Energy

My energy seems to have deserted me today.  A brisk walk on the treadmill felt like a hard run.  I could barely get through my workout with Jason today.  I’m not sure what’s going on.  Perhaps just a down day.  I think I’ll take a break from the gym tomorrow.

I found out from my band surgeon that I’ll have to have my band completely defilled prior to plastic surgery.  Apparently this is to decrease the risk of the band slipping because of post-surgical swelling.  The band will have to stay defilled until I’m fully recovered, which the plastic surgeon tells me is about 6 weeks.  It will no doubt be a challenging time.  I can’t really exercise (other than walk) during that time either.  A defilled band and no exercise seems like a recipe for me to gain a whole bunch of weight.  Throw Christmas in there and I wouldn’t be surprised if I come out of it 30 pounds heavier.  I will try to think positive.

Tighter?

Before I was banded, I had heartburn.  I took medication for it and the heartburn went away.  I was told that when I lost weight, I would no longer need the heartburn medication.  The converse proved to be true.  The heartburn got worse.  The medication no longer controlled it.  I tried different kinds, higher dosages.  I seem to have struck a delicate balance now.  If I take two different types of medication twice a day, the heartburn is controlled most of the time.  About once a week, I’ll have an extreme flare-up, and if I forget one does of the medication, I go through hell for it.

In the meantime, my doctors have been investigating the potential underlying cause.  I’ve had a barium swallow to check if the band had slipped, and an abdominal ultrasound to look for gallbladder problems.  The band looks to be in the right place.  I do apparently have some gallstones.

After talking with my band surgeon today, he gave me an interesting recommendation.  His feeling is that my symptoms (true heartburn) are inconsistent with a band slip (in which case I would likely be regurgitating food when I sleep).  If the heartburn was gallbladder related he thinks the medication wouldn’t help it at all.  So, for some reason, in spite of acid blocking drugs, I’m just producing a whole bunch of acid.  Apparently acid is produced in the bottom part of the stomach, below the band.  Heartburn results when the acid moves up the stomach, to the part above the band.  His recommendation?  Make the band tighter.  A tighter band provides more of a barrier, making the acid less likely to come up.  This is the opposite of what I was expecting to hear, the usual cure for acid reflux being a defill.  Given the fact that I am always hungry, my surgeon thought another fill was warranted in any case.

So, on Monday, I will go get another very small (0.1 or 0.2cc) fill.  I do this with trepidation, since last time I was filled tighter than I am now I couldn’t even keep liquids down and ended up going through hell for a week before being defilled.  I also found out that I will need a complete defill before having plastic surgery since there is risk of the band slipping due to post-surgical swelling if it remains filled.  So I’ll have this small fill for 4 or 5 weeks, before getting everything taken out again.  If it takes away the heartburn and I lose some weight, it will all be worth it.

Wish me luck.

Onward

Not much to say these days, and I’m really tired tonight, so I will continue to not say much.  Today has been a surprisingly good eating day, from a hunger perspective.  I haven’t had any of that horrible pain that gnawed at me all of last week, in spite of eating in approximately the same amount of food.  I hope it keeps up.

I read this article today and found it interesting.  The basic premise is that it appears that people who are obese get less enjoyment out of food than thin people, and are therefore inclined to eat more in order compensate.  I wonder if there’s a chicken and egg thing going on there (do obese people enjoy food less because they are overweight and feel guilty about eating, or are the obese because they enjoy food less and eat more in search of the good feeling?), but it is certainly something interesting to ponder.

Thinking About Getting a Lapband?

It seems like there are a whole lot of people who have a lapband and don’t really have much support, and are struggling, or people who are thinking about getting a band and aren’t sure whether it’s right for them.  I thought I’d give some advice here for people who are considering this surgery and want have a few more things to think about.

1. Most people who have weight loss surgery do not lose all of their excess weight.  If you lose 20% of your body weight and keep it off, you are considered a weight loss success.  Keep this in mind when you are thinking about how much weight you want to lose.
2. Over the long term, the amount of weight lost with people who have a lapband vs. gastric bypass is about the same.  People who have a gastric bypass will (generally) lose weight much faster than those with a lapband, but five years down the road, the amount of weight loss maintain appears to be roughly equal.
3. Expanding on #2 — it can take a long time to start seeing significant weight loss with the band.  Many of the bandsters I know didn’t start seeing real results for at least 6 months, sometimes longer.
4. The band is not a quick fix.  Don’t let anybody tell you that surgery is the easy way out.  You will have to drastically alter your lifestyle if you want this to work.  You will need to get used to taking small bites, chewing everything until it turns into mush and eating drastically smaller meals than you are used to.  You may have to give up certain foods (often bread, pasta and rice) because the band will not tolerate them no matter how much you chew.  You will be strongly advised to give up carbonated beverages — many people have excruciating gas pain when they drink soft drinks and one try at it is all they need to convince them to quit.  You have to get used to the fact that you might end up puking your guts out because you ate too fast, you were stressed, you ate something you shouldn’t have, or you ate one little bite too many.  It almost certainly will happen to you at some point, even if you think it won’t.
5. If you are an emotional eater, you will find ways to eat around the band, even though you really, really don’t want to.  You need to get help for the emotional eating.  Start therapy before you have surgery and stick with it.
6. Find support close to home.  My clinic is a 4-5 hour drive from where I live.  If I didn’t have an excellent fill doctor at home, I would never have gotten a fill.  Ditto the support of the wonderful people who get together every month.  If you can’t find anyone to meet with in person, find some online support groups (start with lapbandtalk).
7. Exercise.  I can’t stress this enough.  If you can afford it (and try to find a way to afford it, because you are absolutely worth it), hire a personal trainer, because they will push you way harder than you will push yourself.  Because of the combination of how much I exercise (6 days a week), and the band, I am able to eat pretty much whatever I want (with the band limiting  the quantity) and maintain my weight (actually, every month I’m gaining muscle and losing fat, even though the scale stubbornly refused to budge).  Note that I didn’t say I could eat whatever I want and lose weight, but I can maintain.
8. Be prepared to “diet” if you want to lose weight.  The band does make this easier, but it doesn’t eliminate the need to watch what you eat.  I know I’m repeating myself here, but this is important.  The weight will not just come off on its own.  I more or less eat what I want (for example, if I go out to a restaurant) but most of the time I make a concerted effort to eat the way I would when I’m on a “diet”.
9. Research your options for surgery.  Meet with several different surgeons if you can.  It is important that they have done a lot of of lapband surgery, that they understand the limitations, the potential complications and are prepared to support you.  Do they guarantee their work?  Will they charge you for replacement surgery if the band slips or the port needs to be re-positioned?  Does the cost of surgery include follow-up visits for fills and de-fills?  Does the clinic have a dietician or nutritionist on staff?  A psychologist or therapist?  Do they run support groups, whether in person or online?  Did the surgeon take the time to meet you and address your questions fully?  Do you feel comfortable with the surgeon?
10. Talk to other people who have had this done.  As Daniel Gilbert says, the best way to evaluate our future happiness is to seek out people who are living our potential future.  Try to find a large enough cross-section of people that you get a broad view.  You will meet a lot of people out there who love their bands.  There are also lots out there that don’t, but they tend to be less vocal.  Keep in mind that weight loss can be slow, so try to find people who have been banded for a while.  You can find tons of people in online support groups who are more than happy to share their experiences.  Google it.

I hope this helps some of you out there who are struggling with this decision.  While it may not seem like it from the tone of my advice, I am happy with my decision to have this surgery.  However, I went into it not really understanding how difficult it would be, and there were times (and sometimes there still are) when I hate it.  The benefits far outweigh the bad stuff, but I think it’s really important to go into this with your eyes open.  If you want more information, leave me a comment with your email address (only I can see your email) and I will be happy to talk to you personally about it.

In the next couple of days, I’ll put up some advice for those who are already banded and struggling with weight loss.

Perfect

Continuing on the perfectionism theme … I’m really worried that I won’t be happy with the results of my surgery.  I look at myself naked and try to manipulate the stomach flub to get an idea of what I will look like without it.  But I can’t imagine it.  It will be so strange to have it gone.  My surgeon showed me before and after pictures (and I’ve looked on the internet), but so many women have tummy tucks after pregnancy, and while I understand why they want to have their stomach changed, my situation is nothing at all like theirs.

I look at people all the time, especially in the gym, trying to identify what I might look like when the surgery is over.  I don’t really know what a normal woman’s body looks like.  I suppose that it doesn’t help that in many cases, the women I’m comparing myself to are probably 10 or 15 years younger than I am.  My therapist tells me that there probably is no “normal” and it would be better if I didn’t try to compare myself to others, but that’s difficult for me.  I’m so afraid that even after surgery to lose weight, and more surgery to correct the after-effects of losing weight, I will still not be satisfied.

People say that losing weight won’t solve your problems.  That if you have self-image issues, you’ll still have them after you lose weight.  I used to think that, for me anyway, this was untrue.  That the only thing that bothered me about myself was my weight.  Now I realize that weight was just a symptom.  I definitely feel better about myself having lost the weight, but somehow, that feeling of being not quite good enough has persisted.

On Facebook, there’s an application called “Define Me”, where your friends can tell you how they see you (anonymously).  My “Define Me” box has wonderful things in it, like intelligent, creative, thoughtful, funny, strong and even magnificent.  I can’t help but wish that it also contained words like beautiful, sexy and hot.  I’ve never been the hot girl.  I might have to accept that I’ll never be the hot girl, even after surgery.  And that just makes me sad.

Amazing

Last week I was talking with my therapist about the 5K run I had done the previous Sunday.  “You must be in really good shape,” she remarked.  I looked at her blankly.  I don’t consider myself to be in good shape.  I told her how several people had congratulated me on completing the 5K, and told me what a big deal it was.  And how I didn’t really understand why it was a big deal.  She then asked me whether I ever look at any aspect of my life and think “wow, I’m doing a really amazing job.”

That’s a no brainer.  The answer is no.

Work:  I do a decent job, but I probably could work harder and be more productive.

Home:  My house is always a mess.  I feel like I can never keep up.

Parenting:  Never satisfied with how I parent my kids.  I could write volumes on this one.

Friendship:  I’m not a bad friend, but I don’t see some of my friends often enough.

Diet:  See previous entry.

Exercise:  Of any of the areas, I suppose I feel I do the best here.  When I’m at the gym, I work as hard as I can.  But I don’t go to the gym or work out every day — more like 5 days a week, and I probably wouldn’t go if Jason wasn’t waiting for me, so I would say I’m doing an adequate job, as opposed to an amazing one.

I had an interesting conversation over lunch the other day with a colleague (a guy I barely know actually).  For some reason, we were discussing discipline, and I said that I don’t have any, citing my need for a trainer to get myself to the gym.  He said, “But who are you comparing yourself to?  People like you tend to compare against the people you want to be like, rather than the average person.  And you’ve identified where you need help to be disciplined and taken the steps to get that help.”  Interesting.  From somebody I’ve met in person perhaps four times.

Reading all of this, I know that I am being too hard on myself.  I know that I am defining perfection as adequate, and setting standards that are unrealistic.  But I don’t know how to stop.

Gah!

I’m going to own up to something I really don’t want to own up to here.  But, in the interest of putting it all out there, here it is.

Previously, I talked about how hungry I’d been all day today.  By the time I got home, I was once again starving.  I heated up another Lean Cuisine (this one a Thai Peanut Chicken – pretty good).  I couldn’t eat it all because I started to feel stuck.  I can’t really explain the feeling of stuck to someone who isn’t banded, but it basically feels as though you’ve swallowed a golf ball.  I was still hungry, but stuck, so I abandoned the meal.  Sometimes, stuck will turn into full, so I was hopeful.

But it didn’t last, and an hour later, I was hungry again.  An after work/school trip to the grocery store resulted in the purchase of a package of Pillsbury Dough Boy Halloween cookies.  These are basically chocolate chip cookies that have some orange chips added, and presto, Halloween cookies.  I figured I could bake these with the kids, and limit myself to 3 of them (for 270 calories), abandon the protein shake for the night, and still come out ok.  Even as I was telling myself this in the grocery store, another little voice was saying “yeah, right.”

So, I made the cookies.  And I ate not 3, not 5, but 10.  Ten cookies.  That would be 900 calories.  So, taking the previous total and adding 900 calories worth of cookies, 290 for the Lean Cuisine and 100 for the milk I had to have with the cookies, and I’m at 2640 calories.

There are so many things that bother me about the cookie gorge that I can’t even go into them all here, so I’ll stick with my top two:

1. Why is it that the band will prevent me from eating a Lean Cuisine sized dinner of chicken and vegetables, but permits 10 cookies to slide through without any problem at all?
2. After all that, I actually still seem to be experiencing physical hunger.  I’ve decided that it probably isn’t actual hunger, but some kind of weird painful state brought on by not eating enough during the rest of the day (although by all accounts, I did eat enough, so I have no clue what’s going on there).

I’m trying to figure out why I felt compelled to eat 10 cookies.  I can’t come up with any decent reason.  I wasn’t stressed or upset or anything.  The cookies were there and I wanted them.  Food like that just speaks to me.  Maybe it’s like lighting up a cigarette in front of someone who is trying to quit smoking.

On the upside, the cookies are gone now (the remaining cookies having been eaten by my kids or put away in their lunches), so I don’t have to deal with them anymore.

I guess I will just try again tomorrow.

I Am Starving

After getting on the scale last Friday and seeing a 1.5 pound gain, I have decided to try to be more serious about my eating habits.  In order to keep things simple and portion controlled (bandster sized), I came up with the following plan:

Breakfast: Protein shake (since I can’t eat solids in the morning unless I want to spend the next 3 hours puking, my options are limited here).  The protein shake comes in at about 300 calories the way I make it.

Snack (if hungry):  Small protein bar or fruit.  This varies from 50 to 150 calories

Lunch:  A Lean Cuisine type meal.  Somewhere around 300 calories

Snack (if hungry):  Fruit.  About 100 calories.

Dinner:  Another Lean Cuisine type meal.  Again, about 300 calories.

Snack (if hungry):  Protein shake.  Another 300 calories.

If I eat all of this, I will be taking in 1450 calories (at the top end) in a day.  This should be way more than enough for someone will a band to get by on, and given how much I work out, I should still be able to lose weight.

So.

I start my day out with the protein shake.  I then spend an hour in the gym.  I’m hungry, but not insanely so.  At work, I have meetings until 11, so I have no chance to eat.  By 11, I’m really hungry, so eat the protein bar.  Half an hour later, still hungry, so I eat the fruit.  I’m at 520 calories now.  I have a meeting over lunch, and emerge at 1pm starving.  I heat up and eat my Michelina’s Lifestyle Honey Barbeque Chicken (which is gross, and is not something I will ever eat again).  Grand total of 810 calories consumed so far today.  By 2:30, my stomach feels like it is eating itself.  So I eat more fruit.  880 calories.  Still starving.  A handful of almonds.  950 calories.  Guess what?  Still starving.  Now I’m out of food, so I am trying to make the heathiest possible choices from the vending machine which turn out to be an Oatmeal to Go Bar and a bag of fruit snacks.  So, I’ve now consumed 1350 calories, and it’s not even 4:00.  The hunger seems to be at bay, but I’m nowhere near full.  In all this time, I’ve also managed to consume 2 litres of water (which had to be carefully timed because I’m not supposed to drink for at least 45 minutes after I eat), and one Diet Coke, which I shouldn’t be drinking at all because it is apparently bad for the band.

I’m pretty sure I’ll have to eat at least once more today, if not twice.

I don’t understand how people manage to exist on 1200 calories a day.  Do they just sit at a desk and do nothing all day?  I’ve had people say “who cares if you’re hungry for a little while?”  But I’m not talking about normal hunger here.  I’m talking about the entire floor can hear my stomach growling, I’m almost doubled over in pain, can’t concentrate on anything type of hunger.

According to this calculator, apparently I burned around 500 calories at the gym this morning.   That sounds about right to me.  I imagine I burn about that much every time I go to the gym, which I tend to do around five times a week.  According to this calculator, I need to take in 3169 calories per day to maintain my body weight, and if I wanted to lose 2 pounds a week, I would need to take in 2169 calories per day.  None of that makes any kind of sense to me, because when I am taking in about 2000 calories per day, I’m losing nothing.

This is really, really frustrating.

And, I think I’m getting hungry again.

Food Diaries

I hear the over and over again that people who keep food diaries are far more successful at losing weight and keeping it off.  It’s certainly one of the things that is recommended for bandsters, particularly when we’re having difficulty losing.

I hate the idea of keeping a food diary.  Just thinking about it makes me angry.  I just want to be a normal person, and normal people don’t remember every morsel of food that goes into their mouths and write it down.  Somehow, it also seems counterintuitive to me to take a person who is already obsessed with food and put even more focus on it by having them record everything they eat.

I’ve tried many times over the years to keep these kinds of journals.  I’ve used SparkPeople (I quite like the website, as a whole) and FitDay as well.  I’ve used the Weight Watchers online program, which I even had to pay for.  Of course, a notebook works too.  But no matter what type of journal I use, I might last a week, maybe two, and then I give because either:  a) it’s too much work, b) I get depressed because I’m eating too much, c) I get depressed because I’m eating so little and still not losing weight, d) I get angry about having to write down everything I eat, or e) all of the above.

I wonder, if could get over this aversion, would something like this really help me?

The Sweet Spot

People who are banded talk about the concept of the “sweet spot”.  This is the point where the band is adjusted such that you feel full on very little food, stay full for a long time, and consistently lose one to two pounds a week.

I don’t think I’ve ever reached the sweet spot.  Any attempts to go to a tighter fill than I currently have result in me being unable to even keep liquids down.  So I don’t play around with the fill level too much anymore.  It’s just not worth the stress.

But recently, my band seems to have tightened up on it’s own.  There are days when I think I may actually be at the sweet spot.  Where I can eat a small meal and be full for four hours, or longer.

It’s an odd thing, when you alter the way your body functions.  The problem is, your mind doesn’t automatically follow.  I frequently feel guilty about overeating.  Even though what I consider overeating now wouldn’t have even registered on the low end of the overeating scale last summer.  But I feel the same sensation after eating a third of a hamburger now, as I would have felt after eating an appetizer, a whole hamburger, a big pile of fries and dessert before I had the surgery.  Since the physical feeling is the same, the automatic thought is “Oh my God, I’ve eaten too much”, and the emotional reaction is the oh-so-familiar guilt.

Interestingly enough, although I do eat relatively few calories, and I exercise more than anyone I know, the weight is not coming off on the scale.  It seems unlikely that I’m taking in more calories than I burn.  Is it possible that your body can refuse to shed the pounds because it thinks you’re eating too much, even when you’re not?  Somebody should do some research on that …