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Wednesday, March 30, 2005

B-Complex Vitamin

Vitamin B-Complex It has long been believed, although not scientifically supported, that mega doses of B-complex vitamins will combat everyday stress, boost energy and control food cravings. I can recall years ago my moody grandmother taking a trip to see the town doctor for a B-12 shot. Much to grandfather’s relief she returned from the visit cheerful and seemingly stress-free. In those days it was common for women “going through the change” to take B-12 shots.

The vitamin B complex refers to all of the known essential water-soluble vitamins except for vitamin C. These include thiamine (vitamin B1) riboflavin (vitamin B2), niacin (vitamin B3) pantothenic acid (vitamin B5) pyridoxine (vitamin B6) biotin, folic acid and the cobalmins (vitamin B12). Each member of the B-complex has a unique structure and performs unique functions in the body. B-Complex vitamins support energy production, the immune system, proper cell division and support the nervous system.

B-Complex vitamins are found in both meat and plant foods. Most dietary supplements contain the B-Complex vitamins, but many WLS patients elect to take an additional B-Complex tablet. There is risk of B-Complex deficiency due to malabsorption. B-Complex tablets can be purchased in sublingual form – a small tablet placed under the tongue to be dissolved and absorbed through the soft tissues of the mouth.

Recent research conducted by the National Institute on Aging found that women over age 65 with a vitamin B12 deficiency were twice as likely to suffer from depression as those with a full store of the vitamin. Maybe Grandma was right to visit her doctor for that shot of cheerfulness. Today things are easier, slip a tab of feel-good nutrients under your tongue.

Spring Vacation

Dear Readers:

I hope you all had a wonderful Easter holiday weekend and enjoyed the activities and traditions that are important to you. We had a wonderful six days and have returned safe and sound to our little piece of heaven this afternoon.

Typically on vacation I have some "episodes" - - dumping or vomitting. I'm pleased to report that I was only sick once in the last six days, and that was my own doing by stuffing myself too full with yummy Chinese food. I've been brutally honest with my food diary and reported the ups & downs as we traveled and broke all the rules. I will touch on some topics at greater length in the next few days.

Please keep your Emails coming and let me know how you are.

Best wishes,

Friday, March 25, 2005

Easter Holiday

Dear Readers:

I'll be offline for a few days while we travel for the Easter holiday.

My thoughts are with you all for a healthy and happy holiday. I'll be back with you next week to share more about Living After WLS.

Best Wishes,

Thursday, March 24, 2005

Ask Kaye: You drink wine?

Since I've posted my food diary some of you have asked me about drinking wine - isn't that against the rules?

This site is about honesty after WLS, so that's why I've recorded it when I have wine with dinner. Most bariatric centers discourage gastric bypass patients from drinking alcoholic beverages. The alcohol absorbs too quickly into the system and can result in rapid intoxication or dumping.

For the first two years following surgery I drank nothing but water. Water. Water. Water. Then I started bending the rules here and there. The occasional cup of coffee or a glass of wine with dinner. I am extremely cautious when I step out of the perimeters given by my bariatric center. However, I am of the belief that I am STILL a person in spite of my gastric-bypass. I am still entitled to enjoy as long as I am careful and attentive to my body. And sometimes when I do break the rules with too much wine (2 glasses) I quickly get silly or worse, sick (dumping/vomiting). These are the terms of my WLS.

For people in the phase of rapid weight loss, my suggestion is don't break the rules. Allow your body to concentrate on the weight loss and the healing from the surgery and recovering from the disease of obesity. When you have stabilized both in weight and emotional wellness you will be better able to make safe decisions for bending the rules.

Truthfully yours,

Suger: Shugr

Our friend, Katherine Prouty, at LowCarbFreedom has an interesting post about a new sugar substitute product:

If this sugar substitute product is all that it says it is, then we only have to worry about refined grains in the future.

What would the perfect sweetener be? It would be natural. It would taste just like sugar. It would cook and bake just like sugar. It would have no calories at all. And it would be healthy: tooth-friendly and diabetic safe.

Sounds impossible? Meet Shugr.™

Click the link above to read Katherine's full post. Thanks Katherine, we'll watch this closely from a WLS point of view.

States weigh covering obesity surgery

Risks, costs debated in several states

HARTFORD, Connecticut (AP) -- Jacqueline Ezell says she felt as if she were drowning when she was rushed to the hospital four years ago.

At 288 pounds, doctors had already diagnosed her with diabetes, glaucoma and high cholesterol, all side effects of obesity. She also had heart problems.

"I couldn't breathe," Ezell said.

Doctors gave Ezell two options. She could seek a heart transplant, or have gastric bypass surgery. She chose the surgery.

The Preston woman recently told Connecticut lawmakers that she went from a size 26 to a size 6. The surgery also helped lower her cholesterol, and she was taken off a heart transplant waiting list. Now, the only medications she needs are for her heart condition.

"There's nothing I can't do now," she said.

A proposal is before Connecticut lawmakers that would require insurance companies to cover the surgery for people with a body-mass index of 30 or more if a doctor deems the surgery medically necessary. The BMI is a widely used formula based on height and weight.

The Connecticut proposal may not get off the ground this session because lawmakers are struggling to define under what medical conditions the surgery should be covered, said Sen. Joseph Crisco, a Woodbridge Democrat who chairs the legislative committee looking at the issue.

Click the link for the full article

Wednesday, March 23, 2005

Crazy? or Magnesium Deficiency

Have you ever felt like you were completely losing your mind? Like the world was swallowing you up and little things were out of your control and unmanageable? Like you were confused, tired, out of sorts and simply wanted to collapse? Has everyday noise become intolerably loud in your head?

That’s how I was feeling a few months ago. I was confident I’d lost my mind and suffered a serious change of personality (for the worse, I may add).

My husband noticed too! He’s a good and wise man and quietly did some research. This is what we learned and how we set about correcting my “problem.” Disclaimer: we are neither one a medical professional, nutritionist or otherwise medical authorities. We are two people who try to learn as much as we can to protect and promote our own health.

As we know the gastric-bypass patient is at risk for vitamin and mineral deficiency. I religiously take my supplements. However, I was not taking the RDI of Magnesium which is 400 milligrams/day. Magnesium rich foods are raw rice bran, raw wheat germ, yellow cornmeal, corn, soybeans, soy milk, tofu, raw seeds and nuts, leafy greens, yellow vegetables and fruits, whole cereal grains, milk products & seafood. Meat and poultry are not particularly good sources of magnesium. Clearly, a WLS patient will not meet their magnesium requirements through diet.

From Dr. Bernard Jensen’s “Guide to Body Chemistry & Nutrition” I quote:

“I want to point out here that the classical deficiency symptoms for magnesium include neuromuscular signs, such as tremors, weakness, muscle spasms and irregular heartbeat; gastrointestinal signs such as nausea and vomiting; and personality changes that display confusion, apprehensiveness and depression. In the “old days” people with magnesium deficiency were often (mistakenly) taken to mental institutions because they acted so radically different than they literally seemed to be mentally ill.”

In other reading we learned magnesium deficiency leads to a hyper-sensitivity to sound:
“It is well established that nutritional effects may result in hypersensitive hearing. Many individuals who are deficient in magnesium suffer from sound sensitivity, and they often experience an improvement after receiving magnesium supplements. A suggested 20 milligrams per each 10 pounds of body weight per day, is an appropriate amount of magnesium. Improvement would occur within a few days if the cause of the sensitivity is a magnesium deficiency. This article appeared in a previous issue of The Sound Connection, 1998, Vol. 5, No. 3, pages 1 & 2. The Sound Connection is the quarterly newsletter of the Society for Auditory Intervention Techniques (P.O. Box 4538, Salem, OR 97302, USA).


I started immediately taking a magnesium supplement and within a few weeks I felt like a new woman back to my old self again. The hyper-sensitivity to sound diminished and life did not seem so overwhelming. Case in point – exactly two weeks after beginning the magnesium supplement my stepsons and their children arrived unexpectedly at our home for dinner. To make matters worse, we had the kitchen disassembled for a minor remodel project. I happily adapted and cooked dinner for 7 without having a breakdown. That’s when I knew the magnesium was working.

Talk with your bariatric center if you have these conditions or concerns. Remember, we are all supposed to be getting our blood checked annually to identify existing vitamin and mineral deficiencies.

Tuesday, March 22, 2005

Harsh Reminder

Here is a harsh reminder I found in information supplied by Kaiser Permanante to pre-surgical patients:

“Gastric surgery for weight loss causes nutritional deficiency in nearly 100% of individuals who have it done. The most common deficiencies are Vitamin B12, Iron, Calcium, Magnesium, Carotene (beta-carotene and other carotene vitamins) and potassium. In the beginning patients will faithfully get their vitamin B12 shots and take their vitamins. After a while they flatter themselves that they are healthy and just like anyone else. They discontinue getting checkups. This is risky. A recent follow-up study done on gastric bypass patients showed that even 10 years later there were severe nutritional deficiencies. You are NEVER normal. NEVER.”

En Papillote - - Cooking in paper

[pah-pee-YOHT, PAH-peh-loht]
1. The French word for a paper frill used to decorate the tips of rib bones, such as those on CROWN ROASTS. 2. En papillote refers to food baked inside a wrapping of greased PARCHMENT PAPER. As the food bakes and lets off steam, the parchment puffs up into a dome shape. At the table, the paper is slit and peeled back to reveal the food.

For a long time I heard about cooking en papillote: in paper. I’ve avoided it as it seemed to fussy and fancy for me. My dear friends, I am here to tell you this may be the most brilliant way to cook for the bariatric patient. The protein cooks tender and moist with limited amounts of fat. You can add vegetables or sauces to taste (or need). And best of all, clean-up is a breeze.

Here are two recipes from Cooking Light that I have tried and they turned out decadently delicious. Once you get the hang of en papillote you will be experimenting with your own food and flavor combinations. Enjoy!
One hint: I used regular paper clips to close the little paper packages and that seemed to work well.

Sesame Halibut en Papillote

En papillote refers to the method of baking food in parchment paper. Steam is trapped inside, and this keeps the food moist and flavorful. The impressive presentation belies this dish's simple preparation.

1 tablespoon dark sesame oil, divided
2 garlic cloves, minced
4 cups shredded bok choy
1/2 teaspoon salt, divided
1/2 teaspoon chile paste with garlic
4 (6-ounce) halibut or flounder fillets (about 1 inch thick)
1/4 teaspoon freshly ground black pepper
1 teaspoon sesame seeds, toasted

Preheat oven to 400°.
Heat 1 teaspoon sesame oil in a large nonstick skillet over medium-high heat. Add garlic; sauté 30 seconds. Add bok choy and 1/4 teaspoon of salt; sauté 5 minutes or until crisp-tender. Remove from heat; stir in chile paste. Sprinkle fish evenly with 1/4 teaspoon salt and pepper.
Cut 4 (15-inch) squares of parchment paper. Fold each square in half, and open each. Place 1/2 cup bok choy near fold; top with 1 fillet. Drizzle each serving with 1/2 teaspoon oil; sprinkle with 1/4 teaspoon sesame seeds. Fold papers; seal edges with narrow folds. Place the packets on a baking sheet. Bake at 400° for 18 minutes or until paper is puffy and lightly browned. Place 1 packet on each of 4 plates, and cut open. Serve immediately.

Yield: 4 servings

CALORIES 233 (30% from fat); FAT 7.8g (satfat 1.1g, monofat 2.8g, polyfat 2.9g); PROTEIN 36.7g; CARBOHYDRATE 2.3g; FIBER 0.9g; CHOLESTEROL 54mg; IRON 2.1mg; SODIUM 459mg; CALCIUM 158mg;
Cooking Light, DECEMBER 2004

Orange Salmon en Papillote

1/4 cup plain nonfat yogurt
1 tablespoon thawed orange juice concentrate
1 teaspoon fresh lemon juice
1 tablespoon minced fresh chives
1 tablespoon minced fresh parsley
1 1/2 teaspoons grated orange rind
1 garlic clove, minced
4 (4-ounce) salmon fillets (or 1 [1-pound] fillet, skinned and cut crosswise into 4 equal pieces)

Combine first 3 ingredients in a small bowl; stir well. Combine chives and the next 3 ingredients in a small bowl; stir well. Cut 4 (13 x 13-inch) pieces of parchment paper or aluminum foil; trim each into a heart shape.
Arrange 1 piece of fish on half of each parchment heart. Top fish with 1 tablespoon yogurt mixture, and sprinkle with chive mixture.
Fold over other half of each parchment heart. Starting with the rounded edge, pleat and crimp edges together to make a seal; twist ends tightly to seal. Place on a large baking sheet.
Bake at 425° for 15 minutes or until the parchment is puffed and lightly browned. Place on individual serving plates; cut open. Serve immediately.

Yield: 4 servings

CALORIES 149 (24% from fat); FAT 4g (satfat 0.7g, monofat 1.1g, polyfat 1.5g); PROTEIN 23.6g; CARBOHYDRATE 3.4g; FIBER 0.1g; CHOLESTEROL 59mg; IRON 1mg; SODIUM 88mg; CALCIUM 34mg;
Cooking Light, JANUARY 1995

Monday, March 21, 2005

Sharing The Story

Sharing our bariatric stories is as personal decision as electing to have the surgery itself. Some of us are very private and others of us are very open. Overall I think we do the best we can on any given day. There are times when the moment is right to share and times when it is best to keep quiet. Here are a few things this bariatric zealot has learned the last few years:

It is well known that when a person affects a tremendous change in their life they often experience a great spirit of sharing and a desire to convert others to the new belief system. This is an altruistic desire to bestow upon others a wonderful new life.

Think of converts to religious beliefs or former addicts graduating from recovery programs; often these people reach out enthusiastically to others who are as they once were. The recovering alcoholic is a champion of reform to the drunken and depressed. The born again believer is a champion to the sinners and downtrodden. So it is with the bariatric zealot, a champion to the fat and hopeless.

The desire to share our stories – to make converts to the bariatric persuasion – is sincere and well intentioned. But just like the recovered addict or the new believer, we must tread lightly when it comes to proselytizing this new wonderful way of life. First, we cannot assume that the obese people we meet are in a place where they wish to hear about our weight loss success. Second, it is quite easy to hurt someone’s feelings by suggesting weight loss surgery – it implies inferiority, even coming from a formerly obese person.

Think back to when you were overweight and hopeless. Didn’t you sometimes feel betrayed by a former fatty gone thin? Chubby folks stick together and when one betrays the band to joining the tiny tummy league the others can feel exposed and vulnerable. They can feel like failures because one of their members has succeeded where they have given up hope.

On the other hand, a bariatric patient is an inspiration for the heavyweight hopeless among us, a living breathing shrinking miracle overcoming the obstacle of obesity right before our eyes. It is my experience that this metamorphosis is the greatest inspiration of all. Let the physical manifestation do your talking and tread lightly on tender feelings. We all share a great empathy for the obese and should never forget where we came from, even after the giant clothes have long been tossed on the garbage heap.

My simple rule is to never give advice unless I’m asked. I often think back to how I felt before my weight loss when well intentioned people offered “constructive criticism” to “help” me with my “problem”. I hated it when well meaning friends or doctors told me to lose weight, to get fit, eat less, exercise more. I felt ashamed when people belittled the illness of obesity saying, “just stop eating so much.” I didn’t initiate conversation about my illness with anyone, but certainly more times than I care too count I endured the constructive criticism of others who were superior to the “Little Fat Girl.”

By calling it constructive criticism it becomes socially acceptable to be superior to another person. When constructive criticism is offered the implication is that the person to whom the criticism is directed is in error and the person providing helpful advice is wiser and above the error.

Criticism is rarely constructive. Obese people are painfully aware they are obese. They know why they are obese and they know the efforts they have exhausted trying to overcome obesity. We have been there and can empathize deeply with every person who sits in seat C-21. As zealous as we may feel we never have the right to constructively criticize or give unsolicited advice to another person.

But when asked about the wonderful transformation WLS has affected, the opportunity is ours to empathetically inspire others with hope. Love the woman in C-21. Commiserate. Obesity is a lonely place to be. Sharing an intimate understanding of that loneliness will go far to ease another’s pain. And perhaps, in their own time, they will have the good fortune to experience living after weight loss surgery.

Sunday, March 20, 2005

Loving C-21

I took my aisle seat aboard the 757 Boeing aircraft and was astonished how roomy it felt. I wiggled around and my body didn't press on the armrests. I crossed my legs, left over right and back the other way. I put the tray table down and back up. And I buckled my seatbelt and actually had to pull it tight - no more belt extender for me! This was my first flight as a "normal" person and a triumphant moment indeed. I sat silently enjoying my bliss.

Then I saw her board the plane: my former self. She was a very large woman lumbering sideways with a bowed head, afraid to meet the fearful looks of passengers who were praying she wasn't seated next to them.

As luck would have it, she took the aisle seat across from me, seat C-21. I couldn't take my eyes away as I watched her fill the seat and spill over the sides like rising bread dough that's been too long in a warm room. Her seatmate shifted toward the window as her fat spilled onto him. I saw her face go crimson; she was humiliated. She looked at me and I smiled at her, the lump in my throat so large I couldn't have spoken a word even if I had the courage. She returned my look with an empty stare; she must have felt my smile was mocking her. At that moment I knew the woman in seat C-21 hated me. How could she know that not long ago I was the fat woman scorned by the normal people for taking up space in their world? So, silently we sat together, C-21 hating me, and me loving her.

I wanted to talk to her, to tell her there is hope and a way out of obesity's prison. I wanted to tell C-21 about the magical world waiting for her, that she didn't have to bow her head in shame and humiliation. I wanted to convert her to the miracle of bariatric surgery. But I didn't think it my place. A few years ago when I was spilling over my seat I didn't want to hear from a skinny bariatric zealot fanatically pushing her extremist solution on me; that would have angered and embarassed me.

The decision to have weight loss surgery is exceedingly personal, sole ownership of that decision lies within the heart of every obese person looking for hope. When I made that decision it was my own, in my own time at my own pace. How in the world could I assume C-21 was in a place to hear my message?

Never a day passes that I don't think about C-21. I hope she is doing all right. I fantasize she has discovered bariatric surgery and joined the tiny tummy league. I hope today she is holding her head proudly as she boards a plane. I wonder if I missed the chance to make a difference in her life? I will never know.

To C-21: I love you.
Kaye Bailey

Tomorrow we will talk about sharing the bariatric gospel.

Thursday, March 17, 2005

Safe Foods: The Bariatric Ball & Chain

So, today is St. Patrick’s day and what appears at the office but a giant plate of sugar cookie shamrocks with green frosting and sprinkles.


But there is not a chance in hell a single bite will cross my lips. Why? Not safe.

As we move forward in this little bariatric experiment most of us will identify safe foods. For me, I must eat safe all day long at my job. I cannot get sick by way of dumping or vomiting. So every day I bring my safe food with me: hard cooked egg, cottage cheese, sugar free Jell-O, plain canned tuna.

Talk about a ball and chain. The monotony is wearing me down. My palate is bored. And those cookies smell divine. But they are not safe and I will not eat them. There are times when I’m so angry and resentful that I had WLS and imposed these restrictions upon myself. Why couldn’t I have been stronger and lost weight the old-fashioned way? It is easy to play the role of martyr.

Now, don’t get me wrong. I don’t regret WLS or the wonderful life I have because I am healthy, fit and comfortable in my own body. This post is simply about the days when it is utterly frustrating to be restricted in so many ways by the gastric-bypass body. Fortunately the frustration is far less common than the jubilation over all the things this surgery has given me. But there are those days. . .

For example, yesterday I was out of town for meetings and starving by day’s end. I had a 90 minute drive home so stopped at the convenience store. The only thing that looked good was a package of Ritz Bits Peanut Butter Sandwiches. So I purchased a single serving package and a bottle of water (of course!). I’ve eaten Ritz Bits before without dumping, but I worried “What if today they make me sick? (That’s the curious thing about dumping: it’s a sneaky bitch and will catch you off-guard. Talk about a ball and chain.) So, I determined to wait until I was 60 minutes from home, then I could have a few and be home in time if they made me sick. I was lucky and did not get sick. Big sigh of relief.

Every day of my living after WLS I must make multiple choices and considerations to avoid getting sick. That’s why sometimes it is simply easier to stick with the safe and the planned and the known foods. It’s just easier to be safe.

Sometimes I leave my safe zone. Sometimes I get away with it, sometimes I don’t and I get sick. But the fear follows me always. Talk about a ball and chain.

I’m interested in hearing from you: What are you’re safe foods? How do you deal mentally with the bariatric ball & chain? Post your comment or Email me!

Tuesday, March 15, 2005

The "E" Word


Nothing is more disappointing than hearing a gastric bypass patient brag that they didn’t have to exercise to lose weight. It’s true; patients will lose weight without lifting a finger. In fact, for many, the lack of physical effort required to lose weight is an appealing part of weight loss surgery. But patients who do not use the time of rapid weight loss to incorporate exercise into their lifestyle are doing themselves a grave disservice.

Obesity cripples the body. Bone tissues are compromised, joints are swollen, the vascular system is inadequate and the skeleton overburdened. Some morbidly obese people are so crippled from carrying excess weight they are confined to wheelchairs and scooters. They yearn to walk painlessly through a park or museum. Perhaps you have spent time confined to a wheelchair: didn’t you dream of walking without pain? When you imagined life after weight loss surgery I suspect there was no wheelchair, scooter or walking stick in that dream.

As weight is lost, the burden on the bones, joints and vascular system is decreased. And the body is a magnificent machine – given proper nutrition and physical motion it will rebuild its broken framework. The systems will become strong and vital.

The most effective way to heal the body from the ravages of obesity is to exercise.

You don’t have to jump up from the surgical bed and run a marathon; in fact, you never have to run. But you have to move your body: walk, stretch, bend, inhale and exhale. If you want to take full advantage of your weight loss surgery you must exercise your body.

Exercise, however you define it, is the most effective, most enjoyable, most beneficial gift you can bestow on yourself as you recover from life threatening, crippling morbid obesity.

There has never been a better time to become fit. Exercise philosophy has changed. Gone are the days of “make it burn” and “no pain, no gain.” Exercise experts say move your body 30 minutes a day, and the benefits will resonate throughout your being. Injuries are down and exhaustion isn’t the objective. Consistency is all that’s required. Fitness is no longer considered an exact science – we are given permission to find what works and enjoy it. Incorporate cardiovascular, flexibility and strength training into your life: the three work in combination to help you become healthy, agile and maintain metabolism.

If quality of life is to be preserved – or restored – exercise is required. The body was designed to require a certain minimum level of physical activity. When physical activity is absent obesity results. Our bodies do not thrive when they are sedentary. It is therefore crucial to deliberately incorporate movement into our lives.

More than any other time in your life, following surgery your body is ready to respond to the benefits of physical motion. We have taken the first step to control obesity by restricting food intake. The time is now to muster all the discipline possible to take a stand for a healthier, happier, longer and more productive life. We must exercise more than we have in the past and more than is convenient.

Do not make the mistake of delaying your exercise program until the weight is gone. If you fail to exercise during the phase of rapid weight loss your skin will sag, your energy will lag and your metabolism will slow. Weight loss will be more difficult to accomplish. You will miss an opportunity to feel good about yourself as you set realistic fitness goals and achieve them. You will miss the euphoria from oxygenated cells. You will betray yourself.

But wait! I need my coffee & diet coke!

Yesterday we talked about the importance of water for a WLS patient. That leads to another commonly asked question: Why not coffee & soda?

Bariatric guidelines strongly recommended against any liquid besides water during the phase of rapid weight loss: specifically, drinks containing caffeine. Caffeine is a stimulant that can increase heartbeat, increase blood pressure, and interrupt sleep. Caffeine is known to cause nervousness or irritability. The effects of caffeine seem to be exaggerated for the WLS patient because liquid is rapidly dumped into the small intestine and absorbed quickly by the body. In addition, caffeine is a diuretic, which causes the body to lose water by increasing the amount of urine. This is only water loss, not weight loss – it can cause dehydration.

Before surgery many of us were hooked on caffeine drinks for the energy boost they provided. You will find, as I have, that the consistent intake of lean protein and restrictive diet prevents the energy highs and lows experienced by unchecked eating behavior. Sugary carbohydrates have long been blamed for severe energy swings, and a gastric bypass patient will not be frequently indulging in such chemical chaos. A small steady diet of lean protein sustains a constant energy level and caffeine will not be missed.

Carbonated beverages, both diet and sugared should be avoided. The carbonation is uncomfortable for the tiny tummy and the sugar and processing ingredients induce the body to a state of panic. The body functions are working around the clock to heal the wounds of surgery and sustain life on limited energy intake while flushing the waste and toxins related to obesity. If you feed this overworked system a beverage beside water it must extract the water from the processing ingredients and eliminate the waste products you fed it unnecessarily. Doesn’t it make more sense nurture your healing body with pure clear water?

After your weight loss is stabilized it is acceptable to moderately incorporate other beverages into your day. Do not forsake your water intake for other less beneficial beverages. These days, rather than drink a pot of low-budget coffee in the morning I enjoy one lovely, good quality cup of coffee in the afternoon after work. I consider it a splurge and a treat, not an addiction.

Monday, March 14, 2005

Water. Love IT!

Throughout our dieting life we’ve been told – drink water. Drink a minimum of 64 ounces a day – eight glasses a day. Well, this time there’s no hedging. You have to drink the water. Other beverages won’t do the trick. Not coffee, tea or milk. Not diet soda or sports drinks. Water. Pure, plain, old fashioned H2O! Clear, colorless, odorless, tasteless: water is the essential fluid for living – without adequate water death is imminent. Water is one of the most important nutrients the body needs to stay healthy, vibrant and energetic.

The human body is a magnificent vessel full of water. The brain is more than 75 percent water and 80 percent of blood is water. In fact, water plays a critical role in every system of the human body. Water regulates body temperature, removes wastes, carries nutrients and oxygen to the cells, cushions the joints, prevents constipation, flushes toxins from the kidneys and liver and dissolves vitamins, minerals and other nutrients for the body’s use.

Sixty-four ounces of water probably isn’t enough for patients in the phase of rapid weight loss. Nutritionists say a more precise measure of the body’s need for water is to divide body weight (pounds) in half and drink that many ounces every day. That number could well exceed 200 ounces a day for some post-operative patients. Follow your bariatric center’s recommendation for your specific fluid needs based on your weight and health status. Continue to adjust your fluid intake as you lose weight.

The body will panic if actual water intake is significantly less than required. Blood cannot flow, waste processes are disrupted and the electrolytes become imbalanced. Proper hydration prevents inflammation, promotes osmosis and moistens lung surfaces for gas diffusion. It helps the body regulate temperature, irrigate the cells and organs and promotes all functions of elimination. Certainly by drinking plenty of water many people could resolve inflammation and elimination problems that result from insufficient water intake. I’m convinced that insufficient water intake caused me inflammation and constipation prior to surgery. My body was unable to flush away toxins.

But how in the world can a person with tiny tummy take enough water to meet the body’s needs? After all, the tiny tummy can hold about one cup – 8 fluid ounces.

First of all, dedicate yourself to sipping water: all day, every day. You cannot gulp down a glass of water a couple of times a day and call it good – your tiny tummy won’t let you.

Next, make a plan. Have specific times of day when you know you will drink water. Carry water with you at all times, an easy thing to do with bottled water available in vending machines and convenience stores. Establish your daily quota and keep track of ounces consumed.

Small Sips: Experience quickly teaches WLS patients to take very small sips of water and swallow carefully. Gulping – and we’ve all done it by mistake – really hurts. I miss gulping on hot summer days when nothing would be better than to chug-a-lug an ice-cold glass of water. But I’ve learned to stay refreshed taking small sips steadily throughout the day. At first I was challenged to drink enough water: I didn’t like it, I wasn’t good at small sipping, I wasn’t thirsty. Before surgery I was a Diet Coke drinker – I called the bubbly beverage my “Breakfast of Champions” and I gulped it all day long. I seldom remembered to drink water. The day before surgery I had my ceremonial final glass – I knew Diet Coke and I were disunited forever. With the money I was about to save not buying Diet Coke I would buy clothes.

Many years later I’m a bottle-toting water woman. I’m like all those fit and fabulous people out there constantly sucking on my bottle nurturing myself with liquid life. You can mark your clock by my trips to the ladies room as I flush those toxins out of my body. Would I go back to Diet Coke? Never. Don’t even crave or miss it. I would have never predicted that.

Sunday, March 13, 2005

What do you eat?

One of the things I'm most often asked: "What do you eat?" I don't give the classic "I eat whatever I want, just less of it" WLS answer. That simply wouldn't be the truth.

For lunch and breakfast I generally eat the same bland, safe things: hard cooked eggs, cottage cheese, sugar free jello and drained canned tuna. My dinner meals are 50% protein with chicken and fish being staples and beef an occasional protein. The rest of the meal is usually steamed vegetables, or a palatable starch such as 1 tablespoon of rice or pasta, or 1/4 piece of whole grain toast. I also drink a 6 ounce glass of red wine with dinner on most nights. Occasionally I have 2 tablespoons of berries (from the frozen foods section) for a dessert.

For the sake of answering this question better I'm starting a food diary on this site. Each day you can click the link and see what I've had -- and I promise to be truthful. If I eat a forbidden food or have a snack I'll include it. If I react badly (dumping, vomiting) I'll note that too.

As always, send me your feedback and best wishes for Living After WLS.

Low Carb Freedom

Here's a site WLS patients (pre and post-ops) can use to benefit our lifestyle. It is written honestly and intelligently by Katherine Prouty, a mom who has lost over 50 lbs. following a low carb lifestyle. Low Carb Freedom: "How to live low carb with pleasure and freedom." Katherine writes:

Having done the low-carb lifestyle for over a year, given numerous "talks" to my local church and other interested families, there are a few things that are critical to long-term success: knowing what to shop for and knowing where to get the right food so it is ALWAYS available -- including the glove compartment of your car.

Katherine shares my belief that life after WLS is essentially low carb living. I agree! Visit her site often for hints and tips for better living. Katherine's content is updated frequently and nicely organized in categories such as low carb shopping, dining out, recipes and news. She sifts through the stockpile of information bringing the best directly to the reader with links and sources. Be sure to sign-up for her weekly newsletter.

Tuesday, March 08, 2005

Dear Kaye:

Why does eating sometimes cause vomiting?
Dear Kaye, I'm pre-op and I've heard that WLS patients vomit a lot. Is this true and what causes it?
Evelyn, Kansas City

This is a good question, Evelyn, and one I think of often as I have become a “frequent puker.” I always wonder what’s wrong with me, especially when I hear other weight loss surgery patients say, “I never get sick.” I get sick a lot. Just this last weekend I vomited my water first thing in the morning – I guess I gulped it to fast. So, here’s what bariatric science has to say:

Most pre-operative bariatric patients have heard woeful tales of post-op patients with severe vomiting problems. Vomiting is caused for two reasons: first, not chewing food thoroughly and second, overfilling the tiny tummy. Doing either of these causes immediate and violent vomiting. It can be painful. It can cause loss of bladder control. For some, the retching and vomiting can be quite loud and embarrassing. It is equally painful to allow the food to sit in the tiny tummy waiting to digest.

When vomiting results from swallowing poorly chewed food, particularly red meat, it is because the passageway leaving the tiny tummy has been blocked. The exit from the stomach to the intestine is only a half-inch opening – that’s roughly the diameter of your little finger! Food that lodges in this narrow passage will digest eventually or be evicted from the body by vomiting. When food is lodged in the passageway it is quite uncomfortable, the pain is in the upper abdomen just behind the sternum. Some people report large pills becoming lodged in this opening. For me, the most common cause of blockage is swallowing salad greens without chewing well.
When we were obese we habitually took big bites and ate rapidly. We didn’t chew our food well. We were fast eaters. As soon as one bite was in our mouth we had our forks loaded to dish in the next bite. When we revert to big bites and rapid eating after surgery vomiting is inevitable. It is good to form the habit of eating slowly and chewing thoroughly. This not only prevents a blockage, but also improves the overall eating experience. If you find a specific food that consistently causes a blockage you may wish to avoid it.

The other reason for vomiting is overfilling the tiny tummy. Just like filling a pail with sand at the beach, once the pail is full excess sand spills over the top. If you fill the tiny tummy too full the excess food will spill out by way of vomiting.

I have found that measuring portions is an effective way to avoid vomiting, particularly with a soup or pasta dish. With these kinds of soft foods, it is very easy to get ahead of myself and suddenly I’ve overloaded my pouch and I’m in a hurry to the bathroom. For example, if I were having spaghetti and meat sauce I would measure one-quarter cup of pasta and one-half cup of sauce. And that would be it. I now know better then to dip back into the bowl for “just one more bite.” That just one more bite has sent me retching more times than I care to admit. I monitor my eating every day to stop eating and not take that last bite.

Do not try to suppress vomiting. The sooner you purge your stomach, the sooner you will feel better. It’s embarrassing and unpleasant to vomit but this is your tiny system’s method of managing mistreatment. It doesn’t take many episodes of nausea before chewing food completely and eating slowly is a habit.

Monday, March 07, 2005

My Life! My Privacy!

I cannot think of any occasion when it is necessary to defend the very personal decision for weight loss surgery.

The only person to whom you answer is yourself. When you discuss your surgery with others, many will be understanding and compassionate. But there are others who will belittle you for the decision calling you weak. They will callously open the wounds you have suffered in a society where it is acceptable to denigrate a person for being overweight. If you are sensitive about your weight protect yourself at all times and avoid confrontations that will hurt. You can protect yourself by keeping your personal medical history private.

Not many people in my immediate world that knows I am a weight loss surgery patient. I made this choice of confidentiality because I am a fragile person. The slightest mention of my size for years brought tears to my eyes and trauma to my soul. For most of my life I believed I was bad person because I was fat. While I have resolved these personal issues with great struggle and effort, I will defend forever my right to privacy. When asked how I lost “all that weight” I answer honestly, “I’ve changed the way I eat, control my portion sizes, and I exercise.”

Some fellow patients don’t agree with my approach, they say it is dishonest. But I compare my answer to a pregnant woman being asked, “Is this your first baby?” If she previously had a miscarriage or abortion, must she be compelled to share that information with someone for the sake of honesty? No. That is her private medical history. Just like my weight loss surgery is my private medical history.

Perhaps the path of privacy isn’t for you and you can openly share your experience with all who will listen. If you can do this I applaud and admire your courage. If you are like me and wish to guard your privacy then I applaud you as well.

You own the decision to be as private or as public about your surgery as makes you comfortable.

Friday, March 04, 2005

Is WLS a Magic Carpet Ride to Happiness?

There is a belief common to pre-operative patients that guaranteed weight loss is a magic carpet ride to happiness. Many patients are shocked and disappointed when weight loss does not bring instant and immediate happiness. Weight loss surgery is not a cure for an unhappiness. Massive weight loss triggers a wide scope of emotion – from anger to joy, from strangeness to recognition, from self-loathing to self-love. Happiness is a big part of the weight loss experience, but so is unhappiness.

While massive weight loss does not give instant happiness, it will empower a person with a new self-respect that can buoy their confidence to change the things that make them unhappy. We each have a mental list, “if only I could change this, then I’d be happy.” That’s probably how our weight loss journey began, “if only I could lose weight, then I’d be happy.” Dr. Dan Baker, author of "What Happy People Know" says happiness depends to a significant degree upon expectations. Happy people keep their expectations in check.

Happy weight loss patients have realistic expectations about the impact massive weight loss will have on their lives. They do not hold weight loss surgery as the sole catalyst for a happier life, the cure-all for what is wrong. But they also don’t miss a beat when weight loss gives them an opportunity to celebrate themselves, to revel in their accomplishments. Happy weight loss patients view this as an opportunity for personal growth and enrichment and they understand it won’t always be wine and roses: there will be painful experiences along the way.

Certainly for most patients there will be a new sense of personal security, a better awareness of feeling secure in who we are. This is what we are hoping for, but even that doesn’t guarantee happiness. Dr. Baker says “No one feels totally secure, and no one should We’re all too vulnerable and life is to uncertain. We all age, we all become ill, we all lose people we love. We all die. These are real insecurities of life.”

Happy weight loss patients have realistic expectations. They understand that bariatric surgery is not a magic carpet ride to happiness. They understand that weight loss does empower them with the confidence they lacked to change the things that make them unhappy.

Wednesday, March 02, 2005

I feel dizzy, Oh so dizzy!

Man do I feel dizzy alot! Frequently I feel light headed and woozie. I blame it on the gastric bypass - but guess what? Research indicates it is a state of chemical imbalance not unique to the bariatric community. All human bodies suffer from occasional to frequent chemical imbalance.

It can occur when too much time passes between meals, or as an early warning sign of dehydration. Lack of food or loss of bodily fluid interrupts the body’s physiological process; the electrolytes get out of balance. Frequently I feel lightheaded or dizzy, not a severe experience like dumping, but certainly an uncomfortable feeling. On many occasions I’ve gotten busy in the gardens and forgotten to sip my water. Before I know it, I’m light headed and weak in the knees. Some cool water and a quiet break under the shade tree quickly refreshes me.

Potassium, sodium and chlorine are the three dominant electrolytes in the human body. Beneath our conscious awareness the electrolytes are very busy jumping in and out of cells making it possible for nerve impulses to travel from one nerve cell to the next. When we are eating correctly, staying hydrated and pursuing a healthy lifestyle it is likely the electrolytes will stay balanced and we can enjoy a dizzy-free existence.

It is extremely dangerous when electrolytes become severely imbalanced. Infants suffering from dehydration have died from electrolyte imbalance. So have sufferers of anorexia.

When a bariatric patient feels dizzy it could very well be related to the restricted diet. Most commonly going too long between meals or not drinking enough water causes bariatric patients to become dizzy or have a mild electrolyte imbalance. I have found The Dizzies will go away quickly if I hydrate with water or little sips of a sports drink like Gatorade.

If flu symptoms cause dehydration to the point of extreme dizziness and disorientation one must see a doctor immediately. Dehydration will force a greater loss of potassium, which raises the sodium level in all muscle tissues. At greatest risk is the heart muscle where an increase of sodium may cause arrhythmia and death.

The sports and nutrition industry’s guideline for water consumption is one ounce of water for every two pounds of body weight. Keep that in mind and keep track of your water intake throughout the day, it will help you avoid The Dizzies.

Interestingly, most of us regularly experienced The Dizzies prior to our weight loss surgery, and probably didn’t even notice. Yet after surgery we are so in tune with our bodies we notice everything, and it is easy to blame the bypassed systems for every abnormal condition. Electrolyte imbalance happens in all human bodies and is not unique to the bariatric patient.