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So this is big for me ... I'm sitting in a conference room at work ... I'm excited and nervous and scared and hopeful and anxious and alot of other stuff. You work and work and work and work to get to this point then when you get there you realize that this journey begins in earnest now.

I'm scheduled for 8/9/10 at 10:45am ... it's real.

1^st Mistake:  Not Taking Vitamins, Supplements, or Minerals

 

Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist. Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results.  Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include:

 

Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning.

 

Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible.

 

2^nd Mistake:  Assuming You Have Been Cured of Your Obesity

 

A "pink cloud" or honeymoon experience is common following WLS. When you are feeling better than you have in years, and the weight is coming off easily, it's hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back.

 

A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don't change what you've always done, you're going to keep getting what you've always gotten -- even after weight loss surgery.

 

3rd Mistake:  Drinking with Meals

 

Yes, it's hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating.

 

4^th Mistake:  Not Eating Right

 

Of course everyone should eat right, but in this society eating right is a challenge. You have to make it as easy on yourself as possible. Eat all your meals--don't skip. Don't keep unhealthy food in sight where it will call to you all the time. Try to feed yourself at regular intervals so that you aren't as tempted to make a poor choice.  And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your "absolutes" based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you.

 

5^th Mistake:  Not Drinking Enough Water

 

Most WLS patients are at risk for dehydration. Drinking a minimum of 64 oz. of water per day will help you avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too.

 

6^th Mistake:  Grazing

 

Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It's one thing to eat the three to five small meals you and your doctor agree you need. It's something else altogether when you start to graze, eating any number of unplanned snacks. Grazing can easily make your weight creep up. Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing.   Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement.

 

 7^th Mistake:  Not Exercising Regularly

 

Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest!

 

 8^th Mistake:  Eating the Wrong Carbs (or Eating Too Much)

 

 Let's face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, which have beneficial vitamins. For example, if you can handle pastas, try whole grain Kamut pasta--in moderation, of course. (Kamut pasta doesn't have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as "condiments," rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies.

 

9^th Mistake:  Going Back to Drinking Soda

 

Drinking soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we know it does is keep you from getting the hydration your body requires after WLS--because when you're drinking soda, you're not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there.

 

 10^th Mistake:  Drinking Alcohol

 

If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it.

 

Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious. Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations.

 

If you think you have a drinking problem, get help right away. Putting off stopping drinking doesn't make it any easier, and could make you a lot sicker.

 

. . . should get submitted this week.

Everything is in place except for th psych evaluation report. I anticipate a Wednesday submit and a 7-day turnaround for a response.

Stay tuned ...

Product Description

A Whole New and Completely Delicious Way to Eat after Weight Loss Surgery

After her weight loss surgery in 2003, Patt Levine knew she would have to stick to a very restrictive diet, but there had to be something better than the "totally tasteless mush" her post-op food guidelines recommended. Levine put her cooking skills to work and now, in Eating Well after Weight Loss Surgery, she and collaborator Michele Bontempo-Saray offer over 140 original, low-fat, high-protein recipes that taste just as delicious pureed and chopped as they do served whole, so you can enjoy flavorful, satisfying meals through every stage of your post-op eating program and cook for your family and friends—all at the same time. These mouth-watering dishes, which cover everything from breakfast to dessert, include:

Crustless Spinach and Cheese Quiche * BBQ-Baked Chicken * Asian Turkey Dumplings * Cider-Glazed Pork Chops * London Broil with Horseradish Cream Moussaka * Salmon with Creamy Lime-Dill Sauce * Scallops Provencale * Orange-Ginger Tofu * Vegetable Frittata * Southwestern Tomato Soup * No-Noodle Zucchini Lasagna * Basic Cheesecake * Apricot and Strawberry Smoothie

Complete with advice from a certified nutritionist, helpful tips for stocking your pantry and refrigerator, and nutritional analyses for each recipe, Eating Well after Weight Loss Surgery is guaranteed to make eating a true pleasure and help you maintain your weight loss for years to come.

Eight Signs of Emotional Eating

A lot of people ask, "How do I know if I am over eating for emotional reasons?" If any of the following statements sound like they could apply to you, then it's likely you are struggling with emotional eating.


1. My hunger comes on suddenly. Physical hunger comes on slowly. Hunger from emotional eating often comes on quickly and suddenly.

2. I crave specific foods-generally not carrot sticks or steamed broccoli.Cravings for specific foods usually unhealthy foods are signs of emotional eating. Often people like the rush they get from satisfying their cravings. The rush is fulfilling emotional hunger.　

 

3. My hunger feels urgent- I need a particular food right away and I am willing to walk out of my way, or get in your car late at night, or raid my kids Halloween candy to get it.  Physical hunger, unless you haven’t eaten for a long time, is usually pretty patient. It will wait for food. Emotional hunger demands to be satisfied immediately.

4. My hunger is often paired with an upsetting emotion- if I backtrack a few hours or a few days I’ll usually find an upsetting event and feeling that triggered the urge. Hunger thats comnnected to an upsetting emotion or situation is definately emotional hunger. Physical hunger is not typically triggered by emotions.

5. My eating habits involve unconscious eating-all of a sudden I’m eating ice cream and I find the whole contianer is gone.

6. I don’t stop eating in response to being full- I keep wanting more of the taste of the food. Physical hunger doesn’t need to be stuffed in order to be satisfied. Emotional hunger on the other hand often demands more and more food to feel satisfied.

7. My hunger isn’t located in he belly- I crave the taste of a certain food in my mouth or I can’t stop thinking of a certan food.  Feeling hungry in this way is usually a sign of emotional hunger or binging. Physical hunger is happy to get what it can, while emotional hunger usually focuses on specific tastes and textures.

8. After I satisfy my hunger, I am often filled with a sense of regret or guilt.  Feeding your body what it needs is not something to feel guilty about. If you feel guilty after you eat, it’s likely because part of you knows you’re not eating just to satisfy physical hunger.

 When you’re eating for phyiscal reasons, you are usually mindful of what you’re doing. If you catch yourself eating, “just because”, then its likely you’re eating for emotional reasons..

Author: Ron Merk

Hopefully I’m not fooling you with the “slimming” part of the title of this article as most vegetables are by far better for us than any other food group in terms of weight gain/loss. The facts are that vegetables are the very next food group below protein for weight loss surgery patients or for that matter, anyone who wants to lose weight. Not only are most of them low in calories, they are also full of nutrients, antioxidants , minerals and vitamins.

Before we get to the Top 10 list of vegies, we need to talk a bit about preparing and cooking vegetables so that we get the most out of their benefits.

Fresh vegetables is always the way to go. Frozen can work as a good 2nd choice, but forget canned vegetables. There’s not much left of all the great nutrients in vegetables after the canning process.

In preparing vegetables, always make sure your thoroughly wash them. It’s estimated that as many as 25 to 30 people touch our fruit and vegetables before we buy them in our super market. That’s form the person in the field who picked them – to the 10 people who dug through them in the bin at the supermarket before you purchased them. Have you ever watched people picking through the vegetables at your supermarket? Who buys those vegetables that the person before you looked at and put back? You do – Thats who! ALWAYS wash every vegetable you eat.

The best way to cook vegetable is to steam, bake or eat them raw. Using these 3 methods retains all the nutrients in the vegetables. If you boil them, the majority of the nutrients are leached from the food. It’s OK if you’re making soup, but if you throw those juices away after boiling vegetables, you my as well have save yourself the  time preparing the vegetable, because you won’t get any of the valuable nutrients from them.

OK, so here’s my list of the Top 10 Vegetables for Weight Loss or WLS Post-ops:

1. Any/All Green leafy vegetables – this includes ALL Lettuces, Spinach, Kale etc.
2. Cucumbers
3. All Sweet Bell Peppers (Any colour)
4. Tomatoes ( I know, they’re a fruit – but you won’t find them on my fruit list, so they have to go here)
5. Carrots
6. Green Peas
7. Yams
8. Squash
9. Sweet potatoes
10. Garlic and Onions

Now you might wonder why Broccoli, cauliflower and Brussels Sprouts aren’t on the list? The facts are, these 3 vegies are wonderfully full of vitamins, minerals, etc – unfortunately they’re also fairly gassy. Many Post-op gastric by-pass people may find they can’t tolerate these 3 vegies. The trick is to try them and see. If you can tolerate them, then you get to add them to your list.

... the insurance approval and pre-operative testing is tough. I've had test after test ... everything is checking out fine. I'm just ready to get this done.

I start working out today in preparation for surgery.

I know this is the right decision ... I really do.

I've heard stories this week of two successful 40 year old brothers who died recently of heart attacks -- scary as shit.

That's it ...

This past week or so has been very interesting in terms of the process of (i) gathering all documents for insurance approval and (ii) getting all pre-operative testing conducted. I want to lay out a few observations in hopes that they might assist others in the process:

1. Go into this experience with the mindset that you are your own advocate. A few tips:

a. Assume that all front office staff  -- receptionists, surgery schedulers, insurance coordinators -- are, at best, incredibly busy and, at worst, utterly incompetent. Do not rely on them to get your paperwork processed in an efficient and effective fashion. 

b. Assume control over the process: (i) take detailed notes -- always get the names and contact information for everyone you speak with. (ii) print and keep a detailed monthly calendar that shows the days on which your tests are scheduled. (iii) buy a large file folder to keep all of your records in and always have it with you. You will make calls from everywhere and you will need it with you at every appointment.

c. Neither be afraid to or shy about calling any physician's office as many times as you need to get your questions answered. My surgeon's front office staff did not return a series of messages from me. I typed a one page memo and faxed it to the office on a continuous loop for three hours! I set the automated fax feature of my machine and left and went to work. Suffice it to say that I received a call addressing my concerns. It seems like overkill but this is YOUR life on the line here. 

2. Understand the difference between insurance requirements and pre-operative requirements. Many of these insurance coordinators and surgical schedulers want to wait until you have every PRE-OPERATIVE test conducted before submitting for insurance approval. I posit that this is inefficient. Go ahead and submit what you need for INSURANCE APPROVAL as soon as possible so that you can receive that. Pre-operative testing can continue while you submit for insurance approval. They are two related work streams that, when conducted efficiently, have logical points of intersect. Office staff, though, will see this as extra work. Let them know that you understand the process and request that they submit for insurance approval as quickly as possible. ANTICIPATE push back; they will tell you that this is what they do for a living and that they know the ins and outs -- respond politely that you appreciate their knowledge and move on. Remember this is ultimately a business for them ... do not get tied up in emotional knots. 

3. Do your part -- go to your appointments, do not miss them. Do all of what you are supposed to do. You have to exemplary through this process. You will be called to the carpet if not.

4. Read, read, read --- all your documentation ... make certain that you understand the insurance and schedule aspects of this process. Ask questions about anything that you don't understand. Do not be shy about ASKING QUESTIONS.

OK -- that's it.

Here's how the devil works ... over the past couple days newly sleeved women have posted threads with titles like: "I want my stomach back!" and "I want my old self back." I got fed up last night and responded, very tactfully, to one of these posts. Essentially I said buck up! This is not a "quick" process. You research and prepare, in most cases, for years to get to surgery. The key is to HAVE A COMPREHENSIVE PLAN OF ACTION BEFORE AND AFTER SURGERY!!!! Map out each hour of each day from the day of surgery and the two weeks that you are on clears afterward. This should not be a friggin SURPRISE.

REALITY: YOU WILL FEEL LIKE SHIT FOR TWO WEEKS TO A MONTH AFTER THIS SURGERY!!!

REALITY: YOU WILL NOT BE ABLE TO EAT SOLID FOODS FOR A MONTH WITH THIS SURGERY!!!

REALITY: YOU WILL NEVER BE ABLE TO EAT A HOG TROUGH FULL OF FOOD AGAIN AFTER THIS SURGERY. NOTE: THAT IS WAT GOT YOUR FAT ASS HERE IN THE FIRST PLACE!

I hate excuses and people who don't take responsibility for their lives. Stop all the complaining and work that tool. There's a great verse in 2 Timothy 2:15 -- Work hard so God can approve you. That is what I seek with this tool. The key is hard work and discipline.

I am comprising a 14 day detailed schedule -- hour by hour -- of what I need to eat, where I need to be, how I need to exercise. This is not fucking game people. This is MAJOR surgery; take this shit seriously.

VSG is a tool ... period. I'm a brilliant guy; given enough time and practice I'm certain I can figure out a way to eat around it. This is a complete lifestyle change and VSG will significantly augment what I bring to the table. Have no doubt, though, that it is what I bring to the table that will ultimately determine success or failure.

I intend to begin rigorous training NOW ... I want to lose 10% of my body weight prior to surgery and get back into lifting heavy weights PRIOR to surgery. I want my body in fat burning mode so that when I get out of surgery I am in hyper drive. My goal is to CONTINUE after surgery a rigorous fat burning workout schedule. The key to my success is exercise and weight training.

I am not focused on weight. I am focused on optimum fat loss ... that is what is slowly killing me.