The Fat Theory

Closing Thoughts...

2011-11-27T21:12:00.002-05:00

Due to a few issues, I'll be ending my blog after this entry (and after I have it made into a small book). I just wanted to thank everyone for the ideas, laughs, and support during my weight loss journey. I wish you all the very best and hope you all reach the goals you've set for yourselves. I admire each and every one of you!

Loving and Learning...

2011-09-28T19:51:00.003-04:00

Okay, most of the people residing in Michigan LOVE the summer weather but MY favorite season is NOW! I love the smell of burning leaves, the aroma of tasty treats baking in my oven, going for walks when the weather is cooler, MICHIGAN STATE football (GO Green!), and spending time with my family.

I took a break from teaching this year and I'm really enjoying the time that I have with my boys. They grow up so quickly and it makes me very sad. Sure, I have days that make me feel like I'm going crazy, but I truly cherish every moment I have with them. A few of the pictures I included with this post are of my boys from their recent photo session (Keaton, almost 3, and Ashton, 10 months).

As for my weight, I'm still holding at my lowest point since surgery. There is a 24 hour gym opening in a few weeks and I'm signing up on the first day. I need to make the time for ME. I find that when I can leave my home for an hour or two, it makes me a better mom. I feel refreshed and I'm more tolerant of the naughty behavior that Keaton is experimenting with now. Exercising energizes me and it helps my mood. This time of year is always most difficult for me...the lack of sunshine, depression (not sure why), etc.

Tonight I went shopping and was amazed at how my mind still hasn't caught up with my body size yet. I always doubt my size and I purchased a new dress and yep, I fit into a 12-14. It's actually a bit loose, but it is mainly made of cotton and a bit of modal, so it will shrink when I wash it. The other picture I posted on this blog is of me with my extensions, right before an interview. What did I learn? I look awful with long hair, I don't have the patience for the time it takes to dry and style long hair, and I'm allergic to silicone (great to find this out BEFORE I have breast augmentation)! I chopped it all off a few weeks ago and I'm enjoying my short hair again -- it's just me.

Letting Go...

2011-03-25T18:35:00.002-04:00

After you lost weight, did you quickly get rid of your fat clothes? I did some shopping over the past month and as I was looking through my closet today, I scolded myself for letting everything get out of control. My closet was a MESS. I still had size 16-18 clothing hanging, no room for my 12's and 14's and I was very hesitant about letting go of those clothes. I was upset because I couldn't believe I let myself get that big (and there is NO way I'm going back to that unhappy lifestyle) and the cost of those clothes were astronomical. I was going to take them to a consignment shop or even EBAY and then decided to donate them. As women transition from big sizes to smaller sizes, they need new clothes....clothes that are affordable. Letting go of these clothes will benefit two types of people: a) The ones who need them, and b) The girl (me) who gained a positive, insightful, therapy session from the process. I still kept the size 28 black pants from Lane Bryant that I wore to my very first Weight Watchers meeting in December 2007, weighing 326 pounds. I will never let go of those because they are a reminder of how far I've come and they will always motivate me to NEVER go back to that deep depressive state that overtook my soul as an obese woman.

Slowly Getting There...

2011-03-25T09:39:00.003-04:00

The closer you get to your goal, the slower the pounds fall off. I have been watching my intake very closely but I need to pick up the exercise. Of course, when I buy a new bike (see picture), Mother Nature decides to give West Michigan another snow storm with freezing rain. I've only been able to ride it a few times but I am in LOVE!

Why does time fly by? My oldest son, Keaton, is 28 months old and Ashton is almost 4 months old. The adjustment of having another little one in the house has finally become easier. I'm loving every minute I have with my boys!

Making Progress...

2011-03-11T09:05:00.004-05:00

I'm SEVEN pounds from my goal that I'd like to reach before 5/4! The above picture is from 1 month post-op 6/09 (left) and now 3/11 (right). Hard work DOES pay off!

Of course I had to post a current picture of my boys, Keaton (28 months) and Ashton (3 months). I can't believe how big they are!

FREE CLICK Giveaway!

2011-03-03T15:59:00.003-05:00

As most of you know, I LOVE CLICK!! This is the only protein supplement that has helped me get through the past two years after my gastric bypass surgery. When undergoing any type of weight loss surgery, adequate protein intake is crucial. This is also true if you are working out a lot or recovering from any other type of surgery.

For the giveaway, I need you to do a few things: 1) Join the CLICK fan page on Facebook, and 2) Post on the CLICK wall: "Aimee sent me to start CLICKn". Post under this posting that you did the above and I will enter you into the contest. The winner will be announced on St. Patrick's Day, March 17th, 2011!!

You will receive: 1) A CLICK cinch tote, 2) Individual samples of CLICK protein, and 3) A CLICK shaker bottle. CLICK comes in two delicious flavors, mocha and vanilla latte. You can also browse Michelle's blog: www.theworldaccordingtoeggface.com for recipes that include CLICK protein.

Lastly, if you want to stay informed regarding CLICKs new products, join their email list by going to FB and clicking on "join lists".

Let's get CLICKn!!!

And the Winner is...

2011-02-24T14:29:00.002-05:00

ME! Actually I didn't win anything but the Marketing Manager for CLICK protein sent me a pretty sweet t-shirt for being one of their BIGGEST (no pun intended) fans! I have wanted a BLING shirt for the longest time but I have never been able to win one.

An update from my previous post. I have been doing the Chalean Extreme workouts (Burn phase) and counting points. Since last Saturday, I have lost SIX pounds! I'm 18 pounds away from my first goal!

A Variety of Emotions...

2011-02-17T20:50:00.002-05:00

I have a mere 2 months to lose at least 22 pounds to make myself temporarily happy. On May 4th, I'll celebrate my 2 year 'surgiversary' and I'd like to hit the goal my surgeon set for me. Despite dropping 7 pant sizes and 3-4 shirt sizes, I'm not pleased. Sure, I'm healthy, more outgoing, more physically active and stronger than what I was two years ago but I thought if I stuck to the plan and worked out, the weight would fall off. Yeah right. I HATE comparing myself to others who had WLS, but they don't workout, eat junk, and have been at goal weight 8 to 10 months post-op. I was doing quite well, hit a few stalls, and at 10 months post-op, found out I was expecting my second son. Now I'm trying to figure out how to fit a workout into my chaotic schedule. I work long shifts (12+ hours) at least four days a week. Sometimes it's impossible to get a workout in due to my kids being on different napping/sleeping schedules. After thinking it through, I decided to just MAKE the time. If that means getting up an hour earlier, so be it. This is how I'm going to change things up a bit:

a) Chalean Extreme: Currently I'm doing the BURN workouts 5 days a week.
b) Following Weight Watcher guidelines but making sure I'm meeting the protein requirements.
c) Journaling all intake.
d) Consuming at LEAST 64 ounces of water daily.

Plastic Surgery...

2011-02-09T13:54:00.002-05:00

I will be going for my first consultation for plastics (breast augmentation with a lift) in three weeks. How many of you have had plastic surgery? Are you happy with the outcome? I'm trying to be realistic with the outcome and I'm just afraid that I'm never going to be happy with my body. I had very poor self-esteem prior to losing all this weight and I still cringe when I look in the mirror. Instead of seeing a healthy woman with an almost "normal" BMI, I see the rolls and fat. How does one appreciate their body after significant weight loss?

Suggestions?

2011-01-02T08:47:00.002-05:00

I'd like some ideas regarding protein and caloric intake. How many calories are you eating daily and what foods are staples in your daily intake? Before having my second child, I was capable of browsing for recipes and cooking new things to eat. Life is very busy now and I'm lucky if I have time to drink water. Yesterday while I was feeding my son at 3 am, I made a note in my iPhone and planned my meals. I had a serving of Special K with 1/2% milk, a protein shake, salad with ham and cheese, yogurt, small piece of lasagna and after exercising I had a serving of cottage cheese with mixed fruit. Eating every 2-3 hours made a difference in my energy!

Today my intake will consist of: Special K with 1/2% milk, string cheese, a protein shake, wheat pita pocket filled with lean ham, lettuce and cheese, skinless smoked turkey sausage with steamed mixed veggies and a serving of yogurt after my workout.

New Year's Resolutions: 2011

2011-01-01T21:14:00.004-05:00

I survived another year! Reflecting on 2010, I have many things to be grateful for: a) I learned from a few mistakes, b) I let go of some feelings/things that were really bothering me, c) I unexpectedly got pregnant and delivered my second (and last) son on December 1st, d) I had a healthy pregnancy, e) I have been free from illness, and f) I'm so LOVING life! A few things I'd like to accomplish in 2011 include: a) Reaching my goal weight by my two year 'surgiversary' on 5/4 (roughly 17 lbs), b) Establish a new routine for working out now that life is a bit chaotic due to the terrible two's my oldest son is going through and the newborn barely-get-any-sleep stage that I'm encountering with Ashton, and c) Participate and complete a 5k run.

I included a few pictures of myself from a few days ago. Unfortunately I don't have anyone to take a picture of me during the day so you'll have to deal with the infamous myspace/facebook-snap-a-picture-of-yourself-in-the-bathroom picture! I still have a little swelling in my lower abdomen from the c-section and tubal...I'm not impressed with my stomach. I can grab some firmness, so I know that I can lose more fat in that area. Does anyone have tips for slimming the thigh area? I'm too hippy!

Christmas/Newborn Photos...

2010-12-20T16:45:00.005-05:00

Here are a few photos from our newborn session on 12/13/10. Laura does phenomenal work and I can't wait to see the rest!

Despite trying to recover, I am sick of being in the house. I really wanted a picture of the boys sitting on Santa's lap, so we went to the Woodland Mall and they got to meet him. Keaton was not thrilled but did sit on his lap and Ashton didn't like Santa. Santa was very stiff and not very soft spoken.

As far as an update weight wise, I am officially below my pre-pregnancy weight by 2 lbs! I hit this number exactly two weeks after deliving Ashton. I now have 19 lbs to go before reaching my personal goal. Hopefully I can reach this goal before my 2 year 'surgiversary' on 5/4/2011!

q 2 hour feedings...

2010-12-14T04:32:00.003-05:00

Yes, Ashton is eating at least every two hours and I'm exhausted. I get maybe 1 hour between feedings (if I'm lucky) and it's impossible to nap during the day because I have a toddler as well. My WLS friend, Shannon, sent me two cute edited photos of my boys. It's the first time I was able to capture Keaton interacting with Ashton and it made my heart melt.

Pregnancy Weight Gain...

2010-12-09T14:13:00.002-05:00

Total amount gained: 35 lbs (most towards the end of pregnancy due to fluid retention).

Weight lost 8 days post-delivery: 27 lbs

Pounds to reach pre-pregnancy weight: 8 lbs

Obviously I am not exercising because I have a c-section incision that is healing and it BURNS like crazy! The last thing I need is for it to split open! I am breastfeeding which burns up to 500 calories a day and staying as active as I can with a newborn and toddler. Life is quite hectic right now!

Sunday Pictures...

2010-12-05T11:51:00.003-05:00

Ashton loves to sleep and this makes Mommy VERY happy! He sleeps 3-5 hours at a time and I'm actually waking him up to feed him and change him. The transition from 1 to 2 kids has been better than what I anticipated and I'm sure it will be even better once I'm fully recovered from the c-section. Here are a few photos of the sleeping prince. Did I mention that I'm so in love with him?!

In an upcoming post I'll share my pregnancy weight gain and I'm going to weigh myself to see where I stand and to see how much weight I'll need to lose to reach my goal weight. I'm actually not paranoid or freaking out about it. Once I'm cleared by my OB doctor, I'll resume exercise and I'm already eating like I did pre-pregnancy.

He's Here!!!

2010-12-04T14:17:00.003-05:00

Ashton Markis Johnson arrived on December 1st at 10:21 am via c-section (repeat) and weighed 9 lbs 4 oz and was 22'' in length. The Nurse Practitioner at the office was pretty sure that he wouldn't weigh more than 7 lbs but she was WRONG! This delivery was much better than my first, considering it wasn't emergent and also because Dr. Bhimalli is phenomenal and inserted the spinal without any issues. In addition to the c-section, I had some scar tissue and excess skin removed and a tubal ligation. The recovery is much more painful but I'm trying to rest and take my pain medications as much as I need to.

The picture shows my two boys, Keaton (left) and Ashton (right). If they weren't 2 years 2 weeks apart, you could almost call them twins!

Insomnia...

2010-11-22T03:13:00.003-05:00

I have been wide awake since 2 and today is my pre-operative appointment for my c-section NEXT week! The last few nights of sleep (should I even it call it that?) have been a challenge and I'm so ready to deliver this little man!

Besides the typical "your body is getting ready for motherhood" theory, I think my not so impressive lab work is also contributing to this lack of sleep. Because I'm considered high-risk, I've had monthly labs drawn from the 5th month of pregnancy until now. I have noticed a decline in all the important post-bariatric labs and despite this being "typical" or "okay" in NON-bariatric patients, it's not okay with me. My OB doc says baby is taking what he needs---yes, I understand that. I have been adjusting my vitamins as I have noticed the decline and it's not helping. Prior to the 5th/6th month, my b12, iron, electrolytes, and hemoglobin were great. Now my calcium is low, b12 is on the low end of normal (used to be double the high end), my iron is low and my hemoglobin is low. What really bothers me is that my protein and albumin levels (to monitor nutrition) have plummeted. I opted to take the full 12 weeks of FMLA and I'm praying to God that I can utilize that time to get these labs within normal range. I have spoken with my bariatric surgeon's office manager and they will evaluate my labs at 6 weeks post-section and they will order intervention (i.e. iron infusions) if needed. THANK THE LORD! I have worked too hard to have issues now.

Enough rambling about negative things! This picture is of my son Keaton when he was only a few weeks old. I can't believe that next week I'll have another little guy to love and cuddle!

Late Post: Halloween 2010

2010-11-09T20:32:00.002-05:00

Here are a few pictures from our Halloween 2010 festivities. Keaton dressed up as a cheeseburger (how appropriate considering I am craving cheeseburgers during the last trimester)! I also purchased the cutest shirt from ETSY that had a big pumpkin across the belly and underneath it read: Pumpkin Smuggler. I wore this with my festive headband and that's as dolled up as I got. Next year I will hit my goal weight and will dress in a fun costume!

Pregnancy Updates...

2010-11-09T20:10:00.003-05:00

1) I have experienced rapid weight gain over the past 5 weeks (19 lbs). Because of this and my visit with the OB last Friday, I was placed on bed rest. At 9:15 in the morning I had ankles the size of softballs. The NP wanted to admit me but because my blood pressure was okay and because I'm a nurse, she let me go home on two conditions: a) I monitored my blood pressure every 4 hours, and b) I had to complete a 24 hour urine collection to check for excessive protein (>300). This was a challenge because I have a toddler and my baby sprinkle was on Saturday. I managed to rest the best that I could and I completed my urine test Monday morning. On Monday I saw the NP again and she said all of my labs came back within normal range and since my blood pressure was good and I had no swelling, we were good to go. I'm going to attempt working this weekend and if it is too much, I will have to reduce my shifts to 8 hours or not work at all. I can't imagine sitting around the house until 12/1.

2) I'm very tired. After Monday, I will not be working any extra shifts because my body cannot tolerate the extra hours. Baby is engaged in my pelvis and is head down. This causes a lot of pressure, swelling, and cervical cramping. There are times I can barely walk because of the pain and I am feeling MISERABLE.

3) I haven't changed my mind regarding the tubal. Due to the history of gastric bypass and my labs being messed up (due to pregnancy) and the fact that I'm now 30, having more biological children is not the best option for me. I love my boys and if I want to adopt someday, that will always be possible!

4) Be watching for pre-RNY pregnancy photos vs. post-RNY pregnancy photos. I cringe when I look at the pictures of me in the hospital when I was delivering Keaton. I was at my highest weight (and they stopped weighing me because it was SO depressing) and I had complications due to pre-eclampsia. I know that the comparison will be amazing!

Help a Fellow Weight-Loss Diva Out!! Votes Please!

2010-10-26T05:02:00.003-04:00

A very close friend of mine, Tiffany, has been losing weight through a very clean diet and intense workouts for over 2 years now and has lost close to 200 lbs. In the beginning, basic activities of daily life would make her short of breath and just this past weekend she completed her first 10K run! She has been an inspiration to me and to others and she's hoping to become a Fifth Third River Bank Run Road Warrior. She is a top 20 finalist and if you could go to the link below, find her story on the main page (Tiffany Duffield) and vote for her, I'd be SO grateful!

http://www.53riverbankrun.com/participants/road-warrior-vote.php

Baby Belly Photo Shoot at 33 Weeks

2010-10-25T15:16:00.026-04:00

I wanted to capture my beautiful baby belly (hey, it's beautiful to ME because with my first pregnancy I was so overweight you couldn't tell I was pregnant!) via photos so I had pictures taken by Laura Gravelle Photography in Grand Rapids, Michigan. Laura does phenomenal work and was so sweet to work with. She will be coming to my home on 12/13 to capture Ashton's first professional baby pictures and I can't wait. Here is a sample of her work from our photo session:

The Terrible Two's...

2010-10-12T21:29:00.003-04:00

There are days in which God is truly testing my patience and my tool that Dr. Schram gave me. My tool is in good condition, and probably is more restrictive because Ashton is crowding my stomach and rib area, but the psychological aspect of my weight issues is slowly creeping back.

Today my son decided to throw several tantrums in public. The first one happened two minutes after we got out of my SUV and we were heading towards the pumpkins. I had let him walk on his own and he decided to run off towards the people eating at the picnic tables. When I directed him towards the area we were going to, he burst out into a full blown tantrum. I immediately tried to correct the situation and when that didn't work, we turned around and went home. I tried getting him to nap three different times and he cried so hard that he was gasping for air. After dealing with this for 2-3 hours, I decided to go to Grand Rapids regardless.

Keaton was exceptional in the mall and at dinner. The 100th tantrum happened as we were leaving Target. Once we got home he was fine and after a nice warm bath, sippy cup full of milk, and a light snack (animal crackers), he fell asleep within minutes. My whole point of this? Mommy wanted to eat everything in sight. A mini-ice cream drumstick, animal crackers, diet pop, chocolate chips...you get the idea. I caught myself going back to bad habits and quickly corrected the behavior. Although my son may frustrate me and really try my patience, I have to remember that connecting emotions to food is not acceptable--it's what started my whole weight problem in the first place.

This picture is from Paulson's and as you can tell, my son was not very photogenic. I am looking pasty, feeling bloated and miserable, and I have to shout this out: I'M WEARING NON-MATERNITY JEANS, SIZE 14 HERE!!! They are big in the thigh/butt and I know that as soon as I deliver Ashton and get rid of the excess fluid, I'll be in a size 12 pant. Not too shabby for being almost 5'10'' (my goal size is a 10 but I'm not sure if that's achievable based on my frame/height).

A couple of BuMp pictures! 29 weeks, 2 days!

2010-10-08T12:14:00.003-04:00

I forgot to attach a few of my belly bump photos! I didn't "show" when I was pregnant with Keaton because I was so obese--I'm proudly showing the belly now! I'll have some cute Halloween photos to post on 10/31 and professional maternity photos on 11/2 (should receive the digital negatives on a CD shortly after). I'm cherishing this pregnancy because it is my last!

The inevitable weight gain...

2010-10-08T12:05:00.003-04:00

I don't have much time to post but I figured I'd hop on and give you all an update. I had my 31 week OB appointment this past Wednesday and my biggest fear came true: I gained NINE freakin' pounds over THREE weeks! Let me first say that my concern comes from my high-risk pregnancy with Keaton and the weight gain and complications I had during that time. Secondly, I am a bit bummed that I am gaining weight but I do know that I'm eating right and staying active. I'm still wearing the same size clothing and the only thing that is changing is the big belly BuMp! My Ob-Gyn was not concerned because she thinks I'm catching up for all the losses I had during the pregnancy, I'm edema-free, and my blood pressure is on the lower side of normal. Attached are a few pictures of the elective ultrasound I had on Tuesday. Ashton looks JUST like his older brother Keaton, scowls and all! In one of the pictures you'll notice that he already loves to play with his toesies!

Pregnancy Post-WLS

2010-08-29T13:45:00.004-04:00

Wow, I haven't posted in ages! I've had a lot of significant changes in my life over the past few months and I've been working on a few personal goals and I haven't had a chance to blog. So yes, I'm pregnant with #2 and will be having a repeat c-section on December 1st. Curious as to what the gender is? It's another BOY! Ashton Markis is behaving himself (not causing mommy to have high blood pressure or excessive weight gain). I lost 13.5 lbs during the first trimester and gained 4.5 so far during the second. My next OB appointment is on Tuesday and I know that I've packed on some pounds but it's all for a good cause. I had my third ultrasound on 8/16 and the baby was measuring in at 1 lb 8 oz and everything looked great. Because I'm considered "high-risk", I have labs drawn monthly and those are also within normal limits. Here are a few ultrasound pictures: 1) Ashton at 17 weeks (profile) and 2) Ashton at 24 weeks (face shot).

Help me reach 75 followers and we will have a DRESS giveaway!

2010-05-20T11:00:00.002-04:00

So yeah, I really have been slacking at keeping my blog updated but I've been so incredibly busy and my summer is about to get even more chaotic. An online clothing store contacted me about writing a review on a dress and I could keep it for myself or give it away. I ordered the smallest size (14/16) and it doesn't fit (YAY! I'm in a size 12 dress)...this means one of YOU can win this dress and I'll even pay for the shipping! In order for the giveaway to start, I have to reach 75 followers. Do you know other bloggers that might be interested in following my journey? Or girly girls who would LOVE to win a free dress (size 14/16)? Encourage them to join. Once I hit that golden number, we will collect entries and I'll randomly select a winner. The dress shown is the dress you'll win!

OH Magazine...

2010-04-14T16:48:00.002-04:00

I received an email asking if I'd be interested in sharing pictures of my WLS journey with Obesity Help and I excitedly agreed! I sent my story with the pictures and I will be in the May/June issue. Due to other unexpected circumstances (just amazing by the way), I predict that I will be sharing my story in the magazine later this Fall.

I also wanted to thank all of you fellow bloggers for your inspirational stories, comments, and support. My life is quite chaotic right now, so I don't respond to all of your postings, but believe me, I read them and they help keep me on track!

A BIG Reward!

2010-03-26T10:31:00.003-04:00

I discussed rewards a few postings ago and I have a confession: I rewarded myself BIG time! Five years ago I fell in love with the Chevrolet Equinox and when I attended the Grand Rapids auto show I avoided looking at the 2010 Equinox but I couldn't resist. Once I sat in the seat, I was in love and KNEW I had to upgrade. I could have purchased whatever car/SUV I wanted and I went with the Equinox. It's a 2LT with all of the upgraded options. Black leather with red piping bucket seats, navigation system, moonroof, OnStar, remote starter, 18'' wheels, towing package, bluetooth capabilities, and a USB port so I can play the songs on my iPhone and iPod on the radio! Love it, love it, love it!!

So congratulations to me for: a) Losing over 100 pounds, b) Finally hitting onederland, c) Sticking to the exercise/nutritional routine, d) Having great lab results and post-surgery visits, and e) Turning 30 in June!

Onederland, Jogging, and VS Biofit Bra...

2010-03-26T10:09:00.003-04:00

Okay, this post will be rambling so I am going to break it down into digestible pieces:

I.) Onederland: Yes girls, I FINALLY hit onederland last week! Have I maintained that status? Nope. My weight is bouncing between 198-201 and I haven't stepped on the scale since then. My response to onederland was similar to Amy's...it wasn't as wonderful as I anticipated. Now my focus in on staying below 200 and slowly progressing to my next goal of 188 (my surgeon's goal for me).

II.) Jogging: I set a goal of 12 runs over 30 days and I successfully completed it last night. I'm working on interval training and increasing my distance slowly. I also changed my routine at the gym and my legs have been a bit more sore, so I'm trying to prevent injuries.

III.) VS Biofit Bra: Jen posted pictures of her 'girls' in this 7-way bra from Victoria's Secret and I knew I had to buy one. Prior to surgery I was comfortably wearing a 42DDD bra. I went to Lane Bryant this past January and they measured me and claimed I was a 40D still (after losing 100 pounds). My little boobs still floated around in the cup and I could lift the strap of my shoulder 2-3''. I KNEW this was not the perfect fit. I have purchased several strapless dresses for summer and I needed a comfortable strapless bra. The biofit bra can be worn as a halter, racer back, normal bra, and strapless. The sales representative measured me and guess what? I'm a 36C! I bought one in nude (they were out in black and white) and then I purchased a demi style bra in black. They are so comfortable but now I look like I've had a mastectomy. I'm very self-conscious of my chest (or lack thereof). Now for a confession: I decided to teach this past Spring and will continue to do so for at least the Summer and Fall term because I'm saving money for a breast augmentation and possible lift. Augmentation alone will cost roughly $5,000 and if I need a lift that will cost $4,000-$5,000 more. With my frame, I don't feel 'normal' (what the hell is 'normal' anyways?) with my small chest. I don't feel feminine AT ALL. It's not about looking like Barbie with ungodly huge breasts, it's about feeling comfortable with how I look and being able to fill out the chest section of dresses, tops, etc.

These are pics from my 10 month 'surgiversary'. I'm down 127 pounds and I'm in a large top (sometimes medium) and size 14 pant (loose in waist, snug in the hips).

Setting Small Goals and Rewarding Yourself...

2010-03-12T15:08:00.004-05:00

Throughout my many years of dieting, I learned to set small goals and rewards. After WLS, I decided to make the rewards quite significant. I purchased many new outfits, new makeup from MAC and Lancome, a day at the spa, and my most recent obsession is the Apple iPad. I just received an email from Apple stating that they are ready to be pre-ordered or reserved. I'm thinking that this will be my reward for reaching my surgeon's goal and for my 30th birthday (in June).

Today I rewarded myself for adhering to my jogging schedule and for reaching a goal of jogging 15 miles (over 3 weeks--I'm just a beginner!). I am focusing on distance and endurance rather than speed and now I'm following a plan created by a fitness coach at Gazelle Sports. The plan is a bit different from the C25k program and I like that the plan encourages me to walk on my "off" days. After completing the interval training this morning, I rewarded myself with a pedicure (see picture of my tootsies).

How do you reward yourself?

Cheesy Chive Dip...

2010-03-12T15:03:00.002-05:00

When I go to family functions, I try to prepare dishes that are friendly to those of us who are losing weight or watching calories. My friend recently had a Tastefully Simple party and I ordered several cheeseball kits. The picture shown is of a Cheesy Chive Warm Dip. I used 1/3 less fat cream cheese, one package of seasoning, mixed them together and put it in the fridge overnight and then I microwaved the dip and added two tbsp of reduced fat cheddar cheese. You can serve this with veggies, crackers, or bread cubes. It's sooooo yummy! I also bought the key lime pie and apple cinnamon cheeseball kits. I will be hosting a party March 24th, and if anyone is interested in placing an online order, let me know. These make the perfect snack!

I'll Pass on the 'Roll'...

2010-03-11T20:19:00.003-05:00

Since this is my blog, I'm going to use it for venting. I don't want to sound ungrateful or unhappy with my progress and hard work, but I'm really not liking this new body of mine. It's almost like a slap in the face when you look in the mirror and your body is a wreck. Ten months of hard work, dedication, sweaty workouts, and I look in the mirror and I cringe and want to cry. Look at the pictures included in this entry. I have a muffin top that won't go away despite wearing jeans that are loose in the waist. I'm wearing a size 12 pant in the picture and I have a very prominent roll that is "friends" with the roll underneath the jeans. I know that I carried a lot of excess fat in my abdominal area and carrying a baby did not help the situation. Will this piece of chub ever go away? I know I have more weight to lose and I think it will flatten out some, but seriously? For all of my followers who have lost weight, what do you ladies use to disguise your problem areas?

10 Month Surgiversary and Signs of SPRING!

2010-03-08T20:43:00.003-05:00

Today was a fantastic day! I went shopping and bought a very cute dress (to be featured in a future posting) in a size large and more cute gym shorts. To be honest, I have not been caught dead in a pair of shorts in years. I have hated my legs but now that they are toned and tan, I'm going to show them off!

I've been jogging every other day and this morning I was able to jog 2.12 miles! After shopping, I walked just over 2 miles on the trail in my neighborhood and the fresh air was just what I needed.

My 10 month 'surgiversary' was on the 4th of this month and I am down 125.4 pounds! I am going to hit a few major milestones within the next week or two: a) I'll be under 200 pounds, b) I'll be 11 pounds away from my surgeon's goal, and c) I'll be 25 pounds away from reaching my personal goal.

I survived my first clinical rotation as an INSTRUCTOR!

2010-03-04T11:53:00.002-05:00

Here is my first group of Ferris State University nursing students! We completed a seven week Medical-Surgical rotation at Spectrum Health Blodgett Campus. I'm off for two weeks and then I will be back for my second round of students!

Treadmill...

2010-02-26T16:31:00.002-05:00

I wanted a treadmill that wasn't going to break the bank yet would be sturdy and effective in helping me train for jogging/running. After trying a few models, I went with the Gold's Gym Crosswalk 570.

From the web site:
Increase your cardio benefits and workout entertainment with the Gold's Gym CrossWalk 570 Treadmill. Equipped with all the extras, the Gold's Gym CrossWalk 570 Treadmill will help you reach the finish line of weight loss. Burn 50% more calories with the CrossWalk Upper-Body Arms. The adjustable resistance will help increase your cardio burn and tone your upper body while the redesigned grip will keep you comfortable. Stay motivated with your favorite music with the Compatible Music Port for iPod. Plug your MP3 player into the Gold's Gym CrossWalk 570 Treadmill console and enjoy the built-in sound system. A spacious 20x55 treadbelt, Lifetime Frame Warranty, the Drive Motor is warranted for twenty-five (25) years from the date of purchase and Precision QuickSelect controls all top off this incredible treadmill by Gold's Gym.

CrossWalk Upper-Body Arms
Burn 50% more calories* and increase your cardio benefits with CrossWalk upper-body arms, featuring adjustable resistance and a redesigned grip for increased comfort.
* Based on the ACSM's formula for caloric expenditure of a 185 lb. male performing all workouts as prescribed.

Compatible Music Port for iPod
Work out at the speed of sound with this Compatible Music Port for iPod**.
**iPod is a trademark of Apple, Inc., Registered in the U.S. and other countries. iPod not included.

ComfortShox Max Cushioning
The Gold's Gym CrossWalk 570 Treadmill is equipped with an extra-large cushion, helping you feel better during and after your workout of walking, jogging or running.

Gold's Gym CrossWalk Treadmill With 16 Personal Trainer Workouts
Burn fat, lose calories and stay motivated. Choose between aerobic, endurance, weight-loss or performance workouts and you'll be on your way to success.

G-Force 2 2.8 HP Drive Motor
Get smooth, consistent operation every time from this powerful motor. Engineered to maintain its strength for long-term use, this motor is perfect for light or intense workouts.

1-10 MPH Precision QuickSelect Speed
Allows you to instantly change the speed of the treadmill between 1 10 MPH with the single touch of a button.

0–10% QuickSelect Incline
Allows you to change the incline with the single touch of a button instead of tediously scrolling through options as you would with traditional incline controls.

20" x 55" Treadbelt
Roomy treadbelt designed to operate more smoothly and quietly than the average belt.

ClearView Backlit LCD Window
The ClearView Display on the Gold's Gym CrossWalk Treadmill has a large viewing angle so no matter how tall or short you are, you can always keep track of your workout progress. Displays time, speed, distance, incline, pulse and calories burned.

Workout Intensity Control
Allows you to adjust the intensity of your workout at any time. Simply adjust the intensity and the program will automatically adjust to your desired performance level.

Dual-Grip PowerPulse Heart Rate Monitor
Equipped with sensors, the sophisticated fan is built right into the console, just like the AC in your car, allowing you to quickly adjust the settings.

300 lb. Weight Capacity
The sturdy deck of the Gold's Gym CrossWalk 570 Treadmill withstands heavy use.

Patented SpaceSaver Design
The deck of Gold's Gym CrossWalk 570 Treadmill folds vertically for storage.

3 months post-op jogging vs. 9 months post-op jogging...

2010-02-25T20:29:00.002-05:00

Some people wonder why I am interested in running (jogging as of right now) and it's quite simple. I have always been doubted when it came to my ability to do something, like going to medical school (I opted for nursing instead), wanting to run cross country in school (I was told that I didn't have the body of a runner), and so on. I attempted the Couch to 5k (C25k) program last August after losing roughly 50 pounds and my legs and feet ached so bad. I really hoped that I would gain enough confidence at the gym to start using the treadmill, but that never happened. There are only a select few treadmills that are even good enough for jogging and they are always taken.

Fast forward to now. I have lost 123 pounds and I purchased a new treadmill. Last night I decided to put my Nike sensor to use and I wanted to see what my baseline is in regards to jogging. I varied my speed between 4-4.5 mph and set the incline at 1. When I finished my sensor said: 1.62 miles. My friend said that this wasn't possible, because running at 4 mph will give you a 15 minute/mile pace. Mine wasn't completely accurate because I adjusted the speed and so we determined that I jogged just over 1.3 miles.

This morning I couldn't sleep, so I jumped on the treadmill at 5:30 to release some negative vibes. I calibrated my sensor and jogged another mile. Woohooo! It's definitely not easy, but I can already tell how far I've come. I never have ran a mile and now my goal is to run two miles! My goal is to jog three days a week and on my off days I will do intervals on the elliptical or I will do an endurance program on the treadmill.

Shopping Trip and Scary Side Effects...

2010-02-18T08:14:00.004-05:00

Last night I went shopping in Grand Rapids for warmer workout clothing (see cheesy self-portrait while in the bathroom) and found some great deals. I bought a pair of black under armour pants (fleece lining), a pink under armour fleece top, and a white under armour shirt. Also due to the wonderful Michigan weather, I bought a black fleece headband to protect my cold ears! After successfully raiding the racks at Dunhams, I found some other great steals at various stores. I bought a beautiful chocolate brown dress with cream, tan, and teal accents for 19.00! I also couldn't refuse a beautiful CK jacket with ruffles around the collar in a neutral khaki color.

Today I have an appointment with my doctor because of my issues from earlier this week. On Monday I had near syncopal episode while I was teaching at Blodgett Hospital. My blood sugar was low and my blood pressure was 70s/50s (manually...they couldn't get my pressure to read on an automatic cuff). My labs were great and I may have a common side effect that RNY patients have: hyperinsulinemic hypoglycemia. I'm guessing that I will have to check my blood sugar daily. I did speak with a dietitian from Barix Clinics and she recommended drinking 2-3 ounces of juice and following it with a high protein snack (mozzarella cheese or cottage cheese). I typically don't drink juice, but I guess I'll have to do so when I feel this way. I am also readjusting my bedtime snack (higher protein) and I will keep water at the bedside.

9 month post-op visit...

2010-02-14T09:06:00.002-05:00

I had my visit with Dr. Schram on Thursday and I am down 116.5 lbs from my highest weight! I have lost an additional 1 lb since then, for a total of 117.5! I have 8.5 more to lose before achieving my BEST goal ever (to be less than 200 pounds). Dr. Schram and I discussed setting a goal weight and he wanted to know what would make ME happy. When I first had my consult with him in July 2007, I listed my happy weight as 210--well I am less than that and that is no longer my happy number! I'm not sure if I'll ever be able to reach the magical number that considers me "no risk" for medical conditions associated with obesity (less than 165), so my goal weight is 175. I am hoping to reach my surgeon's original goal of 188 by May 1st!

A tiny update...

2010-02-10T17:07:00.005-05:00

I just celebrated my 9 month 'surgiversary' and tomorrow is my appointment with Dr. Schram. I'm eager to step on the scale (for once in my life) and I can't wait to see the % of body fat decrease and the % of lean muscle mass increase! I will post again tomorrow with my official results!

As for NSVs, I went shopping and bought tops in the 'regular' section in a size LARGE. I couldn't believe it. I also just ordered my first pair of jeans in a size 12--I wasn't even a size 12 in HS!!

My WLS journey article...

2010-01-29T19:02:00.003-05:00

I am the calendar girl for February! The marketing office at Barix Clinics emailed me about being a featured success story and initially I thought that I should wait but I decided to go through with it for a few reasons: a) I'm a younger patient and I can show how obesity affected me throughout one of the most important decades of my life, b) I can discuss how WLS positively changed my life, c) I can show how I have committed to a healthier lifestyle, and d) People can view my before and after pictures.

I have 42 pounds to lose before reaching my personal goal. I'm feeling great where I am now but I know I will be even healthier once I reach this goal. For once in my life, I'm feeling stable in all areas of my life--mentally, emotionally, physically, and spiritually.

Below is the link to my story:

http://www.barixclinicsstore.com/aimeesuccess.html

The Process of Changing--Involuntarily.

2010-01-27T19:27:00.003-05:00

Pre-operative Aimée: Depressed, quiet, anxious, nervous, avoided social situations, poor self-esteem, low self-confidence, introvert, skeptical, borderline paranoid, hated most aspects of life, inactive, constantly tired.

Post-operative Aimée: Bubbly, outspoken, sociable, independent, extrovert, improved self-esteem and confidence, exercise queen, splenda and pampered chef wannabe, lively, loving, happy, motivated, beautiful (inside and out).

I never realized prior to surgery how much I'd change as a woman. I knew that I would change physically, but I didn't know how my weight loss was going to affect my attitude and the perceptions that others had of me. Last week two close people removed me from their Facebook accounts. I emailed, asked why, and received a response over the weekend. Per their words, I had become: self-absorbed, unhealthy, and obsessive. Instead of approaching me from a caring manner: Are you okay? How's your weight loss going? Are you happy? Can we do anything to be more supportive or to help you?, I received a slap in the face. The Aimée that they once knew, was no longer meek or shy--She had become outgoing, fierce, bold, and proud. Those of you who know me can verify how many pictures I had of myself before surgery--not very many! On my Facebook I was posting pictures of me with my diploma from graduate school, pictures of comfortable sneakers (for those who were interested in running), pictures of healthy post-op foods, etc. For my status I would post updates, my workout plans, and my losses. I was told that I was "freakin'" people out when I would exercise more than once a day (it wasn't happening on a daily basis). We all have transfer addictions when we let go of something major (fat)--Exercise is mine. It truly is my #1 stress reliever.

I'm sad that these individuals chose to turn their backs on me instead of approaching me in a more open way. My mom has told me all along that there were going to be people who exhibited jealousy and hatred because I'm finally succeeding at my personal weight loss journey. My friend, Tiffany, also went through this and continues to do so. Why are people so bitter and nasty? For once in my life, I'm going to use those negative vibes to push myself in the gym, or to change my mind when I'm craving something I shouldn't eat. To give into their game would mean they would win and that is NOT going to happen.

Guts and Butts

2010-01-20T20:23:00.004-05:00

Since joining the gym two weeks ago, I've been wanting to take a class and finally did tonight! The pamphlet suggested that this class is like circuit training for the abs and booty and is approximately 30 minutes--LIAR! The five minute warm-up is a killer and then you do various exercises in two minute increments. Most of the exercises are used with light hand weights and although I struggled in a few areas, I completed the whole 60 (yes, not 30) minute class. For an update on my previous post below, I weighed myself today and lost over three pounds!

POS scale!

2010-01-14T16:39:00.002-05:00

My surgeon's office manager scolded me about weighing myself daily so I told her that I would try to weigh myself once a week. This past Monday I weighed myself and vowed to ignore the pretty glass scale when I walked into the laundry room. Tuesday passed by, no weigh-in, and then Wednesday quickly approached and I stepped on the scale around 8 pm. Boy, this was a BIG mistake. I had been quite busy all day and went to Chuck E. Cheese with my family, yet still followed my "diet". I went to the gym on Monday and Tuesday and even Wednesday night and the scale moved---UPWARDS! Are you serious? Now my scale is residing in the garage rafters and I will only be weighing myself once a week at the gym. I'm praying that this is a temporary gain due to an increase in lean muscle mass. I have an appointment to see my surgeon on February 11th for my 9 month post-op visit, and I'm hoping to lose another 5 pounds by then. Will it happen?

I did it!

2010-01-11T17:51:00.002-05:00

Although I didn't graduate from my original program (Michigan State MSN/FNP) due to a conflict with clinical scheduling due to me moving out of state and for other personal reasons, I finished my graduate degree! After waiting for a few months, my diploma arrived today as I was leaving the house to go to the gym.

On a weight-related note, I am down 108 pounds! A NSV (non-scale victory) for me was announced today: I am going to be a featured success story for Barix Clinics!! One of my goals after having surgery included being a role model to those who are contemplating weight loss surgery or weight loss in general. Being an inspiration to others is inspiring to myself as it keeps me motivated and focused. I would like to thank all of my supporters! Your kind words and positive attitudes have helped me in more ways that I can give you credit for!

New Year's Resolution and the Wii Active!

2009-12-29T13:26:00.002-05:00

For the first time in my life, my resolution for the year 2010 will NOT be weight related! I currently workout at least five days a week and for the New Year I am joining the local gym. My goal will be to workout at least 3-4 days at the gym and I can do other workouts at home (elliptical, total gym). My schedule is going to be more busy this Spring as I will be teaching part-time, working in the ICU, and applying to doctoral programs.

Last night I bought the Wii Active game and I LOVE IT! Today was my first workout in the 30 day challenge and I completed it using the 'moderate' intensity. I had to stop after 10 minutes because my heart was beating too fast and I was shocked at how hard it was! The workout incorporates running, walking, squats, lunges, boxing, skating, and resistance bands.

Do your 'girls' need a LIFT? Try this...

2009-12-24T08:19:00.002-05:00

Okay, so before I give my review, PLEASE do not attack me for pushing you into a plus-size store! I know after many of us lose weight, one of our biggest goals is to stay away from the stores that clothed our big bodies. So, I have a confession to make. Over the past 7 months I lost 100 pounds and I never bought new bras. I adjusted the straps until it was impossible to wear them any longer. Yesterday I made a trip to our most popular plus-size store, Lane Bryant, because they really have the best bras--better than VS in my opinion. LB was running a special, buy 2 bras, get 2 free. What a deal considering the bras are priced $34-$44. The sales associate was super friendly and said I was the exact measurements for a 38D but that she wanted to put me in a 40D so I could adjust it as I lost the rest of my weight. Based on my frame and height (almost 5'10''), she said I would probably always be in a 38. Did I care? Nope!! I love the bras at LB and my friend Tiffany had recommended the plunge style. The associate filled the fitting room with at least 20 bras and when I left I looked at the tag and noticed I picked 2 of the plunge style and 2 of the demi bras. Not only did the plunge give me the much needed lift, they made me feel BEAUTIFUL! These are the next best thing to breast augmentation--at least when you are clothed! I highly recommend these!

Christmas Party #1...

2009-12-22T13:14:00.002-05:00

Tonight my family will be celebrating Christmas and I can't wait! I am in charge of the spiral ham and I also made a dessert (caramel toffee trifle). Tonight will be my first challenge in regards to eating during the holiday season. I'm going to focus on my protein and just a taste or two of the desserts!

Do I need an attitude adjustment?

2009-12-15T08:56:00.005-05:00

Seven months ago I was considered morbidly obese according to the National Institute of Health (NIH) BMI calculator. For the past 10 years, I have listed every excuse possible to not lose weight. Examples: a) I don't have the time, b) My thyroid is hypoactive, c) I hate sweating, d) I have to be super careful of my back, and e) I do not like to workout in public. What's my problem now? I'm tired of hearing the same excuses from other people. I have spent a lot of time with two very close people in my life and I have tried to assist them in finding methods to help them change their lifestyles. I provided recipes, detailed emails regarding meal plans and workout activities, lengthy conversations, and actual materials (cookbooks, weight watchers books). My friend Tiffany had told me a few months ago that she has zero tolerance for those who are not ready to make the commitment it takes to lose weight yet CONSTANTLY complain about it. I wondered how she could feel this way when we BOTH were morbidly obese at one point in our lives. Now I know. Do I feel guilty? A bit. Am I angry? Yep. Do I want to shake those individuals? Yes. What I've come to learn from this experience is that I cannot change others. I can lead by example and hope to inspire others, but I truly cannot motivate them. I cannot pull them off the couch, I cannot be their personal chef, and I cannot spark that internal desire that elicits a major lifestyle change. Prior to having surgery, I made an extensive list of why I wanted and NEEDED to lose weight. Here are a few of the reasons: a) I became a mother and wanted to be the "active" mom that could keep up with her children, b) I was exhausted, c) I was depressed, d) I was diagnosed with hypertension, e) I hated going out in public, f) I couldn't do many activities without being easily winded or sweaty, g) I was tired of feeling like I wasn't reaching my potential, h) I never wanted to travel because I was afraid that I wouldn't fit in the seats or that I'd have to ask for a seat belt extender, i) I was pissed that I was spending hundreds of dollars on clothing in plus-size stores, and j) I was sad that all of my personal relationships were suffering because of how I allowed my weight to control my life. The point of this blog? Regardless of your method of change (i.e weight loss surgery, changing eating habits, increasing exercise) YOU HAVE TO MAKE THE EFFORT. Do I consider myself a cheater for having the surgery? Not at all. My surgeon changed my anatomy (smaller stomach, diverted intestine) which creates physiological changes that assist me in losing weight. I still have to meal plan and eat healthy and I exercise for at least an hour daily. How is that considered cheating? For those of you who still have a bad attitude about the surgery, do me a favor. Find peer reviewed articles that suggest that weight loss surgery is cheating and that it doesn't take commitment from the patient and get back to me. I love to debate with ignorant individuals.

A picture to keep me on track!

2009-12-14T07:06:00.002-05:00

This picture makes me cringe but I have it hanging on my fridge to fight off cravings and potential mishaps when I go to browse for meals and snacks! In the left picture I was 3 months post op, -50 lbs. I can't believe that I looked that way and to think that I was even FIFTY pounds heavier than that?! The second picture was taken last week, 7 months post op, -100 lbs!!! I am now shopping in 'normal' size clothing stores and even though it is still a challenge, I am LOVING it!

It's beginning to look a lot like CHRISTMAS!!!!

2009-12-04T08:32:00.003-05:00

I woke up to beautiful snow this morning and I love it! Give me a few weeks and I'll probably be complaining though. Believe it or not, I'm eager to get outside to shovel the snow because guess what? It burns CALORIES! I went to www.fitday.com and entered my weight, height, and age and it calculated that I will burn an average of 382 calories per hour! So in addition to using the elliptical later today, I am going to shovel until my heart is content! If Keaton naps long enough, I might go over to the neighbors and do their driveway too! Call me crazy!

Watching QVC is pure torture...

2009-12-03T21:10:00.003-05:00

When I was a child, my mom would watch QVC when her soaps weren't on and I swore to myself that I'd NEVER watch QVC. Last Fall, while I was on maternity leave, I became addicted to QVC. They say that people who undergo weight loss surgery will typically have some type of "transfer addiction". Some of those addictions may be detrimental (i.e excessive shopping, smoking, alcohol) and some might be considered healthy (i.e. exercise). For me, I fell in love with QVC. Since this time, I have ordered a KitchenAid mixer (in a beautiful cinnamon gloss--it matches my kitchen decor), a Keurig single serving coffee maker that also makes hot cocoa, hot tea and iced tea, cookie sheets, and a few other items I cannot recall.

So where am I going with this? Well tonight I put on my new fluffy light teal robe (in a size large I might add!) and I sat in the chair and turned on the TV. Hmm, what was I going to watch? I rarely have time to watch TV and I picked QVC?! The host tonight is Dave and he's going through past customer favorites....FOOD. Candy bar apples, butter toffee corn, filet mignon, chicken breasts with double stuffing, strawberry swirl cheesecake, and BBQ ribs. My mouth was salivating and I think I soaked the front of my robe. My point of this entry is that why do we put ourselves in positions that may not be conducive to us following our post-operative guidelines? For instance, I wondered why I have been stalling again. I reflected over my meals and snacks and noticed that I have been way behind on my water intake and that I'm consuming way too many carbs. Eating carbs triggers consumption of MORE carbs and then it can get out of control. I think it's important that we self-reflect every couple of days so we don't ALLOW ourselves to get out of control. When we fall off the wagon for a few weeks, it is harder to get back on track and we make excuses and push ourselves further away from our goals. Lucky for me, I was able to avoid Thanksgiving dinner because I elected to work. Now I need to be strong for the many family Christmas dinners and I'm already planning my course of action!

Today's shopping experience...

2009-10-20T16:01:00.002-04:00

So I had a few things to shop for today and had no intention of shopping for myself but a cute dress caught my eye. I grabbed an XL (14-16) and went to the dressing room expecting to be disappointed. To my surprise, it was big. I grabbed a L (12-14) and about died when it fit perfectly (won't last for long). I immediately bought it and now I have to find the perfect accessories to go with it. I bought the dress for Keaton's first birthday party and I'm so excited to wear it because I actually feel good in it. Also during this trip, I purchased a very cute winter jacket in the same size. I'm going to save SO much money shopping in the "regular" size sections which will give me the perfect excuse to shop even more!

Yummy Recipe!

2009-09-29T16:39:00.002-04:00

Swiss Steak Stew

1/4 cup all-purpose flour
1/2 tsp seasoned salt
1 1/2 lb. boneless beef round steak, trimmed of fat, cut into 6 pieces
1 (14.5 oz) can diced tomatoes with basil, garlic and oregano, undrained
3/4 cup of water
3 cups quartered unpeeled small red potatoes
1 large onion, halved lengthwise, thinly sliced
1 medium green bell pepper, cut into strips
1 cup frozen whole kernel corn (I didn't use this)
salt and pepper to taste

1. In medium bowl, combine flour and seasoned salt; mix well. Add beef pieces; turn to coat.
2. Spray large nonstick skillet with nonstick cooking spray. Heat over medium-heat until hot. Add beef; cook 5-6 minutes or until browned on both sides, turning once.
3. Meanwhile, add tomatoes and water to any remaining flour mixture; mix well.
4. In 3 1/2 to 4 qt slow cooker, layer potatoes, brown beef, onion and bell pepper. Pour tomato mixture over top.
5. Cover; cook on low setting for 7 to 8 hours.
6. About 30 minutes before serving, stir corn into stew. Cover; cook on low setting an additional 20 to 30 minutes or until corn is tender. If desired, add salt and pepper to taste.

Servings: 6
Calories 255
Total fat: 4 gm
Fiber: 4 gm
Protein: 26 gm

The picture shows 1 serving (1 piece of meat, a few small pieces of potato and the tomato/green pepper/onion gravy). I found the recipe in the Pillsbury Doughboy Slow Cooker Recipes book (surprised that it's healthy and WLS friendly)!

Riled up for ricotta...

2009-09-18T19:05:00.003-04:00

I tried a new recipe tonight from a fellow bariatric post-op patient's blog: www.theworldaccordingtoeggface.blogspot.com. Here is the easy way to make it: 1 cup ricotta cheese mixed with 1 tsp italian seasoning, salt/pepper to taste, 1/2 cup parmesan cheese and 1 egg beaten (I used egg beaters). Mix well and scoop into an oven friendly dish. Add 1/2 cup marinara sauce and 1/2 cup mozzarella cheese. Cook for 20-25 minutes at 450 degrees. This was delicious!!

True Indicators of Success...

2009-09-09T20:56:00.002-04:00

Are they measured by pounds or by inches? Technically, shouldn't it be by how we feel? Why do we have to have meet a certain number before we are happy? What do I want to get out of weight loss surgery? A few things: A) Restoration of my health (no diabetes, hypertension (did have...not on meds anymore), B) Improved self-esteem and confidence, C) A 'normal' BMI, D) To weigh less than 200 pounds (almost there) and E) To generally feel GOOD about myself. My weight loss has been a struggle even with the tool that the surgeon created for me. I still want to eat fast and sometimes a bit too much and I end up paying for it (severe pain, foamies). I become frustrated when I plateau and do I quit? Nope. As of this morning I have lost 73 pounds and I am hoping for 27 more by Christmas. I set mini goals so I can hold myself accountable...not so I can set myself up for failure. At this stage, failure is not an option.

New shoes, new perspective?

2009-08-28T17:12:00.002-04:00

It looks like I will have to wait until Spring to buy a new bike. Instead of buying my bike today, I found myself shopping for running shoes. I went to The Runnery in Comstock Park and purchased the New Balance 1011 (shown in picture). I hate the colors but they supported my feet and felt very comfortable. On Monday I am going to start the couch to 5K program. I have my shoes, the podcast and my motivation!

Biking...

2009-08-26T09:40:00.002-04:00

My friend Tiffany helped me pick out this Trek bike. I was originally looking at a comfort cruiser in hot pink and baby pink but she highly suggested a bike with gears and the proper suspension. It has been 10+ years since I've been on a bike! I am going to be buying this on Friday and cannot wait! I'm also going to The Runnery in Comstock Park to buy my first official pair of running shoes! Once I can no longer ride the bike, I'm going to train for my first 5K. I originally planned on participating in the Fifth Third River Bank run in May but it is a very large event and I think I would feel more comfortable in a smaller 5K. I am going to do the Yellow Jacket 5K run in April, which is located right here in Greenville!

16 weeks out...

2009-08-25T09:20:00.002-04:00

I can't believe that it has been 4 months since I had gastric bypass surgery! I am down 68 pounds, 4-5 sizes in pants (depends on the brand) and 3 sizes in tops. I have hit a few stalls throughout the journey and revised my cardio routine.

I'll admit, the first few months were not easy but now that I have a routine and I can try new foods, I'm loving life! I was really hoping to lose 100 pounds by my 6 month 'surgiversary' but instead of being upset if I don't meet that goal, I'm just going to reflect on how far I have come.

3 month post-op appointment...

2009-08-07T09:01:00.002-04:00

I saw Dr. Schram yesterday and I do NOT like his scale anymore! My scale suggested a 62 pound loss, his suggested 56.2 pounds. Either way, it's better than nothing! Also, my best weight is usually in the evening and I was wearing heavier clothing yesterday. He said for 3 months out, losing 25% of your excess weight is good. I am at 32% and he said that's phenomenal!

After leaving Holland I decided to do some shopping because my clothes are falling off me and I need stuff to wear for teaching. I couldn't believe it when I purchased several tops three sizes smaller and pants two sizes smaller!

I'll have blood work in November and February but I do not have to see the surgeon until May...my one year surgiversary! Around that time I will be doing my first 5K as well (Fifth Third Bank one in GR).

3 months out...

2009-08-05T18:27:00.002-04:00

I cringe when I look at my pre-op pictures...but I'm feeling quite fabulous now and I'm loving my RNY! Tomorrow is my 3 month post-op appointment. I'll post my weight loss progress tomorrow evening.

Changing the routine...

2009-07-29T08:13:00.002-04:00

I spoke with a personal trainer yesterday in regard to my frequent stalls and I explained to him that I am 12 weeks post-op (RNY) and what my routine is like. As I predicted, he believes I am not eating enough to support my extensive caloric burn. He suggested I separate my resistance training from my cardio and limit the time to 30 minutes each day. I will do something like this:

Day #1: Cardio 30 minutes
Day #2: Resistance training 30 minutes
Day #3: Cardio 30 minutes
Day #4: Resistance training 30 minutes
Day #5: Cardio 30 minutes
Day #6: Resistance training 30 minutes
Day #7: Off (or can do something light like walking or pilates)

I'm expecting my bodybugg to arrive today and I am eager to see what my normal caloric deficit is. I will be trying this routine for 2-3 weeks to see if it helps with the weight loss.

Loving the lab results...

2009-07-27T02:11:00.003-04:00

After fasting for 20+ hours I had my blood drawn at work. I was happily surprised when I reviewed the results:

Hgb/Hct: 13.9/42.5
BUN/Crt: 9/0.6
Cholesterol: 148
Triglycerides: 87
Protein (total): 7.3
Sodium: 137
Potassium: 4.5
Calcium: 9.2
Magnesium: 2.6 (a bit high)
Glucose: 81
Iron binding: 370
Vitamin B12: 1,677 (normal is 243-894) Going to take the 2,500 mcg of B12 qod.
Folate: 34.1 (a bit high)
Iron: 55

I was wondering if I was anemic or may have had a low iron count due to the lack of energy I've been having for the past two months. My surgeon says that it's because I'm doing too much (work full-time, grad school full-time, 8 month old, teaching part-time).

I also purchased a BodyBugg on EBAY tonight. They normally run $300 and I got mine for $200. I'm excited to use it again so I can figure out what my daily caloric deficit is.

Oral health post RNY...

2009-07-24T22:58:00.002-04:00

I've heard some horror stories from fellow WLS patients who claim that their teeth have rotted after surgery. Many of them admit to not taking their vitamins faithfully and some associate previous health issues (i.e. GERD) for the breakdown of their enamel.

I had an appointment today for a routine cleaning and I asked my dentist for his recommendations. In addition to the 1,800 mg of calcium (with vitamin D) and the 3 servings of dairy that I consume daily, my dentist wants me to use "MI cream". This is a calcium based cream that you apply to your teeth for 3-4 minutes. After rinsing your mouth out you cannot eat for 30 minutes. The tube is good for 2.5-3 months of applications and costs $25.00. Flavors include: tooti-fruity, vanilla, mint, strawberry, and mango. I went with the vanilla and I can tolerate it but I don't like it.

Comparing...

2009-07-24T08:52:00.003-04:00

I have to admit that I am very frustrated right now. I am working out almost every day of the week and following the Barix Bible guidelines (78 gm of protein, 64+ oz of water, less than 12 gm of fat per meal (3 meals), 3 snacks, and less than 2 gm of sugar (for all meals/snacks) and the pounds are slowly coming off. I then hear from friends (a few of my friends had surgery 3 weeks after me and one had surgery the same day as me) and their weight loss is very impressive and some of them are not even working out. What gives?

Right now I'm kicking myself for selling my bodybugg system 8 months ago. I am wondering if I am working out too much for the amount of calories I am consuming. On August 6th I will see the surgeon and I'm hoping that the dietician will be in the office so we can review what my net caloric intake should be. It looks like I will have to purchase the upgraded bodybugg model and I will also be buying the digital display so I can see where I stand calorie wise and also how many steps I'm taking daily.

Instead of being so negative, I need to focus on the positive aspects of my OWN weight loss journey. I'm almost down 60 pounds and I'm building muscle. I may not lose weight as fast as others but I do know that I am doing what's best for me and I'm trying the best I can. Incorporating exercise may be tricky and it may slow my weight loss down some but hopefully once I figure out the caloric burn/net calorie situation, I will be on my way to a steady weight loss again.

My first stall...

2009-07-11T22:42:00.005-04:00

As most WLS patients know, a stall or plateau during your journey is to be expected. Needless to say, I was not happy that it happened during week #9. The entire week I weighed myself daily and saw slight gains of 1-2 pounds and I decided to review my food journal and workout log. I noticed I wasn't meeting my protein goal on a daily basis and I had been doing the same workout for 7 weeks (elliptical training). Halfway throughout the week I decided to change things. I cut back on my dairy and bought a total gym XL. The total gym arrived a few nights ago and I love it! Beware! It will make you incredibly sore if you have not done resistance training in a long time. I decided to practice a few of the exercises and could barely squat or lift Keaton up the next day! My workout schedule is like this: I do 6 days of cardio (45 mins) and resistance training (the gym came with a routine for women and that is what I'm doing). Day #7 can be a pilates day or free day. I also try to walk as much as I possibly can. For eating, I am incorporating the following: SF Carnation Instant Breakfast (CIB), low-fat/small curd cottage cheese (1/2 cup), 1 oz of almonds or peanuts, deli meats with cream cheese, 1/2 of a grilled cheese, chicken salad, veggies with fiesta ranch dip (YUMMY), fresh fruit, chai protein drinks, jerky, veggie sausage, taco salad (made with the leanest beef...I hate ground turkey), etc.

My three-month post-op appointment is on August 6th in Holland. I'm nervous yet very excited to see how I'm doing (weight AND lab wise). So far I am down 55 pounds and just bought new shorts and shirts 2 sizes smaller!

I'm still not thrilled about full body shots just yet! Until then, be patient! I'm a work in progress! The picture above is of Keaton and I. I had worked 13 hours the night before and happen to be without makeup. As many of you know, I rarely leave the house without makeup on.

Happy Father's Day and 6 weeks 6 days post op report..

2009-06-21T18:34:00.002-04:00

After not sleeping well Saturday night, I woke up and weighed myself and to my surprise I am officially down 40 pounds. I have not been keeping track of inches lost, but I can tell that my clothes are much looser. I'm trying to hold off until Fall to purchase a few items. My next post-op visit for the 3 month mark will be in August. My goal for then is to be down a total of 50 pounds I think this is very realistic.

6 week check up...

2009-06-15T10:16:00.002-04:00

I had my 6 week check up on June 11th but it was actually only my 5 week check up. I am down 35 pounds and I have been eating regular foods for the past 2 weeks. Unfortunately I have had a few episodes of foamies and food getting stuck in the pouch. This can't be blamed on anyone but myself. I'm eating too fast or not chewing my food good enough. Do this a few times and you learn your lesson!!

This morning I tried veggie sausage patties for the first time. 2 patties have 20 gm of protein and it took me almost 45 minutes to eat them. They aren't bad but they are not the sausage flavor and texture that I'm used to!

I use my elliptical daily and I'm walking as well. As soon as I go to day shift this summer, I will be heading back to the gym. The daycare hours at the gym are not convenient with my class/night work schedule so I'll have to wait until later.

3 weeks, 2 days post WLS...

2009-05-27T12:22:00.006-04:00

I am down 30 pounds and over 12''. I have went down one pant size and one shirt size. Yay! Here is a picture from today and hopefully once I start feeling and seeing the progress, I'll post updated body pictures.

1st post-op visit...

2009-05-24T12:30:00.005-04:00

On May 21st I had my first post-op visit with Dr. Schram. I was very surprised to find out that I had lost 25 pounds and I have lost 19% of my excess weight. My incisions looked well, my intake was good according to the dietician and I was cleared to do pureed/soft foods.

I was also cleared to return to work on May 25th (which is tomorrow). I'm nervous about this because I work 12 hour nights and I am now used to sleeping on a normal schedule and I feel tired throughout the day. Add the night shift to a full-time graduate course load and being a mom to the cutest baby ever? A little stressful.

After this visit, I decided to move my scale to the garage rafters. That scale has the ability to change my mood every time I step on it. It is very inconsistent and I vowed to only be weighed when I see the surgeon. My next visit is June 11th and I'm hoping for 40 pounds by then!

Dirty ummmmm......mouth?

2009-05-19T12:10:00.003-04:00

To all of the pre-ops out there....Yes, your flatulence will be extremely nasty! Recovering after the surgery is incredibly difficult due to the gas pains. Most hospitals recommend Gas-X strips but these did nothing for me! You can buy Gas-X chewables (Simethicone) over the counter...I took two at a time, enjoyed a nice cup of warm decaf mandarin orange tea and this helped immensely. Don't forget to lay on your LEFT side!

Cheddar Combos and Life Post WLS...

2009-05-08T08:10:00.003-04:00

I am 4 days post-op (lap RNY) and I'm feeling a bit depressed. I'm feeling discouraged that I'm not able to drink 64 oz of fluid daily and that I'm not meeting my protein goal of 78 gms/day. The protein powders smell so nasty and I will be purchasing Pro-Stat when I see my surgeon on the 21st. He told me that this offers a high amount of protein in 2 oz and you can drink it like a shot and be done with half of your protein for the day. This sounds much easier than drinking 8 oz of fluid over 1.5 hours and only getting in 20 gm of protein. It's incredibly frustrating!

Yesterday night I came across a bag of cheddar combos and the smell made me salivate enough to fill a pool. I wanted to chew on one of those combos to savor the taste but I resisted. I filled my Barix water jug with Crystal Light and moved along.

The mental hunger is my biggest challenge so far but I'm finding ways around it.

My surgery is less 24 hours away!

2009-05-03T11:34:00.002-04:00

My time has finally come! I can't believe that in less than 24 hours I am going to be in the operating room for my new "birthday". I think I've prepared my house for post-surgery. To avoid going up and down the stairs, I have my guest bedroom ready for my arrival! The fridge/pantry/cupboards have been cleaned out thoroughly and I'm on my way to donate boxes of food. I have disinfected every applicable object in my house, the grass is cut, flowers watered and my bags are packed.

Today has been quite emotional as I keep contemplating the risks and my fears and I'm struggling to remain calm and collected. All seems to be going well until I hold my son and then I just lose it. I become incredibly angry that I have allowed myself to get this way and that I couldn't do things the 'normal' way. On the contrary, I'm proud that I am holding myself accountable and that I'm being proactive. I have watched others struggle for years and being approved for WLS is not easy. When I reflect on my experience this time around, I'm almost positive that this is meant to be. I had no difficulties receiving insurance approval, my appointments all went as planned, I passed PAT and here I am blogging about my soon-to-be surgical experience.

This will be my last entry before I make it to the 'other' side. The hospital doesn't have WiFi but I can access the internet from my iPhone (I still don't understand that concept). For my friends on Facebook, be watching for my status updates!

Preparation...

2009-05-01T10:48:00.005-04:00

Only 3 more days until surgery! Wow! Besides being anxious, scared, nervous and excited, I'm trying to finish many tasks around the house. Tonight I have to work my last shift before surgery (let's pray it's a good shift) and tomorrow morning I am cleaning my house (already have some of it done), so I don't have to worry about it once I'm home. I did minimal shopping this week and purchased chicken and vegetable broth, SF jello and pudding, unflavored protein powder, various flavors of Cystal Light, SF popsicles and soup (they have to be strained of course). I also bought 2 new dresses for my dad's 50th birthday party this July. I grabbed 2 sizes smaller than what I wear now and when I got home, I tried them on and they were huge. I took them back and bought the smallest size and hopefully they will fit in July...if not, I guess I won't be shopping until the time comes. I also have to clean out my fridge/freezer, pantry and cupboards. I'm throwing out ALL items that may be tempting and do not follow the Barix Bible guidelines.

PAT 4/22/09...

2009-04-22T21:29:00.004-04:00

Today I left Greenville around 4:00 a.m. for PAT in Ypsilanti at 7:30 a.m. I had my blood drawn first and the tech asked which spot would be easiest. After all my blood draws during pregnancy and during the times I was having issues with my thyroid, the medial AC area is the best. She palpated it and claimed she couldn't feel anything but then claimed it was an artery. Absolutely no way! I watched blood draws before..I think she was feeling the pulse underneath the vein...I wasn't going to argue with her but I kept telling myself she better get it on the first attempt, which she did (in my left hand). After filling five vials, I was on my way to see the nurse. The nurse reviewed my medical/surgical history, weighed me and did the routine vital signs. Next was the nutrition session which is always a good review. I received an updated Barix Bible (100+ pages of nutrition post surgery and recipes) and then I went for my chest x-ray and gallbladder ultrasound. Both came back perfect! My EKG and PFTs (pulmonary function test) were "textbook" according to the doctor. What does all of this mean? I passed! I'm cleared for surgery and the next 12days are going to fly by!

Pre-Admission Testing...

2009-04-20T11:45:00.002-04:00

I am going to Ypsilanti for my Pre-Admission testing on Wednesday, April 22nd. The clinic will check for certain things via blood work, urinalysis, chest x-ray, gallbladder ultrasound, and an EKG. After the testing is done, I'll attend a mandatory nutritional seminar to learn how to read labels (again). I'm going to stop by the store to purchase a sample pack of the various proteins.

Teaching Good Habits...

2009-04-20T11:40:00.003-04:00

I can't blame my weight issue on how I was raised but I plan on doing certain things differently with my son, Keaton. When Keaton is old enough he will have chores to do and he will be rewarded with money or some other gift (not food). Good behavior will NEVER be rewarded with treats. I believe in 'eating in moderation' so I will teach Keaton that he can have a bit of everything as long as he doesn't eat it excessively.

For Keaton's first Easter I bought him a radio flyer deluxe wagon (with matching canopy)! This will be used for our trips to Lake Michigan and the Zoo this summer. He also received a chocolate bunny (more accurately, his mom received a chocolate bunny) and four books.

Couch to 5K

2009-04-04T04:21:00.004-04:00

When and how did I become interested? I researched this program a few years ago but never gave it a try. When I was in 10th grade I wanted to run during the months that I wasn't playing softball or volleyball and some of my family members laughed at the idea. Why? They thought I was too big. I didn't have the body of a runner. Now my motivation and desire is more than it has ever been. My friend Tiffany is training for a triathalon right now and even though I think she's crazy (love you Tiff), I admire her willingness to try new things and bust her ass to meet her goals. As a one year "surgiversary" celebration, we plan on participating in the River Bank Run in May 2010. I'll start preparing for this once I am cleared by my surgeon and I can't wait!

The Couch to 5K program can be viewed at this link: http://www.coolrunning.com/cgi-bin/moxiebin/bm_tools.cgi?print=181;s=2_3;site=1

Body Image and Self-Esteem...

2009-04-04T03:59:00.004-04:00

A few thoughts from the Barix Web site:

A poor body image can have a huge impact on a person’s quality of life in a culture that values youth, beauty and thinness. Most people feel dissatisfied with some aspect of their body. They may feel that their nose is too large or that their hair is too thin. But overall their satisfaction with their body does not have a direct impact on other areas of their life. To a slightly greater extent, a poor body image may prevent a person from participating in some activity that they would enjoy, such as going to the pool or beach. In more extreme cases, it may prevent a person from seeking a new job or new social interaction. Low self-esteem, depression, and eating disorders can be products of a poor body image.

The feelings that you have toward your body develop throughout your life. Childhood and adolescent experiences may be particularly important. Factors that influence your body image may include what others have said about your body, what others have done to your body, how different your body is from the images you see in the media and from those that you interact with on a daily basis. And most importantly, what you tell yourself about your body-those internal thoughts and feelings.

A poor body image may come from the constant media bombardment of images of young, very thin, tanned bodies, giving the message that we need to look the same way in order to be attractive. People that have experienced physical or sexual abuse are less likely to feel good about their bodies. People that experienced neglect as babies or toddlers may grow into adults that do not feel good about their bodies. No matter what the source of a poor body image is, there is hope. Hope for self-love. Hope for self-acceptance. Hope to move beyond the immobilizing effects of a poor body image.

If negative thoughts are about weight, regular exercise and healthful food choices tend to make people feel better about themselves and more connected to their bodies. For many, the answer lies in learning to love, accept and appreciate their body -with all of it’s imperfections- for all of the things it allows them to do. Bodies allow us to walk, to work, to hug, to reach out to others, to dance, to skip, to hold hands, to pet a dog, to build, to smile, to laugh, to create. A person’s value or worth is not contingent on the size of their midsection, the color of their hair or the absence of cellulite. Accepting all that you are with kindness and love is an essential step to a healthy body image.

A healthy body image and a healthy self-esteem often go hand in hand. A positive attitude and a healthy lifestyle are an effective combination to boost body image and self-esteem. You can train yourself to Reprogram the way that you look at your body and defend yourself from negative thoughts. First, acknowledge that there are some things about our bodies that we cannot change, such as our height or shoe size. Learn to accept those things. Buy some new clothes that accentuate the parts of your body that you feel good about. If there are things that you do not like and you are able to change, set a goal to work on that area and commit your time and energy toward making a change.

When you hear negative comments coming from within, tell yourself to stop. Rephrase your inner comments in a positive way. For example replace “I am such a loser” with “Oh well, I am human,” when you make a mistake. Restrain your inner critic by giving yourself compliments every day and thinking about three things each day that gave you pleasure. Focus on the positive aspects and change the way that you feel about yourself. Replenish your reserves by keeping stress under control and providing your body with down time each day to relax.

You may find it helpful to Reach Out. If your body image is interfering with your enjoyment of life, seek support from therapy to discover what is keeping you from accepting your body. You may need to acknowledge and then confront your negative feelings; realistically align your expectations with normal, healthy bodies rather than those in the media; increase confidence in other areas of your life; earn to manage stress and allow yourself to feel and express feelings. Working with a professional may enhance your ability for emotional growth, self-love and self-acceptance.

My thoughts:

Losing weight will not solve the behavioral problems that I battle on a daily basis. I asked my psychiatrist if I should pursue counseling pre-operatively and post-operatively and he encouraged it. Adjusting to a new physical appearance is not as easy as it may seem. I'm nervous about "exposing" myself...for 10 years I've been able to hide inside a fat body...how will I react when I shed the weight?

Body image: Your internal reaction to what you see in the mirror. Retrieved April 4, 2009, from Barix Clinics Web site: http://www.barixclinicsstore.com/body_image.html

To take my mind off SNACKING:

2009-04-01T15:38:00.004-04:00

50 ways to keep your mind off snacking...from a fellow post-RNY buddy:

1. Imagine the new healthier you
2. Walk around the block
3. Call a friend
4. Make a list of your Top Ten Reasons to Lose Weight
5. Make a To Do list
6. Turn on music and dance
7. Jot a thank you note to someone
8. Go to bed early or take a nap
9. Read a book
10. Blog or journal
11. Give yourself a manicure or pedicure
12. Plan a healthy meal for your family
13. Surf the Internet
14. Finish an unfinished project
15. Walk your dog, pet your cat, feed your fish
16. Brush your teeth
17. Balance your checkbook
18. Say a prayer
19. Chop veggies to keep on hand
20. Give a massage
21. Clean out a junk drawer
22. Play a game with your kids
23. Try a new route on your walk
24. Drink a glass of water
25. Kiss someone
26. Try on some of your clothes
27. Look at old pictures
28. Rent a video
29. Wash your car
30. Take a hot, soothing bath
31. Update your calendar
32. Work in your yard
33. Start your holiday shopping list
34. Count your blessings
35. Write a letter
36. Fold some laundry
37. Check your e-mail
38. Give your dog a bath
39. Send a birthday card
40. Meditate
41. Hug someone
42. Rearrange some furniture
43. Light a fire or some candles
44. Put your pictures in an album
45. Plan a trip
46. Straighten a closet
47. Load music to iPhone
48. Visit a friend
49. Clean out your trunk
50. Do something nice for someone

A few helpful links...

2009-04-01T15:27:00.003-04:00

A few of my favorite links (and no, I'm not talking about sausage!):

http://www.lapsf.com/weight-loss-surgeries.html

This reviews the differences between RNY (Roux-en-y), VG with DS (Vertical Gastrectomy with Duodenal Switch), VG (Vertical Gastrectomy) and LABG (Lap-Band).

http://www.obesityhelp.com/morbidobesity/information/post+op+planner.php

To calculate your BMI (body mass index) and goal weight.

http://www.healthcalculators.org/calculators/protein.asp

Protein caculator.

http://www.hungry-girl.com/

Tips & Tricks for Hungry Chicks!

My thoughts on protein shakes...

2009-04-01T14:49:00.003-04:00

One word: NASTY! I think that when I drink my protein shake my face looks like Keaton's in this picture. He's not fond of rice cereal yet loves everything else I feed him. The GNC Bananas and Cream isn't too bad but it's a little too sweet. The Strawberry made me gag...I couldn't even finish it! When I go for my PAT on 4/22, I'm going to buy protein bullets which are 3 oz and contain over 40 gms of protein. Even if I don't like it, I can manage to drink 3 oz rather than 8+ of the other crap I have right now.

Am I Getting Older?

2009-04-01T10:08:00.002-04:00

I feel like I am! Here is my new pill organizer! I wanted a monthly one but could only find this one and it will do. One thing I like is that this one has a section for PM meds. I do have to take Vitamin C twice daily so this will help me remember. I have been taking the following: Vit C, B12, MVI, Lisinopril, Synthroid and Lexapro but the Synthroid and Lexapro are not shown (just took my last dose of both this morning...refills should be done in 1 hour).

Medications...

2009-03-31T14:05:00.002-04:00

I'm on my way to the store to buy something I never thought I'd have to buy...a pill organizer/reminder box. Yikes! I've went from taking 3 pills to 6! I have a hard time remembering to take my Lisinopril so I decided that I need to have my pills ready to go on a daily basis. I also decided that it would be a good idea to start taking my vitamins and minerals pre-surgery. I'll post pictures of my special pill box once I'm home!

I'm so bad...

2009-03-31T04:04:00.004-04:00

I decided a few weeks ago that I am going to start a tradition with my son where we will enjoy a small honeybaked ham and dessert from Junior's. This year I ordered a 7 lb. ham and side order of potatoes au gratin. In 34 days, I am going to have to give up my sweets, beloved sausage and ham and all other foods that I have grown to love. In April 2010, Keaton will be 17 months old and he will enjoy his first honeybaked ham. We will incorporate healthier desserts and vegetables and he will take after his mommy...we will fight over the pieces of ham that have the most glaze!

ASMBS Bariatric Postoperative Concerns...

2009-03-28T19:06:00.004-04:00

Roux-en-Y Gastric Bypass and Dumping Syndrome
Dumping syndrome is a common side effect after Roux-en-Y Gastric Bypass (RNYGB) surgery. About 85% of gastric bypass patients will experience dumping syndrome at some point after surgery. The symptoms can range from mild to severe.

Dumping usually occurs due to poor food choices. It is related to the ingestion of refined sugars (including high fructose corn syrup) or high glycemic carbohydrates. It can also occur with dairy products, some fats, and fried foods. These foods rapidly empty from the gastric pouch into the small intestine which triggers a cascade of physiologic events.

The effect of dumping is twofold. It is both good and bad. The benefit is that if dumping occurs after eating these foods the patient is less likely to eat that food again. It is a built in mechanism that says, “I shouldn’t have eaten it the first time, and I definitely won’t eat it again.” This is called negative reinforcement. The fact is these foods will interfere with long-term weight loss and should not be eaten anyway.

The bad news is that dumping makes you feel awful; it can be confused with other problems; it is scary and sometimes difficult to manage; and it may have some short-term physiologic consequences.
There are two types of dumping:
1. Early dumping which occurs 30-60 minutes after eating and can last up to 60 minutes. Symptoms include sweating, flushing, lightheadedness, tachycardia, palpitations, desire to lie down, upper abdominal fullness, nausea, diarrhea, cramping, and active audible bowels sounds.
2. Late dumping which occurs 1-3 hours after eating. Symptoms are related to reactive hypoglycemia (low blood sugar) which include sweating, shakiness, loss of concentration, hunger, and fainting or passing out.
Early dumping occurs as a result of rapid emptying of sugars or carbohydrates from the gastric pouch into the small intestine which causes the release of hormones (gut peptides) that effect blood pressure, heart rate, skin flushing and intestinal transit, leading to a light-headed, rapid heart rate and flushing sensation often accompanied by diarrhea. Late dumping symptoms are related to increased insulin after oral glucose (sugar) with subsequent hypoglycemia (low blood sugar).

The diagnosis of dumping syndrome is primarily made by obtaining a history of the presence of classic symptoms related to food intake. Management of early dumping can be relatively straightforward. First, the symptoms should be discussed with the Bariatric Surgeon. Dietary compliance with avoidance of refined sugars, high glycemic carbohydrates, or other foods that may be associated with the syndrome would be the primary treatment.

Management of late dumping that persists in spite of the above dietary measures may be treated with a small amount of sugar (such as one-half glass of orange juice) about one hour after a meal, which may prevent the attack. Medications such as Acarbose or Somatostatin may be helpful if still symptomatic despite dietary changes. -. One should consider the rare possibility of insulinoma or neisidioblastosis of the pancreas if late dumping remains refractory to medical management.

Bowel Function Changes After Bariatric Surgery
Bariatric surgery can have an effect on different bodily functions, and this does include bowel function. The effects on bowel function can be acute and short-lived, or chronic and more problematic. These changes are related to and dependent upon which type of bariatric operation has been performed.

Diarrhea or loose stools is mainly a potential side effect of Sleeve Gastrectomy with Duodenal Switch (also known as Biliopancreatic Diversion with Duodenal Switch). Diarrhea may be seen with Roux-en-Y Gastric Bypass (RNYGBP), but would not be associated with the Laparoscopic Adjustable Gastric Banding (LAGB).
With the Duodenal Switch (DS), bowel movements are more commonly affected, and the usual alteration is the likelihood of developing soft or loose stools. Frank diarrhea is related to fatty acids passing directly into the colon. These fatty acids would normally have been absorbed in the small intestine. Once in the colon they induce irritation. Diarrhea can also be produced by relatively undigested food passing rapidly through the gastrointestinal tract.
A third contributing factor is sorbitol, found in fruits, berries, and also used as an artificial sweetener. Sorbitol is not well absorbed in the GI tract, and when in the colon, it is fermented. This fermentation will result in increased gas and diarrhea.

Diet is a major influence on bowel movements after a DS. Reducing the amount of fat will usually have a direct beneficial effect on the number and quality of bowel movements a patient may have. Usually, with close questioning, it can be revealed that a patient has not been watching his or her diet as carefully as he or she should. If they can be identified, there are other “trigger” type foods that may induce diarrhea, and the patient should attempt to avoid or minimize these foods.
Both the DS and the RNYGBP may unmask previously unidentified lactose intolerance. This can result is diarrhea and gas complaints. An early step in the assessment of diarrhea after surgery is to eliminate dairy products from the diet completely.
Management of diarrhea (provided there is no identifiable pathologic etiology or dietary factor) is varied. A dose of Imodium at bedtime can decrease the number of early morning bowel movements. It may also delay the onset in those who have been previously awakened early in the morning by urgent bowel movements. If beneficial, some patients may stay on a maintenance dose of Imodium® or Lomotil® for long term control.

Many patients will benefit from a course of probiotics. They are a form of natural colonic flora that is administered orally to restore the natural bacterial milieu toward the normal state. Typical probiotic products include Lactobacillus Acidophyllus® and Ultraflora® lactose-free. The more complex and inclusive the product, the better it seems to work. Unfortunately, these products may not be covered by third party payer insurance companies. However, the probiotics usually only need to be taken for a brief period of time to restore the colon to a more normal bacterial state.

In any postoperative patient with especially watery diarrhea, extremely foul flatus, and abdominal cramping, one needs to consider a Clostridium difficile (C. diff.) colitis or antibiotic-associated diarrhea (AAD). This may occur after DS, RYGBP or LAGB. It may manifest itself early after surgery, or it may take 2 or 3 months. Treatment of AAD is with a 10-14 day course of Flagyl®. Not uncommon relapses can be treated with a repeat course of Flagyl® or with oral Vancomycin®. In treating C. diff. colitis, it is important to replenish the colonic flora as the therapy is proceeding with probiotics as described above. Flagyl® is effective in the management of bacterial overgrowth not related to C. diff. infections as well.
Cholestyramine (Questran®) and similar products such as Welchol® and Cholestid® are used to bind bile salts. This may decrease the frequency of diarrhea and the severity of gas. Start with a low dose and gradually increase weekly until a beneficial effect is seen. Cholestyramine has been used to treat C. diff. infections as well, but only with Flagyl® not Vancomycin®.

Rarely, with the above management strategies a patient may continue to have an unacceptably high frequency of bowel movements. It is reasonable to give the bowel time to compensate and adapt, so that fat absorption increases. This will allow diarrhea to improve. If after one year there is no improvement in diarrhea, then the situation requires intervention. Surgical lengthening of the common channel can be entertained. This is usually a relatively straightforward surgical procedure that may be done laparoscopically with an overnight hospital stay. Subsequently, diarrhea will be controlled without causing significant weight regain.

Constipation is also seen in patients following bariatric surgery. This occurs more commonly after LAGB and RNYGBP and is less likely with DS, although it may occur in rare cases with DS. It is usually due to insufficient intake of water, and may be corrected by diligent attention to water ingestion and the addition of fiber products like Metamucil or Fibercon. Also, it is helpful to avoid diuretics such as caffeine. Some nutritional supplements, including calcium and iron, may contribute to constipation. Narcotic (pain medication) ingestion can slow bowel function resulting in constipation as well. In addition to increasing water intake, supplementing the diet with healthy fiber can assist in overcoming the difficulties of constipation after surgery.

Dysphagia, is a medical term for “difficulty swallowing”. This may be a side effect of any operation that causes restriction: LAGB, RYGB and even DS. This is caused be eating too fast, too much or not chewing well enough when the stomach has been made smaller. Therefore, the food backs up into the esophagus and causes chest pressure or even a tightness in the throat. It is important to stop eating and drinking if you have dysphagia, otherwise regurgitation or vomiting may ensue. Dysphagia can be avoided by chewing very well (approximately 15 times), eating slowly (putting the fork down for 1 minute between swallowed bites) and avoiding tough foods such as doughy bread, overcooked steak or dry chicken breast.

Nutritional Aspects of Bariatric Surgery: General Practice Guidelines

• Roux-en-Y Gastric Bypass (RNYGBP)
• Vertical Banded Gastric Bypass
Gastric bypass procedures produce weight loss primarily by gastric restriction, combined with an element of malabsorption. A small gastric pouch is created at the upper normal stomach. This small pouch (less than 1 ounce immediately following surgery) results in a significant reduction in the amount of food a patient can consume in one sitting. Then ingested food bypasses the rest of the stomach, the entire duodenum (first portion of the small intestine), and a short segment of jejunum (second portion of small intestine). This bypass results in mild fat and protein malabsorption due to a slight delay in mixing of food with bile and pancreatic enzymes.

One impact on digestion affected by this type of surgery is reduction in the absorption of calcium, iron, and B-complex vitamins. Another change is with ingestion of foods rich in carbohydrates or fats which may produce an unpleasant combination of side effects known as “dumping syndrome.” Due to the nature of this transient condition, patients quickly learn to avoid the foods associated with this condition.

After gastric bypass, patients must prioritize the foods they eat, emphasizing various sources of protein, such as fish, dairy products, meat, beans, legumes, and soy. Fats and carbohydrates become secondary, but patients should still try to eat fresh vegetables and fruits. Daily vitamin and mineral supplementation is a must for these patients since they will not be getting adequate amounts from the small quantity of foods they eat. B-complex vitamins, iron, and calcium must be supplemented at higher than daily recommended levels, because of the impact of the bypass on their absorption.

Vitamin B-12 is very poorly absorbed when swallowed as a pill. Therefore, it must be taken in a very high daily dosage if taken in this form. There are other alternative forms for B-12 administration which includes monthly intramuscular injection, sublingual (under the tongue) liquids or sprays, or nasal spray which more adequately enable absorption.

Elemental calcium supplementation should be taken in amounts that preferably exceed daily recommended levels as mentioned to prevent early osteoporosis. An acidic environment is needed for calcium absorption. The lower stomach where most of the acid for digestion is produced is bypassed with surgery. Therefore, a citrated form of calcium is recommended. Maximal absorption may be achieved with the elemental calcium taken in divided doses not to exceed 500 mg three times daily.

Iron also requires an acidic environment for optimal absorption, such as with Vitamin C. Iron deficiency anemia may occur if supplemental iron is not taken. Iron is also best absorbed in the elemental form. However, it should not be taken with calcium since the two will compete for absorption. Pre-menopausal women should take even higher dosages (prenatal amounts) since ongoing blood loss with menstrual cycles will increase the risk for anemia.

Reaching a Plateau
Following weight loss surgery, patients may lose weight fairly rapidly at first, and then as time passes the weight loss becomes more gradual. Commonly, weight will stabilize at about 18 months after RYGB and DS. During these 18 months, weight loss does not follow a predictable trend, but can be erratic with alternating periods of significant weight loss followed by no weight loss. Charting this weight loss may give the appearance of a stairway. It is not uncommon for patients to question why their weight loss has stalled at times, and wonder if they are doing something wrong or if the operation is not functioning properly.

Day to day or even week to week, fluctuations in weight loss occur due to other factors beyond just loss of fat mass. Water weight is probably the most common cause of this variability. This is dependent upon hydration status. Other factors other than fat mass that may result in inaccurate weights are current contents of the gastrointestinal tract, gaining muscle mass, or menstrual cycles. It is thus recommended that patients should not weigh themselves too frequently due to inherent inaccuracies due to these factors.

There are also specific activities of patients that may alter weight loss. Exercise frequency and intensity may affect your metabolic rate resulting in weight loss plateaus. The exercise may increase muscle mass, which although beneficial in many ways, may result in slower weight loss. Eating habit adjustments that may seem innocuous can affect weight loss as well. It is recommended that a patient eat several small meals a day high in protein. An increase in the meal frequency to high (grazing) or a decrease in the frequency by starving during the day and binge eating at night may reduce one’s ability to lose weight.

For the operations that have a malabsorptive component (Roux-en-y gastric bypass and Duodenal switch), the gastrointestinal tract may adapt over time to its new anatomic change. This adaptation may allow for better absorption of the consumed food, especially fats reducing the benefit of the surgery. Unfortunately, nothing short of further surgery can avert this adaptation effect. However, once again adhering to eating small meals high in protein may limit this effect.

Anatomic factors exist which may limit one’s ability to lose weight. With the Roux-en-Y Gastric Bypass, the size of the gastric pouch may change over time. If it enlarges, it will accommodate larger meals. -- - In addition, anastomotic dilatation between the stomach pouch and the intestine may allow quicker emptying of the pouch reducing its effect on satiety and potential weight loss. Once pouch expansion or anastomotic dilatation occur, they cannot be reversed, and correction can only be obtained through surgical revision. With the gastric band, the stoma may widen due to weight loss at which point the band should be tightened with an adjustment. Weight loss can be resumed after this.

For the same reason, after gastric bypass, a patient should not drink during meals. This activity will result in more rapid transition of solid food from the gastric pouch eliminating the sensation of fullness and resulting in ingestion of larger portions.

In general, it is normal to have periods of plateaus through all phases of weight loss after surgery. It is important for the patient to recognize these plateaus as being normal. Expecting these fluctuations in weight loss to occur can avert patient depression or exasperation with the surgery. Adhering to the basic rules of eating correctly and exercising regularly may shorten the duration of a plateau and lead ultimately to greater long-term weight loss.

What is most important to remember is that weight loss surgery does not guarantee easy and consistent weight loss. The operation is a tool that if used appropriately by the patient can help one achieve successful weight loss. However, if used inappropriately, overall weight loss may fall below expectations.

Exercise is defined as exertion of the body for sake of health. Exercise should never be considered a chore, but incorporated into one’s regular daily activities like brushing your teeth, eating your meals, or going to work. This philosophy applies to everyone obese or thin, man or woman, young or old, before or after bariatric surgery.

Mild exercise (20 min./day 3-4 times/week) may be beneficial for reducing surgical complications, facilitate healing, and enhance post-operative recovery. Every patient should consider exercise prior to surgery.
Regimen:
1. Improve lung capacity by blowing up balloons
2. Improve aerobic conditioning with walking, swimming, or bike riding. Gradually increase distance with each outing. Within one month exercise capacity will be greater and surgery will, therefore, be safer.
3. Increase your strength with light weights or resistance training with rubber bands

Postoperative exercise
Exercise after surgery is absolutely imperative, and it may be the most important factor that can help a patient achieve long-standing and successful weight loss.
Regimen:
1. Start walking from day 1.
2. Increase your walking each day. Add other aerobic exercises like swimming and bicycle riding as your surgeon permits and as you feel so inclined.
3. Start light weight training and sit-ups as your surgeon allows. Increase weights and number of reps gradually. This type of exercise will increase muscles mass which improves strength, increases bone density, and increases metabolism.
4. Consider using a personal trainer to educate one about exercise, improve motivation, and help assure proper routines.

Independent of what phase a patient may be in before or after surgery, there are certain basic safe and reliable rules to follow in regard to exercise:
1. Consider your goals and how you want to accomplish them. You can achieve it!
2. Use exercise in combination with weight loss surgery to maximize results.
3. Remember everyone starts from a different state of physical ability and strength. Gradually increase your activity and exercise capacity. Mild discomfort from exercise is acceptable, but pain should be avoided. Ignore the cliché, “No pain no gain.”
4. Drink plenty of water before, during, and after exercise.

In addition to loss of fat mass, there are other numerous benefits to exercise. These benefits include prevention of loss of muscle mass when losing weight rapidly after surgery, and improved overall weight loss. One’s immune system is enhanced by exercise and this will help maintain overall general health. Exercise may also reduce a person’s appetite. Fatigue, which sometimes is problematic after surgery, may be reduced. Finally, there can be improved balance, improved self-confidence, and overall improved sense of well being.

Bariatric Surgery: Postoperative Concerns. (2008). Retrieved March 28, 2009, from the American Society for Metabolic & Bariatric Surgery Web site: http://www.asbs.org/html/pdf/asbs_bspc.pdf

Pre-Surgery Diet...

2009-03-28T18:49:00.002-04:00

Today I went shopping and had a fun time picking out the stuff I'll need for my liquid diet and for my post-op care.

GNC: (1)XL container of Cookies and Cream 100% Whey Protein (less than 2gm of sugar),(1)Large container of Bananas and Cream 100% Whey Protein, (1) pouch of Cookies and Cream 100% Whey Protein (to take to work, 15 servings) and (1) pouch of Strawberry 100% Whey Protein.

Sams Club: I decided to purchase my vitamins and minerals in bulk. (2) 200 sublingual B-12 tabs 2500 mcg to take once a day, (1) Children's MVI 300 tabs to take once a day, and Chewable Vitamin C 400 tabs to take twice a day.

At Walmart I bought chicken and beef broth, a strainer, water bottle (no straw), Gas-X strips (2 boxes) and an ice bag.

When I go for PAT, I'll purchase the protein called Nectar. It is a thinner consistency and tastes like fruits rather than desserts. I'll probably buy the peach and strawberry.

What to do?

2009-03-27T16:04:00.002-04:00

I am starting to prepare my body for the first three dreaded months post-surgery. In two weeks I'm starting a voluntary liquid diet (with protein shakes) to prepare my liver for surgery. Dr. Schram does lap RNYs but if the liver is too large and he cannot retract it, he will do an open. Things I have to say buh-bye to:

-Pop: I can have this months after surgery but only if it's flat. What's the purpose?
-Coffee: Yikes, what am I going to do?
-Emotional eating: No more late night binges, unhealthy food choices, etc.
-Alcohol: I'm going to enjoy my last fruity drink tomorrow night.
-Large meals: Hello to 1/4 cup to 1/2 cup of food.
-Drinking with meals: Have to follow the 5/30 rule.
-Grazing: Enough said.

Perfection

2009-03-26T09:41:00.002-04:00

per.fec.tion:

1. the state or quality of being or becoming perfect.
2. the highest degree of proficiency, skill, or excellence, as in some art.
3. a perfect embodiment or example of something.
4. a quality, trait, or feature of the highest degree of excellence.
5. the highest or most nearly perfect degree of a quality or trait.
6. the act or fact of perfecting.

It will never be a reality so why do we set ourselves up for disappointment and perceived failure?

Personal Reasons for WLS...

2009-03-26T09:26:00.002-04:00

Most bariatric surgeons ask their patients why they want to have WLS. My answer isn't limited to one specific thing...

* To be within a normal BMI range
* To feel comfortable in public
* To be able to shop at a variety of stores
* To feel comfortable in seats (airplane, baseball stadium)
* To not be automatically judged for being sloppy, lazy or unworthy
* To be able to watch my son grow up
* To regain the energy and motivation that I once had
* To be free from obesity related ailments (HTN, DM)
* To regain that 'bubbly' attitude that I once had that was tarnished after years of ridicule and people acting like jerks

The 10 Commandments of Weight Loss Surgery...

2009-03-25T20:47:00.001-04:00

From a friend on the Barix Boards:

1. Thou shalt NOT drink with thy meals. This means never. This is cheating...cheating yourself. It washes the food out of your pouch and allows you to eat more. This will slow and eventually stop your weight loss.

2. Thou SHALT eat slowly, very slowly. This is not a rule for the first few months post-op. This rule is for the rest of your life. If you eat too quickly, you will surely stretch your pouch. Eat too quickly and you will learn the hard way. The nausea is stifling.

3. Thou SHALT take thy vitamins. This surgery is a great tool for weight loss. But, as with all benefits, there are costs and malnutrition is one of the costs of this surgery. Take a multivitamin supplement every day for the rest of your life. You also need to have your blood checked periodically for B-12 levels.

4. Thou SHALT eat adequate protein. What is adequate? I am not a physician, so I cannot say for sure. Your nutritionist will tell you, and that is based on your height and is different for each person.

5. Thou SHALT exercise. Just do it.

6. Thou SHALT drink 64 ounces of water, everyday. It seems some people have problems doing this. Use a water bottle and carry it with you everywhere. Sip all day long. Follow the 5-30 rule: Stop drinking 5 minutes before a meal, and wait 30 minutes after a meal to resume drinking.

7. Thou SHALT eat well-balanced meals. I think my doctor said it best: protein first and foremost, then green/yellow vegetables, then fruit, then starches.

8. Thou shalt NOT eat sugar in any form...no candy!!!

9 Thou shall NOT modify these commandments to suit thy needs. It will not work. You will only defeat yourself.

10. Thou shall love thyself and be happy with the body God gave thee. God did not intend for all of us to be supermodels, and this surgery will not make you one. Happiness comes from within. Be happy with who and what you are.

Why am I blogging?

2009-03-25T16:37:00.002-04:00

I decided to create a blog to journal my experience with my upcoming weight loss surgery (WLS). In order to remember this important time in my life, I plan on taking several before and after pictures.

Why WLS? Simple. I'm tired of being fat. Now that I have a son, my priorities in life have changed. Do I want to be the mom that doesn't attend events because I'm ashamed to be in public? No. Do I want my child to grow up overweight and not understand the importance of healthy eating and exercise? No. My family has a strong history of heart disease, hypertension, cancer and diabetes. Being overweight increases my risk of developing one or all of these ailments. Unfortunately, I was just diagnosed with hypertension and I can't honestly say that it was attributed to my pre-eclampsia. Why do fat people always have to be in denial? One of the most challenging things I have noticed about any type of lifestyle change is that you must be 100% accountable. With that being said, I'm hoping that this blog keeps me on track.

And who is the cutie next to this entry? That's my son, Keaton. Keaton was born November 17, 2008 and he's the main reason why I'm going through this journey. He has this amazing way of making me want to do things for myself and for him...he's my biggest motivator and supporter.