Post Date: 4/6/07 11:36 am

Hi Debra ~ Thought I would throw in my two cents...and don't worry, I don't think you are being judgemental of those like me who have regained - my reaction was one of helping you to NOT become like me! I am six years out from my surgery - have gained 65 lbs from my lowest weight - never reached my goal and just this week had to have the scleroherapy procedure done....again. 

I can remember coming to this site so often after surgery to post updates on my progress and being so happy to type statements like "50 pounds gone FOREVER"  oooohhhh if I only knew!  The only explanation that comes to mind is "Denial ain't just a river in Africa"  LOL  Denial is a big problem. 

We all know that it was our tummies not our brains that were changed.  And if we don't work to find out why we were fat in the first place - then the surgery is just a band aid.  The first year or so after surgery is a dream - a lot is being done for you...nothing has stretched yet, so the amount of food is taken care of....the dumping is still strong, so you are afraid to eat the wrong thing...and the pounds are flying off...geez you can sneeze and lose 10 pounds!  You are feeling great, looking great and forgetting what it was like to be fat... I have always weighed myself everyday...sometimes this worked for me, sometimes it worked against me.  At first, when I would be a pound or two up - it would motivate me to get back on the program - watch what I ate and exercise regularly.  Then it started working against me...when I thought I had been good, got on the scale and it hadn't changed or had gone up a pound...I would get so defeated - Gosh why am I killing myself!?! It didn't make a difference anyway....where are my twinkies? After two years is when it started to get away from me - the surgery started to fail, or more correct, I started to fail the surgery.  I got into the bad habit of drinking with my meals...actually taking a gulp of something after each bite.  So now I was eating way more than I should have.  This also dulls the dumping syndrome....all of a sudden a peice of chocolate cake isn't going to give you the shaky sweats when you washed it down with a diet coke!  And for me, what was further keeping my head in the sand... I kept saying to myself "Hey, I still look pretty good...better than 300lbs looked" Denial, denial, denial. So before this post turns into a novel....what I am doing to try and turn it around - the sclerotherapy is working ( yes it's only been 5 days) - I have decided to make the most of it and turn my diet back to what it was in the first weeks after surgery - liquid/puree diet and no drinking when I eat!  I have lost 7 pounds, so that feels great and I hope to build on that momentum.  Also, I have started seeing a therapist - and this I think is even more important in my "recovery" than the sclerotheapy - I am determined to find out what the hole in me is that I am trying to fill with food! I hope this helps - thanks for posting this question - I know it will cause all of us, no matter how many years from surgery and how many pounds gained/lost, to think about what we are doing! Take care!

Post Date: 4/6/07 7:32 pm
Sclerotherapy is a treatment that reduces the size of the stoma through "scarring" the area.  It thickens the tissue, making the stoma smaller.   Since I am not an expert on this, perhaps someone else can explain it better.  I believe it can be done by applying a caustic agent to the area, such as a high level saline solution.  My surgeon said the effects were only temporary, however, sometimes only lasting for several months.  The body has an incredible desire to heal itself, and the thickened tissue can slough away over time, returning the stoma to its previous size. Debra M.

Post Date: 4/6/07 11:47 am
My surgery date was 3/11/05.  High weight 262 now weigh 130 5'1" (I guess this is goal--per doc.)  i certainly can not lose any more.  I weigh every day on a diginal scale and write it down on the calendar.  I slip up a pound or two ranging from 127 to 131.  At 131, I jump into action increasing protein and exercise.   I still drink protein drinks from one to three a day,  I take weight lifing and yoga/pilates classes at gym.  I walk from two to six miles most days.  i know I sound compulsive, but keeping this weight off is top priothy in my life.   I ,too, am far from perfect, but I am dedicated 

Post Date: 4/6/07 1:26 pm
I'm going to add my two cents (and it's worth just about that )! I had my surgery 8/18/04.  I weighed 278.  My surgeon's goal for me was 170 but my personal goal was 150 (and I was hoping to be one of the luck ones that loses w/o even trying and get to 135!  Fat chance of that!!  LOL)  I, at my lowest, was 147.  I always have, and still do, write down everything I eat and drink.  I weigh myself daily but only record it once a week on my "official" weigh in day.  I walk, and have done so since the beginning, 6 days a week. Starting back in late November to early December, my weight started to slowly creep up until I was 10 pounds over my goal.  I didn't panic but increased my exercising intensity and cut out one protein drink a day.  (They are 120 calories each and my husband suggested doing this.)  As of January, when I had hernia surgery, I had leveled off to 155-160 but still couldn't get back to the 147-150 that I prefer.  I called my nutritionist and got some suggestions from her but basically was told that it's normal to lose to under your body's setpoint and 2-2 1/2 years out, gain about 10 pounds and that's where your body wants to be.  I don't like that answer!!  But, having said that, no matter WHAT I do, my weight hangs at 155-160. I have no answers - just am DEEPLY concerned about regain and what else to do!  I really had hoped I was done w/weight obsession - but I think it's worse now than ever!!!!!

Post Date: 4/7/07 9:52 am
Thanks, Willow!  You brought up a lot of good points - and I'll be the first to admit that I'm my own worst critic!!  My self-esteem is still in the toilet - but I'm working on changing that!  That was interesting about our bones - I've never heard that!  Thanks for your response!!

Post Date: 4/6/07 1:40 pm
Debra, I think this is a great post and a concern all of us have, regain.  I'm 2 years, almost 2 months post op and I everyday worry about regain.  I am up from my lowest of 119 lbs, today I weigh 126.5 lbs.  My surgeon's goal was 130 lbs (I'm 5'1") my goal is 125 lbs so I'm over my goal and I've been stressing about it.  I just had plastic surgery and OMG my weight climbed to 138 lbs, this about caused me to have a stroke, even though I know it's from swelling it has been unbearable.  It brought about lots of fear. I am still pretty diligent most of the days in what I eat, however, when PMS is here I really struggle.  I'm a boredom eater so I try my best to stay busy, or you guessed it......I'm grazing like it'll be my last day of eating. I think we must always remember where we came from and I'm also a firm believer in weighing, even though I don't always like what the scale shows (especially if I'm doing extra well in my choices), I concer the scale a tool just like my pouch is a tool.  If I use that tool (scale) to monitor my progress then I SHOULD be able to stay in control 95% of the time. I do believe that therapy is necessary for some of us, there is a reason the majority of us self-medicate with food.....it's a deep reason that we cannot always find without help.  I strongly recommend therapy to those that are struggling right now.....I sometimes feel the need for therapy myself, there are things I can't deal with myself......unfortunatly my insurance doesn't pay for therapy and right now financially I cannot afford it.  I'm trying to self-help myself and in the near future my insurance is changing, I do pray then I'll have the option of an experienced therapist to deal with my life issues. Just remember, the tool is that, a tool; we have to use the tool but also relearn healthy eating, I feel some people don't optimize the tool in the honeymoon stage as it should be used.  Getting back to basics will help but it takes allot of work the further out we are.  I sympathize with those that have regained and I am scared to death as most started the regain where I'm at now.  Seeing 126 lbs isn't good for me.....but it definitely makes me aware of what I put in my mouth.

Post Date: 4/6/07 4:40 pm
Hi Deb,  I too am a CORI alumni. I had my surgery by Dr. Wood 8/19/03 I am almost 4yrs post-op. I am post-op TT since 2/05 with Dr. DiNick. I lost the last of my weight after my tt. I know you are a couple of years behind me, but when I went to CORI they offered NO pre- or post-op nutirtion counceling, We were falsely lead to believe this was permanent, that there had never been a revision on a micro pouch..... (I personally know a few). well I beg to differ. Very sad but true. Don't get me wrong, I loved my surgeon, I picked him after much research, I wanted the best if I was going to go thru this life altering process. But I was sold on my surgeon and not on the program (CORI). CORI was not a good program, I never went back after my 6mo. check up that was such a feasco(sp). I lived 2hrs. away, and the last time I went I waited 31/2 hrs and I seen him for literally 2min. I was very upset to say the least!!! Well now that CORI is no longer. I have an appointment with Dr. Wood for next month. Hopefully I will get to the bottom of some of my issues. I have posted about some of them already so I won't bore everyone with the details again.  Well, I guess it is time to face your questions, to be totally honest, I was angry when I first begun to read it. You said or did NOTHING WRONG!  You where honest and you asked thought provoking questions that I do appreciate, I just came from a board that where many are at your stage of the journey or less and Things are still honky dorey, Those of us that are struggling are being slammed and looked at as weak. Instead of support we where getting that holier then thou attitude. I know many that won't even post to the board anymore because of it. Sad but true, we are here for support. That is why I was so glad to find this board, I finally found others who are struggling many for different reasons, as well as physical problem. Sometimes we feel like we are the only ones dealing with these problems, but we are not. Well back to your questions....LOL.  1. I didn't gain until after I was in the hospital the last time with my "mystery pain" which was last august. After I was discharged from the hospital I gained 20 lbs with in 1 mo. I was up 20lbs at my check up, then I have gained another 14lbs since the end of the year. I am trying to figure out how and why I am gaining. I wasn't exercising very consistantly for some time, I thought that must be it, Sooo I kicked it up, well no change. I still am exercising. So then I looked to my eating. Well, I do my best to eat healthy EVERY meal. I never eat sugar ie, cake, desserts made with sugar etc. I am not saying I am perfect. I just never tested those waters. I HATE to throw up!!!! I also figured out a few years ago that I have an allergy to wheat, so that helps to keep me on the straight and narrow in the dessert food department. I eat protien, fruit and veggies as my main eating. I get in my fiber ie. oatmeat w/ flax seed and fiber sure. Everyday I take many vitamins and suppliments ( a handful 2x a day)....LOL. Well a recent post had brought a thought to me that I hadn't thought of. I do eat rice and potatoes, not a ton but I do everyday.  She called them bad carbs, I hadn't thought of them as bad carbs, I guess when I think of "bad carbs" I think of junk food....lol, but I am probably wrong. In the beginning of my journey I didn't eat any of those. when I was close to my goal I intoduce them back. I was figuring that since I was in the maintance part of my journey, I could enjoy them again, just as long as I didn't eat them as I did pre-op, well I don't. I watch the protion size. Heck, preop I would eat 3/4 of a plate would be potatoes and with a tiny piece of meat or no meat at all. Needless to say I was a carbaholic!!! Maybe I will never be able to eat them, but on rare occations. We will see. I have noticed if I like something to much, even if it's healthy I will over endulge, not in one setting, but I will eat it until I realize that it is becoming a problem. When I have to go to the store JUST because I may be out of that Item, then I know it's a problem and I refuse to buy anymore.ie. I found a wheat free/ sf chocolate chip cookie that I loved, I could see if I continued to buy them It would be a big problem and that was long before I gained any weight!! Go figure....LOL.  When I recognize things I am doing wrong I try to correct them, but sometimes" we don't see the forest beyond the trees! " I thought as long as I eat healthy everything else would be okay.....WRONG! 2.Then the next thing I had to look at was my sleeping habits. I was averaging 2-4hrs a night. I HATE TO SLEEP weird huh?I have recently found out that a lack of sleep will cause anyone to gain weight. I am not sure exacty why, but it does make since.  I have real issues in that part of my life that I think, no I know I need to deal with. They seem to be getting worse lately. I have to conciously take 3 tylenol pm to get to sleep, I have to be sooo drousey before I will even go to bed. Sometime I will fall asleep with my computer in my lap. It's a miracle I haven't dropped it. 3. I am sure this one is my big problem, but until I figure out how to fix problem 2. I am not going to be able to fix this one. I night eat! There I said it! I don't eat bad thing but I am still eating very late. Why, To stay awake....yes....stupid huh! I guess I am a freaking nut case....LOL. In the beginning of my journey it didn't matter because, I had to eat 6-8x a day. I would save much of that for night eating. 4. My surgeon never gave me a goal, but I set my personal goal for 135. I made it to 140, then I went back to 143-145 that is where my body seem most comfortable. I was happy with that. I looked good. I felt great! At least until I started with the mystery pain that comes an goes. I haven't had a problem with it since last aug. which is a blessing. Sadly I am at 174. I can barely fit into my jeans anymore. I refuse to buy any bigger!!! So unless I want to where these until they fall apart I better figure out what is going on. 5. I do feel like I am able eat sooo much more then I should be able to, but nothing like I could eat pre op, but more then early out.  I do drink after meals. To be honest I kinda forgot about the waiting. I guess I have become complacent.  Writing this I am wondering to myself, why have I let it get this far. I thought if I where eating right that everything else would be okay, but I am seeing that it takes soooo much more. I had been so busy trying to defend my eating that I didn't see some of the other things I am doing wrong. I guess the sad part of all of this is I am a support group leader!!! Lousy leader huh? Well I hope I can get this figured out, cause I don't know how I can continue to lead others when I am not a very good example anymore. Thanks for bringing this to us. IT IS TIME TO PAY THE PIPER.

Post Date: 4/6/07 7:27 pm
WOW.  All I can say is wow.  Well, no, I can (and probably will) say alot more. Thank you all so, so much.  This discussion is exactly what I was hoping for, I send a hug to all of you.  I think you've understood that I am not finger pointing (thanks, Toni, I've followed your posts on the Michigan board for years, and thought you have been extremely supportive to members there).  I am just trying to understand the how and why of regain. If one never reaches a realistic goal while following all the rules, I think it is a good idea to find out if there is a medical reason, such as the pouch being too big or stomal stretching.  The question of what is goal is also a valid one.  My surgeon wouldn't give me a number, and the one weight I chose for myself was simply to have a normal BMI.  I realize this is a totally arbitrary number, but it was one that made sense to me.  How would I know where my natural setpoint weight is?  I am still asking myself that. For some reason, I couldn't be satisfied with the medical profession's definition of success, 70-80% of excess weight loss.  I didn't want to always feel I needed to lose some more weight.  I feel I have been one of the fortunate ones to have lost so much weight.  Please note that I am not saying I am a better person, or better patient, I am just lucky.  When I read how hard so many of you work to lose your weight and can't, it makes me wonder, why me? I feel like a newbie all over again.  A newbie at maintainance.  I figure it's like being a WLS grad, I will have to maintain at least a year before I can even begin to think I know anything about maintainance. I appreciate all of the thoughful comments I have read thus far on my post. Debra M.

Post Date: 4/7/07 7:57 am

I think this discussion has been interesting, thank you.  But it also begs to ask:

WHAT IS GOAL?

Is it the number on a scale [and we know how that goes, my scale, the doctor's scale, naked first thing in the a.m., after a b.m. LOL]?

Is it a size of clothes [once again, am I a 10 in regular or an 11 in Juniors?]?

I think for many of us, goal was getting years back of our lives, getting off meds and rid of conditions that made us SICK, living life again as a participant instead as a spectator.

But how to measure?

My WLS didn't give me a goal weight, he said he expected me to lose 'about a hundred pounds' [I have lost 155 to date].  My PCP considered me a success when I was off the CPAP, off B/P meds and my diabetes was in remission.  I, quite frankly, was thrilled to fit into my pre-pregnancy jeans.  But, sure, I still have a number I'd like to see on the scale.  And imagine what sizes I may wear some day.  I am not at my goal yet, and what does that mean?

We all need a goal, " the end toward which effort is directed."  To help give us direction, to have something to work for, but should it be the point where we measure success? Probably not.

Is there a WLS patient out there who doesn't worry about getting to goal, or about regain? 

Have we looked at the numbers and gone from seeing our success to seeing failure?

Yes, for me having a goal to work for has made me work harder, but just as important, if not more, I make the effort to remind myself every day that regardless, I am a success.  If I never reach goal, if I never wear a size 7, I am a success and I deserve good things.  I think as long as we continue to TRY and never give up, we are all successful.  And sometimes, when one loses sight of this, one can forget that we deserve good things.  Eating well, exercise, never giving up - that IS being good to ourselves!

JMHO.

Post Date: 4/7/07 1:33 pm

Hi Sharyn,  Thank you for the information. I can't say it wasn't a bit shocking. Something so different then what I was told when I had surgery. When I had surgery my dr. had us follow the Atkins diet. We were on 20 gram of Carbs for a Loooong time. I think I ate that way for at least a yr. Now I would say I eat about 150 or so. You mentioned that all carbs are not created equal, but you never elabarated. I do know that there are good and bad carbs, but I guess I always though any carb that was natural i.e. veggies, fruit, potatoes, and rice would be okay, at least at maintanence. I guess I was  WRONG!!!  It is probably more then just the potatoes and rice that are a problem. As I mentioned in my last post, This discussion has given me a lot to think about, and face many of my demons. Eating well is not the only answer. From what I am reading from others, our only true salvation is going to be exercise....GRRRR....LOL. I will be doing some research. It is just so difficult. One dr. or nutritionist will tell you one thing and then the next 3  each will tell you something totally different. It truely can be frustrating. Thanks for posting and the info, it is very interesting.

Post Date: 4/7/07 5:17 pm
Sharyn,   Thank you for the valuable info. I think you have found your passion (calling). I would love to read your paper when you are finished.  There are a lot of grants out there for medical research, all you have to do is find a program, dr. or university that will back you up. There is a lot of info on the net about research grants, the only catch is if you don't know how to write the grant you really need to find someone who does. Because you basically have to sell yourself and your idea. Just a thought.   Thanks, Toni

Post Date: 4/8/07 10:39 am
Last Edit: 4/8/07 10:48 am
[QUOTE]... Carbohydrates typically fall into two categories - simple and complex.  ...

Some examples of simple carbohydrates are:  sugar, REFINED white flour, REFINED white rice, and white potatoes.   Basically, the more processing that man does to the food makes it easier for the body to digest it. ...As a WLS patient, I strive for a mix that looks more like this:

Carbohydrates - 50%
Fat - 25%
Protein - 25%[/QUOTE]

First of all, Sharyn, thank you for sharing your studies.  I, too, would love to read your paper when it is done.  I hope you don't mind if I pick your brain a bit more.

I have a question about simple carbohydrates as listed above, does a baked potato fall into the same category as 'white potato' since it is not processed?

Also, your carb ratio is double your protein.  Why isn't it the other way around?  I think I understand that you said the complex carbs are needed for proper nutrition, but I thought we should be at 50% protein, 25% complex carbs, 25% fat.  Can you elaborate more as to why you choose the 'mix' you do?