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Many post weight loss surgical patients deal with blood sugar fluctuations, particularly those of us whom have had roux en y gastric bypass.  Aside from dumping, we often have a blood sugar reaction after dumping -- and sometimes without -- called reactive hypoglycemia.  

Nutrition for Reactive Hypoglycemia -

via http://www.mckinley.illinois.edu/Handouts/hypoglycemia_nutrition_reactive.html

What is reactive hypoglycemia?

Reactive hypoglycemia can occur when blood glucose falls, stores of glucose from the liver are exhausted and an individual chooses not to eat. The body gradually adjusts to this situation by using muscle protein to feed glucose to brain cells and fat to fuel the other body cells, but before this adjustment takes place, an individual may experience symptoms of glucose deprivation to the brain. Symptoms such as: anxiety, hunger, dizziness, confusion, sleepiness, weakness, shaking muscles and racing heart may result. Most of these symptoms diminish five to ten minutes after eating a source of carbohydrate. Because these symptoms are common to many conditions, a health care provider should be consulted to assess an individual’s specific symptoms and concerns.

via http://www.mckinley.illinois.edu/Handouts/hypoglycemia_nutrition_reactive.html

Who is affected by reactive hypoglycemia?

Reactive hypoglycemia occurs in about 2-3 out of every 10 young women - more often in obese women and less often in people over age 45. While most people experience low blood glucose levels at times, if the symptoms are severe or ongoing it is important to learn to eat a balanced meal or snack promptly. Reactive hypoglycemia does not lead to more severe conditions.

How can I control reactive hypoglycemia?

Reactive hypoglycemia can be managed with:

• Nutritionally balanced meals
• Frequent meals and snacks
• Regular exercise
• Smoking cessation
• Weight management
• Medical supervision, if indicated
• Regular blood sugar checks, if advised

How can reactive hypoglycemia be controlled with nutritionally balanced meals?

When blood glucose falls, eating carbohydrate foods can bring blood glucose levels back up; a meal or a snack must be eaten. Some people believe the obvious solution is to eat a candy bar or drink a cola beverage. Such a meal or snack is very high in carbohydrate, and consists mostly of simple sugar. It may cause your blood level to rise quickly and then fall quickly. Some people then experience the symptoms of rebound hypoglycemia.

A more helpful choice is to eat food with complex carbohydrates (higher fiber whole grain crackers, bagels, breads or cereal). Complex carbohydrate foods deliver glucose over a longer period of time, eliciting less of a rise and fall in blood glucose. A cracker or other grain food with cheese or another protein/fat is the best choice. The protein/fat slows down the digestion of the carbohydrate and keeps blood sugar more stable.

Some snack and meal suggestions that meet the goal of including a complex carbohydrate, a protein source or a fat include:

• Meat or cheese sandwich on whole wheat bread
• Yogurt and fruit
• Cottage cheese and whole grain crackers
• Turkey, cheese slices and veggies on a salad
• Salad with beans or nuts added
• Peanut butter and whole grain crackers
• Cheese and whole grain crackers
• Bean soup and whole grain crackers or bread
• Cheese on baked potato with skin
• Whole grain bagel and cream cheese

Nutrition tips to manage hypoglycemia

• Eat a small meal or snack about every 2-3 hours. Skipping meals can make symptoms worse.
• Choose high fiber foods at each meal and snack.
  Fiber helps stabilize blood sugar. Increase fluid intake when you increase fiber intake.
• Eat a source of protein and or a source of fat with carbohydrate at each meal or snack.
  Protein and fat eaten with carbohydrates will help slow glucose release and absorption.
• Limit simple sugars. (candy, soda, fruit juice, sweets).
  Simple sugar intake can make hypoglycemia symptoms worse. Moderate your intake.
• Limit alcohol and caffeine (coffee, tea, soda, chocolate).
• Eat a meal or snack 1-3 hours before exercise.
  Extra carbohydrates may be needed before exercise to compensate for energy used.
• Nutrition for Reactive Hypoglycemia

Well, hello there protein.  How have you been?

From - http://www.meltingmama.net/wls/2012/01/bariatric-advantage-high-protein-meal-replacement-in-chicken-broth.html

I'm in that precarious spot that I seem to find in the winter.

Hibernation mode.  (It happens.)

I have gained a few pounds -- about 5-7 lbs -- which triggers my internal post WLS alarm that SCREAMS "CUT IT OUT!  You know better, woman!"  Weight gain sparks me to pay attention to what I am doing each day.  

What have I DONE to cause this?  What has slipped into my routine that wasn't there before?  

It's pretty clear this time, but I refuse to allow it to get out of control.  (That is another post.)

What do I DO about it?  OMG! SCREAM?!  Freak out on Facebook!?  No.  For me, cutting back a little is easy-peasy.  I may replace a few excess calories with protein shakes -- for one thing.  (See also:  biting off my husband's head for the baking of the sweet-carbs!)

Today I cracked open a container of Bariatric Advantage's High Protein Meal Replacement in Chicken Broth flavor.

WAIT.  KEEP READING.  Don't you go clicking away 'cause you done think hot protein is ewwyucky!  You might have had a Bad Experience With Another Savory Protein Brand, but hear me out.

It's good.  Really.  

I opened the container, assuming I'd be too distracted with the protein smell to go ahead with the taste-test, but that didn't happen.  Score one.  The protein powder is a very light yellow color with specks of what appears to be the tiniest herbs you have ever seen.  It smells like chicken boullion powder or cubes, and a bit of whey protein.  My nose was not offended, I carried on.

I added two scoops of the powder for 150 calories and 27 grams of protein, to a BlenderBottle near-filled with water warmed in the microwave.

 I allowed the water to cool just slightly -- in case of protein malfunction.  The water was nice and warm when I added the protein and BlenderBall.  I shook it very, very well.  Again, a reason to NOT OVERHEAT YOUR WATER OR YOUR PROTEIN.  

What resulted was a slightly creamy chicken protein soup.  Due to the fact that it's a protein replacement -- it's not entirely clear like typical chicken BROTH.  It tastes just the same:  creamy chicken boullion.  There is zero aftertaste of protein, and I am very pleased.

To be honest - however - I had prepared a little bit of chicken boullion to ADD to this protein replacement JUST IN CASE I did not enjoy it.  (Because, I haven't always had a good experience with savory proteins -- and I do not like to waste.)  

I added a touch of the broth after a few sips, and it was A FREAKING AMAZING with it.  That said, I am a salt-fiend.  I adore the creamy, buttery flavor of a boullion cube, and that mixed with the protein, kicks arse.

I love you chicken high protein meal replacement.  

The details -- you get 27 grams of protein and 5 grams of fiber in one two-scoop serving of this meal replacement:

BA-

High Protein Meal Replacement soup comes in a 21 serving tub with a measured scoop to make accurate dispensing easy. Each 150 calorie serving provides a full 27 grams of protein, with only 7 grams of carbohydrate (of which 4 grams are fiber, and less than a gram is sugar) and 1.5 grams of fat. One hundred percent of the protein is from a high quality whey protein isolate (There is no soy protein, only a small amount of soy lecithin to mask aftertaste). Fortified with between 15 and 50 percent of the DV for 23 essential vitamins and minerals, this comforting soup makes a perfect meal replacement for those seeking to control calories.

They're right.  It's good.  It's good for us.  

I would certainly give it a try if you're seeking a savory option to your sweet or fruity shakes.  This product is perfect for pre-operative eating plans, and early post op.  It's way better than a can of cream of chicken soup.

• Price - $2.85 per serving
• Pros - 27 grams of protein, 150 calories, 5 grams of fiber... in a comforting, savory broth blend.
• Cons -   
• Rating - Pouchworthy, ^MM
• From - http://www.meltingmama.net/wls/2012/01/bariatric-advantage-high-protein-meal-replacement-in-chicken-broth.html

I remembered something I saw on Pinterest recently and didn't want to look it up, so this happened sans directions.  The typical recipe contains TOAST as the base of the bacon and egg cups.  This is the low carb MM version this morning.  ;)  I won't tell you that I totally ate my on TOP of a slice of bread, because I didn't, did.  ;)

• Bacon slices
• Eggs
• Salt and pepper
• You could also add herbs - chives, scallions, onion?   I used a tiny bit of onion, salt, pepper, oregano, and added a tiny bit of shredded cheese. Next time I plan to use shredded spinach and feta cheese.

1. Cut bacon slices in HALF.
2. In a large skillet, cook bacon over medium, until almost crisp. It will continue to cook in the oven.  (Or bake it in the oven until half-cooked...)
3. Lay bacon slices in X's in the muffin cups and crack an egg over each. 
4. Alternatively, beat eggs to make scrambled egg cups (I did both...)
5. Season with salt and pepper. 
6. Bake until egg whites are just set (or scrambled eggs are puffed and slightly browned...)
7. Run a small knife around cups to loosen bacon pieces that might have overlapped... and make a valiant attempt at popping up the eggs.  It worked, almost!  

My 600 Pound Life - Melissa

While I don't normally watch "weight loss" shows, I tuned in to My 600 Pound Life on TLC last night. In fact, I recorded it.  *See this post for her "after.."

Why this program, and not others?  For one - My 600 Pound Life features super morbidly obese persons whom lose weight via surgery.  And?  I was also a super morbidly obese woman, who lost weight with the aid of a surgical procedure.  Regardless of size difference, there IS a level of complete understanding of the process.

"TLC's My 600-lb Life follows four individuals--Melissa, Donald, Henry, and Ashley--over the course of seven years as they struggle to go from weighing over 600 lbs. to being at their ideal weight. Their journeys begin with gastric bypass surgery, which allows them to start losing weight."

 Melissa, the 31-year-old woman featured last night, had much more weight to lose than I can even fathom carrying on my body.  I said to my husband -

"That's like me -- at my highest weight -- carrying you at your highest weight -- on my back."  

I cannot even begin to describe what it might feel like to be 600 lbs or better.  Dealing with 600 lbs of body is beyond my understanding -- but somehow  -- I still get it.  Also, she had the same surgery as I did, the gastric bypass.  She also had surgery around the same time my husband and I both did more than seven years ago.

Prior to her surgery, the video clips were heartbreaking.  I am sure she was a full on spectacle just going to the grocery store with a cameraman.  I know it was a TV show, and it was supposed to be dramatic, but being 600 pounds brings the drama. 

 It’s true -- people ARE cruel, people DO stare, people DO say things.  I can remember back in the early 2000’s when I had two small toddlers at home, my next-door neighbor would casually walk by and call me a cow, and “moo” at ME.  And, I was “only” 320 pounds.  “Only” 320 pounds and taking care of my personal business – which when you are morbidly obese – apparently becomes everybody ELSES business.  My husband was taunted at work about his size, he was “only” 375 lbs, and he was pushed so far that we ended up in a weight loss surgery seminar.  (That’s how all of this began!)

Why does a random onlooker give a single gram of fuck about you taking care of your home, your children, or your grocery shopping at the store?  Morbidly obese people immediately become a sideshow at times.  You might recall what it feels like to be stared at in the aisles of the grocery store – or to have your cart analyzed by other shoppers.  Have you ever been to the store while shopping with your overweight spouse – or GASP! – What if you have overweight children?  Your grocery cart choices are somehow – PUBLIC DOMAIN.  “Can you believe that fatty is buying frozen dinners?  Doesn’t she care about her kids?” I would gather that many of us have been there.  You want to fall into a hole in the floor, just like Melissa on My 600 Pound Life described. 

Maybe that’s why I can empathize – I have been there too? 

Later, as she’s losing weight dramatically and dealing with some of her food demons, I had the urge to climb through the screen and had to realize that it was filmed many years ago. 

Watching the plastic surgery for her massive skin excesses is something I have not dealt with firsthand, but I watched as my mother in law had numerous skin-removal procedures and plastic reconstructive surgeries and failed to heal properly like Melissa.  I also played nurse for my husband who had a panniculectomy and thighplasty with smooth sailing and quick healing.  Admittedly, my mother in law’s plastics horror story has scared me away from having my own procedures done.  Watching Melissa on the show just brought back the drama of broken plastics.  But, it’s real, it can happen.

And then, Melissa hits her low weight post-surgery.

You can FEEL her BOUNCING OFF THE SCREEN in the true post-massive weight loss honeymoon stage.  She is in a word that I LOATHE:  “Uh-MAAAAAAZING.”  She’s got on colors and form-fitting clothes, and she’s working for the bariatric surgeon!  Life is wonderful and we love our newness!

The Consumer Guide To Bariatric Surgery says, “After years of fighting the battle of the bulge unsuccessfully, this dramatic weight loss may also be quite energizing and empowering. It is often called the “honeymoon phase.”  You may feel that the battle has been won forever. This can set you up for depression down the road if you do regain weight. What further complicates this is that those who experience weight regain after bariatric surgery often feel shame and humiliation, preventing them from seeking professional help for their depression.”  

For someone like Melissa who had not just 100 excess pounds to lose but, more than 450?  Her honeymoon period was likely exaggerated – perhaps she’s got what many of us HAD – but times three.   You can feel her happiness – and absolutely expect a crash later on.

 And, crash she did.  A few times.  I can relate to a lot of it.

It happens,  bodies get tired, overworked and sometimes malnourished, and brains often get overwhelmed.  Weight loss cannot fix what's in our heads.

PubMed -

"The anatomic and physiological changes resulting from bariatric surgery can affect both nutrition and psychological attitudes. Modifications of the gastrointestinal tract lead to a diminished ability to absorb nutrients, electrolytes, and bile salts, as well as deficiencies in iron, calcium, and other vitamins and minerals. Dehydration, lactose intolerance, and protein calorie malnutrition are other common sequelae. Alterations in bone metabolism increase long-term risk for osteopenia and osteoporosis. Noncompliance with postsurgical nutritional regimens has been estimated to occur in from one third to almost two thirds of cases and can exacerbate these complications. Psychological issues are often present in patients with morbid obesity and can affect surgical outcomes. These issues include mood and personality disorders, destructive eating behaviors, and poor body image. Nearly one third of patients undergoing bariatric surgery also have a history of substance abuse disorder. The literature suggests that although the mental health of patients improves as a result of bariatric surgery, the benefits may be transient, and problems such as negative personality profiles, detrimental eating patterns, and negative body image persist to some extent. Identification of presurgical psychiatric problems can help identify those patients more likely to achieve lasting weight loss when surgery is combined with long-term follow-up to minimize medical and psychological complications."

Like many of us – life happened.  This is where we reiterate that Weight Loss Cannot Fix You.

Weight loss cannot fix your brain, your spouse, your family or anything other than making it physically easier to deal with those things.  I think you need to watch the episode to really GET this, if you haven’t already. 

I appreciate that the TLC Channel actually showed a realistic view of long-term life after weight loss surgery – complete with it’s painful, dramatic and yucky parts.  

We get it.  If you don't get it now, you will.

http://www.meltingmama.net/wls/2012/02/my-600-pound-life-melissa.html 

20 January 2012

$3000 Wellesse New Healthy You Sweepstakes! Help the OAC!

Enter now for your chance to win everything you need to help you on your way to losing weight from Wellesse!  

This is an AWESOME contest, GET ON THIS!  Quickly!  (Like, now, please.)

• The Grand Prize includes a Treadmill or Elliptical or 
• Fitness club membership
• Plus a Zumba DVD to melt away the pounds
•  And a BodyMedia® FIT system to measure your progress. 
• And, don't forget Wellesse supplements to get the essential nutrients you need every day!

There are four easy ways to enter:

 Click here to register now

 Visit Wellesse on Facebook and follow the on screen links including choosing to "Like" Wellesse.

 You can also visit the Wellesse Twitter page and follow the onscreen links 
including choosing to become a "follower" and re-tweeting.

1. Become a follower of the @Wellesse brand on Twitter at http://twitter.com/Wellesse.
2. Retweet this message: Achieve a New Year New You with the get healthy grand prize from @Wellesse worth $3,000! Follow and RT to enter: http://ow.ly/8zjAL
3. Between January 19, 2012 at 9:00 a.m. PDT and February 1, 2012 at Noon PDT and you will be automatically entered in the Giveaway.

 Like to blog? Then visit the Wellesse Vital to Health and Wellness blog and follow instructions to enter.

Plus!  Wellesse Will Help Support the Obesity Action Coalition!  

Wellesse will donate up $.25 to OAC for every new Facebook Like or Twitter Follower up to $1,000!

The Obesity Action Coalition (OAC) is an IRS registered 501(c)3 National non-profit organization dedicated to educating and advocating on behalf of the more than 93 million Americans affected by obesity.  To learn more about OAC and join today, please visit www.obesityaction.org or call (800) 717-3117.

Go enter now for your chance to win everything you need to help you on your way to losing weight from Wellesse!  

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Building Blocks Essential Bariatric Vitamins Coupon Code for MM Readers!

Building Blocks Vitamin-Essential Bariatric Supplements is dedicated to providing a quality product designed especially for the bariatric patient. Made with the highest bio-available ingredients, we offer a complete product line of bariatric specific formulated vitamins and minerals. 

Yeah, yeah... we know.  BUT --

Have you heard about Building Blocks Vitamins?  And have you tried them?  Please do!

Personally, I love the Multiple Mixed Berry Multivitamin, Orange Calcium, and ADORE the sublingual B12 spray. 

Here's a super opportunity for Melting Mama readers to try a selection of Building Blocks Vitamins at a huge discount.  

Order a 30 day supply of selected vitamins and receive -

• Up to a 35% discount on a 30 day supply of multiple, calcium and iron chewable vitamins
• Get a 50% discount on shipment
• Use this form - Melting Mama - BBV Patient Order Form 
• Call Building Blocks with the code 04MM120101at (877) 419-1568 
• Fax the form to Building Blocks at (954) 670-0495      

Don't forget to join Building Blocks online at -

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Drama Llama - How To Be Drama Free?!

Did you ever notice a pattern is the drama surrounding you at WORK -- at HOME -- or even ONLINE?  *shameful look*  Um, yes. /shameful look  

Did you ever notice it might have something to do with... you?  It often does.  So?  What to do about it?

How to be DRAMA FREE!  Start with yourself.  
via - http://www.workhappynow.com/2011/09/how-to-be-drama-fre-start-with-yourself/

(Gulp.  This hurts.)

Blame Game

It’s easy to blame drama on others.  After all, you’re the good guy in these dynamics; why don’t they get it?  

One of the most difficult challenges for aspiring leaders is to “own their stuff”—to acknowledge that they are equally responsible for creating any situation where drama exists.

Four Energy-draining Personalities

Most drama is caused by four primary energy-draining personalities that sabotage workplace collaboration and synergy:

• Complainer -- The Complainer is the one who is never at fault – not enough time, resources or support. 
• Controller -- The Controller has to be in charge – perhaps micromanaging, sometimes being the bully. 
• Cynic -- The Cynic must be right; often pointing out how others’ ideas will never work and making fun of the person who brought it up.
• Caretaker -- The Caretaker wants to be liked so much that they say yes to everything, which becomes a problem when they bite off more than they can chew and they miss deadlines.

(Which one are YOU?  I am a mix of all of them, but mainly Cynical -- I pick everything apart.  Mr.  MM is a Controller/Complainer.  Unfortunately.  This is a fail on my part -- I'm working on it. -MM)

 How do I help others change? But, we have found that before you can guide others, you have to take inventory of your interaction strengths and the ways you sabotage relationships. The strength inventory is usually easy. It’s fun to appreciate your talent and amazing ability to do what you do. The sabotage inventory is more difficult. It requires the vulnerability and courage to seek others’ candid observations and advice about your behavior.

Watch Yourself

Taking my own advice, I asked myself what my part was in creating the drama. I wondered which Drama personalities I was using that were sabotaging us. I noticed how I had fallen into Complainer. I didn’t have enough time to do everything he asked and his requests were too hard. I realized that I would have micromanaged someone acting the way I was. Then I saw my Cynic. The enthusiasm I had at the beginning of the project had become critical… I saw everything wrong with what we were doing, but didn’t offer any suggestions to change. Once I saw myself in these drama roles, I could shift into taking responsibility – renegotiating our deadlines and making suggestions for how we could change the writing to be better.

By identifying and correcting the four drama roles (Complainer, Controller, Cynic, Caretaker), you are well on your way to eliminating drama. If you want even more clarity, invite your work colleagues, family members, and friends to give you timely, direct feedback.

Quick Drama Reducing Tips

Here is a quick way to start looking at how these drama roles show up for you.  Ask friends and coworkers (or others!):

• Where do you see me complaining? Not taking responsibility for my situation?
• Where do you see me controlling? Taking over and micromanaging?
• Where do you see be being cynical? Discounting others or being sarcastic?
• Where do you seem me care-taking? Rescuing others instead of letting them do things on their own?

Okay.  Maybe it will take some time.  Don't attack me with all of them at once.  LOL.

via - http://www.workhappynow.com/2011/09/how-to-be-drama-fre-start-with-yourself/

Need reminders?  I do.

Here's a nifty list from Drama-Stoppers - LIVING DRAMA FREE

• 1) Treat others the way you want to be treated.
• 2) Keep what’s most important, MOST important... good relationships with family and friends matter MORE than material things.
• 3) Be CAREFUL what you say. Cussing and foul language is mean and nasty.  (I uh...well.)
• 4) No matter how old you are, listen and obey your mom and dad. Show them the RESPECT they deserve.  (Fine.  *pout*)
• 5) Don’t fight/bully people. Violence is NEVER the answer.
• 6) Stay TRUE. Be a person who keeps your word. Don’t cheat on the people you’ve made a COMMITMENT to.
• 7) Stealing isn’t cool. If it doesn’t BELONG to you, don’t take it. If it doesn't BELONG to you and you find it, turn it in.
• 8) Lying and gossiping will get you NOWHERE. Be CAREFUL what you say...
• 9) Don’t be a HATER. Be HAPPY with what YOU have.
• 10) Get enough rest so that your tiredness doesn’t EFFECT your mood and judgment.

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PS.  This stuff is EXTRAORDINARILY HATEFUL.  If you are easily angered, go take your happy first and come back.   Also, I know the truth, I realize this is NOT my problem.  However, in the spirit of being open, honest and in my way of TMI -- you get to see what I see.  I also realize that 'haters gon hate,' and all that jazz.  But you might as well see it.  I don't want pity.  I'm not the one who needs it.  Clearly.

Today I was pointed to a forum that was loaded with all sorts of anger, some directed at me, quite pointedly.   "Why?"  I don't understand, to be honest.  There are some really effed up accusations, and I only read two threads.  I copied it all and sent it to my husband -- because he was involved in the hate -- and I was deleted from the forum.

• "Hi Beth, you f-cked up Munchhausen bitch."

2012: It's not the end. It's the beginning.

"What the eff, Beth?  2339 words?"  Yes.

Continue reading "2012: It's not the end. It's the beginning." »