Happy Bandiversary!

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

Happy One Year Bandiversary to me! What a physically introspective year it has been – from my band surgery last July and my foot surgery this May.

Weigh-wise it has been a good year. Despite all the struggling, and the slowing weight loss toward the last half of the year, I lost 17% of my weight – 37 pounds.  I am not where I would like to be, and I know the struggle will continue (see next paragraph), but that’s a decent amount of progress for me.

Earlier this month, my mother in law passed away, and that combined with  foot injury and recovery, I found myself lapsing, quite easily, into old eating habits. My weight went from 160 to 164 in about two weeks.  So last night I went back to a support group meeting, heard so many other patients a few weeks to a few months after their surgeries and realized I had been ignoring the rules – the ones that would  help me continue to loose the next 35 pounds.

I started keeping track of what I ate today with my Lose It app. I did lapse this evening because I was at a social event (with people I had never told about my surgery, not that anyone has commented to me on my weight loss. Maybe they thought I was sick, or maybe they suspect but have never asked.). Even though I may not have “counted” this evening’s cheeseburger, fries, and two Rolling Rock Ciders, I did stop myself from stopping on the way home for a self-serve frozen yogurt.

So here they are: the official “before” and “one-year after” photos.  I took them in the same bathing suit and in the same  location as before:

JULY 2014

BAND-One-year-later-July-23-2014

JULY 2013

BAND-the-official-before-photo-july-23-2013

Yeh, so about 30 pounds (this was right before the surgery so I was around 195, or six-pounds lower than my highest weight) makes a difference! I have to do something with those saggy boobs but all in all there’s less face, arm flab, belly bulge and leg puffiness. And more neck.

So, I will struggle on, because sometimes every day feels like a struggle, but then you come through it and you get to coast for awhile before the next of life’s big waves swell.

Derailed

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

Current weight: somewhere in the 160s

It has been awhile since I’ve written, predominantly due to a life derailment that occurred on May 6. One second I was walking the dog, preparing to cross the road, and the next second I was leg deep in a water main hole, it’s metal cover slewed sideways and my foot in the hole. At 53 years old I had never broken a bone in my life, but I was pretty sure something was broken.

Not just something. Somethings. Mainly, all my metatarsils from the center bones in my left foot. It is called a Lisfranc dislocation, which sounds much nicer than it is. Here is what the x-ray showed when I drove myself to the Urgent Care center and cried out for someone to bring a wheelchair to help me get inside because by that time the pain was pretty overwhelming and I couldn’t walk.

Lis franc image 1-SL-050614As you can see, from the little toe bone up to the big toe bone, they are not aligned with the other bones in my foot.

I had surgery on May 14, and this is what my x-ray looked like after that:

5-14-14 LS x-ray top1The metal plates will remain in my foot for the rest of my life, for which I’m in for loads of fun anytime I pass through airport security. The pins will come out next week, when I get my cast off and get into a walking boot cast.

I would have thought being unable to walk for a month, mostly lying on the couch catching up on the Outlander series by Diana Gabaldon, would have completely derailed my weight loss journey, but somehow it dropped me out of the 170s and into the  lower 160s, I believe. When I last stood – one legged – on the scale, I was down around 160, but as I still am in the non-weight bearing stage of my recovery, I cannot be sure. For all I know the left leg weighs 10 lbs and since I  cannot put it down on the scale my results are skewed.

I’ll have the walking boot cast on during my one-year bandiversary so I will not be able to truly see what the actual loss has been and do the celebratory announcing on blog and Facebook pages. Maybe I’ll see if I can weigh the boot cast and subtract that from the total once I can get both feet on the scale. In the interim, I’ll just keep hoping that the daily hauling myself up the stairs on my ass is creating better upper body strength which will continue to burn more calories.

I have cut back on the ice cream, to which I briefly lapsed during my invalid state, but I still cannot give up the Dominion Ginger Ales.

Electrifying

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

Today I am climbing off my platform to find a plug for this string of lights.

Weight chart 4-8-14

This is electrifyingly exciting.  I first hit 174.5 on November 19, 2013.  I have been between 171.3 and 174.5 (including last week, when I hit that high) FOR 19 weeks!  That’s 4.75 months with the same 3 1/2 pounds.

I haven’t done anything different since the last time I wrote; I still haven’t received my Synthroid and Cytomel hormone moderators, I haven’t been back on the Welbutrin long enough for that to have made a difference,  and my i-phone food app does not show a dip in my trend of calories.

Maybe my body finally realized this was no temporary starvation tactic…who knows? I just kept trying. Making my way, one step each day.

Don’t give up.

I can’t.

Stringing XMas Lights

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

It’s April. We here on the east coast in the mid-Atlantic have had a more challenging winter than most. While I love snow and think it’s beautiful, we’ve had so much of it this winter. The average snowfall in this region is between 16-22″ (as measured at the two large airports, one next to DC and the other about 30 miles to the west.)  The 30-yr average for this region is 15.4″.  This winter, we had 32″.

That is not why I titled a blog on my band weight loss journey Stringing XMas Lights.

This is:

photo (25)

What looked like lumpy boobs in the last post now looks like I’m stringing lights.

In frustration, I talked to my therapist, a nurse practitioner who prescribed me Adderall for my constant urges to snack and adjusted my medication. {We added Welbutrin back into my medicine regimen, which I also had to stop before surgery and did not go back on afterwards).

As we were wrapping up and talking about menopausal hormones, I told her that before my surgery I had been on Cytomel and Synthroid, two hormone adjustment medications, that I had not gone back on after my band surgery. She told me that if my hormones were low, there would be no way I would lose weight regardless of what I was doing. So she told me to go get a blood test (and include Vitamin D levels).

I made an appointment with my primary care physician, who scolded me for stopping these two medications and not going back on.  “Why didn’t you go back on?” he asked.  I shrugged.  Because I already take 4-6 medicines and supplements and I’ve always hated taking pills?  I didn’t say that, but that’s probably a big part of the reason.

So I have a renewed prescription for these two medications (generic: lyothyronine and levothyroxine) and we’re going to see if that makes a difference. I expect it will, since my primary Dr. told me that hormones were the gas to my engine, and if I didn’t have the gas the engine wouldn’t run.  (I should have told him I have plenty of gas, but I just thought about that now.)  🙂

Before I go, though, I want to say something about my primary care physician. I have seen this doctor for about 25 years. He used to run a weight loss clinic and helped me lose weight when phen-fen was popular (I always had appropriate testing done each visit while I was on that medication).  He’s my husband’s and son’s PC. His wife was my acupuncturist for several years.  He has a very sarcastic sense of humor, and I know several people who haven’t liked him for that.  However, I’ve always liked people with a sense of humor, regardless of whether it’s clever, witty, goofy, dry, or direct. When I was at my heaviest, he once told me that I looked terrible. Well, he was right. He was also the one who suggested, more than once, the band surgery, and recommended me to the surgeon who performed it when I was finally ready for that solution.

But this time he crossed my line of tolerance. First of all, he poo-pooed my going on Adderall. “Well, of course it’s good for weight loss, it’s a stimulant.” That’s not why I went on it, although I did go on it to counteract a  function of my brain that was making it difficult to control my eating. He also poo-pooed my therapist, for telling me to get the blood test. “What is she going to do with that information? She can’t do anything with that information…those psychiatrists don’t know what they’re doing sometimes…”  To which I should have replied, Well, I like her better than I like you, but I also just thought about that now.

He told me it was a waste of money to get the blood test now, he knew what it should show.  The blood test should be taken after I’d been back on the hormone medications again. While he was scolding me for not going back on those after surgery, he said something that shocked me. After having the whole day to go over it, I realized that I was really pissed off.

He said, “You know, you’re the first patient I know of Dr. A’s that’s a failure.”

“A failure? ” I replied, in a shocked tone. “Well, yes, you’re not supposed to hit plateaus on the band, you’re supposed to have a steady weight loss.”  

I thought about that all day yesterday and by the time I got home after working late, I was fuming. I was even wondering if it was time to find a new primary care physician.

I know exactly what I want to say to him when I go back for a followup in about a month. By the time I go back to see him, I will have had time to prepare this statement so that I can speak it without emotion, because I am not eloquent, nor can I think rationally when I’m emotional about something. This is what I plan to say to him:

“Dr, K, you said something the last time I saw you that really pissed me off. You said I was a failure with the band. Well, that was insulting and mis-informed. I have been a member of band Facebook pages, band forums, band blogs, and band support groups, I can tell you that I am by far not the only person struggling with the band.

I might even add: “You cannot shame into compliance – I would have lost the weight a long time ago if it were that simple. I hope you’ll think twice if you ever have the urge to say something so denigrating and negative to me in the future. ”  

Back to the App

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

This is what my weight has looked like for the past two months:

1st quarter 2014 weight recap

 

Like a lumpy somewhat misshaped boob.

There’s nothing like a 2-lb gain in one week to make one realize that its time to put the proverbial foot down NOW.  So I’ve gone back to my Lose It App on my cell phone to track my calories, because this long, cold and rather snowy winter has kicked my tush when it comes to snacking.  Always remember, we really cannot do this alone. Use those tools!

Now, I have to go program my lunch into my cell phone.  ~Sigh

 

 

 

Oh, Plateau

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

The subtitle of this post is: How I’m not Using All My Tools

I’ve been listening to a book on CD called Full: A Life Without Dieting, written by Michael A. Snyder, MD, F.A.C.S. I knew him only as the maker of the Full Bar, which I tried once but it made little enough impression on me to remember how I felt about it. What I didn’t realize was that Dr. Snyder is a bariatric surgeon, and much of the book so far has been about his patients and the studies about obesity and weight loss (95% of all people who lose weight gain it back within five years). I can totally relate to this book, more than I thought I would, as a bariatric patient myself.

I have become frustrated with this plateau on which I find myself. I have been stuck between 170 and 174 since before Christmas, so we’re going on about 10 weeks now – mostly at 172. This is 30 lbs down from my pre-surgery weight and 37 lbs from my goal weight. I decided to listen to this book on CD to give myself a little motivational boost, since I have not yet been back to the support group in 2014, and have been so busy at work that I’ve found little time to pop onto the Lap Band forum or the Facebook Bariatric page.

The book has taught me some interesting facts. I was aware of the vagus nerve, and of the hormones grehlin (feelings of hunger) and leptin (feelings of fullness). Dr. Snyder has gone in depth on how they work together and how it takes 30 minutes for the hormones to balance out so that one is not hungry and feeling full. So I’ve realized that I’m really not utilizing all my tools to get me moving again in the right direction.

Here are the tools (aka rules) that I was given with my band that fallen into disuse:

  • It’s hard to make a small meal stretch 30 minutes. I need to be more aware of how long it is taking, and try to stretch it out as much as possible, not only to feel “full” but to let the leptin/grehlin hormones regulate and signal the brain. This might involve getting myself a timer.
  • Protein is not just important because it keeps your body from metabolizing muscle; protein acts as an additional boost to the feeling of fullness.  I have decreased the size of my meals but should be decreasing everything but the protein – protein should make up 50% of the meal – and it’s recommended to eat the protein first to feel fuller faster. Here’s a headline from the American Journal of Clinical Nutrition:

    “A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations…”

  • Drinking – ah, my one big fault. Don’t drink 30 minutes before or after a meal. This was the advice I was given. Some are given the advice to not drink 15 min before a meal and up to 1.5 hrs. after! But I’ve always had a problem with fluid intake – I drink when I’m thirsty, and I get thirsty while (and after) eating. One article I read suggesting front-loading on as much water as possible 15 minutes prior to eating so you don’t get thirsty during. Perhaps I need to investigate alternate strategies for the use of this tool/rule.

So, in addition to watching my intake of hot chocolate with marshmallows and whipped cream, increasing the amount of exercise I get because the weather has been rotten and hasn’t been conducive to longer walks, and decreasing the amount of nuts I’ve been eating as snacks, I need to pay more attention to the use of these tools to support my band and step off this plateau. The scenery from here is getting a bit monotonous.

Addiction, part II

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

I was thinking about yesterday’s post when I stepped on the scale this morning. I was thinking that, in my response to the e-mail inquiry about my lap band, I had said nothing about my co-morbidities, such as sleep apnea, depression, thyroid issues, joint pain, and high blood pressure (all of which have improved moderately). These factors were of equal, if not more, “weight” as the extra 70 lbs. I carried. I slid the bar along the medical scale until the bubble settled in the middle, and then, as force of habit from the days of sharing my weight with the weekly weigh in group, I snapped a photo with my iPhone.

It wasn’t until the flash highlighted the number that I was shocked into reality: I have gained two pounds.

2-5-14 scale - up two lbs

2-5-14 scale – up two lbs

I got into the shower, which is always an excellent time to process information, especially that which is disturbing. I reasoned that yes, my train had gotten off track. This was not a complete derailment – in reality I wasn’t so shocked with this gain, considering how I had been eating lately. I would make a true effort to get back on track.

That behind me, I let my mind wander – a state in which it is in frequently, and I found myself resuming anger and disappointment over the death of actor and director Philip Seymore Hoffman, who died over the weekend on the floor of his bathroom with a needle in his arm. I had been fond of him, and my prevailing thought about this whole thing was “what a waste.” I understood he had struggled with addiction before and had been clean for 23 years before he relapsed last year, but why did he let himself do this? He had a wonderful career, he was only 46 years old, and he had children for God’s sake! Why didn’t he stop himself from  sticking a needle in his arm?

At this point YOU may be asking yourself why am I writing about Philip Seymore Hoffman’s drug overdose in my blog about my weight?

Because at that moment it all came around full circle. He was an addict, and when a brain is addicted to a something, it’s not about the world around you. It’s not about your children, your partner, your career or your fans (friends).  Addiction is a single minded focus – it’s only about yourself. He could not stop himself from shooting up. In a similar manner, I was unable to reason with myself last night when I ate the Trader Joe’s chocolate peanut butter cupcake before bed, after I had had eaten the equivalent of one large fried donut earlier that afternoon to celebrate a co-worker’s birthday. I am a food addict.

While this addiction won’t leave me dead on the floor when I put that next piece of cake in my mouth, it’s the same concept. I relapsed and all my my intentions won’t amount to anything. Mr. Hoffman should have taken himself right back into rehab.  Just as I need to take myself right back to a support group and start tracking my food again on my Lose It app.  I need to be accountable for my behavior and to resume what I already know – my former eating habits are bad for me.

In addition, I started listening to this audio book “Full” that I checked out of the library two weeks ago (which I decided, at the last minute before dropping into the return bin at the library last night, to renew). It’s by bariatric surgeon  Michael Snyder, discussing permanent weight loss principles taught to his patients, to end “diets” forever and learn to feel full and satisfied with less food. Which is exactly what my tool is supposed to give me.

It’s time to be in rehab again.

Update and recap

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

I had an e-mail from someone else in VA who is considering the Band and wanted me to share.  So I shared, and then I thought, well, this would make a nice recap for my blog.  So basically, this was the message I wrote.  I’ve added a bit (in italics) for this post.

I had my band surgery on 7/23/13. I chose to go with the band because I wanted the least invasive, most minimal “surgery” I could get. I also was just over 35 BMI (35.5) and “only” have about 70 lbs to lose to get to my ideal weight of 135 (I’m 5’3″).

My highest weight ever was 209; I was down at 201 when I decided to have the surgery, and at about 196 after my pre-surgery fasting. 

I lost 15 lbs right away (within the first six weeks) but leveled out bit after that. I had my first fill two months after my surgery (to 5ccs) and my second fill on 11/4 (to 6 ccs). In the beginning of Oct. I was down to 179 and have been on a plateau around 172 since December. (The holidays were fine – it was after the holidays I “jumped” off the wagon). Smile In total, since July, I have lost 29 lbs (it’s been about six months). I have not had any problems whatsoever with my band, with getting food stuck (although I have had a few uncomfortable swallows when I’ve not been mindful about how fast or how much I’m eating), and I’ve never thrown up.

I did seriously over-eat this past weekend, while at a Superbowl party.  Wow, was I really uncomfortable! I actually wondered if I was going to have to throw up to not be so uncomfortable.  I waited it out, and drank water, and vowed never to do that again!

I find the band difficult in that you are still able to eat whatever you want to eat, even though it keeps portion control down. It is easy to allow old habits to creep back. (Been there, done that, day after day – sometimes over and over again!)  I’ve struggled the most with not drinking with meals and not drinking carbonated beverages, although I make my own now so I can keep the carbonation light and I usually mix a little fruit juice in – I have given up sodas for the most part.

I was having difficulty with snacking so I talked to a new psychiatrist (because I’ve been on antidepressants for years) and she decided to treat my ADD (which I’ve suspected for years I have but since I’m in my 50s I’ve lived my life like this.) It did curb the urge to snack in the afternoon, although I haven’t dropped any additional weight for the past month. Still, my perspective is that this is a lifetime of behavior modification and I don’t expect things to happen overnight.

In a nutshell, I’d recommend the band if:
– you don’t like the idea of surgery to re-construct your stomach
– you have around or less than 100 lbs to loose
– you are ok with a slower weight loss / less drastic results

Either way I would recommend joining groups where there are a variety of comments and experiences to help you make a decision; do lots of research – everyone is different. Also, join a support group, a weigh in or something where you are aware of your accountability to yourself and to your health. This is not the kind of journey you can make alone Smile

So, there we go.  I was supposed to weigh myself today – weigh in dates are Tuesdays for me.  I forgot.  Still, I’m taking a photograph of the scale and charting my progress, even though I no longer participate in the secret Facebook group where that was a weekly habit.  (I didn’t want to spend the money to “join”).  I know I need to get back to the bariatric support group at the hospital.

Because it’s true.  This is not the kind of journey you make alone.  When you allow yourself to fall back into old habits, as I have,  successes tend to lose the excitement they have when you can share with others.

 

Making my way, one step each day…

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

I find it hard to believe that I haven’t written a post in almost two months.  So, what has gone on in the seven weeks since I last wrote? SOS (same old s–t), actually, and I’m not just saying this. I was able to maintain my band eating habits up until the week of Christmas, when I took two weeks off from work, and, out of my daily routine, lapsed into a chocolate and sweets orgy that I’m still trying to break.  See? this sits beside me as I write. Yes, that’s a bottle of cider that I drank with dinner sitting next to the damn (empty) candy box, behind the seven empty wrappers.  This lovely photo I will title “My Ghiradelli Nightmare.”  Maybe this should have been the title of this post…

 

My Ghiradelli Nightmare

The reason I’m not flogging myself — yet — is that I haven’t gained much. I did get down to 170 on  Dec 17, after the weekend I had a stomach virus and didn’t eat anything for nearly two days. I went back up to 172.5, which was where I was before the stomach virus.  The following week I stayed at 172.5 after a weekend trip to New York City where I did more walking than usual. Then last week, after the trip to M&M World and Hershey World (across the street from each other) that we made with my teen niece and nephew, the upward slide began on the scale. The Tuesday weigh in came up at 173.5.

All in all, I’m still down 1 pound from when I last wrote.  So self-loathing is at bay.  I know what I need to do:

  • I need to stop eating the chocolate, and thank God the after-Christmas sale candy is (almost) gone!
  • I need to go back to not drinking anything with meals – the hardest part of the “new rules” for me with the band.
  • I need to go back to eating on the tiny plate, even though 1/2 of the larger plate I moved to was to accommodate bigger salads.

I need to do this now, because even though I’m no longer reporting my weight on the Facebook group page, I still weigh myself every Tuesday, and this one’s coming up the day after tomorrow.

I wonder how much exercise I’d need to do to burn off 7 Ghiradelli squares?  Hmmm, I don’t think I really want know.

Update and down weight

SD 7/23/13; first fill 9/23/13; second fill 11/4/13

This is the photo that I posted this week to the online Facebook (secret) support group: Hangin’ Through The Holidays”:

Image

Every week we’re supposed to take a photo of our scale to post on the page, on which we also comment about our successes, our failures, our strategies and our goals. So this week I posted a weight of 174.5.  In the two weeks since my last band fill and start of the Adderall medication, I’ve lost about four pounds.  

I’ve been hesitant to blog about being on ADD medication with my bariatric surgery because a) I wanted to give myself time to see how this combination really works, and b) I still feel a bit of stigma taking Adderall in conjunction with my band.  Am I cheating? Is this like taking diet pills to help with the weight loss?  Will other band patients scorn me because I am not achieving positive results through sheer will and fortitude?    I posted a topic “ADD, Compulsive Eating and the Band” on the Lap Band Forum to which I belong. It’s had eleven views (at three or four of which have been me) but no comments.  

This past Monday, however, I received the validation for which I think I was looking.  I went to the monthly bariatric surgery support group and this time, when we broke out into groups based on our surgeries, there were four other band patients with me and the nurse who was presiding over our group. I decided to share my experience. 

I indicated that I was taking a new medication for ADD recommended by the psychiatrist I was seeing and that it appeared to be helping me by curbing my single-minded compulsion to snack (which two other people had also indicated were problems.) When the nurse asked me the name of the medication, she nodded and proceeded to talk briefly about the growing understanding in the medical community of eating and adults with attention deficit disorder. She actually recommended that others with difficulty controlling their snacking look into this as an option and she confirmed that the use of stimulants in patients with ADD actually had the benefit of calming them down. 

I couldn’t have been more relieved. Here was another medical professional, in the bariatric surgery community, confirming that my crazy urges to snack could in fact be related an internal brain function and that my taking the medication was an acceptable method of control.

I know there are people who swear off taking medications  because, in fact, we are a nation of overly-medicated individuals.  We allow the pharmaceutical companies to hook us with ads of how better we’ll feel or how much healthier we’ll be and we spend no time looking at the foods we eat and the environmental factors that may be contributing to our illnesses.  In part, we ignore the guidelines for living a healthier all-around life and take pills to fix us instead.

However, I also believe there are incredible advancements in the understanding of how the brain functions and the medications that have come about in the last 50 years have made it possible for some people with depression to get up every morning, leave the house, interact with others without crippling anxieties, and face life’s challenges with enough emotional balance to keep them from crumpling in total despair.  I see my sister, still depressed fifteen months following our father’s passing, while I have had the ability – with the medication that I have been on for the past dozen years – to move past the grief stage. 

I am still questioning my decision to carry on with taking Adderall.  Have I lived most of my 52 years without medication for my ADD? Yes.  Could I live my life without it?  Yes.  Is the sole reason I want to take it for weight loss alone? No – the medication is not only helping me control my urge to snack, it is also helping me stay more focused on the job and it is starting to help me tackle the immense problem I have with de-cluttering my home and office, although not as fast or as much as I’d like. 

For now, the medication is helping me to balance, like the bubble on my physician’s scale that hovers between the lines and tells me that I need to continue to do what I’m doing.