Self Sabotage

Dear Self:

Why is it that when you decide to go hardcore on program and adjust your eating and exercise accordingly, and do really well to lose excess weight again, that once you get to a certain number, you decide that self sabotage is needed?

Why do you let the number on the scale dictate your happinesss and your worth every day and then once the scale gets stuck once yet again, do you feel the need to throw in the towel, do a complete 180 and start going on crazy binges yet again?

Why do you give up when you are so close to a goal that you can taste it and feel the need to eat and eat until you feel sick and the scale goes up, up and up.

Are you scared of seeing a number? Are you afraid that you won't be pretty when you are thin? Are you hiding from someone? Are you hiding from yourself? Do you need fat on your body to feel hidden from the world and to fall into oblivion?

Why do you insist on doing this to yourself, making yourself miserable and digging yourself deeper and deeper into a hole? Into a funk?

Why?

Why do you sabotage your own success? Why do you continue to ruin your chances to feel good about yourself? Why do you punish yourself constantly? What exactly are you afraid of?

UGH.

And every time, I have to pick myself up and dust myself up and pick my self-esteem up from the toilet do you have to whisper "What is one more cookie? One more ice cream?". "Why can't you just eat and eat and eat?".

This ghost of addiction is haunting. It's destructive. It's depleting. It's frustrating.

It takes every ounce of strength I have to pick myself up, dust myself up and begin again.

To not let the scale solely define me.

But every day is a new beginning, isn't it?

Dawn

"Why Are We So Misinformed?".

I read a post on a board this morning and it was entitled "Why Are We So Misinformed?". Here's what the poster said:

The more I read the more I get bothered for us all about how much we dont know before and after surgery.

I, myself, dont even know when my surgery is(I had to put in a date when I listed my surgeon?), I dont even know who to ask since it seems we all meet many different people throughout all this.

It really is getting frustrating. There are so many people on here that dont know what to eat when they get home, what to do, or even before WLS, they have many unanswered questions.

Is anyone else frustrated and bothered by how little we dont know, and how noone even tells us who to ask???

And I'll be honest. The post IRKED me to no end. Basically this person is EXPECTING other people to tell her about surgery. I find this is often the case in my support group too. People come in with no information. They don't want to be advocates for themselves. They go strictly by the information given by the doctors and are like sheep just following the masses, waiting to be told things on a need to know basis.

While I realize that there are some people that perhaps don't have a skill set that may allow them to access information (perhaps not online, illiterate etc) I believe that most people should have the skill set needed to investigate, to ask, to research, or in the very least, to read a couple of books about Weight Loss Surgery. I believe that everyone should at least own a copy of a book or two. I always suggest Weight Loss Surgery for Dummies as a good beginner tool. I know that most people are not going to be as crazy as me and read study after study, but I do think that with a life changing surgery, everyone should be doing some reading to learn and study their surgery.

There should almost be a test on terms, basic ideas of surgery, basic complications. I shudder when I hear people, 3 weeks out say "What's a stricture?". In this day and age there is SO MUCH out there. All one has to do is LOOK FOR IT!! To Google it for goodness sakes.

This topic reminds me of the conversation that I had last night with my friend and walking buddy from my support group. She is a quiet gal, who doesn't always say much at our meetings  but here's the thing, she had surgery 11 flippin years ago.

11 years ago!!!

I can tell you that five years ago, information wasn't as easily available as it is today to come across. Back then, when I had surgery, there were literally a handful of books to buy and some sites - not a ton of personal ones though - about bariatric surgery. Thank goodness for obesityhelp.com because that one at the time was the best (and still is in my opinion!).

Anyway, when my friend had her surgery 11 years ago, she got nothing in the way of information. Basically the information was to stay away from "Sugar, fatty foods and pop". She had no instruction on post op care, no information of complications (she had no idea of strictures until she came to our group many, many years later). They did not tell her to stay away from NSAIDS. They did not tell her to take any vitamins. There was very little information given to her.

And yet, she did amazingly well. 11 years out and she'd like to lose a few more pounds but she is still in a good place with her weight and eating. She was a success DESPITE her program and I'd venture to say that probably a lot of patients back then were not as successful.

She's amazed by how much information newbies get. She wishes she'd had the supportive network that they have. She never had any kind of follow up care. She's envious that there are so many great resources for newbies to have now when she didn't get any. Not even a support group in her area when she was out. She was like an "island" and the only person that she knew after surgery that her surgery was HERSELF!

I'm in awe of the woman for this reason.

But this day and age, no one has a reason to be uninformed. It is now a choice. This is the INFORMATION AGE. Use it. Study your surgery, know it inside and out. Know every term from strictures to foamies to NSAIDS. Learn about reactive hypoglycemia (so you can catch it if you get it), all complications (especially those that are common), vitamins, exercise, strength training and all things to do with physical fitness (basal metabolism, learn about the different types of surgery and what is covered in your area because some surgeries are better for different people than others. YOU MUST BE AN ADVOCATE FOR YOURSELF.

Don't assume that your doctor is going to remember the "no nsaid" rule everytime s/he gives you an NSAID.

Don't assume that doctors are going to procedures that are in your best interest. (Like the lady who 2 weeks out was going to get a scope had she not stood up to her emergency room doctor and said, "I can't have one this early out!".

LEARN, READ and learn some more ;)

So my only response to the lady who asked the question "Why are we so misinformed?".
is very simple.

It's a choice. I wasn't. Are you?

Dawn

The Myth of the "Call your surgeon!".

When you have surgery and ask questions or have problems afterwards, you will find people saying this simple statement "Call your surgeon!" or "What does your surgeon say?". This is a bit of a confusing response that I feel the need to explain.

When that phrase is used, what most of us really mean is "what does your surgeon's team say about that?". You see there is a bit of a myth that goes along with surgery - that you'll constantly be in contact with or need to see your surgeon every time a problem erupts.

It is true that if you are having major issues like strictures (not keeping things down) or issues with the mechanics of surgery that you will need to actually see your surgeon, but for the most part, you have to realize that your surgeon is an expert in the mechanics of surgery. Your surgery is not necessarily an expert in your aftercare such as diet, nutrition or psychological aspects that go along with surgery. That's why it is of the utmost importance to make sure that your surgeon has an excellent aftercare team comprising of experts like a dietician, social worker or psychologist, and so forth. These are the people that you will need to talk to the most after surgery. If your surgeon is isolated and has no team behind him/her, I would seriously think of a new surgeon. You need after care. After care is critical to being successful with WLS.

Recently, a lady in my support group was upset because she was having pain and the bariatric team told her to go to emergency. Another lady I know was upset when at her 6 month follow up, she did not see the surgeon but rather "just the dietician and social worker".

Any time you have pain, it will not be the surgeon that you will not see. Again, his/her duty is over. You would go to emergency and they would decide by tests whether it would be something like your gallbladder, kidney stones, or appendix. Your surgeon again is the expert at the surgery he performed on you. If you cannot hold things down and have a stricture, s/he would fix that because it is a direct issue with surgery. But otherwise you will see the inside of the emergency department when you have pain, not your surgeon's office.

As well, the surgeon's last job really is to check that your incisions are healed. When that's done, his/her job is pretty much done and that's when you need the other specialists - dieticians etc to help you with your aftercare. The surgeon does not necessarily read the latest studies on how many grams of protein you need or what studies say in terms of the latest vitamin info.

So remember when we say "see your surgeon!" that it means call your surgeon's office and contact that after care team. That's what they are there for and they are worth their weight in gold :)

Dawn

Why I Hate My Scale

One year post op gastric bypass and five years post op are two very different animals. One thing that I LOVED my first year out was my scale. It was my best friend. It gave me validation practically every day as I would get on and the numbers get smaller and smaller. It was a thrill to step on. It was an amazing feeling to know that I was in the next ten pound range. What an amazing feeling. When I got to ONEderland (out of the 200 lb range), I practically wanted to kiss the scale. My goodness how much I anticipated that love affair with the scale! Along with the compliments from friends and family, it made me feel like a million bucks almost every day. And then new clothing sizes! Can you say: HIGH!! Who neededs alcohol or drugs when you have the scale, compliments and a size medium? They are the "crack" of weight loss.

But then after a year or two, the scale stops. No more validations. Compliments eventually stop coming. You stop and you stay the same (called maintenance) and there's no more new sizes, no more new numbers, no more rewards).

Then temptation starts, food calls out to you more and more and ta-da, as quick as an instant, the scale can start to creep up again.

That's the 2-3 years out range that it happened for me. Gosh, that was a hard year!! All of a sudden I didn't like the scale. If it was down one day, I'd be happy, excited and thinking "yay I'm doing great" but then the next day, it could be up two pounds for no particular reason.

I'd want to weep. I'm not kidding. I'd want to cry. What did I do? I didn't eat anything different. I exercised and did everything right. WHY WHY WHY?

Realistically, the scale does this especially being out a long time. Take for instance, yesterday when I ate very healthy and exercised. Here's my day in recap:

Breakfast: Veggie Omelette with low fat cheese, 1 piece toast, light becel
Lunch: leftover cabbage casserole (1 cup).
Dinner: Piece of pork chop (deck of cards size, 1 small ear of corn, 1 tbp butter, 1/4 cup of potato salad).
Snack: apples and 22 almonds.
Exercise: Walked 10 miles.

Pretty good day. Eating was fairly good - even the potato salad (made by my mother in law) was "low cal, no salt and "healthfied" as much as possible). And those 10 miles - c'mon on!!

Yet, I'm up a half of a pound today.

What power that little scale has over me. It made me feel totally worthless this morning as I was sure I'd have a loss and I was up. So automatically the thought/mindset does this:

"Those 10 miles weren't worth it".

"Why bother watching what I'm eating if I'm just going to gain anyway. I should have had the chips (or chocolate or whatever I am craving at the time).


The scale is no longer my friend. It beats me up. It validates if I'm doing a good job (even if I just happen lose despite eating poorly) or if kicks me in the rear when I don't see the results I want. It either starts my day feeling like a million bucks (if I'm down) or feeling like a dog's breakfast (if I'm up on the scale).

I hate it. I love it.

Dawn

There are no guarantees with WLS.

I'm a die hard realist and for that reason, I always like to express how there are no guarantees with weight loss surgery. I see and talk to a lot of people being that I run the local support group and I see a variety of attitudes within the group. Most people have very realistic expectations but once in a while, I run into people that make a lot of assumptions about surgery - only to disappoint themselves when they don't get the results that they want. Realistically, we need to go into this surgery with the mindset that we do this for health. Here are the statements that I hear sometimes that worry me:

~ "When I get to a size 2, I will....".
~ "When I'm smaller than my sister, I will....".
~ "When I lose all my weight, I will....".

I worry about these because even though I was positive I had realistic expectations, I know that there was somewhere deep inside of me, where unconsciously I was certain that I'd end up being an 18 year old, blonde bombshell who was too small for a size 2.". LOL!! I think everyone subsciously has this desire to turn into Britney Spears with rock hard abs and a killer body. LOL!

Then we are disappointed to end up as a scraggly, wrinkly 40 year old like myself who looks good when I dress myself appropriately upscale but looks haggard in a pair of shorts and tank top. I'm serious here.

And I barely got to a normal bmi despite the fact that I exercised like a mad fiend my first year (I walked a half hour to work and home and then jumped on my treadmill for four more miles after that!).

I ended up not a size 0, not a size 2, not a size 4...but a size 10. I mean I had coworkers who were size 0 after having three kids!! It was devastating!

Realistically though I know that I'm bigger boned in many respects. I didn't even change a shoe size after WLS whereas many people can change and lose 2 or 3 sizes in their shoes.

The Bariatric Centres of Ontario often quote that a 50-60% loss of excess weight is what they consider a success with WLS. I surpassed that easily my first year. But then hit bounceback and, still went higher than that amount. Even with bounceback I've lost more than 50 - 60%.

So what does that mean? That means that they are being absolutely conservative in their numbers and well, they have to be. Knowing that people's genetics are all different, people's metabolisms vary greatly, mobility varies and definitely the amount of weight to lose. Most people that are 400 lbs will not see a number in the 100s. Some do - but they are few and far between. That means that being 400 lbs, you won't necessarily be guaranteed to be 150 lbs by the time two years are out. Can you be happy with 200?

That's the concept that people need to grasp. There are no guarantees that you will ever be a size 2, that you will lose *all* your excess weight, or that you will ever be smaller than your sister.

Mindset is key here because where you end up will be determined by *YOU*. If you don't reach a certain size or a certain weight (yes you can keep trying!) will you define yourself as a success or a failure? For me, because I was a 10, for a LONG time I defined myself as a failure. Now I'm changing that attitude and seeing that life is SO MUCH MORE than just a dress size or a number on the scale.

So be sure to measure your success by NON SCALE VICTORIES. Make lists of things you can do after surgery that you couldn't before. Keep those biggest pair of pants to remind you were you were and where you are now.

Remember my friends, attitude is EVERYTHING!

Dawn

10+ Expectations for Newbies: LONG POST!!

10 Expectations for Newbies Having Gastric Bypass

Remember to always go by the instructions of your surgical centre. I am not a surgeon and do not give medical advice. This is a rehash of what I talked roughly about at my last WLS support meeting:

1.Expect to lose a lot of weight your first year.

The first year is crucial for how you will do. It is a predictor of your success. The more you follow the rules, the better off you'll be and generally the more you will lose. The more you cheat and go off program early out, the more you'll probably struggle down the line. Your first year will have your greatest loss and is called your “window of opportunity”. Typically after that weight loss does dramatically begin to stop. Most people lose their lowest weight at the 1.5-2 year mark. After that your body is “just like everyone elses” and you may possibly gain a little “bounceback” due to the loss of malabsorption.
Expect to minimally lose 50-60% of your excess weight.
If you are 100 lbs overweight, it means around 60 lbs.
If you are 150 lbs overweight, it means 90 lbs.
If you are 200 lbs overweight, it means 120 lbs.


These figures are conservative. Some people lose more, some lose less. If you want higher numbers, you'll need to work at it more (think: exercise), watch the processed food (you should be primarily eating “clean” from the outside of the supermarket: dairy, fruits and veggies & meat. Protein first generally, veggies second and carbs generally last (smaller portion). Work your new “tool” the first year and you could be one that has a huge payoff losing 80-100% of your weight.

2. Expect to come off your medications but also expect to supplement religiously for the rest of your life.

Most people right away come off medications, even diabetes medication from the day that they have their surgery.

But you will trade this for a lifetime of vitamins and supplementing for the rest of your life. Most common are all b vitamins, iron, vitamin a, d, calcium etc.

Expect to get your bloodwork done regularly – usually every 3 months the first year, at least one or twice a year after that. Supplement according to your surgeon. You can always choose to supplement more – but be VIGILANT with your blood work. That's the key!!! Get tested every 3 months the first year out and at least 1-2 times a year for life. If you go through a period of feeling especially tired or draggy, then get it tested too.

Blood work is CRUCIAL. Playing “catch up” with a nutritional deficiency can be an awful thing and may even require you to take off time from work! So you need to be SUPER VIGILANT about your blood work and following your surgeon's program. All you have to do is talk to one person that has had a SERIOUS deficiency and you'll know why it is so important to deal with your issues in your blood work right away!!!As well, it is a good idea to get a bone density scan at the year out mark to make sure your calcium levels are good especially if you've been on medications that predispose you to bone issues such as Depo Provera.

3. Expect that you may have a complication at some point.

The term “complications” always brings up scary thoughts doesn't it? A complication doesn't have to be a total nightmare. Expect them and be pleasantly surprised if you don't experience them.

Most Common: Infections, strictures, ulcers, gallstones, kidney stones, bowel obstruction, reactive hypoglycemia. We rerouted our natural plumbing – so expect issues now and again. You should be familiar with what all these things are – there are lots of great books such as WEIGHT LOSS SURGERY FOR DUMMIES that give you great basic info. If you expect and watch for issues, then you will be ready for them mentally when they occur then if you are oblivious to them (education goes a long way with surgery!).

If you don't have any issues (and many ofpeople don't) you'll be pleasantly surprised!

ANOTHER KIND OF COMPLICATION: The other “loss” is often relationships change, friendships change. But be prepared to lose a friendship or two or to have one or two family members tell you that surgery is going to be a terrible thing for you.
BE AWARE THAT THE MORE PEOPLE YOU TELL ABOUT WANTING TO HAVE SURGERY, the more negative you will hear before surgery. Most people tell people after they've had surgery.

EXPECT TO DO SURGERY FOR YOU AND NO ONE ELSE!!! BE PREPARED TO HAVE DEFICIENCIES AT SOME POINT IN THE ROAD. BUT BE PLEASANTLY SURPRISED IF YOU DON'T HAVE PROBLEMS.

4. Expect to have a hard time eating and expect to have dumping syndrome.

Surgery changes our relationship with food. Everything we did before surgery will be different after surgery.

We used to wolf down food. Now we have to chew, chew and chew.
We used to eat a lot of carbs. Now it's protein, protein, protein.
We used to drink while eating and we could get a lot of food stuffed in there.
Most of us ate a lot of carbs that helped us gain weight, now it's all about focusing on protein.

For most people eating after surgery is not a fun activity. It is NOT enjoyable in the least. It is your daily duty and your daily job. That sums it up!! You must force yourself to eat even on the days that you really aren't even remotely interested in food. Yes, that is often the case!!!!!

Early out, you may find that foods that you liked before surgery, you no longer like or they do not agree with you. This is extremely common as your “taste buds” seem off. It doesn't last forever. Think of this as power over food. Your first year is amazing for this. If you can “take it or leave it” leave the junk food off your plate as long as you can. It's a powerful thing to say NO!

In addition, some things may make you vomit, some may make you feel ill. You may become lactose intolerant. Expect the unexpected – a food you have one day can totally not agree with you the next.

Expect to read labels of every food you eat.

Dumping syndrome is basically a negative reaction to high levels of sugar and fat in your diet. Know your limits well and do not test those limits. The people that have the most success with surgery are generally those who eat like they “dump” - ie. They avoid simple sugars. They eat very little processed foods. Don't test the waters too much especially your first year.

You'll experience much more success (and weight loss) and you'll avoid the constant craving for carbs if you keep the simple sugars away. Most people do who dump do so only in their first year and it is a terrible terrible thing if you've experienced it. Eat within the sugar guidelines as suggested by your dietician. Set yourself up for success as much as possible!

Surgery changes our relationship with food especially for the first year (unfortunately it doesn't last forever!). It may mean for the first time in life, you don't like eating anymore. It becomes boring, regulated, the joy is gone. Eating becomes our job. It becomes not exciting anymore. It is routine and boredom. Some days you'll have to force yourself.

It's changing from live to eat, to eat to live.

Many people for this reason have “buyers remorse” - they experience depression after surgery – they have lost their best friend. Some people feel great after surgery, others feel like they have been hit by a mack truck. For some people it will take 6 weeks before they feel 100% back to normal and they feel like the food issues are more tolerable.

Remember that your water and protein goals are only goals and you may not consume enough for a while. Some people get in only half their protein and water initially. The key will be pushing yourself to take in a little more each day and eventually get to the point that you are reaching goals.

Also: your pouch will make a lot of noise especially initially out from surgery. (mine does to this day). You'll hear lots of gurgling inside. Do not confuse this with the “growling” of hunger as many do. It's gas and air.

5. Expect that your journey will be different than others.

You will lose different numbers than others even if you had the surgery the same day! You will lose it from different places. Your body is a very unique thing. As a general rule of thumb, the older you are the slower your metabolism may be. The more you lose before surgery, the slower your loss may be (just initially) and men tend to lose faster than women due to their muscle mass.

EXPECT STALLS! It's normal. First one usually at 3-6 weeks out and then every so often on your way. Absolutely normal and be prepared: Some stalls can last a month or more!

Don't compare – your journey is your journey.

Don't EXPECT TO LOSE THE WEIGHT OVER NIGHT. Remember 2, 3 and 4 lbs a week over time adds up!!!!!!! Remember losing 2 lbs a week x 52 week in a year is 104 lbs!!!!!!!

When the scale, stops use alternate ways of measuring success. Keep a log of all the things you want to be able to do – make it while you are pre op. Then cross them off the list as you do them (Eg. Cross your legs). Use the tape measure to measure your success too. As well keep one of your biggest shirts and pairs of pants. It's a great thing later on to try them on and “see” where you have come from. Take a lot of awful “before” pictures – trust me, you'll learn to love them later!


6. Expect to be your own advocate.

You need to read, read and read some more. Studies abound online, there are many books. Do not depend on the bariatric centre to tell you everything and hold your hand during this process – you will need to do reading beyond what they give you. You should spend as much time researching your surgery and reading about your surgery as you can.

You need to be an expert in your new body.

You will need to also do your own research. There is a HUGE LEARNING curve with surgery and the more you know, the more successful you'll generally be in the long term. You need to embrace this surgery, and study your surgery– and know everything about it.

You should know that you had a ROUX EN Y GASTRIC BYPASS. Not an RYN and not a “gastric bypass”. You need to know the name and what you had done!You need to ask every time a doctor prescribes you something “is that an NSAID?”. To make sure that it is not. Never assume they'll remember!


You may want to invest in a medic alert bracelet or necklace your first year out or at least a “fake” that way your information will always be on you your first year.   Although some programs recommend them, it's generally overhyped.  Just put your surgery type and date on it.  Please see my post about medical alert bracelets as there are some things I would never put on mine that many do.

You NEED TO KNOW THE INS and OUTS of this surgery. THE INS and OUTS of how to read a label. If you are online, there are many sources of great information. Www.obesityhelp.com is one of them.

7. Expect to have a surge in confidence.

The first year is amazing – you'll learn to love clothes shopping, looking in mirrors, seeing the weight come off, and you'll generally feel empowered and ready to take the world on at your one year out mark. (Yes the first few months can be tough but the pay off is big by one year out).

Be careful though about assuming that your surge of confidence is going to be forever. Be careful especially if you are on medications for depression. Some people take themselves off medications during this “high phase” only to come crashing down at a later date. Please don't take yourself off of medications – only do so when a doctor tells you and make sure you are being monitored closely. Losing weight does not mean that your hormones and body is going to fix itself even if you are feeling in a somewhat “good place” with your weight loss.

"Bariatric surgery does not cure depression, and these patients need treatment for depression," --There are studies that warn about this because there can be a high rate of suicide for these people. You may find that after a while old issues come back, you are struggling with your food addiction and may need therapy after a year or two. This is quite normal for many of us that have been overweight for a long time. Seek help from the support group if you need resources in your community or consult the experts at the Bariatric Centre.

The high of the first year or so will dissipate once you start having issues with food again. Your issues WILL come back. Surgery fixes our body, not our head.  Please look into your eating issues before surgery. 

8. Expect to attend support group meetings

Zirui Song, et al published an article in the ASMBS publication Surgery for Obesity and Related Diseases (SOARD) in 2006 entitled: "Association between support group attendance and weight loss after Roux-en-Y gastric bypass."

Results: Patients who attended more than 5 support meetings within the first year lost 55.5% of their excess weight. Patients who attended less than 5 meetings lost 47.1%. So by attending meetings, they lost an additional 8.4% of their excess weight.

In real world numbers that would mean:300-pound pre-op weight, with 135-pound ideal weight = 165-pound excess weight
>>  47.1% EBWL = 77lbs lost
>> 55.5% EBWL = 92lbs lost

Why support groups important:
network with people going through issues
you refocus yourself and your thinking
you are reminded constantly about what constitute success
you get feedback, suggestions from others
it is “you” time. It's about refocusing on your journey again.

And yes sometimes its hard to do!!!!!!!!!!!!!!!! Sometimes the hardest thing to do is come to meetings when you are ashamed or struggling. Trust me everyone has been there. We all struggle with our weight EVERY SINGLE day even those who have gotten to a normal weight. You'd be surprised how many people struggle with still psychologically feeling fat or with their body image. You are never alone in this journey.

9. Expect to exercise regularly.

You don't need to belong to a gym once you have surgery. Walking is generally free although I highly suggest buying a GOOD pair of properly fitted shoes – well worth the investment.

Exercise should be a part of your life from the time you get home and start walking. Within a few weeks, you should be regularly walking. Try to find a walking buddy and even if you feel like sitting on the couch, you need to find someone to push you off that couch! Recovery will be faster if you push through the feeling of “blah I want to sit on the couch”. Push yourself through the tough time and tell your supporters not to baby you but to encourage you and walk with you.

The Bariatric Centre wants you moving as much as you can.

That doesn't mean kickboxing or Tai Kwon Do.....but just walking and moving your body. As long as you are moving it doesn't matter what pace. Go slow and when you can, adjust accordingly. As Nike says JUST DO IT!

Expect to need cardio and strength training. (toning). Toning won't necessarily make that skin look beautiful but it should make you a little less jiggly!

In a 1999 study of successful gastric bypass patients: Successful patients exercised regularly to maintain their weight an average of 4 x a week for at least 40 mins. Patients reported exercise as a key factor in their ability to maintain their weight after the initial loss.

10. Expect to deal with your addiction again and the possibility of bounceback/regain.

Eventually the weight loss stops, the scale stops moving, the craving comes back...you are going to need to deal with your addiction at some point again. That's when you might consider therapy, overeaters anonymous, BANA, private counselling, and even support groups again like Weight Watchers. That's when you need to make a point of coming back through our doors again.

Most patients hit their lowest on the scale at 1.5-2 years out.

Most gb patients regain 10 – 15% of their weight loss in 2nd- 3rd year out from surgery. (“bounceback”). Be careful of the phrase: “x amount of lbs gone forever” because they can come back.

YOUR WEIGHT LOSS JOURNEY DOES NOT END WITH THIS SURGERY.

Eventually the weight loss stops, the scale stops moving, the craving comes back...you are going to need to deal with your addiction at some point again. That's when you might consider therapy, overeaters anonymous, BANA, private counselling, and even support groups again like Weight Watchers. That's when you need to make a point of coming back through our doors again

Some people are just not successful with surgery. You've heard about them too -A study in 1999 The most common was lack of exercise, poorly balanced meals, constant grazing and snacking, and drinking carbonated beverages. The first postoperative year is a critical time that MUST be dedicated to changing old behavior and forming new lifelong habits.

I see people often bragging about what they CAN eat the first year out.  "Hey I just ate two tacos!!" at a month out.  Okay, just because you CAN eat it, doesnt mean you SHOULD.  Often these people down the line are the ones saying "OMG I stretched my pouch!!!!!!".  You need to preserve the pouch as much as possible.  Keep it small. Try not to let your eyes get in the way of your stomach.  Respect the smallness of the pouch as much as possible.  It's a tool that CAN BE UNDONE.


A FEW EXTRAS :)

1. Expect Gas.

I found gas extremely painful initially after surgery. They pump you full of fluids too so there's lots of gas floating all over your body after surgery. I found the shoulder to be particularly painful. My pain meds were used for that more than for an incision! Gas X strips are really great. The other kind of gas (flatulence) is also extremely common. Yes, you might not know initially – but you'll find as you add carbs that's often where it comes in. A few hints: “Just a drop” is found at Walmart and is great for those post-toilet smells.

2. Expect to be cold.

It's true. It doesn't happen overnight that you'll be cold...but you may find that a month, or two or even after 6 months, you'll find that you are always cold. This is normal. Remember how when you were at your heaviest weight, you tended to overheat? It's the reverse for thin people. They are usually often cold. Welcome to the polar bear club! Bring lots of extra sweaters!

3. Expect to lose hair.

It is very normal. At about the 3rd-7th month will be the big period of hair loss. Things should slow down after that. Unless you have very thin hair to begin with, you should be fine. I was the only one who noticed my hair loss. Sure people will notice your hair in the bath tub, in the shower, in the pool....but they won't necessarily notice your lack of hair on your head. They'll just know you are shedding by your evidence that you leave. Many people swear by supplementing Biotin or by using Nioxxin shampoo or Maxxi Hair (found at Betterhealth Nutrition in the US). I just rode it out. I found I had a lot of breakage and did choose to do the chop to a bob hair cut so as to avoid more loss from breakage (I have very coarse hair that tangles easily so just combing I'd lose some hair). The bob cut really helped. Hey, isn't it great to update your look anyway?

Dawn

Went to Surgical Class Today

Going through the process of surgery with hubby is a pretty neat thing. Now that I have 5 years of life post op behind me, revisiting the process is a pretty neat thing. I attended class with him today, learned some new things, remembered some old things that I forgot (hey it's been a while!) and found out some interesting statistics. I wrote a few notes and so I'm going to share them here with you today.

I always knew about the fluid that they pumped into you before surgery. I gained 11 lbs in the hospital because of it....but I never really thought of "why" they do it. They basically pump you full of extra liquids because they want to make sure that you don't get dehydrated your first few days. It is a preventative measure.

I never experienced it but many people do complain about numbness at one of their surgical sites. (incisions). The numbness can last 6 months to a year. If it lasts more than a year, you'll experience that numbness forever.

As you are recuperating in hospital, check both your temperature and blood pressure if you can if you are experiencing problems to see if there are any signs that your body is experiencing a complication.

One of the biggest causes of weight loss failures are those that drink way too many high sugar and high fat drinks. So put the Tim Hortons Ice Capps and Starbucks drink away. You still should be primarily drink water.

At the 9 month mark is where they offer a class with the social worker because they find that at the 9 month mark is where people start to have "trouble" with their eating and drinking choices again (making bad choices).

If your Optifast is too thick, add ice or water. Freeze to make slushies.

Guelph patients tend to have a quicker recovery turnaround. They "bounce back" after surgery than patients from other surgicial centres. Thought to be attributed to the longer time on full fluids than other surgical centres.

Guelph wants you to take a prenatal vitamin, calcium with vitamin D. They don't want you to worry about your vitamins though for the first few weeks as it's just one thing to have more trouble with. They want you to focus first on fluids and food first so that you can recover and then you can worry about vitamins at the 3 week out mark.

Guelph does not have you do protein shakes.

I really enjoyed the whole talk. One thing that I really really liked was how Kristine the dietician used lots of real life examples of bad choices people make and things that people do erroneously. I liked how she emphasized that it is going to be a life long struggle. The last part of their slide show mentioned that the most important thing is to "keep up the battle" for the rest of your life.

Amen to that.

Dawn