Pam T.

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Here's a list of the WLS blogs I stalk regularly.  Let's not even talk about all the non-WLS blogs I stalk, we don't need to go there.  LOL!  I keep track of all my blog subscriptions using www.bloglines.com -- that way I only need to visit a single website and can read them all in one place. 

My blog link is in my siggy if you care to stalk me.  :-)

http://theskinnyonmechele.blogspot.com/ 
http://lovelybigloser.blogspot.com/ 
http://amy-amysjourney.blogspot.com/ 
http://lookingforward73.wordpress.com/ 
http://www.airdefendersfamily.net/blog
http://www.obesityhelp.com/member/djwood/uzone,blog/blog_id,131917/
http://rjsdadrecipes.blogspot.com/
http://transforming-aj.blogspot.com/
http://www.obesityhelp.com/member/gonnadoit/uzone,blog/blog_id,126418/
http://www.obesityhelp.com/member/lithia/uzone,blog/blog_id,112097/
http://lovinlifewithlea.blogspot.com/
http://signgurl.blogspot.com/
http://sunshinesheart.blogspot.com/
http://theworldaccordingtoeggface.blogspot.com/ 
http://www.obesityhelp.com/ohblog/ 

Holy cow!  That list seriously looks like an addiction!  Good thing all those people don't post on their blogs everyday or else I'd be spending way too much time in the blog sphere!

Pam

  Imagine my surprise when I stepped on the scale this morning and saw 199.4. I had a full 3 pounds to lose this week to reach that goal and I hadn't lost 3 pounds in a week since my first month after surgery. Wow! I finally hit the 100-pounds-lost mark!  
 
A month ago I'd set the goal to be down 100 pounds before the Crim. The Crim Race is just 4 days away and I've hit the goal in the nick of time!

I posted this a while ago over on the Michigan Forum when someone asked about how the pouch could possibly work for the long term.  Thought it might help here too.

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Your original stomach (before surgery) could hold up to 4 liters of food (that's 16 cups!!).   Your new pouch at the time of surgery was about 1oz and could hold about 2oz of food.  Your surgeon made your pouch out of the least-stretchy part of your stomach, so it's difficult to stretch it. 

BUT...

Our pouches will GROW over time.  Yes, it's a living organ and your body tries to compensate for the rearranging we did to it and it will grow to help get in as much nutrition as possible.  A mature pouch is anywhere from 6oz to 9oz in size... and can naturally stretch to hold up to 12oz of food at a time.  A pouch reaches maturity at about the 2-year mark.  By 6 months post-op your pouch has grown to about 2/3 of it's maturity level.   You're nearly a year out.  So your pouch is no longer 1oz in size ... it's more like 3oz or 4oz right now. 

Studies have shown that the size of your pouch has very little to do with your overall success with weight loss.  Your success has more to do with how well you follow your eating and exercise plan and how well you follow the "rules of the pouch." 

Also remember that your body immediately begins to compensate for the surgery.  Once your body realized that a portion of your instestine has been bypassed and you aren't absorbing all the calories you're eating, it begins to figure out how to become more effecient.  Your intestines grow additional cilia along the intestinal wall -- the little fingerlike tenticles that grab nutrients/calories as food passes by.  No, we won't ever replace those first 100-150cm where various vitamins are absorbed, so we'll always malabsorp nutrients.  But the body figures out how to absorb all the calories we eat eventually.   By the 2-year mark you're likely absorbing every single calorie you eat.   (This is also the case with DS folks too!)

As for not feeling full -- that's perfectly normal.  The nerves in our stomach were cut during surgery.  These are the nerves that signal to our brain when we are full/hungry/etc.  In some people those nerves repair themselves as early as 3 months post-op, but for others it might take 18 or 24 months for them to start working again.  And often they don't have the same "signal strength" as they once had before surgery.  So that's why it's so important to always measure/weight the food we eat. 

By ALWAYS following the rules we were given we will always be able to effectively use the tool we have.  NO drinking with meals -- that's a big rule that so many people get lax on the further out they get.  I have a post in my profile about why its so important to follow this rule.  Once we fall back into that bad habit, we have basically rendered our tool useless.  But once we stop drinking with meals... we realize the pouch tool still works just fine.  And that's just one of the rules we follow.... gotta keep them all at the top of our list. 

So yes, I firmly believe the tool continues to work for the rest of our lives.  As long as we protect it and be kind to it.  But by understanding that it grows, matures and changes is very important when you have to adapt your behavior to what's going on inside your body.

Sorry.. this kind of turned into a long rambling post.  But I hope it helps a bit...
Pam

I often see new members here on OH ask about how they can prepare for surgery.  Either what to buy or what to do while they are waiting for insurance approval. Or even after you have a surgery date, but still need to wait a month or two before the big day arrives.

I answered one such question this past week, so I thought I'd repost it here so I don't lose all that valuable typing time. (grin)

______________________________

It took me about 18 months to get approved after I started the process (which is a pretty typical amount of time) -- this is what I did:

* Read, read, read and read some more. Read every profile you can get your hands on here on OH and every book you can get your hands on about WLS. WLS for Dummies is a great place to start when it comes to books. And you're welcome to read my profile on OH or my blog too.

* Research your butt off! Learn everything you can about how your digestive system works, what your body does with different macronutrients (protein, carbs, fats), what happens after surgery to our system and how it processes medications, how certain vitamins and supplements effect your body, why certain supplements are better for us than others (i.e.: iron and calcium citrate vs. carbonate), the differences in types of exercise and what is best for your body type and how you want your body to burn energy (i.e.: burning fat and not muscle for energy). Also research multi-vitamins to find out which one is best for you based on nutrition and the way it's produced (look for the USP symbol). The links in this paragraph point you to some of the research I've done for myself or websites that'll help you dig deeper.

* Start a WLS Binder. I have this great binder where I keep all my information about my own personal WLS. I have a copy of my medical records; a listing of all my current medications (including dosage, prescribing doctor, reason for taking it, etc.); a list of contact info & phone numbers for all my doctors, the pharmacy I use, my insurance company's customer service line, etc; my personal reasons for wanting WLS and a list of my goals. I also have a copy of all the paperwork my surgeon's office gave me including the checklist of requirements I needed to fulfil before surgery; letters from my insurance and PCP; my 12 month diet documentation paperwork, etc. I also keep a copy of the eating plan and all the sample menus from my nutritionist. I keep my weight loss chart and measurements chart in this binder. Each section is concise and well organized. I take this book with me to all doctor appointments and keep it on my kitchen counter for easy access and reference. I call it my WLS Bible.

* Start collecting recipes. Eggface's blog is a good starting point. Charlie and Lea have great blogs/sites too. I put all my favorites into a binder that I refer to often and keep on the bookcase in my dining room with the rest of my cookbooks.

* Clean house. Clear out the pantry and cupboards of any foods you won't be eating after surgery (or shouldn't be eating before surgery while trying to lose weight). Give it all to family members or a food bank -- get it out of the house. The sooner you get rid of temptations the easier it'll be to stick to your pre-op diet plan.

* Take a critical look at your dishes. I got rid of my huge pasta-type bowls and other dishware that promoted over-sized servings. I then started shopping around for some new dishes that were pretty, smaller and something I'd enjoy eating off of. This is the set I decided on - but instead of buying the big dinner plates and bowls... I bought sets of salad plates and dessert size bowls only. I bought these for myself after I was approved for surgery as a congratulatory gift to myself for dealing with all the insurance hoops. And then I didn't start using them until after I came home from the hospital after surgery. They're pretty and make me happy when I eat off them and it reinforced the fact that I'm completely changing my way of eating -- not only is the food different, even the dishes are different.

* Consider your disposable dishes too. Protein shakes are messy and make washing glasses very difficult if you don't rinse them right away. I also have my protein shakes on the run most often -- and leaving a glass in the car all day is a pain in the butt. So I opted for disposable plastic glasses for my protein shakes. Makes my life easier. I also opted for disposable plastic storage containers --- the 6oz kind with a lid. You know those little plastic containers you get for to-go salad dressing or cole slaw from a restaurant... that's what I bought. When you open a can of something (soup or whatever) you won't be able to eat it all. So why not store the leftovers in individually portioned containers so it's easy to grab something for the next meal. BUT -- at the end of the week you're going to have dozens of those stupid leftovers and you aren't going to feel like washing dishes. So it's easier to just toss the whole bowl instead of washing 20 tiny tupperware bowls every week. I had enough to worry about in the early days after surgery, I didn't want housework to be one of them.

* Find a support group and start attending. An in-person group is the most important thing I've done for myself. The information shared at a peer-to-peer support group is invaluable. You hear what others are struggling with and the suggestions they receive from other members. This is real-life stuff here! I've made some great friends and have been able to help others with my story and experiences. I learn something every single time I go to a meeting. I attend 3 different support group meetings each month and wouldn't give up any of them.  Online support groups like OH are fine, but nothing compares to attending one in person.

* Protein Powder. If you're doing high protein dieting right now, you're going to want to find a protein shake that you like now, before surgery. Definitely expect that flavor to not work after surgery, but at least you'll have the chance to get into the habit of shakes in your meal planning. Once your surgery date gets closer, you can order some samples of protein powder that you can use after surgery -- finding the right protein powder for you is a huge game of experimentation.

The more knowledge you have about how things will be after surgery, the more successful you'll be for the rest of your life. Knowledge is power!

~Pam

Sometimes understanding WHY we have to do something (or not do something) helps us follow the rules.  Here's the low-down:

Before surgery you had the pyloric valve at the bottom of your stomach to keep food in the stomach while is began the digestive process.  As food was digested and ready enough to be released into the intestine, the pyloric valve (a trap door really) would open and let a small amount of food out of the stomach and into the intestines.  Digestion would continue, the trap door woud open and a bit more food would be released.  And on and on...  This process can take 2 to 3 hours in a normal stomach.   AFTER RNY we have to mimic this action manually and the only way to keep food in our pouch (which is basically a funnel now with no trap door) we have to eat dense foods and not mix it with liquid.  The denser the food, the longer it can stay in the pouch.  The minute you add water to the mix, you are creating a "soup" that will quickly empty out of your pouch. 

About 40% of the digestive enzymes our food needs to be broken down is contained in our saliva.  Which is another reason why need to chew, chew, chew really well.  Once food gets to the pouch, those digestive enzymes go to work on the food to begin breaking it down.  Our pouch doesn't churn as much as our old stomach used to, but there is still some movement with that well chewed food.  The longer it stays in the pouch, the more it is broken down and prepared for the intestines to do their work of grabbing nutrients from the food.  If we wash the food out too quickly, the intestines can not absorb the nutrients from the food we eat because it passes too quickly undigested.  (This can also increase the risk of constipation and intestinal blockage.)

Of course with your pouch being empty you'll get hungry sooner.  For new post-ops, this isn't necessarily a big issue because the hunger hasn't returned.  But for those further out, the hunger can be ravenous and you want to keep food in that pouch for as long as possible.  that's why it's recommended that the further out you are, the longer you wait to begin drinking after meals (60-90 minutes). 

SO... besides all that there's the risk of stretching the stoma (the opening between the pouch and intestines).  If you have dense food that has not begun to be digested in the pouch and you drink water you are FORCING that dense food to be pushed through the stoma prematurely.  That opening is only about the size of a ladies index finger, but if you push food through the opening before its ready to go, you'll eventually stretch that opening.  This is FAR more worrisome than stretching your pouch.  Once it's stretched it can become the same diameter as the pouch itself... essentially creating one big long tube that food can be packed into at meals.  Basically a 20-foot long stomach. 

It is NOT a scare tactic.  This is about biology and medical science.  You have to manually do the work of the pyloric valve now that you don't have one.  It's also about preparing your food in a way that will allow your body to absorb as manu nutrients that are vital to our survival.

Pam

I posted this message on my blog back on July 13th and just realized that I didn't update my profile here on OH... so I'm copying this post to here. 

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Today marks my 8-month mark. Wow! Eight months. I can't believe it's been that long. Wasn't it just last week that I was coming home from the hospital or doing my first weigh in? Time is going so fast.

I've lost 93 pounds. I started this journey at 299 pounds and I'm about to cross that threshold into the 100's. I'm just 6 pounds away from another 25-pound reward. How exciting. But there are some days I can't seem to wrap my head around those number or the dramatic changes I'm seeing in myself.

I'm 2/3 of the way to my goal weight. I'm 100% at goal for my health issues and feel great about my progress and success with getting healthy. I'm still working on my "Character Goals" and will update you on my progress in that area soon. Today begins my quest for better emotional health.

But ...

Here I sit on the 8th month anniversary of my WLS and I am misbehaving. I ate cookies today. Yep, you read right. I actually bought chocolate chip cookies on purpose - 3 of them - and ate every single crumb. I've also eaten too many snacks today including popcorn, a Skinny Cow ice cream sandwish and a rice cake. Not that those snacks were bad by themselves... but all in one day at unscheduled snack times makes them bad.

I'm at my calorie limit for the day, but not at my protein goal yet. Nice job, Pam. Idiot. And I still have to figure out what to do for dinner. Gonna have to be pure protein, right?

"Tomorrow is a new day with no mistakes in it."

One of my favorite quotes from Anne of Green Gables. Guess I need to take that advice to heart and not beat myself up too badly over today's mistakes.

~Pam

1.  Studies show that drinking diet soda can actually lead to weight gain.   Drinking ONE soda per day increased your risk of obesity by 1.6 times.  Here's the research:
http://www.abcnews.go.com/GMA/OnCall/story?id=4271246&page=1

2. diet sodas (as well as some flavored bottled waters and bottled teas) contain high levels of phosphorous.  Phosphorous is known to leach calcium from your body which can lead to osteoporosis.   After WLS we obviously malabsorb calcium in our altered digestive system, so we don't need anything else in our diet that is going to suck away nutrients.

3. Many surgeons believe that the carbonation (even if you let it go flat) will cause the pouch to stretch.

Also here's an article that might change your mind about your addiction:
http://www.waterforlifeusa.com/blog/uncategorized/8-ways-sod a-fizzles-your-health/

A lot of people swear by the New Whey Protein Bullets.  but from my own research I am not thrilled with the quality of the protein it provides.  Here's what I know:

Ingredients in New Whey Protein 42g
67.4% pure deionized water, 31.5% Actinase (patent pending blend of enzymatically hydrolyzed collagenic protein isolate, whey protein isolate and caseine protein isolate), less that 2% of malic acid, vitamin c,b3,b5,b2, b1, folic acid, biotin, and b12, natural flavors, sucralose, blue-1 and red 40.

As we know, the highest percentage of ingredients are listed first, with lesser amounts listed last.  So we know that of that 31.5% of protein mixture the highest amount of protein would be Collagen Protein.  Next is Whey Protein Isolate, then Caseine Protein Isolate.  Let's look at each one:

Callagen Protein:
This is the main protein of connective tissue in animals and the most abundant protein in mammals, making up about 25% of the whole-body protein content.  When broken down, collagen becomes a gelatin used in many foods such as Jell-O type desserts.  It’s also used in cosmetics, pharmacology and photography industry for the production of various products. Collagen and gelatin are poor-quality protein sources since they do not contain all the essential amino acids that the human body requires - they are not complete proteins.

Whey Protein Isolate
This is the highest quality protein currently available.  The BV rating is often shown at 110-159 because the BV scale was devised before Whey Protein Isolate was developed and the scale is based on the perfect protein of an egg.  This form of protein has the highest biolavailability of any other form of protein.

Casein Protein Isolate
Casein is a slow-digesting protein source that actually forms a "gel" in the stomach and slowly releases it's amino acid components over several hours after ingestion.  This slow release can last up to 7 hours (for comparison: Whey is released within 40 minutes).  Casein is derived from milk - same protein source as if you drink a glass of milk.  My concern though with this source is because it is concentrated and process to be slow-digesting, the Casein Protein Isolate may actually leave our altered/shorter digestive track before it has a chance to release all of the amino acids it contains.

And just a side note:  The words "enzymatically hydrolyzed" don't really mean much.  Enzymatically just means it's a "variety of protein enzyme sources" and hydrolyzed just means that the protein has been "broken down" into it's basic amino acid component.

So basically with those $3.50+ protein bullets you're paying for 68% water and 32% of a low quality combination of protein (with a little bit of good whey protein thrown in for good measure). 

I personally would rather feed my body the high quality Whey Protein Isolate that is proven to be the best for my body, will be processed in less than an hour in my shorter intestines and allow me to use every single bit of what I'm drinking and not waste any protein.

HTH
Pam

It's a pretty common question on the forums.  People want to know if they should buy the  Magic Bullet or just a regular blender.  My answer is always the same, so figured I'd post my latest answer here.

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Right after surgery I bought a Magic-Bullet-Like blender.  HATED IT!   I took it back to the store.  Why?  Because my food was trapped inside that silly little blender cup.  If I needed an extra ice cube or an extra splash of water, I had to disassemble the whole thing, add my stuff, then reassemble it again to blend again.  What a PITA.  Plus the cups are so small that you can't do much more than make a protein shake or blend up little batches of stuff.  So I'd need an additional blender to do the normal cooking stuff too. 

So I just used my regular old 15 year old blender for a few months.  Then it finally gave up the ghost and I broke the jar.  Hey, it was 15 years old, I got my money's worth out of it. I knew I wanted a full sized blender because I use my blender for more than just making protein shakes and I didn't want a little shake maker AND a blender on the counter all the time.   So I went in search of a good blender.

I found the Oster Fusion. 

Wow! I love this thing!  It's powerful and cuts through ice cubes like butter.  It also has some food processing features to do chopping.  I bought it at Wal-Mart.  But then I found out I should have bought it on the Oster website.  Buying it on their website gets you a whole package of goodies.  The normal blender jar, a food processer bowl with different blades and a shake cup (like a bullet one) .  For the same price I paid in the store.  So if you buy one, definitely get it on the website.  Here's the link: https://www.jardenstore.com/shoppingcart.aspx?bid=5

This is one of the best purchases I've made since surgery.  I use it nearly every day.  :-)

Pam