ObesityHelp.com: Making the Journey Together
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Goals

become a role model for my daughters for living a healthy lifestyle.

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2 People
 in progress, 
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finish the Bay to Breakers

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1 Person
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finish a half marathon

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Surgeon Testimonial

Barry Sanchez
Pros:
Very streamlined, very efficient at gettting folks through the surgery. Dr. Sanchez is very informative, and comes across as warm and competent. Good sense of humor and would be fun to grab a beer with.
He shares office with Dr Wetter as well, who is equally warm and competent. I met with him a few times when Dr. Sanchez was unavailable, and I would recommend him as well.

Cons:
Office staff is VERY unorganized. (Phone calls not returned, appts cancelled, follow ups not done)

The best recommendation I can give is that I am now helping my sister go through the process with Dr. Sanchez as well.
Member Interests
  • Books & Literature - Bill Bryson, Jennifer Weiner, Child Rearing books, Biographies
  • Travel - Love to travel--the more exotic the better
  • Cats - Got two of em! Toxie "Cow Cat", and Milly "Fat Cat"
  • Musical Performance - LOVE musical theather-- Wicked, Rent, Avenue Q, Ragtime
  • Dancing - Tap dancing, cheerleading
  • Army - Hubby is career Army--22 years and counting. Just made E-8!

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My name is Denise, but I also answer to 'mom', b*tch', and 'boss', depending on the time of day. I am an overly perky, cheerful, bouncy, ball of giggle--even first thing in the morning. During the day I hold down a too-serious-too-much-to-do job, and at night I am a silly goofball who loves to laugh. I have a loving husband, and a beautiful little girl. I firmly believe that things in life do tend to work out, so stressing over the minor stuff is a waste of time.

Personality wise I am outgoing, warm, and affectionate. I am not afraid of constructive criticism and am willing to apologize for my mistakes. I tend to be very direct and blunt, rather than beating around the bush or expecting others to read my mind. I am told that I am very easy going and funny(especially when cocktails are involved!!) My sense of humor is more guy oriented than girl--meaning that I tend to offend more than be offended.

My daughter is 13 months old (as of 1/17/07). I am a software project manager by day, volunteer cheerleader by night. I am a performing member of Cheer San Francisco. We raise money for people living AIDS, Cancer, and other life threatening challenges. For videos and photos of our performances, check out my MySpace page or go to the Cheer SF website.

Denise's Blog
My random thoughts.....


Starting over, getting back to basics. Great information!
on July 8, 2008 12:41 pm
Maybe I can help you start over. YOU have to do it. One thing is to start
recognizing the physical portion of the disease. I could've told you that
you don't care about bfast, don't start eating til mid day and have trouble
slamming on the brakes at night. That is how our disease works.

We start out ok. Then as life starts smacking us down, the serotonin level
goes down. We eat food (carb) to raise serotonin level ( and label it
emotional eating, because it makes us feel better. DUH, it is a chemical
feeling). OUR serotonin level doesn't just go up to a nice comfy level, it
shoots thru the roof, then a lil later, KA THUD, back in the basement.
Repeat cycle. Hence, the more carb we get, the more we want (need) to try to
level out the serotonin, which cannot be leveled for us because it's broken.
Of course, this is taking the blood sugar on a wild ride as well. You can
see the cycle.

SOOOOOOO, you do protein drink (30g each, no added milk, fruit, juice) , small non-carb meal (well, complex carb on
the side is ok, once you get out of the binge cycle) 2-3 hrs later, protein
drink, "sensible meal". Protein drink (esp mid-day, about 2-3pm in a normal
person day) and protein snack. Yet another protein drink
before dinner to lower volume or prevent grazing while prep. About 2 hrs
after dinner, when the S level starts to plummet, stick in a protein shake,
followed by a protein snack. Maybe like meat & cheese with grain cracker or
bread. You'd have to experiment & see if it triggers you. If the craving is really bad, you can do another protein.

All meals are over in 15 min. You take your food on a plate to the eating
place. You can eat anything but milk or sugar & white carbs (right now),
preferably normal fat, not fat free. You can have a big fluffy salad, if
you want. With breaded chicken, with normal dressing--I don't care. What I
don't want is white bread or saltines with it. See?

And of course, start sucking water 30 min after eating and get as much as
possible.

Does it sound do-able?

Vites go (roughly) like so:
iron + C with the first non-dairy, non-caffeine protein or meal (no eggs or whole grains)

1 multi
2 calc (if mine)
1 A-25
1 D-5
1 E

with next protein drink or snack

1 multi
2 calc
1 A-25
1 D-5
1 zinc
1 E

with next protein drink or food
another pair of calcium (or use UpCal D in all shakes EXCEPT the one taken near iron)

B12 any time

If you take HSN or B-complex, it can go with either multi-grouping.

And another 2-3 calcium before bed

And the usual set of "rules",
64+ oz of water, as in water
no drinking with meals
distinct "meals", not grazing
limit sugars to 6 g per MEAL
try to avoid "white" things, like bread, potatoes, rice, pasta

Good snacks:
cheese
beef sticks
jerkies
tuna
chicken (don't care about skin)
smoked salmon
other meats or fish
some protein bars

Issue yourself a portion in a Ziploc bag to take to work or on the go. Control your portion in advance, before you are hungry

It's all about rhythm. Creating a system that keeps you in a "I'm doing the
right thing almost all the time" frame of thinking. That alone helps keep
the serotonin level closer to smooth, esp for US, with the 100# of guilt we
carry at any weight. Ditch the guilt to keep the S level from dropping. If
you fall off the wagon, then by the next meal, you get back on. One slap to
correct yourself and stand back up, do the next one right. Keep the
serotonin level smooth, not whacking all up & down like a yo-yo. You can
ALWAYS insert another protein in the trouble spots until you get a grip on
them.
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Great post about volume/measuring
on June 26, 2008 8:07 am
It's really hard getting used to eating more after being able to eat so little in the beginning - like you're doing something wrong because you get more in then a couple ounces.

Here are some pictures of a one cup measuring cup versus a 1 ounce (2 TBS) meausring cup. As you know volume wise - there is going to be an obvious size difference.

DSC06238.jpg picture by BabyRhiDSC06236.jpg picture by BabyRhi

Well - when looking at a measuring cup it doesn't really tell the whole story of what's happening inside of our new anatomy. Here is a visual of 8 ounces of white meat chicken breast versus 1 ounce of white meat chicken breast. 

DSC06239.jpg picture by BabyRhi

DSC06241.jpg picture by BabyRhi

In the very beginning your pouch is made on average 2 ounces in size. That is why you can only eat small amounts of food at one sitting. As time goes by a natural relaxation happens and makes us capable of eating more volume, usually between 6-10 ounces. Now understanding how what you eat impacts how your feel is vital to know how your man made pouch/stoma works. 

If you've had your RNY for any length of time you've started to understand your head hunger versus true physical hunger and how what you eat impacts how you feel. Well, as we get further along, being able to consume more at one sitting can be terrifying. I know it was for me. Finishing my first South Beach frozen meal almost gave me a panic attack. Well, what people told me was that things are going to be chewed down to a nice compact tightness, thus making me able to consume more - so it's important to make sure to have protein first to not consume too much of the really soft (pass through the stoma easily) foods.

That brings me to simple carbs. Simple carbs - crackers, chips, cookies, etc - are going to chew down to mush. Who here hasn't ever eaten a donut? Do you swallow chunks of donut after chewing it or is it pretty liquified before you swallow? There ya go. It's a matter of consistency. Here is a picture of 8 ounces of chicken versus 8 ounces of bread crumbs (which I figure is good enough to show the texture of simple carbs after consumption).

DSC06245.jpg picture by BabyRhi 

Notice how compact the chicken breast is on the plate. Notice how the breadcrumbs are spread out and sandlike. If you've ever seen breadcrumbs they are lightweight and airy. Although it looks like more volume on the plate it's actually less dense then the chicken - so 8 ounces of chicken breast versus 8 ounces of simple carb CAN NOT be considered the same on a satiety scale becasue it's all about texture and density. To get the same fullness from 8 ounces of chicken breast you would more then likely have to double the amount of simple carb - and double the calories, carbs, fats, etc. AND the chicken will stay in the pouch longer then a simple carb would because it has to be broken down to get through the stoma. Slider foods don't require as much work and can exit the pouch quicker then something dense making you hungrier sooner. So eating right is more then just avoiding simple carbs because they're "bad" for a diet. It's because they offer almost no satisfaction for anything but your tongue. And I'm all about fullness now that I want the most bang for my fullness buck.

So taking a look at the above pictures I wish I could see everyone who thinks they eat SOOOO much at one sitting raise their hands if they thought they could finish all 8 ounces of dry white meat chicken breast at a couple months out.  I think people think they're eating a lot but in reality they're not. At 15 months I'm able to eat the 8 ounces of chicken salad and usually a small salad or piece of fruit if I'm still hungry. Keep in mind that salad will chew down to nothing (if you don't believe me go throw a salad in a blender and whir it up). But compared to a Big Mac, large fry, 2 apple pies, and couple refills of Diet Coke - and still being hungry -  I am nowhere near my pre-op volume and likely never will be again. 

So thanks for letting me share this. I don't measure my food - never have. I just eyeball it. I really focus on the cardinal rules and let them guide my actions. But I know without a doubt if I sat down with a bag of Ruffles and french onion dip I will be consuming WAY MORE to get the same fullness I would from the chicken salad in the fridge. It's about choices and choosing to get the most satisfying volume for your caloric needs. You very possibly can eat too much - but not if you're eating the best options available! And this is something to remember for life - not just the first couple years.

Hope this helps people who think they eat too much!
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3 Day Liquid Protein Test
on June 9, 2008 12:41 pm


Who Should do the 3 Day LPT?
1. If you have gotten off track (or just plain de-railed in your weight loss journey!), then the 3 day LPT is for you.
2. If you find that you are addicted to carbs, are eating junk food, are snacking and grazing, then the 3 day LPT is for you.
3. If you need to jump start your weight loss once again, then the 3 day LPT is for you.
4. For those who have no weight to lose and are not addicted to carbs, this is probably not necessary. Instead, you may want to check out Susan Maria’s Basic Bariatric Eating Plan to stay on track.

Before You Begin:
1. How many days will I do this program? Normally it’s done for 3 days. You may choose to continue for up to 5 days. Anything over this might be excessive.
2. Will I drink ONLY protein shakes or will I add a light supper? The choice is entirely up to you. If you are able to get rid of carb cravings by cutting back to eating a light supper (high protein), then you may want to stick with drinking shakes all day but a light supper at night. However, if you are overly addicted to carbs and need a more aggressive approach, the full liquid shake only approach may be the best for you.

Preparation for the Program:
1. Make sure you have plenty of protein shakes available – there’s nothing worse than to be in the middle of a program and run out of products! Stock up on high protein, low carb, low sugar and low calorie protein powders or ready to drinks. Bariatric Eating sells a wide variety of great tasting protein products.
2. Decarb your pantry – get rid of foods that you should not have (crackers, chips, cookies, high carb sugar free products) as these will be a stumbling block to you. Also, the purpose of the LPT is to get back on track and away from those items that cause you to fail. You don’t want to sabotage your own success by having these tempting products in the house. They do have a tendency to call your name at the most inopportune (usually your weakest) times!

How It's Done:
1. Drink a protein shake whenever you feel hunger (whether it be real body hunger or head hunger) – one person said they drink a shake every two hours. I figured that if a person would start at 6 am, drink a shake every two hours, this would allow them to drink up to 8 pm! (Sounds great)
2. Consume a minimum of 800 calories for the day
3. You may drink fluids after consuming protein shakes. The "30 minute wait period" before drinking after food does not apply in this case.

Keep in Mind:
1. Get off sugar products
2. Some people include a few additives in their shakes to help spice them up such as a little peanut butter, or sugar free Davinci syrups, or a little bit of fruit (although fruits do have carbs, so it depends on what your preference is). If the additive causes you to crave more, DON'T add it.
3. You may want to include thin soups with light vegetables, yogurts or custards as they are considered full liquids.
4. It has been suggested that if you are exercising, drink a protein shake right before your workout.

Transitioning Back to Normal:
1. If you are doing full liquids for 3 days, on the fourth day you will want to add a light supper. When comfortable, add a light lunch until you are back to your 3 meals a day. The LPT will help you to be more in tune with how food makes you feel. In other words, you will know when you are full on a meal. Stop there, do not overeat. Listen to your body and pouch when it says its full.
2. If you did liquid all day and a light supper at night during the 3 days, then just add your light lunch back into the routine.
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Some good quotes...
on May 30, 2008 12:34 pm

I can anything I want, just never all that I want.

Some people want to say I'm "a success."  I dunno, maybe.  All I know is that so far today is OK; tomorrow might be different. 

a thought from Animal House: "Fat, drunk and stupid is no way to go thru life, son."

Exercise. It's not about hating it or loving it, it's just about doing it. Period.

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Height and Weight photos
on May 8, 2008 1:15 pm
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My Story

My introduction sums up the basics of my life pretty well, but I guess here is where I am supposed to talk about my weight struggles. I figured I would include pictures, since they lay this out so much better than I could with just words alone.

As a kid, I don't think I was ever really fat. Just a bit bigger than the other kids. I was always the tallest in the class, with a bit of a pot belly. Looking back, I think that every kid gets teased for something, mine just happened to be weight. And it was hard. I remember running home crying after school. I remember the ridicule. It sucked.

    

My weight was up and down as a teenager. I don't remember ever being HUGE, but I know that I wasn't considered slim. I was active in high school, taking dance classes, being on the swim team, etc. I was a cheerleader my senior year of high school which kept me pretty active. Again, I was never slim, and I was definitely the biggest one on the team, but I wasn't fat either.

    

However, once I graduated high school, I wasn't nearly as active as I used to be, and my weight slowly started to climb. At maybe 160ish when I graduated, I crossed the 200lb mark sometime during junior college. I don't remember every really being concerned about, or even really trying to do much about it.

In 1994, I went off to college, moving away from home for the first time. Not only did I gain the freshman 15, but also the sophomore 20, the junior 30, and then some. I went to a party school, which included copious amounts of alcohol 5-6 nights per week.

I actually worked in a doctor's office while in school, and tried the whole Fen/Phen thing, which actually worked pretty darn well! However, I wasn't exercising, and still drinking a lot. When I graduated, I was the heaviest I have ever been in my life - 289.

After graduation, I moved back to San Francisco to start work. My degree is in Information Systems, so I spend a lot of time on the computer, at a desk. I remember about 8 months after graduation, concentrating on trying to lose weight. I remember bringing my lunch every day, and then going out walking or to an exercise class after work. I had moderate success each time I dieted, but nothing ever stuck.

In 1994, a coworker recommended a program she was doing, which was a medically managed liquid diet. Again, I did moderately well, losing about 45 pounds, but it didn't stay off. When my gallbladder became blocked and had to come out, I was out of the program and completely fell off the program.

It was around then that I was diagnosed with diabetes--having had hypertension since I was 16 since it runs in the family.

For the next 10 years, I tried a variety of diets without sucess: Weight Watchers, Atkins, etc. My weight continued to fluctuate with each attempt, however I mostly stayed in the 225-230 range for during this time. I also realized that I dropped weight when I ate horridly, on account of my diabetes. It is a horrid diseases, that actually rewards you for eating crap! When your sugars are out of control, your body drops weight in an attempt to regulate itself. Of course, you are doing all kinds of long term damage, but it is hard to keep that in mind when you are chowing down on fast food every day and still losing weight.

In 2005, I tried out for Cheer San Francisco, and adult co-ed cheerleading squad. There are about 50 of us that raise money for people living with Cancer, Aids, and other life challenges. Between practices and performances, it gave me the motivation to get the weight off.

                     

That same year, my Dad challenged the family to our own version of the Biggest Loser. My sister, dad, brother in law, and grandmother all have weight issues. I started at 257 in July 2005. The competition was good for me, and gave me a lot of motivation. Around that time (Dec 2005) I saw an ad for the TrimSpa challenge, and figured that if I was losing weight for one competition. why not step it up and try to win some serious cash?

I started the 12 week challenge in early January at 208, and ended up at 185! It took a HUGE amount of effort to attain this, but I felt fantastic!!! I was tracking every calorie, working out with a trainer, taking all kinds of different exercise classes, etc. Anything to get me off my butt. Losing weight had become my second full time job.

I didn't make it to the finals for TS, but it was a great finish. That same month, I met the man that I would eventually go on to marry. (This puts us at January 2006, for those of you keeping track). It was a whirlwind courtship which included going to my first ball!!!

Being the skinniest I had ever been in my adult life, I bought a gorgeous ball gown, and felt like a princess.

On April 1st (funny date for it), Mark proposed in front of the fountains at the Bellagio. I said yes, with the intention of having a long engagement. However, by mid May, I was pregnant! So we moved things up and had the wedding in August (4 months pregnant!).

My pregnancy was rather uneventful, except for having to closely monitor my diabetes and blood pressure. I was immediately put on insulin, which was a new experience for me. The problem with insulin (which I didn't learn until 6 months after my daugher was born) is that is makes you gain weight.  I was maybe 190 lbs when I learned I was pregnant, and shot up to 220 in 3 weeks, due to the insulin. The weight continued to climb until the date I was induced, at 268 lbs.

I knew that this was to be expected, and figured that it was would come off quickly while breastfeeding. But no, that didn't happen. I had to stay on the insulin while breastfeeding, and while I was 225 when I got out of the hospital, I quickly ballooned back up to 260. I was frustrated beyond belief, since at this point (6 months out - July 2007) I was back to my pre-baby weight loss habits-eating healthy, counting calories, exercising, etc. And my weight continued to climb.

I stopped breastfeeding at 6 months (long story---baby never latched, was pumping 10 times per day, had to get back to work), and went to the doctor in tears. She explained the side effect of insulin (gee, now you tell me!!), and we changed meds.

That helped a bit, but even 2 months later, my weight hadn't budged. At this point, I gave up and threw any thoughts of weight loss out the window, and just ate what I wanted. My weight didn't climb, instead, I actually lost a bit due to the diabetes.

Knowing that I was slowly destroying myself, and given that I have been battling my weight since I was 17 --I was done. My sugars were off the charts, having been diabetic for 13 years now, and I needed help. I asked my doctor about the surgery and she was immediately supportive.

I researched my options under my insurance (Tri-Care through the military) and started down the road. In case you are interested: First, I researched doctor's in my area, and then looked up each name on the insurance website to see if they were covered. Then, I did the same with the nutritionists and psychologists in the area. I then typed up my diet history and brought all of this to my doctor. I walked away with three referrals (surgeon consult, nut, and psych) and my recommendation letter. My insurance didn't cover the Nut, but everything was covered. My first appt with the surgeon was Sept 17th 2007. They coordinated getting the approval for the surgery, and I had it on Jan 7th 2008. The procedure was approved from the first request.

This was taken on a Caribbean cruise about 4 weeks prior to surgery. Notice that I cropped out the arm fat, and you can't see the belly.....I have so many pictures like that!

 Anyhoodles, there we have it....my entire weight struggle. I have to admit, it was tough writing this, and digging out the photos. Anytime I would take a good photo (looking thin, flab hidden) it would be preserved, hung on the wall, etc. But all my fat photos, like the ones here, I had to really dig for and then scan. Looking at them made me really sad, but at the same time, I treasure where I am now, and know it will continue to get better and better!

I have NEVER in my life, let my weight hold me back from anything. I have traveled, jumped out of an airplane, dated, and more. I am very proud of this, because I look at others I know who blame every problem in their life on their weight. My point is that we MUST NEVER let our weight define who we are. It is just another aspect of a person, but it does not need to dictate how you live your life.

I am going through this for two reasons. One, I want to be healthy. I want to be here to see my daughter grow up, I want to travel the world with her and my husband, I want to meet my grandchildren. I was eating myself to death and it needed to stop. Two, I need to be a good role model for my daughter. Growing up as a fat girl is a miserable experience that I wouldn't wish on anyone. As a parent, it is my duty to do whatever I can to ensure that I pass on healthy habits and realistic expectations to my daughter. If she sees me stuffing my face, chances are good, she will start stuffing hers.

 


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