Since I started working out at the wellness centre I've been mortified that i've been physically unable to grab my foot from behind to stretch my quads. I hate hate hate that i always have to have my trainer 'give me a leg up' so to speak. I've been determined to do it myself.
and today i did it! well only with my left leg. but i did it. felt kinda pathetic to be so excited about it, but as terrell (trainer) said, it shows progress.
spent much of my torture training session today with terrell (who's a physiotherapist) doing deep tissue massage on my left knee. when he had me doing lunges i was getting a sharp pain in the muscle running along the upper inside. ouch. he worked it out. we figure the pain was from saturday morning's insanely rough boatride to the exuma cays for the start of the kayak for cancer event. it was BAM! BAM! BAM! for an hour and a half. ouch!!! the next day i was so sore i wondered if i'd actually done the kayaking!
btw - i'm super proud of my dad. he and his partner finished the 32 mile course in about 9.5 hours. to call it grueling is not doing what they accomplished justice. best part is my dad alone has raised more than $8,500 in sponsorships for the local cancer society. so proud!
ok ladies. send lotsa positive vibes that i get the right answer from the insurance company... should hear from them by monday.
Tuesday, August 31, 2010
Friday, August 27, 2010
I'm getting healthier!
After my torture training session this afternoon, I asked my nutritionist (she owns the wellness centre where I work out) if she would do my body composition again.
I have lost about 30 or so pounds, but I was curious to know if my body fat percentage had changed much. When I started mid-June, I was over 42 BMI. Today I was 37. something. That takes me out of the morbidly obese category.
When I started, my body fat percentage was 45.7%. Today I am 41.6%. Doesn't seem like a HUGE change when we're aiming for somewhere between 25 and 30%, but according to Dr Patty, that's MAJOR progress that she doesn't usually see in such a short period of time. As she explained, fat is the hardest thing to actually lose.
I walked out of there on cloud nine!!!
Ok... I've packed my stuff up, have my bathing suit and stuff at the ready for my 3am wake up call. Tomorrow is the kayak fundraiser. My dad is one of a number of people kayaking from Ship Channel Cay in the Exumas to Nassau. I am going on a support boat and dock call is 3:30am. good lord what have i gotten myself into????? We are likely to be on the water for about 10-12 hours. Those of you who pray, please do. Those of you who don't, send positive vibes :)
I have lost about 30 or so pounds, but I was curious to know if my body fat percentage had changed much. When I started mid-June, I was over 42 BMI. Today I was 37. something. That takes me out of the morbidly obese category.
When I started, my body fat percentage was 45.7%. Today I am 41.6%. Doesn't seem like a HUGE change when we're aiming for somewhere between 25 and 30%, but according to Dr Patty, that's MAJOR progress that she doesn't usually see in such a short period of time. As she explained, fat is the hardest thing to actually lose.
I walked out of there on cloud nine!!!
Ok... I've packed my stuff up, have my bathing suit and stuff at the ready for my 3am wake up call. Tomorrow is the kayak fundraiser. My dad is one of a number of people kayaking from Ship Channel Cay in the Exumas to Nassau. I am going on a support boat and dock call is 3:30am. good lord what have i gotten myself into????? We are likely to be on the water for about 10-12 hours. Those of you who pray, please do. Those of you who don't, send positive vibes :)
Thursday, August 26, 2010
Set for Sept 22
To get my band! Well, that's the date the surgeon and I have set. Please, please, please everyone send positive vibes that the insurance company comes through and approves my surgery.
Just found out at my appt that my insurance company just denied another woman, saying she needed to do a year long programme. W.T.F.!?!?!?! If someone is diagnosed with heart disease do they say go off for a year and treat yourself and then we'll approve your quadruple by-pass?
Anyway, I work in news and so we're hoping that, and the fact that the ins company recommended this other woman work with my nutritionist, not realising she's part of the lapband programme, will work in my favour.
So fingers crossed.
I do have my hospital form - diagnosis is morbid obesity. Oh dear lord how I HATE that term!
Anyway, assuming all goes well, I will be checking into the hospital at 9am on the 22nd and surgery is scheduled for 10am. Great thing is my surgeon says I don't have to stay overnight in the hospital unless there are any complications. My mom will take much better care of me than the hospital nurses will :)
oh... and we didn't set a date, but my surgeon recommends I go out and have a meal with the patient advocate to really get an idea of what eating will be like post-op..... chew, chew, chew... the length of time it takes to get through a meal... the tiny portions. I think it's probably a good idea, besides, I like her.
oh.... and I did ask the patient advocate if they shave your lady bits for this surgery and she said yes, that i can go ahead and do it myself if i want. i made her laugh when i told her i was going to get waxed because i don't intend to be dealing with crotch itch along with all the other post op pains!
oh.... and turns out my doc is a stickler for the 2-weeks nothing but liquids before surgery rule. so guess who's going to have a sucky trip to atlanta! I'm going the 14-18th... just before surgery! Ah well. I also asked what his post op food protocol is and it's 1 week clear liquids, 1 week full liquids, 1 week pureed foods, 1 week soft foods and then on to regular food. so that's 6 weeks of no chewing for this chica. just gotta keep my eye (and mind) on the prize.
Just found out at my appt that my insurance company just denied another woman, saying she needed to do a year long programme. W.T.F.!?!?!?! If someone is diagnosed with heart disease do they say go off for a year and treat yourself and then we'll approve your quadruple by-pass?
Anyway, I work in news and so we're hoping that, and the fact that the ins company recommended this other woman work with my nutritionist, not realising she's part of the lapband programme, will work in my favour.
So fingers crossed.
I do have my hospital form - diagnosis is morbid obesity. Oh dear lord how I HATE that term!
Anyway, assuming all goes well, I will be checking into the hospital at 9am on the 22nd and surgery is scheduled for 10am. Great thing is my surgeon says I don't have to stay overnight in the hospital unless there are any complications. My mom will take much better care of me than the hospital nurses will :)
oh... and we didn't set a date, but my surgeon recommends I go out and have a meal with the patient advocate to really get an idea of what eating will be like post-op..... chew, chew, chew... the length of time it takes to get through a meal... the tiny portions. I think it's probably a good idea, besides, I like her.
oh.... and I did ask the patient advocate if they shave your lady bits for this surgery and she said yes, that i can go ahead and do it myself if i want. i made her laugh when i told her i was going to get waxed because i don't intend to be dealing with crotch itch along with all the other post op pains!
oh.... and turns out my doc is a stickler for the 2-weeks nothing but liquids before surgery rule. so guess who's going to have a sucky trip to atlanta! I'm going the 14-18th... just before surgery! Ah well. I also asked what his post op food protocol is and it's 1 week clear liquids, 1 week full liquids, 1 week pureed foods, 1 week soft foods and then on to regular food. so that's 6 weeks of no chewing for this chica. just gotta keep my eye (and mind) on the prize.
I have a date...
with my surgeon. this afternoon. to hopefully set my surgery date!
So hopefully later today I will be posting the date I'm set to get my lapband. Feels like I've been waiting on this forever, even though i only started the journey in mid-June.
Of course I realise that Dr D and I can set all the dates we want, but if the insurance company wants to act the ass, ain't nothin happenin. I still don't understand why my doc waits until after we've had this appointment to start submitting everything to insurance. wouldn't it be better if i walked in today and was told 'great news, they've approved it, now let's look a a calendar'????? ah well.
Thanks Catherine and Christine for responding to my last post about giving clothes away. At least I know that I'm either a) not crazy, or b) not alone in my craziness! I think once I've had the surgery I'll feel more comfortable getting rid of too big clothes.... that and another 2 sizes down :)
My work trip to Atlanta has been set for September 14-18. I've told my boss I'll let him know if I can go on the October 17 trip once I get my surgery date squared away. Ideally I'll be having surgery the week of the 20th September so I have almost a month before needing to travel again. Also would like to have it then because one of my bff's who happens to be one of my biggest supporters in this whole journey is having some eyelid surgery on the 21st and will be down and out for 2 and a half weeks too. I'd have someone to play with while I'm recuperating.
Saturday is going to be interesting.... up at 3:30am to get on a boat and go to the northen tip of the Exuma Cays to spend about 10 hours in a very slow moving boat. My dad and a friend of mine are participating in a 32-mile kayak event from exuma to Nassau to raise money for the Cancer Society. My mom, a friend of mine and I are going along in my dad's boat (captained by another good friend) as one of the support fleet. Pray the weather's not rough! Whenever we get back (they figure they will be paddling for about 10 hours and it's a 1 1/2 hour boat ride down there) there's a beach party to raise even more money. All for a good cause.
So tonight I'm joining my parents and my dad's kayak partner, his wife and kids for their big carb loading dinner at a nice local italian restaurant. I, of course, won't be doing pasta, but will find something else to eat.
Ok. enough rambling. Will post surgery date and official doc's scale weight later today. this morning my scale was 226.4 - down 36.1 in 10 1/2 weeks with no band yet :) Not too shabby
So hopefully later today I will be posting the date I'm set to get my lapband. Feels like I've been waiting on this forever, even though i only started the journey in mid-June.
Of course I realise that Dr D and I can set all the dates we want, but if the insurance company wants to act the ass, ain't nothin happenin. I still don't understand why my doc waits until after we've had this appointment to start submitting everything to insurance. wouldn't it be better if i walked in today and was told 'great news, they've approved it, now let's look a a calendar'????? ah well.
Thanks Catherine and Christine for responding to my last post about giving clothes away. At least I know that I'm either a) not crazy, or b) not alone in my craziness! I think once I've had the surgery I'll feel more comfortable getting rid of too big clothes.... that and another 2 sizes down :)
My work trip to Atlanta has been set for September 14-18. I've told my boss I'll let him know if I can go on the October 17 trip once I get my surgery date squared away. Ideally I'll be having surgery the week of the 20th September so I have almost a month before needing to travel again. Also would like to have it then because one of my bff's who happens to be one of my biggest supporters in this whole journey is having some eyelid surgery on the 21st and will be down and out for 2 and a half weeks too. I'd have someone to play with while I'm recuperating.
Saturday is going to be interesting.... up at 3:30am to get on a boat and go to the northen tip of the Exuma Cays to spend about 10 hours in a very slow moving boat. My dad and a friend of mine are participating in a 32-mile kayak event from exuma to Nassau to raise money for the Cancer Society. My mom, a friend of mine and I are going along in my dad's boat (captained by another good friend) as one of the support fleet. Pray the weather's not rough! Whenever we get back (they figure they will be paddling for about 10 hours and it's a 1 1/2 hour boat ride down there) there's a beach party to raise even more money. All for a good cause.
So tonight I'm joining my parents and my dad's kayak partner, his wife and kids for their big carb loading dinner at a nice local italian restaurant. I, of course, won't be doing pasta, but will find something else to eat.
Ok. enough rambling. Will post surgery date and official doc's scale weight later today. this morning my scale was 226.4 - down 36.1 in 10 1/2 weeks with no band yet :) Not too shabby
Tuesday, August 24, 2010
Giving clothes away... a dilemma and a question
Something Sam said in the comments section on my last post about going down a size got me to thinking..... am I ready to give away the clothes I've only just grown out of?
In short. No.... DEFINITELY not before I've had surgery.... I just don't trust myself enough yet to run the risk of having nothing big enough to fit in the event I start gaining weight again.
Can you tell this is a 'been there, done that, have a few t-shirts' moment?!?!
At what point did you guys feel comfortable giving away too large clothing? Or am I the only one who's felt this way?
In short. No.... DEFINITELY not before I've had surgery.... I just don't trust myself enough yet to run the risk of having nothing big enough to fit in the event I start gaining weight again.
Can you tell this is a 'been there, done that, have a few t-shirts' moment?!?!
At what point did you guys feel comfortable giving away too large clothing? Or am I the only one who's felt this way?
Monday, August 23, 2010
I went clothes shopping....
In my closet.... and came out with a bunch of 'new' clothes!
Yesterday morning I was out and about (oat and aboat if you're Canadian :) ) and realised that not only was I constantly pulling up my white size 20 capris, but I could pull them down without unbuttoning or unzipping (I waited til I got home to test this theory).
Clearly I am no longer a size 20, so I pulled all of those out of the closet and start rooting through to see what else I have and figure out what fits. My 18's are comfy (if *gasp* a wee bit loose) and at least one pair of 16's fit nicely though all the others I'd say are about 10-15lbs away from wearing in public.
I still have a pile of jeans on my bed to try on (it was just too hot last night to bother with tugging on and off denim).
Today I'm wearing a lovely pair of khaki slacks that I don't think I'd worn more than a couple of times before I outgrew them.
Nice to be in fitted clothing again as my 20's were quite clownish they were so baggy.
The only bad thing is I realised by going through the contents of my closet that I've got a decent supply down through size 14, but once those are too big (hard to imagine that ever happening right now) I'm going to have to start buying a few 12's to get me through.
I LOVE closet shopping!
Yesterday morning I was out and about (oat and aboat if you're Canadian :) ) and realised that not only was I constantly pulling up my white size 20 capris, but I could pull them down without unbuttoning or unzipping (I waited til I got home to test this theory).
Clearly I am no longer a size 20, so I pulled all of those out of the closet and start rooting through to see what else I have and figure out what fits. My 18's are comfy (if *gasp* a wee bit loose) and at least one pair of 16's fit nicely though all the others I'd say are about 10-15lbs away from wearing in public.
I still have a pile of jeans on my bed to try on (it was just too hot last night to bother with tugging on and off denim).
Today I'm wearing a lovely pair of khaki slacks that I don't think I'd worn more than a couple of times before I outgrew them.
Nice to be in fitted clothing again as my 20's were quite clownish they were so baggy.
The only bad thing is I realised by going through the contents of my closet that I've got a decent supply down through size 14, but once those are too big (hard to imagine that ever happening right now) I'm going to have to start buying a few 12's to get me through.
I LOVE closet shopping!
Saturday, August 21, 2010
Delish! pics of my first juicing attempt
I've been playing with the Vitamix Blender quite a bit with amazing results. this morning i decided to give the juicer a whirl. I know to watch for calories, so decided to make a red apple.golden apple.lime.ginger juice. This is what I started out with
Then One by one, I plunged the pieces of fruits and veggies into my juicer and this is what i ended up with
It's amazing just how dry that pulp is. gonna pack it up in a container and dump it on mom's compost this afternoon.
And the final product. I only had about a half cup and put the rest in the refrigerator.
Thursday, August 19, 2010
I am sooooooo in love!
.... With my brand spankin' new Vitamix Blender and Omega masticating juicer..... oh, and my dbf who offered to buy these pricey gadgets as a very belated birthday present!
They arrived yesterday and last night I used the blender to pulverise (was not my intent.... i need to practice with different speeds for different tasks) red, yellow and green pepper and onion for a spaghetti sauce I was making. It actually worked out really well.
For dessert I spent about 10 seconds making a delicious treat for me and dbf out of frozen strawberries, vanilla greek yogurt and a bit of sugar. It blends to an almost ice cream consistency and was lovely and on plan!
Tonight I intend to use it to make a steaming black bean soup - yes, just as you can make ice cream, you can make hot soups with the same gadget!!!
Haven't tried out the juicer yet, but that's more for when my nutritionist puts me on my liquid diet leading up to the surgery.
Speaking of surgery.... I am getting a little stressed. I have my surgeon's appt next Thursday and hopefully we set a date then. That's also when he'll put in the insurance paperwork so I'm not sure how long they'll take to respond.
Here's my dilemma. or dilemmas. One boss wants me going to a workshop in Atlanta on Sept 14-18. That means earliest I can think of surgery is Monday 20th. That's stressful in that I'll be juggling a liquid diet while travelling. oh well.... i can manage.
Now today just found out another boss wants me to go to a conference in Austin, Texas from October 17-19.
These trips are squeezing my window of opp for surgery quite a bit!!!!!
Am going to call the surgeon's patient advocate today to let her know my dilemma and ask if it's at all possible for them to start the paperwork before my appointment in a week. I know the nutritionist, psycho therapist and doc who did my physical have all cleared me for surgery so that isn't an issue....
fingers crossed. I really don't want to have to wait until late october to have surgery.....
Vitamix Blender |
Omega juicer |
They arrived yesterday and last night I used the blender to pulverise (was not my intent.... i need to practice with different speeds for different tasks) red, yellow and green pepper and onion for a spaghetti sauce I was making. It actually worked out really well.
For dessert I spent about 10 seconds making a delicious treat for me and dbf out of frozen strawberries, vanilla greek yogurt and a bit of sugar. It blends to an almost ice cream consistency and was lovely and on plan!
Tonight I intend to use it to make a steaming black bean soup - yes, just as you can make ice cream, you can make hot soups with the same gadget!!!
Haven't tried out the juicer yet, but that's more for when my nutritionist puts me on my liquid diet leading up to the surgery.
Speaking of surgery.... I am getting a little stressed. I have my surgeon's appt next Thursday and hopefully we set a date then. That's also when he'll put in the insurance paperwork so I'm not sure how long they'll take to respond.
Here's my dilemma. or dilemmas. One boss wants me going to a workshop in Atlanta on Sept 14-18. That means earliest I can think of surgery is Monday 20th. That's stressful in that I'll be juggling a liquid diet while travelling. oh well.... i can manage.
Now today just found out another boss wants me to go to a conference in Austin, Texas from October 17-19.
These trips are squeezing my window of opp for surgery quite a bit!!!!!
Am going to call the surgeon's patient advocate today to let her know my dilemma and ask if it's at all possible for them to start the paperwork before my appointment in a week. I know the nutritionist, psycho therapist and doc who did my physical have all cleared me for surgery so that isn't an issue....
fingers crossed. I really don't want to have to wait until late october to have surgery.....
Monday, August 16, 2010
An interesting article on restriction
I've pinched this article from a wonderful blog I've been reading my way through. Fluffy has been banded for five years and continues to share her journey. She found the article on another blog but can't remember where, so claim it if you first posted it!
Here's the article: (source: Dr. Terry Simpson - It's Not About Restriction)
The Lap-band is NOT about Restriction
When talking about the band, some patients talk about restriction. Let's first be clear about one thing: the purpose of the band is not restriction; the purpose of the band is to lose weight by suppressing the appetite.
When band professionals talk about restriction we are talking about something totally different than "restricting what a person eats." In fact, many band surgeons avoid talking about restriction so as to not confuse patients. The band works by dimming the appetite, and this provides a conscious control and decision made by the patient, it does not work by "making" a person do something, or keep them from eating too much.
The Lap-band works by suppressing your appetite
As a result, you are less interested in food between meals, making it easier to resist temptation. The analogy is when you are near a vending machine when you are hungry-- what do you do? Probably find yourself with some junk food that is not a part of your plan. But, when you pass a vending machine when you are full, it may not even catch your eye. Having the appetite dimmed makes you less tempted by the many food choices modern living throws at you - -this is what the band does, by suppressing appetite you become less interested in food.
What you should not feel, with the band, is the sensation of being "stuffed."
When you eat Thanksgiving dinner, you can feel stuffed. Contrast that with the sensation two hours after you eat your big meal, at that point your appetite is suppressed. It is the subtle dimming of the appetite that the band should provide. Being stuffed after a large meal is a complicated sensation of the abdominal wall stretching and a lot of gas in the bowel, in addition to feeling a diminution of appetite. You will not, and should not, feel the abdominal wall stretch with the band. You should not feel the "near nausea" and you should not feel bloated.
Key point: You should NEVER eat until you feel full. It is best to stop eating before you "feel full." If you do eat until you feel full you will most likely be overstuffed. This leads to the universal key to success -- patients who eat a small volume of food (which, if you measure, is consistent) will be successful with the band. If you want to succeed, you need to know how much you are eating, and then stop eating -- it is in your control, but the band will help you -- not by stopping you, but by allowing you to feel satisfied after the small volume.
Early on, most Lap-band patients do have a sense of "restriction"...particularly after the first fill. When we place the band on a patient the stomach above the band typically will hold one to two ounces (by volume, not by weight). The stomach has a lot of muscle fibers, and the wall of the stomach is fairly thick. When food is consumed, it arrives in the pouch, and meets some resistance, first against the newly adjusted band, and then against the stomach which does not stretch easily. People love this feeling! It is a sense of control over food -- a leash. But it is not permanent. It makes it difficult to eat more, because the top part of the stomach and the band will resist it. If you over eat you will feel uncomfortable.
This is the honeymoon phase, you feel full with less, no appetite, and if you try to eat more it doesn't work. They eat a small amount of food, they feel satisfied, and they are losing weight.
For patients who rely on this sensation, they will find it will take ever increasing volumes of food to obtain this sensation. The initial response is to have their band adjusted so that they can "feel full again." Against a tighter band, the upper stomach stretches a bit (and if they eat fast it stretches more)and they again have the sensation of "feeling full." This becomes a cycle, a tighter band, the stomach stretches more-- and then instead of going back to its original size, the stomach stretches more and more to where it takes more to fill it.
The person who continues to eat until they have this sensation, will find that it takes more and more food to obtain this feeling. Two things happen -- first the stomach stretches to where it accommodates more food, and to stretch it means you have to eat more. The second is that to "feel full" it takes the brain time to register this sensation -- this is not the sensation registered by the hypothalamus, but registered in the conscious cortex. So your stomach can be full, but your brain won't register it for a while, and if you keep eating you can overeat. As a result, the pouch dilates. Similar to a balloon, when you first start to blow up the balloon it takes a bit of force. As you continue to fill the balloon, the wall of the balloon stretches (thins out), it is easier to blow it up -- the same is true with the upper pouch. Early on, before the pouch is stretched, it takes a little bit of food to cause it to stretch, but with chronic over-eating the pouch will accommodate more and more food. The stomach wall is thinner, it is easier to stretch, and to get that sensation it takes more food than at first. Often patients will complain that they "don't feel restriction," and wish to have the band made tighter.
There are two potential results to this: one is the patient will passively stretch the stomach and esophagus and not be eating a small amount of food. These patients simply do not lose the weight that the surgeon expects. The other is that the band will be forced down the stomach, the band will slip, which generally requires operative intervention to reposition it.
For those patients who are rigorous about the volume of food they eat, and do not let the stomach to tell them when to stop eating - they do very well. This is one of the keys of successful patients, only eat a certain portion of food - period. If the band is properly adjusted, the appetite will be dimmed for several hours. Once your brain realizes that a small amount of food keeps you satisfied, then your eyes will adjust to the amount you eat.
Some describe a "soft stop." Where before a sense of fullness occurs, there is a signal from your body -- this can be a runny nose, a sigh, or a subtle ache in the left shoulder. Patients who find this "soft stop," do very well with the band.
The other advantage of eating small portions is it becomes a lifestyle change--you will have the ability to gauge the amount of food you can comfortably eat, knowing it will keep you satisfied for several hours.
You can always -- always, always, always, -- eat more food, because, contrary to what we believed for a long time-- food passes by the band within a minute and then into your stomach. But the key to successful patients is not how much they can eat, but how little they can eat to suppress hunger.
The band goes around your stomach, not around your brain, or your lips
This simple concept, of eating a specific volume of food -- eating it slowly, and then walking away, is the key to successful eating habits of patients. This means that the band works with effort from you -- not by it doing everything for you. You have to make the decision to eat a small volume of food, and let the band work with you.
The sensation that we would want the band to produce is the "soft stop." The soft stop is when you eat a small portion of food and walk away. Sometimes this is difficult, like most things, practice makes perfect. To set yourself up for success -- we recommend you use smaller plates, along with smaller utensils. If you go out to eat, ask for the to-go bag immediately, and remove the excess food from your plate. You can physically always eat more food, but the advantage about practicing small portions and walking away, is ultimately your eyes will get use to what the stomach is telling it, and it will be much easier to eat smaller portions as time goes on.
It isn't uncommon for patients to want an adjustment because they say they can eat more
The first question we ask is, "Why are you eating more?" The typical answer is, "Because I can." The typical response, "Just because you can does not mean you should." Since the band's job is not to restrict the amount of food you eat, do not leave that to chance -- that is your job. Part of personal accountability is to account for, to measure, to know how much you are eating at a time. The band is empowering; if you eat an appropriate amount and make appropriate food choices, you will be satisfied for several hours. This results in either weight loss, or weight maintenance (if you are at your goal). The purpose of the band is to assist you to lose weight -- and this occurs only with active participation by you: you chose what to eat, you choose how much to eat, and you practice walking away after eating that amount. The band is a tool to allow you to eat less and have your appetite dimmed resulting in weight loss, or maintenance. It is a tool to help you adopt a healthy lifestyle -- you still have the choices to make, but the band allows you to be satisfied with those choices.
"If I could eat less and walk away, what would I need this band for?" -- a common question we are asked. Without the band, if you eat a small amount of food and walk away your appetite would rise within a couple of hours -- you would find yourself hungry and wanting more food, possibly leading to unwanted snacking. You would also find, if you willed yourself to withstand the hunger, that your weight loss gradually decreases. The band fools your brain into thinking you ate more.
Think of it another way -- the hypothalamus does not have eyes -- it doesn't know how much you ate, it doesn't know if there is a lot of food around and you are not eating it, or if there is a band on your stomach. The hypothalamus reacts very simply to the stimulation provided by the upper part of your stomach. Stretch that thermostat, it thinks you are eating a lot -- do that consistently over time, and it behaves as if you are eating a lot all the time and will allow your body to release fat stores and not cause your body to go into a metabolic slow-down. Conversely -- if you go on a diet, without the band --and that part of the stomach is not stretched, your hypothalamus thinks you are in a famine -- it doesn't know that there is a lot of food around you.
The purpose of banding is weight loss. Patients who are successful do not "feel tight," or "feel restricted." Instead, successful patients report that they rarely have an issue with the band, they do not "feel restriction." Successful patients come for adjustments when they notice that their appetite is returning between meals -- patients who are not successful rely upon the band to tell them when to stop eating.
The band, in successful patients, is empowering. While, on occasions, the band is "fickle" the proper way for the band to work is for it to allow you to eat less and not be moved by an appetite.
There is another group of Lap-band patients who do not like any sensation of restriction--a group we call volume eaters. They want to eat a lot, when they want to eat, and they do not like the sensation of a "hard stop." Nor does this group want to eat a small volume and walk away and allow their appetite to be suppressed. One patient even asked for pills for nausea, because she could not eat "a quart of chili." Yes, this person thought a quart was a normal serving size -- not a cup, a quart! Sometimes these patients come in for an adjustment, then come back thinking that the band is too tight, because when they overeat they become acutely uncomfortable, or feel as if they are "obstructed." Often these patients will come in for a fill, then an unfill, then another fill.
It does take a bit of work to change a person's perspective about the volume of food they eat. For some there is a feeling of deprivation, a period of mourning, but ultimately the band can become a tool to overcome this sensation, and allow the patient to eat. Remember, if you want to be a 125 pound person, you have to eat like one. The band allows your body to re-set the thermostat to the amount of food that it takes to keep you satisfied between meals.
To be more specific - food does not stay in the pouch above the band for a long period of time. Typically it travels through this area fairly quickly, usually less than a couple of minutes. The effect of the band is NOT to have food stay above the stomach in that small pouch - the effect of the band is on your appetite after a small amount of food stimulates that. Does this mean you can eat more -- yes, you can. That is always in your control.
So the first lesson -- Eat a specific, and small, portion of food, and walk away
If you can measure it -- you can manage it
The Lap-band is NOT about Restriction
When talking about the band, some patients talk about restriction. Let's first be clear about one thing: the purpose of the band is not restriction; the purpose of the band is to lose weight by suppressing the appetite.
When band professionals talk about restriction we are talking about something totally different than "restricting what a person eats." In fact, many band surgeons avoid talking about restriction so as to not confuse patients. The band works by dimming the appetite, and this provides a conscious control and decision made by the patient, it does not work by "making" a person do something, or keep them from eating too much.
The Lap-band works by suppressing your appetite
As a result, you are less interested in food between meals, making it easier to resist temptation. The analogy is when you are near a vending machine when you are hungry-- what do you do? Probably find yourself with some junk food that is not a part of your plan. But, when you pass a vending machine when you are full, it may not even catch your eye. Having the appetite dimmed makes you less tempted by the many food choices modern living throws at you - -this is what the band does, by suppressing appetite you become less interested in food.
What you should not feel, with the band, is the sensation of being "stuffed."
When you eat Thanksgiving dinner, you can feel stuffed. Contrast that with the sensation two hours after you eat your big meal, at that point your appetite is suppressed. It is the subtle dimming of the appetite that the band should provide. Being stuffed after a large meal is a complicated sensation of the abdominal wall stretching and a lot of gas in the bowel, in addition to feeling a diminution of appetite. You will not, and should not, feel the abdominal wall stretch with the band. You should not feel the "near nausea" and you should not feel bloated.
Key point: You should NEVER eat until you feel full. It is best to stop eating before you "feel full." If you do eat until you feel full you will most likely be overstuffed. This leads to the universal key to success -- patients who eat a small volume of food (which, if you measure, is consistent) will be successful with the band. If you want to succeed, you need to know how much you are eating, and then stop eating -- it is in your control, but the band will help you -- not by stopping you, but by allowing you to feel satisfied after the small volume.
Early on, most Lap-band patients do have a sense of "restriction"...particularly after the first fill. When we place the band on a patient the stomach above the band typically will hold one to two ounces (by volume, not by weight). The stomach has a lot of muscle fibers, and the wall of the stomach is fairly thick. When food is consumed, it arrives in the pouch, and meets some resistance, first against the newly adjusted band, and then against the stomach which does not stretch easily. People love this feeling! It is a sense of control over food -- a leash. But it is not permanent. It makes it difficult to eat more, because the top part of the stomach and the band will resist it. If you over eat you will feel uncomfortable.
This is the honeymoon phase, you feel full with less, no appetite, and if you try to eat more it doesn't work. They eat a small amount of food, they feel satisfied, and they are losing weight.
For patients who rely on this sensation, they will find it will take ever increasing volumes of food to obtain this sensation. The initial response is to have their band adjusted so that they can "feel full again." Against a tighter band, the upper stomach stretches a bit (and if they eat fast it stretches more)and they again have the sensation of "feeling full." This becomes a cycle, a tighter band, the stomach stretches more-- and then instead of going back to its original size, the stomach stretches more and more to where it takes more to fill it.
The person who continues to eat until they have this sensation, will find that it takes more and more food to obtain this feeling. Two things happen -- first the stomach stretches to where it accommodates more food, and to stretch it means you have to eat more. The second is that to "feel full" it takes the brain time to register this sensation -- this is not the sensation registered by the hypothalamus, but registered in the conscious cortex. So your stomach can be full, but your brain won't register it for a while, and if you keep eating you can overeat. As a result, the pouch dilates. Similar to a balloon, when you first start to blow up the balloon it takes a bit of force. As you continue to fill the balloon, the wall of the balloon stretches (thins out), it is easier to blow it up -- the same is true with the upper pouch. Early on, before the pouch is stretched, it takes a little bit of food to cause it to stretch, but with chronic over-eating the pouch will accommodate more and more food. The stomach wall is thinner, it is easier to stretch, and to get that sensation it takes more food than at first. Often patients will complain that they "don't feel restriction," and wish to have the band made tighter.
There are two potential results to this: one is the patient will passively stretch the stomach and esophagus and not be eating a small amount of food. These patients simply do not lose the weight that the surgeon expects. The other is that the band will be forced down the stomach, the band will slip, which generally requires operative intervention to reposition it.
For those patients who are rigorous about the volume of food they eat, and do not let the stomach to tell them when to stop eating - they do very well. This is one of the keys of successful patients, only eat a certain portion of food - period. If the band is properly adjusted, the appetite will be dimmed for several hours. Once your brain realizes that a small amount of food keeps you satisfied, then your eyes will adjust to the amount you eat.
Some describe a "soft stop." Where before a sense of fullness occurs, there is a signal from your body -- this can be a runny nose, a sigh, or a subtle ache in the left shoulder. Patients who find this "soft stop," do very well with the band.
The other advantage of eating small portions is it becomes a lifestyle change--you will have the ability to gauge the amount of food you can comfortably eat, knowing it will keep you satisfied for several hours.
You can always -- always, always, always, -- eat more food, because, contrary to what we believed for a long time-- food passes by the band within a minute and then into your stomach. But the key to successful patients is not how much they can eat, but how little they can eat to suppress hunger.
The band goes around your stomach, not around your brain, or your lips
This simple concept, of eating a specific volume of food -- eating it slowly, and then walking away, is the key to successful eating habits of patients. This means that the band works with effort from you -- not by it doing everything for you. You have to make the decision to eat a small volume of food, and let the band work with you.
The sensation that we would want the band to produce is the "soft stop." The soft stop is when you eat a small portion of food and walk away. Sometimes this is difficult, like most things, practice makes perfect. To set yourself up for success -- we recommend you use smaller plates, along with smaller utensils. If you go out to eat, ask for the to-go bag immediately, and remove the excess food from your plate. You can physically always eat more food, but the advantage about practicing small portions and walking away, is ultimately your eyes will get use to what the stomach is telling it, and it will be much easier to eat smaller portions as time goes on.
It isn't uncommon for patients to want an adjustment because they say they can eat more
The first question we ask is, "Why are you eating more?" The typical answer is, "Because I can." The typical response, "Just because you can does not mean you should." Since the band's job is not to restrict the amount of food you eat, do not leave that to chance -- that is your job. Part of personal accountability is to account for, to measure, to know how much you are eating at a time. The band is empowering; if you eat an appropriate amount and make appropriate food choices, you will be satisfied for several hours. This results in either weight loss, or weight maintenance (if you are at your goal). The purpose of the band is to assist you to lose weight -- and this occurs only with active participation by you: you chose what to eat, you choose how much to eat, and you practice walking away after eating that amount. The band is a tool to allow you to eat less and have your appetite dimmed resulting in weight loss, or maintenance. It is a tool to help you adopt a healthy lifestyle -- you still have the choices to make, but the band allows you to be satisfied with those choices.
"If I could eat less and walk away, what would I need this band for?" -- a common question we are asked. Without the band, if you eat a small amount of food and walk away your appetite would rise within a couple of hours -- you would find yourself hungry and wanting more food, possibly leading to unwanted snacking. You would also find, if you willed yourself to withstand the hunger, that your weight loss gradually decreases. The band fools your brain into thinking you ate more.
Think of it another way -- the hypothalamus does not have eyes -- it doesn't know how much you ate, it doesn't know if there is a lot of food around and you are not eating it, or if there is a band on your stomach. The hypothalamus reacts very simply to the stimulation provided by the upper part of your stomach. Stretch that thermostat, it thinks you are eating a lot -- do that consistently over time, and it behaves as if you are eating a lot all the time and will allow your body to release fat stores and not cause your body to go into a metabolic slow-down. Conversely -- if you go on a diet, without the band --and that part of the stomach is not stretched, your hypothalamus thinks you are in a famine -- it doesn't know that there is a lot of food around you.
The purpose of banding is weight loss. Patients who are successful do not "feel tight," or "feel restricted." Instead, successful patients report that they rarely have an issue with the band, they do not "feel restriction." Successful patients come for adjustments when they notice that their appetite is returning between meals -- patients who are not successful rely upon the band to tell them when to stop eating.
The band, in successful patients, is empowering. While, on occasions, the band is "fickle" the proper way for the band to work is for it to allow you to eat less and not be moved by an appetite.
There is another group of Lap-band patients who do not like any sensation of restriction--a group we call volume eaters. They want to eat a lot, when they want to eat, and they do not like the sensation of a "hard stop." Nor does this group want to eat a small volume and walk away and allow their appetite to be suppressed. One patient even asked for pills for nausea, because she could not eat "a quart of chili." Yes, this person thought a quart was a normal serving size -- not a cup, a quart! Sometimes these patients come in for an adjustment, then come back thinking that the band is too tight, because when they overeat they become acutely uncomfortable, or feel as if they are "obstructed." Often these patients will come in for a fill, then an unfill, then another fill.
It does take a bit of work to change a person's perspective about the volume of food they eat. For some there is a feeling of deprivation, a period of mourning, but ultimately the band can become a tool to overcome this sensation, and allow the patient to eat. Remember, if you want to be a 125 pound person, you have to eat like one. The band allows your body to re-set the thermostat to the amount of food that it takes to keep you satisfied between meals.
To be more specific - food does not stay in the pouch above the band for a long period of time. Typically it travels through this area fairly quickly, usually less than a couple of minutes. The effect of the band is NOT to have food stay above the stomach in that small pouch - the effect of the band is on your appetite after a small amount of food stimulates that. Does this mean you can eat more -- yes, you can. That is always in your control.
So the first lesson -- Eat a specific, and small, portion of food, and walk away
If you can measure it -- you can manage it
a quote
A friend posted this as his status on Facebook a short while ago and it really resonated. So I thought I'd share with you and put it up here also to remind myself on those 'meh... i don't wanna' days.
"If you really want to do something, you'll find a way. If you don't, you'll find an excuse." - Jim Rohn
I'm in NSV heaven
I figure I might as well document as many of these NSV's as possible so I have something to look back on when times get rough. Here are 3 more:
- Yesterday afternoon I called my usual walking buddy and asked if she felt like joining me for a walk. we both wanted/needed it so headed out on our usual route. A little while into it, I commented that the ocean seemed closer than usual. We were going at a much faster clip than usual. So we agreed to extend our walk and it was great. 8 1/2-9 weeks ago when I started this process I had to stop numerous times along the usual route to stretch out my aching calves. no stopping me now!
- The same friend was away on vacation for a week and last week we didn't actually see each other. She's one of the few friends I've told about the lapband and is super supportive. She asked how much I'd lost now (30 or so lbs) and commented that she can really see it
- Just ran into my contractor's wife in the grocery store as I was grabbing my baked chicken breast and salad for lunch. They are both long time family friends and she said her husband told her the other day when I was out on the construction site that he forgot to comment that something seemed different about me and she said 'and he's right. you're glowing'. What an absolutely lovely comment!
Ok - now off to a meeting for me
Friday, August 13, 2010
picture of health
had my complete physical yesterday to ensure i'm healthy going in to surgery and alert the docs of any problems.
Yippeeee... there were none. With the exception of my HDL (that's the good cholesterol) absolutely everything (and they tested EVERYTHING) was smack in the range of where it should be. And the HDL can be improved with exercise, which I'm doing.
ECG was good, blood pressure, glucose..... I'm healthy. Wonder what it would have been 8 1/2 weeks ago when i started this process and was up 30lbs and not exercising at all!?!?!
Next step is my appt with the surgeon on August 26 when hopefully we set a date. He had indicated this should be mid-late september. well my dbf is travelling for work sept 13-19 so i don't want to have it til he gets back and now my boss has told me he wants me to go on a work trip sept 14-18. i'm going to have to work a deal with my nutritionist and surgeon because there's no way i'll manage a liquids only diet while travelling for work!?!?! Any thoughts on this? Those of you who have done liquids only for the pre-op diet, do you think this is do-able when I'm travelling and attending conferences all day? Also will be travelling with boss so not sure if i'd be expected to do dinners as well as the conference lunches.... argh !!!!!
thanks for the happy thoughts on my nsv's - a few more.
yesterday in my torture training session i did 4 sets of 10 pushups. when i did my fitness evaluation 7 weeks ago i could only do 3.
I also did 5 sets of 20 different crunches for my ab workout. we were aiming for 150 and that next set derailed me.... again..... i was frustrated and teary but my trainer was awesome and pulled me out of that funk.
today i'm wearing a pair of jeans (LB Red 2's) that I haven't been able to wear in a long time. they fit well, but are creating some serious muffin-top action. luckily i'm wearing a flowing peasant-style top to hide that :)
Yippeeee... there were none. With the exception of my HDL (that's the good cholesterol) absolutely everything (and they tested EVERYTHING) was smack in the range of where it should be. And the HDL can be improved with exercise, which I'm doing.
ECG was good, blood pressure, glucose..... I'm healthy. Wonder what it would have been 8 1/2 weeks ago when i started this process and was up 30lbs and not exercising at all!?!?!
Next step is my appt with the surgeon on August 26 when hopefully we set a date. He had indicated this should be mid-late september. well my dbf is travelling for work sept 13-19 so i don't want to have it til he gets back and now my boss has told me he wants me to go on a work trip sept 14-18. i'm going to have to work a deal with my nutritionist and surgeon because there's no way i'll manage a liquids only diet while travelling for work!?!?! Any thoughts on this? Those of you who have done liquids only for the pre-op diet, do you think this is do-able when I'm travelling and attending conferences all day? Also will be travelling with boss so not sure if i'd be expected to do dinners as well as the conference lunches.... argh !!!!!
thanks for the happy thoughts on my nsv's - a few more.
yesterday in my torture training session i did 4 sets of 10 pushups. when i did my fitness evaluation 7 weeks ago i could only do 3.
I also did 5 sets of 20 different crunches for my ab workout. we were aiming for 150 and that next set derailed me.... again..... i was frustrated and teary but my trainer was awesome and pulled me out of that funk.
today i'm wearing a pair of jeans (LB Red 2's) that I haven't been able to wear in a long time. they fit well, but are creating some serious muffin-top action. luckily i'm wearing a flowing peasant-style top to hide that :)
Thursday, August 12, 2010
Worse than a kid on Christmas morning
Today I have my boodwork and physical work up to determine if i'm healthy enough for lapband surgery. it's the final step before my meeting with the surgeon on august 26 when hopefully we set a date.
I took the day off work because i have to go for blood work at 10 and then at 1:30 have the other tests and the doctor's office is on the other end of the island.
Figured I could sleep in today. So why did my eyes pop open at 5:45 and I was wide awake. Like a little kid on Christmas morning. Who am I kidding. Like me on Christmas morning!
I was instructed to have nothing but water after 10 last night. I scribbled a note saying 'No Food' on a piece of paper towel and stuck it on the fridge. I'm not a late night eater, but I could totally see myself forgetting and going ahead and making and eating breakfast this morning!!!
Ooooh. One scale victory and one NSV to report.....
Hopped on the scale this morning and despite my weekend indiscretions with the fruit pastilles, I am on the cusp of seeing 229 on the scale. it was 230.4 today. Yipppeeeeee.
And yesterday, one of the cute young reporters I work with popped into my office to chat about some work and all of a sudden said 'you got a hot date tonight, huh'. i asked why he'd assume that. he said i looked really nice. i commented that i'd not even bothered doing my hair. just showered, combed and go. he said 'that's why it looks sexy'. lolol.
oh and i guess this is another NSV
I catch my reflection in the mirror these days and I swear I look 10 years younger than I did mid-June when I started this process. The horrendous dark circles I had as a result of adrenal fatigue are gone.... can't remember the last time i wore undereye concealer and just a few short months ago i couldn't leave the house without it!
Man I'm hungry!!!!
I took the day off work because i have to go for blood work at 10 and then at 1:30 have the other tests and the doctor's office is on the other end of the island.
Figured I could sleep in today. So why did my eyes pop open at 5:45 and I was wide awake. Like a little kid on Christmas morning. Who am I kidding. Like me on Christmas morning!
I was instructed to have nothing but water after 10 last night. I scribbled a note saying 'No Food' on a piece of paper towel and stuck it on the fridge. I'm not a late night eater, but I could totally see myself forgetting and going ahead and making and eating breakfast this morning!!!
Ooooh. One scale victory and one NSV to report.....
Hopped on the scale this morning and despite my weekend indiscretions with the fruit pastilles, I am on the cusp of seeing 229 on the scale. it was 230.4 today. Yipppeeeeee.
And yesterday, one of the cute young reporters I work with popped into my office to chat about some work and all of a sudden said 'you got a hot date tonight, huh'. i asked why he'd assume that. he said i looked really nice. i commented that i'd not even bothered doing my hair. just showered, combed and go. he said 'that's why it looks sexy'. lolol.
oh and i guess this is another NSV
I catch my reflection in the mirror these days and I swear I look 10 years younger than I did mid-June when I started this process. The horrendous dark circles I had as a result of adrenal fatigue are gone.... can't remember the last time i wore undereye concealer and just a few short months ago i couldn't leave the house without it!
Man I'm hungry!!!!
Sunday, August 8, 2010
proof positive i need this band
just realised it's been a week since i posted. nothing spectacular been going on, i suppose....
until yesterday. i don't know what the hell got into me, but i od'd on junk. thursday evening i bought 11 tubes of fruit pastilles. no idea why i felt the need to get so many since i know i can always go back out to that store and get more if i really need them.... besides the fact that i really don't need them at all. ever.
anyway, as of yesterday evening all 11 packs had been scarfed down by yours truly. i just kept on going. i was aware that i was doing it, but didn't care. felt a bit sugar sick, but kept on going until they were all gone.
i think once i started something in me clicked that if i was headed down that road i might as well get it all over with. fast.
i also think i somehow gave myself license to do it because i don't meet with my nutritionist (and hence don't officially hop on a scale) until the end of the month when i have my surgery date set.... up until now i've been seeing her every week or 2 weeks so there really wasn't room for foolishness.
anyhow, today was another day and apart from indulging in the three cheetos my 4 year old niece insisted on sharing with me, i've been on track. and i will be tomorrow.
on a positive note, i ordered two pricey tools that my nutritionist feels will help me tremendously - an omega masticating juicer and a vitamix blender. my dbf is insisting on paying the damage, so i don't feel utterly that i'm going to come through this whole process healthy, thin and broke!
ok. that's me. gonna go check on the 4 year old. it's been awfully quiet in that back room :)
until yesterday. i don't know what the hell got into me, but i od'd on junk. thursday evening i bought 11 tubes of fruit pastilles. no idea why i felt the need to get so many since i know i can always go back out to that store and get more if i really need them.... besides the fact that i really don't need them at all. ever.
anyway, as of yesterday evening all 11 packs had been scarfed down by yours truly. i just kept on going. i was aware that i was doing it, but didn't care. felt a bit sugar sick, but kept on going until they were all gone.
i think once i started something in me clicked that if i was headed down that road i might as well get it all over with. fast.
i also think i somehow gave myself license to do it because i don't meet with my nutritionist (and hence don't officially hop on a scale) until the end of the month when i have my surgery date set.... up until now i've been seeing her every week or 2 weeks so there really wasn't room for foolishness.
anyhow, today was another day and apart from indulging in the three cheetos my 4 year old niece insisted on sharing with me, i've been on track. and i will be tomorrow.
on a positive note, i ordered two pricey tools that my nutritionist feels will help me tremendously - an omega masticating juicer and a vitamix blender. my dbf is insisting on paying the damage, so i don't feel utterly that i'm going to come through this whole process healthy, thin and broke!
ok. that's me. gonna go check on the 4 year old. it's been awfully quiet in that back room :)
Monday, August 2, 2010
a Lazy holiday Monday photos included
It's Emancipation Day here in The Bahamas. The day we celebrate the end of slavery in our country. Freedom. I'm celebrating emancipation from all that weight i've been carrying around :)
Not got much going on today other than getting my hair coloured. my good friend and hairdresser is horrified by the grey streak i've been letting show for a while now and insisted i come into the salon today since she's working to make up for being off last week and taking next weekend off!
Spent yesterday over on Rose Island - a short boatride from Nassau. it's usually a day of overindulgence on all the incredible food everyone brings. But this time I went with a plan and pretty much stuck to it. Mom and I made chicken and veggie kebabs to grill for everyone so that was definitely on my plan. I also ordered and took a huge batch of fresh conch salad. Another winner on plan. I avoided the chips and dips, brownies, potato salad and sodas. Had a bit of the turkey kielbasa, chicken kebabs, conch salad, lovely salad, fresh fruit salad and one small rice krispie treat over the course of a long day. And drank my weight and then some in water. Felt good to not come away feeling stuffed to the gills.
Anyway, here are a few pics for your enjoyment!
I just snapped this one of me on my balcony as the rain clouds make their way across the harbour. One of the least horrific pics of me I've seen in a while!!!! |
I snapped this pic of the ocean and eastern end of Rose Island. It was the first day of crawfish (lobster) season here yesterday so the beach wasn't really crowded at all. |
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