balanced meals frequently, and occasionally having a treat/special item that may extend my calorie range for that day, but overall balances out nicely for the week. It's more of a head thing than a body thing at that point. But I don't know...I'm kind of confused about it all and what I should be doing. So, I'm going to sit on it for a few days and try and figure it out.

Thursday, August 14, 2008

The Top Ten Reasons Why Weight Loss Surgery Is NOT "The Easy Way Out"

by Glenn Goldberg

This was posted by Kristen on one of the OH boards that I frequent...and I loved it and thought it would be invaluable to post here.

10. It's very expensive. Many health insurance companies don't pay for the surgery, and even when they do, co-payments and other costs add up quickly. Also, it can become very costly to constantly replenish wardrobes as the weight comes off.

9. Recovery can be very painful. Besides the pain from the surgery wound, patients may experience nausea or severe gastric distress. Patients with sleep apnea may become sleep-deprived, with all of the associated adverse affects, when they must discontinue use of their CPAP machines to avoid disturbing the staples creating their tiny new stomach pouch.

8. Recuperation can take a long time. Patients may be “out of commission” and absent from work for a prolonged period of recovery time. In some cases, patients may not be able to return to work or normal pursuits for up to 10 – 12 weeks.

7. It's hard work and a major time commitment. For optimal results, patients should engage in aerobic exercise for up to an hour daily. For bodies unaccustomed to vigorous exercise, this can be very hard. It's also a real challenge for WLS patients to learn all they must about nutrition so they can assure that their food and vitamins are sustaining their body. Finally, it can be exhausting to consciously, carefully and painstakingly chew every bit of food that enters your mouth.

6. Vomiting isn't fun. Nor is diarrhea. It may take patients many months (and frequent episodes of vomiting or diarrhea) to identify incompatible foods and to learn the practical limits of their newly reduced stomachs or digestive systems.

5. It takes extraordinary courage to consciously limit food choices for the rest of your life (and potentially limit social opportunities built around meals). For many patients, life after WLS means treating food as a fuel, not as a source of drama, excitement, comfort or a central life focus: i.e. eating to live rather than living to eat. While some procedures may be reversible, for most patients WLS is a lifetime commitment, requiring a lifetime of major lifestyle changes.

4. Weight loss surgery can be dangerous. As many as .5% of surgery patients may die from the procedure, and up to 5% may experience debilitating medical complications (especially if they listen to their peers' advice more carefully than their doctor's.)

3. It takes great bravery and strength to deflect other people's judgments and society's myths about obesity. Fat people are often blamed and shamed by family and friends with simplistic advice, unrealistic solutions, and uninformed prejudices. Whether it's for genetic or metabolic reasons, diet and exercise, willpower and discipline have never, by themselves, been enough. Our appetite regulators simply don't work. Without WLS, we don't know when we're full!

2. What gives anyone the right to judge which path is right for another? Is a person who runs a 10K taking a “better” or “tougher” route to wellness than the person who walks vigorously every day? Is working with weights better than water aerobics? Different strokes for different folks. Each of us finds our own right way, and how dare others judge our path to health and longevity! By their reckoning, the most courageous thing would be for us to suck it up and die young.

1. For many morbidly obese people, WLS may be the ONLY realistic alternative for achieving a long, healthy life. The newest research provides irrefutable evidence that body weight is largely a function of genes — just like height or a family propensity for cancer. These genes help regulate appetite and metabolism. People prone to obesity seem to gain excessive weight easily, while finding it difficult or impossible to lose it. That's why diets almost always fail and why WLS is currently the only viable weight loss option for many morbidly obese people, according to endocrinologist David Cummings of the Veterans Affairs Puget Sound Health Care System. Most people can lose no more than 5-10% off their "natural" body weight by exercising and eating wisely. Decades of diet studies show that more than 90% of people who lose weight by dieting gain it all back within 5 years. "There are exceptions, but when you are speaking of general rules, the only people who are able to lose more than 10 percent of their body weight and keep it off are people who have had gastric-bypass or other bariatric surgery," Cummings notes.

Sunday, August 10, 2008

Confusion...Brain Whirling...Body Dysmorphia

One of the things that has been causing great confusion in this mind of mine is my thoughts about my body these days. I know I'm not fat...but in my eyes, I'm not thin either. Others say I am. I don't feel it. I feel like I look fit, but not thin. I can look at my arms, my legs, and see muscle definition and be very pleased with how both look...but it's like it's not MY's A body, but not MINE. Will it always be this way? Or will I someday be able to reconcile the body I see in the mirror with the one I see in my head? In therapy this week, I discussed this quite a bit and we talked about the need for me to do more affirmations that refer specifically to MY body, not THIS body (which is how I tend to refer to it). These arms, these legs, this stomach, not MY arms, MY legs, MY stomach. The only time my brain actually feels connected to my body (yes, I had to backspace over THIS body there and change it to MY) is when I am working out and I can look in the mirror and see my muscles moving while I can feel my heart pounding and hear my breath and feel my sweat. It all feels very surreal the rest of the time. I think it's probably typical that people who have had WLS and experienced significant weight loss take some time for their minds and bodies to catch up and be in sync. I find it particularly unsettling.

Today, Zachary and I went to brunch with my brother and sister-in-law at Denny's. Not the easiest place to find something reasonably healthy to eat, but I stuck with a veggie and cheese omelet, gave away my hash browns and so other than being higher in fat that I might like, I got in some good protein and veggies. Then we went to the mall, saw a movie, and shopped around a bit. At Old Navy, I ran into not one, but three people I know. And the first two that I ran into were chatting with each other...Maureen, from Heart and Wellness, was standing there chatting with one of Zachary's classmate's mom, who I also know. So I stopped over to say hi and I told the mom how I knew Maureen, and Maureen said "I wasn't going to say it" and I said "well I knew that, but I'm not quiet about it." Maureen gave me some kudos about how well I've done to Erica, and that really made me beam a little more. And then, standing in line to check out, I saw Sandy Skinner, who is on our relaxation CD and led relaxation and did some other education talks during my post-op Heart and Wellness program. I obviously recognized her and I thought she might have recognized me, but I wasn't sure, so I smiled and said hi, and she said hi, told me I looked great...and I wasn't sure if she had placed me just yet, but then she said "people are really enjoying your writing" and I said I was very happy to hear that. And I told her that I had just run into Maureen not 10 minutes earlier there as well. It felt like affirmation to me to be out and about, and seeing people, and being confident enough to approach people and say hello. I feel "normal" and not like some fat freak most of the time. The weight loss has definitely made a tremendous impact on my ability to socialize.

Dating...well, I'm on both and eharmony now. Neither are proving to be particularly fruitful these days. I will continue to do my best to put myself out there and maybe someday meet someone. There are times when I feel like the years of my life are spinning by too quickly and I don't want to run out of time to enjoy my life. I don't think I ever held that perspective before. Despite my confusion about my body and my brain, I guess I'm still feeling very positive overall about my life and the changes I've made in it.

My brother asked me today about how my coworkers have reacted to my weight loss. We talked a bit about that, and he also said that it will effect my career in ways that he imagines I haven't probably even thought of. For example, he said that they have now seen me take care of my own health and be consistent in my efforts to manage my health issues, my weight, continue to move forward daily, and that they also know health-wise, I take care of myself and so my reliability/dependability because of health issues is less likely to be a problem as I continue to work there. I never thought about it in those terms, but he's right. They've learned quite a bit about me, my character, what is important to me, my determination by something that is completely unwork-related but still bodes well for me in the work environment.

A couple of weeks ago, my brother gave me an apology for, as he put it, not necessarily always giving me the benefit of the doubt or thinking about my perspective when our mom used to talk to him (read that as complain to him) about me. He said that he realizes now that her perspective was likely very skewed and that as a result of him taking the situation at face value from her vantage point, he'd done me a disservice. He wanted me to know that he was sorry for that as it probably effected our relationship quite a bit then. I told him not to sweat it...that I learned a long time ago that there is always his side, her side, and somewhere in between is "the truth." As such, I try very, very hard to be a good listener in any situation but not place any judgment on the things I've heard because frankly, I haven't lived in either party's shoes. I'd like to think that in the couple of years since our mom has died, he and I have gotten to be closer (at least a little) directly, without mom's manipulative interference to color either of our perspectives on the other. I'm a direct person...I'm an honest person...and so, when I've had an issue with my brother, I've dealt with him with it directly...usually without anger or harsh words. I think he's learned a bit about who I really am, and how that person is different from who he thought I was based on the things he heard from our mom. I know it's a good thing...and it reassures me that if I am true to myself, everything will work out as it should.