Question:
I'm sorry if I've stepped on anyone's toes
As a reaction to a post a couple of weeks ago from a woman who was having a hard time eating her double cheeseburger from MacDonalds, I recently posted about a resource book called "Before and After" by Susan Maria Leach. It was one of the books highly recommended not only by my surgeon's office, but also by a friend back east who had WLS 5 years ago, and calls it her "Bible". I've been researching the RNY prodecure since Carney Wilson had it years ago, reading everything I could get my hands on. At 55 years and 312 pounds (with many rounds of Weight Watchers, Dr. Atkins, South Beach, NutriSystem and other programs beneath my belt), and with painful osteoarthritis in my knees and hips, I finally decided this summer that quality of life was much more important than the unhealthy diet I'd been consuming and the way I was living. I attended a seminar given by the surgeon (who works with Rose Hospital Bariatric Center of Excellence in Denver - and has done over 2000 surgeries), talked with some of his patients, began going to support groups ad nutrition classes, and jumping through the insurance hoops I would need in order to get approval. I had two options - a 6 month physician-supervised weight-loss program with documentation, or a three-month "fast track" where I saw both my PCP and the dietician for three months and began an eating plan mandated by the dietician. I chose the fast-track option, and have been eating a normal post-op diet since then - six small meals per day, each one about 200 - 250 calories, and 75% protein and 25% carbs, as her plan recommends, with no more than 25 carbohydrates per day post-op. They prefer that I get my carbs from vegetables and fruit. I never said I was not eating vegetables and fruits (I know all about "good carbohydrates" and "bad carbohydrates"), however, with the other carbs I need to work in (like ground flax seed, and other fiber) - it's not easy to get a lot of vegetables and fruit in there and still stay under 25 carbs per day. Heck... a quarter cup of sliced peaches is 4, a quarter cup of brown rice is 11, a half a cup of chopped broccoli is 6, and a half a cup of mashed potatoes is 18.5. According to both the surgeon and the dietician (who works with him) - sugar and too much fat will almost invariably cause dumping syndrome (something so unpleasant you don't EVEN want to go there), but if for some reason it DOESN'T cause dumping syndrome - it still isn't something that should be included in your post-op diet because of the way it creates an insulin loop with high-and-low-blood-sugar levels. And I was told that refined WHITE carbohydrates, including potatoes, rice, pasta, bread, popcorn and chips, were also to be avoided like the plague in the post-op period after you get to the "normal food" stage. However, they DID say that whole wheat pasta, whole grain breads, and brown rice were okay in very limited amounts - but they still preferred that I eat protein first, then if there was room, vegetables or fruits, and finally, the whole grain carbs. The nutritional notebook they gave me is very specific on what I should eat, and in what amounts and what order. I ordered a beginners kit from one of the bariatric eating sites, with samples of Nectar Protien, Matrix shakes, sugar-free puddings and other things, and have been trying them out. It also contained the "Before and After" book. I read it in about 3 days. Almost without exception, her book echos everything my surgeon has told me, and also the bariatric center at the hospital where they hold support groups, nutritional classes, and exercise classes. YES, I understand that I will have to take nutritional supplements for the rest of my life. I also understand that there are many options for "snack foods" like the high-protein soy chips from SmartForme and stuff like that. But as I said before... we have ALL OF US - EVERYONE ONE THIS BOARD - worked so hard to have this opportunity to turn our lives around, that I don't understand why someone would be eating a MacDonald's double cheeseburger, or challenging their pouches by deliberately eating sugar, drinking carbonated drinks, or eating refined carbohydrates in place of their protein just "because they are able to without feeling bad! We've all been given a second chance at life, and I want to see all of us succeed. So, once again, I apologize if I came off too pompous or "know it all".... and I wish the best of luck to all of us. — Erica Alikchihoo (posted on January 9, 2009)
January 9, 2009
I really admire you! You are doing your homework, unlike most people who
have weight loss surgery. Your doctor and his practice has given you great
advice and showing you that you need to take control and change your life
after surgery! You are so ready! Many people that I encounter who have
not been successful in losing the weight have tried doing it their own way
or haven't had good guidance or instruction after surgery. I know few
people who really read books and do research so you are to be commended!
Good luck to you, we are almost the same age...my RNY was 2 years ago, I
did it also to change my quality of life for the future...to be able to
travel, play with my grandchildren and lead an active and full life! Keep
in touch!
— Sheri A.
January 9, 2009
I read your first post and wasn't offended in the least! We are all
entitle to our opinion and I just happen to agree with yours. Much good
luck to you in your journey!
— GlitterGal
January 9, 2009
Well said. I had my surgery in Cheyenne, WY and they also were very
adamant about learning the nutrition and diet parameters before and after
surgery. It is very easy to fall back into old habits because carbs a lot
of times will not make you ill and they go down so well. I learned that
during the holidays with the breads, potatoes, etc. I have since modified
my diet again with no "white" foods again and am still losing but
losing faster.
While I was in the hospital after my surgery, one of the nurse's told me
about a paitent that had gone out two days after surgery and had a double
cheeseburger and fries at McDonald's and had to be rushed to the hospital.
That person did not make it as their pouch stretched and literally burst.
But even at that - that one cheeseburger had to have been 1200 calories and
then add the fries...that totally defeated the purpose.
Why do people have the surgery? Do they think that once their
"pouch" is in place that it is an automatic weight loss? No
matter what they eat? Unfortunately, the nutritionist meeting, support
group meetings and the manual they give from the surgeon spells it out
differently. The healthy eating diet that we incorporate is for the rest
of our life. We are doing this to be healthier. At least that is what the
psych eval is supposed to determine our reasons to be. Not for instant
weight loss.
Anyway - I think youdid a good job in explaining this. I for one, do not
think you are stepping on anyone's toes.
— Brenda S.
January 9, 2009
It is good you have gathered a lot of information. Sounds like you should
do well. Many people struggle with the life changes they go through. We all
have comfort foods we can not longer have. It is hard when traveling and
everyone stops at Mc Donalds on the way. This board is about helping with
the problems people encounter. once you have had the surgery you will see
that it changes things.
We need to remain encouraging even when people do silly things.
— trible
January 9, 2009
I didn't see the post about the cheeseburger. I WAS offended by your post.
You did come off as a know it all to me.
I can, however, admit that I am very easily offended right now due to other
circumstances.
Also, I was under the impression this is a Q&A thing and not anyone's
personal soapbox. That's what your blog is for. That's what the message
boards are for. NOT the Q&A database.
I agreed to get these messages delivered to me so that I can be here to
help others not to be told what to do by someone who hasn't even had or
lived with this surgery.
— Launa N.
January 9, 2009
I do appreciate your feelings on this but must say that it is human nature
to test the limits of anything...
I may be the very person that you are referring to in this story..I had a
really bad experience from a bad choice of a BK double cheeseburger...
I have lost 175 lbs and need to lose 100 more. I had lap RNY in June 08...I
have been on a strict diet for over 2 years and have only faltered a few
times...I got busy and left myself very short on food and made a very bad
decision...I paid for that decision...I think for a person who lived on
fast food, carbs and fat as a regular menu, I have done quite well with my
diet for the better part of two years with behavior modification and
surgery, but sometimes you just have to make a mistake to learn...noone
really deserves to get slammed for it or scolded and basically told they
are a failure for a slip up...you need to remember that most of us have all
dieted short term and lost weight but those natural learned eating habits
come back and bite us every time...it is no exception after surgery...Right
now you are on the super focus gotta get this done track...it was this time
that I was very focussed on how I was eating and what I was eating...I
still am very focussed on all of that, but find I have triggers for bad
eating as you will...don't think you won't have challenges we all do...I
find that if I do not plan well I can make very bad choices, if I am
somewhere I did not prepare the food I am tempted by bad choices, the radio
and tv temps me with bad choices...90% of the time I am focussed and do
very well, 10% I make poor choices and deal with myself on why and try to
change the next time I am faced with it.
No one here needs to feel ashamed of makeing a bad choice, it happens. You
are a crazy person if you think you will sail through the rest of your life
without making a poor choice...
— lori042499
January 9, 2009
I don't think you stepped on anyone's toes either. Personally, the last
post offended me from Laurie N. Just because you go through something
doesn't mean you will have the same experience as the next person. And I
certainly don't see you as a know it all. Maybe people who see you that
way need to address some of their own issues first. I am in your age
group. I also understand trying to do everything you can do. Anyway, I
am a type 2 diabetic with hypothyroidism. This just makes it 3 times as
hard to lose any significant amount of weight in a short period of time. In
my opinion, no one can ever have enough information about something they
are going to do that is going to change their entire life. And I'm not
trying to offend the young people but comfort with food when something bad
in life happens to you is bad; I was a victim of this. It started at age
14. Not too many 14 year olds weigh 163 pounds even today. So weight has
been a life long issue with me as it probably has with you. To cut to the
chase, I had the WLS 10 plus years ago when they didn't know as much about
it as they do today. I stay on a fairly strict diet; but I don't starve.
That isn't healthy anyway. Just a note if you THINK you aren't getting
enough to eat then physically your body will actually become hungry no
matter your weight. My diet has yogurt, cheeses, lots of fruits and
veggies, chicken and fish, healthy for the most part. About once a week,
red meat but most of the time less. I also exercise(not a four letter
word) and do yoga. Yoga is also a form of exercise depending on the type
you chose. I applaud you for at least thinking and trying to do something
about your weight; it is a bigger step than most people realize. I would
like to communicate with you further if you wish to; email
[email protected]. Good Luck and God Bless,
vinnigirl,retired RN
— vinnigirl
January 9, 2009
I appreciate your explanation but some of us have NOT had the same opinion
from OUR specific Nutritionist, Registered Dieticians, Surgeons and
classes. You last post you strictly forbid any grains ever (Your words
"Life long plan")...and now you say it's okay in moderation and
as whole grains! That's all I was defending. Pushing it with such force
reminds me of religion and you even referred to your prefered diet as a
bible! Yet you have not even had surery yet...Yes, I find that as pompous
as pushing religion on someone with different beliefs. Diets are only
suggestions from people who study nutrition and then then decide which
direction to take based on their OPINION...IF THERE were a right way and a
wrong way, and a 100% successful way, would any of us need surgery or
STRICT rules of what to eat EVEN WITH malabsorption? NO! If scientists
and doctors KNEW exactly how our bodies all work 100 %...We wouldn't. Fact
is...the human body is still a vast land of mystery...Most of our problem
is in our heads and NO amount of nutrition classes are going to help with
diet if we do not deal with our heads first and CHANGE the way we think of
food and WHY we over eat or what TRIGGERS a comfort foods binge. Some of us
can and do, like the few who conquer addiction...But we're all still
addicts with eating disorders...And some struggle forever...Some who
succeed want nothing more than to help people and hug or hold their hands
thru tough times, guide them and motivate them...or teach them YOUR OWN
experience and what works for you...You can't experience what you don't
live, even reading it in a book. You preach you book when you've found it
to work...Otherwise you are just helping leach lady get richer and you
don;t even know yet if it truly works long term or how HARD it is long
term!! Some just cannot control the food addiction like so many other
addicts...and I truly believe that it is the surgeons and nutritionist who
recommend these very stringent rules along with the low carbs, low fat, low
calories, no gum, no straws, no alcohol, no sugar, no GOD given veggies and
plants...no food for weeks, just liquids...etc....... are the ones who have
NO confidence in their patient and no program in place to help them deal
with their head first...I have been taught right from the beginning that I
would eat like a regular person...regular food and that I could even have
sugar later (MODERATION). In general, under 100 g of carbs is a low carb
diet...With the amount of food you are going to eat after surgery eating 25
g's is fine for losing weight because of the lack of calories you will be
consuming! so of course you carbs and fats and proteins will be smaller
numbers..and no fiber is really recommended until your stoma heals.(That
sort of thing is just common sense) Afterwards when you are maintaining
weight, the amt of calories you eat will grow and so should the carbs (It's
all math)...I eat a low carb diet...For 1800-2200 calories to maintain
weight I can eat between 180-300g carbs (That's for a normal small
person)...But I try to stay just at 100-150 g a day with 30 g's of fiber to
offset the carbs. I'm not trying to lose weight. And if I were, carbs are
only water weight and only help you lose fast for a short time. I still
firmly believe that there is NOTHING wrong with eating a hamburger...even
if it's from (OMIGOD), Mc Donalds! Not my personal choice...I eat organic
whenever possible...so to me that's just emergency travel or chump-change
food ...However trying to eat the entire thing is where the problem was and
I read your answer and you were concerning yourself with the choice of food
rather than the biggest problem which was grazing on that choice of food
(just to finish the whole thing) and the length of time she took to eat
it...That was mental... not carbs, fats, or calories...So it still had more
to do with the AMOUNT of food she ate and how LONG it took (an hour I
believe) and NOTHING to do with the food itself. (even though it was not
the greatest choice...it was not the worst either) Trust me there are far
worse choices out there! A chicken Ceasar Salad for example is a FAR WORSE
choice for carbs, fat and calories. Some still do not realise stuff like
that...This surgery is a life long committment and it's not the easy way
out...If I thought that I would have to eat with a strict diet excluding
most of the food I love, I would not have had the RNY surgery...I would
have had DS so I can eat everything! I chose the RNY so I could eat small,
healthy food amts by choices and moderation with restriction and hopefully
dumping of sugar...Unfortunately for me...I dump fake sugar too...But I can
handle real sugar better, up to about 28 g's of sugar! That limits me from
eating a large piece of cake or something, but it also severely limits SF
stuff more! SUCKS!!!!...But not all get dumping and for those that do...it
fades after several years for most. You can only help people who want to
help themselves...I'm all for honesty and bluntness when you think someone
needs it...but that punishing and pompous (your word) attitude is hurtful
especially when your "bible" is not the only book being sold for
profit! JMHO...I truly wish you luck and success no matter how or what you
eat! But above all...stay healthy! Being thin means nothing without your
health. I just wanted you to understand that the way one eats for the
first year GREATLY differs in what they eat for maintenance or long term.
AND things change...not a little..A LOT...and what worked before suddenly
does not after time...Weightloss is not all that needs to be maintained
after surgery either...HEALTH does and if you think losing the weight is a
huge change and a lot of work...wait til you try maintenance when doing all
the things in your book suddenly don't help and you start gaining weight
for no apparent reason!! The thing is...there's always a reason and it
seems 7 times out of 10 different people is for DIFFERENT reasons! And the
best one can do is try to help people individually...one size does not fit
all...that's my experience.
— .Anita R.
January 9, 2009
Hello, am waiting on the insurance company to approve the realize band, but
just read your message, thank you for the encouragement. I agree,why would
some one want to sabatoge all the hard work they had to do to even get the
surgery? My mother is one of those folks, who has totally ignored what her
doctor told her to eat and not eat. She had gastric bypass almost 10yrs
ago, and to this day still throws up on occassion. She eats cookies,
cakes, etc. Has put on 2/3rds of her lost weight. She is an emotional eater
and never tackled the problem at hand. It upsets me to hear her when she
tells me what was on her menu for the day.
Please folks, take care of yourself, find out what causes your eating of
the wrong foods and learn to deal with the problem without the crutch of
food. I wish everyone nothing but great success. Farmgirl58
— Farmgirl58
January 9, 2009
I saw the posted question on the double cheesburger. I just rolled my eyes
and didn't respond. Sorry I missed your post from reading this post and
what others are posting about your response you hit a nerve that needs to
be hit. Making bad choices is what lead us to having the surgery in the
first place. If McD's is the only option that someone had to have a meal
then again making the right choices comes into play. McD's among other
fast food places do have healthier choices then there burgers. Side salads
with light dressing, yogurt, grilled chicken breast on a salad etc. So
anyone making poor choices should be called on the carpet about them and
guided into making better choices the next time. You have received
outstanding education from your Bariatric Center. I didn't receive nearly
half that information when I had my surgery last June and the hospital I
had my surgery is a Center of Excellence. Surgery is not a get of fat for
free card. Thank you for your insight and good luck.
Sue A
— yankeefan75
January 9, 2009
I 'd have to say you have gotten some bad responses. However, this isn't
one of them. I applaud you for doing your homework and trying to help
others out there who are struggling. And you haven't even had the surgery!
Congrats on the decision to do so. In my opinion , anyone who cannot take
something good from advice others give, isn't listening to the real
message. Its just my opinion. You are trying to help, not sabbotage. It is
tantamount to not liking whats on tv and refusing to change the channel. If
you don't like what someone says, stop reading. I give advice on here. I
give my opinion to my experiences. Not everyone has the same experience to
be sure, but maybe, just maybe, the person posting is like me. If thats the
case, read my advice , if not, don't. I will not be offended. Everyone out
there is having their own experience, some are successful, others are not
as successful, but we are all here to help. I appreciate any info I come
across on here. It may not be my experience, but it very well may be in the
future. Hugs to you, kim
— gpcmist
January 10, 2009
I am going to tell you honestly and I am not someone easily offended. I
have read the hamburger post, your rebutal post, and now this post and I am
not pleased with any of them. I have yet to have surgery but I am in the
process of getting my insurance approval. Like you said this is a life
changing process and I applaud you for getting all the knowledge before
hand that you possible can. But while knowledge and information about a
topic can be easily acquired, it takes a lot more to actually put it into
practice. I am a college student currently so I know a lot about recieving
information and I also know how hard it is to implement your new found
knowledge into real life situations. I have a woman in my schools health
center who has been my mentor, she had RNY about 6 years ago lost 200+
pounds and she has managed to keep it off and if I might say so...she looks
amazing, couldn't even tell she could have possibly been overweight at a
certain time. With the approval of my surgeon she, as well as my schools
nutrionist, have be working with me to help me understand the adjustments I
am going to have to make after surgery...and if you think its going to be
hard for you its going to be double hard for me. I dorm on a college
campus, therefore the healthiest food choices are not always going to be
readily available. However by time I return to school after surgery I will
be in a stage where I would have already reintroduced normal (I say this
word while working on egg shells) foods. Now the point of my even writing
this...NOTHING IS ON MY COMPLETE NO-NO LIST. I am getting my surgery done
at one of the most highly recommended places in NYC so these doctors and
specialist who have been working in collaboration with my schools
nutrionist are some of the best of the best. They told me as young as I am
to tell me I can't eat something for the rest of my life would be like
telling me never to breathe again, it's just impossible. Instead they told
me how to choose the lesser of the evils. So yes, after years of being a
post op I will be able to go to McDonalds (the dreaded place that started
this whole thing) and eat a hamburger..even cheeseburger, but it has to be
done in moderation. To quote my nutritionist.."Forbidden is a word set
up for failure, Moderation is the key to success." I believe this. So
as you can tell, my teams plan is very differnt from many other surgons and
their staff but it has been proven to work. So just remember, what may work
for you and your team may not work for others and it may not be against
their rules. Also this site is meant to help others not make them feel like
idiots for relapsing, it was a long journey to put the weight on and its a
long journey to get it and keep it off and sometimes people just need a
shove (sometimes blunt but niceness never hurt anyone) to get back on
track. Everything in life is learned by falling down or making mistakes and
learning from them because honestly, no one gets anything hard done the
first time without making at least one mistake. I hope you won't take this
as harsh, rather just insightful. But I wish you luck on your path and hope
you will make no mistakes OR just one but in the end you reach your goal
cause thats what everyone on this site shares...one common goal to be
healthier.
— uNiQuE, iTs wHaT i Am!
January 10, 2009
i fully agree with you -- i stay away from potatoes, rice, pasta and breads
-- i limit my snacks to Pringles Stix and Wheat Thins or a small bag of
chips if we are travelling and stop at a convenience store -- i do not
drink soda at all -- i drink flavored water all day and night -- i do not
mind the way i have altered my eating habits -- i will NEVER be fat again
and i know that i have all the control in that matter -- i had my surgery
25 months ago -- lost all my weight by 10 months and have maintained my
weight for 15 months -- some may say that isn't a long time -- but to me it
is -- i too am amazed at the way ppl test the limits -- my husband being
one of them -- he now has to struggle to relearn how to eat after almost 3
yrs post op -- he gained back at least 50 lbs by not eating right -- fries,
chips, breads, soda (not even diet)-- and he justify's it in his head -- i
just get pissed at him -- please stick to your way of thinking -- it will
work for you -- it's been working for me -- yes ppl will call me pompous
and such -- but if i keep the weight off i don't give a rats butt what they
call me -- i call me accomplished :) good luck and do what is right for you
-- seems like you have a great surgical team behind you -- i know my
sugical team is awesome and set me up to suceed with the surgery :)
— RCassety
January 10, 2009
Erica, I just wanted to say that you should not feel bad about saying
anything to someone that is eating a double cheeseburger!! I think that
anyone that says something like that on the boards should EXPECT to be
called out on the carpet!! It's absolutely ridiculous!!!
It makes me crazy to see some people talking about eating things like hot
dogs, pizza, fast food burgers and such and then wonder why they are not
losing weight or having complications!!
I bet that they also wonder how they ended up being obese in the first
place. These people are completely in denial. They do not have enough sense
to follow their doctor's and nutritionist's advice and still expect to have
the same results as those that do follow instructions.
Anyway, I don't think that you should feel bad about it, at all!! I would
do the same thing (although, I didn't actually see the post that you are
referring to. I think that you have done wonderfully with researching as
much as you possibly could. I would think that you would have great success
with WLS.
I know that we all "fall off of the wagon" once in a while, but
nobody can expect to eat like that and not have it affect them. The problem
is that once you try things like that, and if you dont have any severe
problems eating those things, you tend to continue to eat the things that
are not good for you.
It is best to not even try it, then you dont' know what will happen and the
"fear" of dumping or getting something stuck, or whatever, will
keep you from pigging out and making your weight loss "tool"
totally useless.
That's just my two cents worth! ANYONE that thinks that they can eat junk
food or eat like they did pre-op, is destined for FAILURE!! I don't care
if any of you get angry with me for saying this either! It is complete
sabotage to do this!
Good luck, Erica, you deserve it!
— anitak
January 15, 2009
Hello, I am not going to step on anyones toes here, but I was given your
Bible 2 days before my surgery in Sept. 08, and there is no way I can eat
even 98% of the things listed so far.
I can not tolerate any substitute sugar at all, but can eat regular sugar.
Not much, as for I am scared of a lot of things.
Each and every one of us who has had the surgery, has a different system. I
can eat Mcdonalds burger patty with cheese for the protein, but that is all
I eat. I can not eat a patty at different fast foods, as for they don't go
down right, so I don't even attempt to try again.
I eat a lot of re-fried beans at taco bell, chili at wendys, this has a lot
of protein in them. But as for the BIBLE, most foods and I don't get
along.
I to, like you, had it all planned out. I had the BIBLE, and was ready to
go. But, the BIBLE is not for me.
I pray for your sake, that when you do have the surgery, you will be able
to follow the book and it works for you. Just remember, food tastes
different, smells different, and if your like me, just don't look good, and
I am never hungry.
I know I am a newby to surgery, just 3-1/2mo. out, but I have lost 71-lbs
in this time.
As for the person who ate the Ham burger, remember, not everyone is told by
their surgeon that it is bad.
My sister had this surgery by a big surgery group out of Nashville Tn., and
was told it is ok to eat and drink anything she wants to. BAD, BAD, BAD...
2 months ago, I told her Dr. what he is telling his patients is wrong. She
was never even told about vitamins, calcium, B-12 or any of these things.
MIND YA, THIS SURGERY GROUP HAS A T.V SHOW ON EACH WEEK ABOUT RNY SURGERY
AND SHOWS THEIR PATIENTS EACH WEEK.
So, maybe this person who eat a buger, was seeking help, so lets support
each of us on here, and not be so harsh to each other.
Love and Hugs to each of us
— daizi55
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