Tonya1263

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So- I got on the scale and low and behold I am now 206 lbs and I promised myself that 200 was the trigger point - the no kidding I don't care what is going on in your life get it together and lose the weight- trigger point.

I'm not in a panic but concerned, my low weight was 180 so this is 10% - enough to take a serious look at cause and effect and take action now.  I am going back to what worked in the past - water, exercise, protein, vitamins! 

Wish me luck!

Tonya

Apparently I have lost a few posts.  I would like to have a tantrum but too bad.  So here are a few highlights that seem to have gone missing:

APRIL 2012

Korea!  I went to the Republic of Korea to meet with a potential customer.  We had virtually no time to see anything and it was 110 degrees in the shade (literally) but it was still a great adventure.

MAY-JUNE 2012

Plastic Surgery.  I had a lower body lift (tummy/butt tuck), a breast lift and an arm reduction.  It was the most painful experience of my life.  I actually found myself saying over and over why did i do this to myself?  What was I thinking? I put my parents and sister through hell and worried my friends to death.  For weeks everyone who came to my house wanted to look at my butt to see how the incision was healing.  That said - getting rid of 16 lbs of excess skin has completely eliminated the painful recurring skin infections that have plagued me for the past year.  Now my sleeves and pants fit properly - I'm still not going to be a swimsuit model but I much more comfortable with my body. 

JULY 2012

Beach Week and my parents 50th Anniversary.  My family rented a house on Top Sail Island in NC for a week to celebrate my parents 50th wedding anniversary.  It was really great except when my brother got heat stroke and we had to take him to the Emergency Room.  It was very scary - he is overweight and I was terrified he was having a heart attack. Both my sister and I have lost weight this year and I really wish I could find a way to encourage my brother to do the same.

AUGUST 2012

New York City - my Mom told me she had never seen the Empire State Building or the Statue of Liberty so we took a day trip into the city for sight seeing and then went to see Mama Mia.  She kept up pretty well - given she's had 2 knee replacements in the past 3 years and she's 71 years old.  We had a really nice italian dinner at a little trattoria called Maria Pia on 51st just off 8th avenue (delicious and really reasonable).

SEPTEMBER 2012

Canoeing in the Adirondacks!  I went on a weekend canoe trip with a few friends.  We took 5 canoes up the Oswegatchie River including up and over 15 Beaver Dams or fallen logs.  We camped and hiked.  It was beautiful and without the weight loss over the past 3 years I would never have been able to keep up!

 

So - It's been two years since I had a Lap RNY and (as you can see in the ticker) I have lost 235lbs! Everyone tells me I look great and I know I look better but I don't see great.  I have the turkey neck and am really, really seriously pear shaped (like 10" bigger in the hips).  The panni is creating problems in the skin fold and making my ankles swell.  My butt and arms wiggle and jiggle ten minutes after the rest of me stops moving. 

SO I have decided to go and have plastic surgery.  I am scheduled for a lower body lift (an LBL for those in the know) and a tummy tuck, a breast lift, and I'm having my bat wings removed.  I am having so many "ectomies" it takes-up an entire line in the letter from the surgeons office.  I am so looking forward to not having to wear black, navy, or dark brown pants, to not have to buy long shirt tails, to always wear sleeves.  I have worked and worked and worked and I don't want to still feel fat.

I am also struggling with numbers.  I had wanted to get to 180 and I struggled to get to 185 but my body just fights like heck when I get below that.  That means my BMI is 29.8 - I am only 0.1 from obese.  I have struggled for 2 long hard grueling years to be on the verge of obese. 

My WLS surgeon tells me I am a poster child for RNY surgery and I can not hope to have done better since I bested his prediction by a bunch.  He tells me to get to the weight and shape I want I need a surgeon to remove the excess skin. SO I went for a consult with a plastic surgeon last November.   He tells me he does this week in and week out and I am an excellent candidate.  I will get the results I see in the pictures in his web site.  The real down side - 6 hours of surgery and   three weeks of time off for recovery, and 4 drains.  Still on May 11, 2012 I will go into the hospital for the third time in just over 2 years and I hope that the end result will be worth the risk, the pain, and the cost.

I deserve this and later this fall I am going to have a face-lift to get rid of the turkey neck.  Nothing extreme but I am only 50 and I look 65 or more.  I have worked really hard and I deserve to feel beautiful. 

Wish me luck!

So I have reached a final stable weight and I am now considering plastic surgery.  Is this crazy?  To put myself through 6 hours of surgery, 3 weeks of recovery, a massive expense, and the risk of serious complications -for what?
To look and feel normal. 
I have worked so hard - I go to the gym 3 times a week, I eat well (80 g of protein a day), drink my water and take my vitamins.  My blood work came back good across the board.  My blood pressure is normal and my sleep apnea is resolved.  I have lost only 10 lbs in 6 months and have maintained a stable 178-188 lbs for 3 months. I had an initial consultation with a plastic surgeon and he was extremely positive.  
I have lost 240lbs and I am 47 so the impact is pretty ....extensive. I can't wear short sleeves or tuck my shirt into my pants.  I sag and jiggle and overhang in lots of places.  I can't even handle a massage to say nothing of intimacy.  I am unhappy with my body and I have come so far to not be happy with the final outcome.
At an normal BMI I should weigh no more than 155 - which I haven't seen since junior high school.  My WLS surgeon says he thinks I am at my final weight unless I have this surgery.  The plastic surgeon said my muscle tone was good - I just need to remove the extra skin- and he can and does do that for his patience 1-2 times a week.
So I have done my research - I like the surgeon I picked (Dr. Capella) and I am moving forward with this next phase.  Wish me well.

So last week was my families yearly re-union which we usually hold at the beach. 
This year it was almost 2 years to the day of my first meeting with the surgeon who would eventually do both my gastric bypass and my lap-coli (gall bladder removal) and I weigh 230 lbs less than I did at that meeting. 
This year we stayed at my sister's house in Richmond and made an overnight trip to Virginia Beach and a day trip to Pocahontas State Park and Kings Dominion.
This year I am wearing a Size 16 bathing suit- bought from a "regular" store!  I was the healthy active one riding a bicycle up and down the boardwalk. 
This year on our day trip to King Dominion park I rode all of the roller coasters! and I figure I climbed 20 floors of  stairs in the water park.
This year I also gained almost 4 lbs on vacation (too many waffles and pizza) - unlike last year when I was still losing weight.  I did panic for a couple of days but now I'm okay.  My goal is to maintain my weight and maybe lose another 10 lbs over the next year.  Gaining a few pounds over vacation is normal - the test is my reaction to it.  So today, I bought a re-usable mug and walked to the cafe for morning coffee (which is about 0.25mi and 2 flights of stairs), walked 30 minutes at lunch, ate a healthy lunch and breakfast and I am going to the gym tonight. 
I will reduce my daily calories to 1200 and focus on increasing my incidental exercise (using the copier downstairs, printing to the far printer, taking the steps to meetings not the elevator, etc) as well as maintaining 4X to the gym a week until I have lost that 4 lbs and an additional 4 lbs for margin.  I feel much better about this response- there will be ups and downs and I need to be able to cope with them.
In the long run as long as I deal with the weight gain in a constructive not punitive fashion, understand how it did and may again happen and not beat myself up over it then it will become a positive thing and not a negative one.
Two years ago I could not have said that - I would not have believed it.  In this journey I am continuing to grow and change - this is another of those necessary steps along the way. 

So - I have debated with some people the value of having a weight goal -  I get the incredulous "if you don't have a goal how will you know when your done?"
Done?  I am not a loaf of bread in the oven - I am never done.  No matter what I weigh every day I need to decide:
What am I eating? 
What exercise am I doing? 
How much will I drink? 
Will I take my vitamins?
Yet, I have a ticker with a number on it and I am pretty close to that number.  I have enjoyed watching the little character triumphantly march down the scale.  But now I have to face it - what happens when I reach the end of the scale - what happens if this is goal? 

In my mind this is when the hard work starts because now I have to maintain my weight.  I need to balance intake with activity and I realize I have never done this before.  I have never set out to just maintain my weight.  In the past I have always been losing or gaining mostly out of control.  Now I need to find a balance. 
I have set myself up pretty well.  I have established healthy eating habits.  I'm up to about 1400-1600 calories a day at this point.  I drink 6-8 cups of water a day as a matter of habit.  My vitamins get packed and eaten with lunch each day.  I go to the gym 3 days a week and just bought a bike so I can get out more in the nice weather. 
But I fret - can I do this?  I know there are a few people who are watching me just waiting to see me gain it back so they can say I told you so.  A lot of people congratulate me on my weight loss and some of them are truly happy for me.  Some are jealous, some envious- recently I had someone ask me - what are you going to do about all that loose skin?  I told them I would much rather deal with 20lbs of loose skin than all that extra fat.
Yet I still can't face having someone touch me - I have scheduled and canceled a message three times now!  But I am going out in public in shorts and my new avatar is me in a bathing suit.  I am still clearly a work in progress but I am happy with the progress so far!   

So I have been hovering at 200.x for the last week and then 199.x and finally this morning  (drum roll please) 197.  Cheering is permitted - this is not a golf game!  I did a small dance and promised my scale new batteries for life.  I think I need a new avatar picture - maybe the one from our ski trip to Lake Placid.  I have been so much more active - I go to the gym 2-3 times a week.  I've been doing a calisthenics tape with a friend once a week, and (gasp) I meet with a personal trainer once a week to work out.  That sounds so pretentious.  A "personal trainer" ...but here's the deal I hire professionals to do things for me (and to me) that I don't have the training or skills to do for myself.  I don't cut my own hair, I don't wax my own eye brows.  I didn't do my own WLS or put down the granite counter tops in my kitchen.  I hired professionals because it is important, the results will vary based on the skills of the person performing the task, and (with proper budgeting) I can afford it. 
I do mow my own lawn (but hire someone taller than me to trim the 6' hedges), I have painted every room in my house, torn up old linoleum, and put down tile.  Because I either had the skills or thanks to a Saturday am workshop at the home depot could acquire them.  This gym thing is different though - I have been going to the gym since last October and if you look at my blogs you will see my rant on the need to work out more after WLS. I have been losing weight but not meeting my fitness goals.

So I hired a trained and skilled professional!! My personal trainer is phenomenal! 

She works with 3-4 people at the gym at work (talk about convenient and no excuses!).  I work out harder and do things I would never try on my own because she is there to tell me - it's okay here's how you start and here's how you progress.  I am stronger, have improved my balance and coordination, and my stamina too.  My weight continues to drop and now I am starting to achieve my fitness goals.  Next week I start a Zumba class - good lord what has gotten into me?
 

Post Date: 3/12/11 7:36 am
Flintstones won't cut it, folks.

The American Society of Metabolic and Bariatric Surgeons has made a series of suggestions for postoperative vitamin supplementation prior to labs dictating otherwise.

Multivitamin
- Adjustable Gastric Band/VSG: 100% of daily value
- RNY: 200% of daily value
- BPD/DS: 200% of daily value

• Choose a multivitamin that is a high-potency vitamin containing 100% of daily value for at least 100% of daily value of 2/3 of nutrients
• Begin with chewable or liquid
• Progress to whole tablet/capsule as tolerated
• Avoid time-released supplements
• Avoid enteric coating
• Choose a complete formula containing at least 18 mg iron, 400mcg folic acid, as well as selenium, and zinc in each serving
• Avoid children’s formulas that are incomplete
• May improve gastrointestinal tolerance when taken close to food intake
• May separate dosage
• Do not mix multivitamin containing iron with calcium supplement, take at least 2 hours apart
• Individual brands should be reviewed for absorption rate and bioavailability
• Specialized bariatric formulations are available

Additional cobalamin (B12)
- AGB/VSG: Not Applicable
- RNY: 350-500mcg if taken orally, 1000mcg / mo intramuscular injection
- BPD/DS: NA

Additional elemental calcium
- AGB/VSG: 1500mg /day
- RNY: 1500-2000mg
- BPD/DS: 1800-2400mg

• Choose a brand that contains calcium citrate and vitamin D3
• Begin with chewable or liquid
• Progress to whole tablet / capsule as tolerated
• Split into 500-600 mg doses; be mindful of serving size on supplement label
• Space doses evenly throughout day
• Suggest a brand that contains magnesium, especially for BPD/DS
• Do not combine calcium with iron containing supplements
• Wait 2 or more hours after taking multivite or iron supplement to take
• Wait 2 or more hours between doses
• Promote intake of dairy beverages and/or foods that are significant sources of dietary calcium in addition to recommended supplements
• Combined dietary and supplemental calcium intake greater than 1700 mg/day might be required to prevent bone loss during rapid weight loss

Additional elemental iron
- AGB / VSG: NA
- RNY: Minimum 18-27mg / day elemental
- BPD/DS: Minimum 18-27mg / day elemental

• Recommended for menstruating women and those at risk of anemia
• Begin with chewable or liquid
• Progress to tablet as tolerated
• Dosage may need to be adjusted based on biochemical markers
• No enteric coating
• Do not mix iron and calcium supplements, take at least 2 hours apart
• Avoid excessive intake of tea due to tannin interaction
• Encourage foods rich in heme iron
• Vitamin C may enhance absorption of non-heme iron sources

Fat-soluble vitamins
- AGB / VSG: NA
- RNY: NA
- BPD/DS: 10,000 IU of vitamin A, 2000 IU of vitamin D, 300 mcg of vitamin K

• With all procedures, higher maintenance doses may be required for those with a history of deficieincy
• Water-soluble preparations of fat-soluble vitamins are available
• Retinol sources of vitamin A should be used to calculate dosage
• Most supplements contain a high percentage of beta carotene which does not contribute to vitamin A toxicity
• Intake of 2000 IU vitamin D3 may be achieved with careful selection of multivitamin and calcium supplements
• No toxic effect known for Vitamin K1, phytonadione (phyloquinone)
• Vitamin K requirement varies with dietary sources and colonic production
• Caution with vitamin K supplementation should be used for patients receiving coagulation therapy
• Vitamin E deficiency is not prevalent in published studies

Optional B complex
- AGB / VSG: 1 per day
- RNY: 1 per day
- BPD/DS: 1 per day

• B-50 dosage
• Liquid form is available
• Avoid time released tablets
• No known risk of toxicity
• May provide additional prophylaxis against B-vitamin deficiencies, including thiamin, especially for BPD/DS procedures as water-soluble vitamins are absorbed in the proximal jejunum
• Note >1000mg of supplemental folic acid provided in combination with multivitamins could mask B12 deficiency

 

So - I have now officially lost 50% of my starting weight and now weigh less than I have lost (I started at 421, I've lost 211, I now weigh 210 lb).  I now weigh the same as my best friend.  Half the weight - twice the woman - So why am I not happier?  I am holding off to celebrate one-derland I guess.  I have already booked a Caribbean Vaca to celebrate my 1 year anniversary.  I know I will be under 200 by then.  I am really looking forward to walking on the beach, snorkeling, diving for sand dollars, riding a bicycle. It will be warm and sunny and sandy.  See its just the cold and gray getting to me - maybe I need a SAD lamp.

You know you are setting yourself up to fail with that attitude.  Exercise does not have to be a chore!  I started a regular fitness routine 6 months before my surgery.  I had never had a regular routine before that- ever.  But I decided if I was going to put my life at risk with this surgery I was going to do everything I could to reduce the risk and improve the outcome from my surgery.

 I went to the local YMCA and signed up for a water aerobics class.  The class had older and larger people in it - I felt at home.  The water reduces the stress on your joints, keeps you cool, and controls your heart rate.  Because of that you can exercise harder and longer when you are just starting out.  I LOVED IT and I still do.  16 months later and I still do the class, plus 40 minutes on the elliptical, a Pilate's class once a week and now I am cross country skiing on the weekends.  When I was heavy I fell down a lot and broke my ankle, dislocated my knee- I felt trapped in a giant unmovable body.  As I have lost weight I have gained strength, flexibility, coordination.  I enjoy my fitness routine- and it is a routine. I do it like I brush my teeth and shower - it is part of my life.  I work full time so I have to be flexible - we had snow and ice here this week so I skipped the water aerobics (a 20 minutes drive) to use the elliptical here at work.  Sometimes I need to be at home (work men or whatever) and I put in a DVD and play on my WII instead. 
Over time - I have noticed I feel better when I exercise, I am less stressed and happier when I work out.  But you don't get that by deciding you hate something and you are going to force yourself to do it.  You get that by finding something you enjoy doing, by allowing yourself to take pleasure in it even if you can't do it perfectly, and by being patient and persistent.
I tried Yoga and it wasn't for me - but I did it for 8 weeks to give myself a chance to experience it and the improvements I would see in doing it.  I'm  thinking about a low impact land based aerobics class - maybe in a Zumba class as I progress and get stronger, more flexible and more coordinated. 
I am planning to buy a bicycle this spring and go on a bicycle touring vacation this fall in New England.  last year we went to the beach - I walked for miles!  picked up shells, swam, walked up and down the steps.  All because I was getting healthier and stronger everyday that I was exercising.
Th other thing - if you do a regular fitness routine you will see measurable progress.  I started at 6 minutes on the elliptical at a snails pace.  Slowly over time I have increased that to level 5 and 40 minutes - I burn 500 calories 2 or 3 times a week doing the elliptical.  The pride you feel in seeing yourself get better over time- it's really really good. 
And the stamina and strength you gain - do you have kids or a hubbie?  You can now go for walks, runs, rides, hike or bike in the summer.  If you are out of shape you will not enjoy it - but if you have a regular fitness routine you will be able to enjoy it and the people with you.
I know this is really long but I feel passionately that exercise is a critical part of this process and sometimes it gets ignored.