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Thursday, June 30, 2005

Kabuki's Kitchen
Simple Summer Supper

I’ve selected three great recipes from our contributor Kabuki Dancer. They are easy to prepare, picnic portable (properly chilled of course) and high-protein low-volume nutritious goodness. Enjoy them this weekend and Happy 4th of July!

Marinated Beef Salad

Garden Veggie Deviled Eggs

Jell-O Dessert

Monday, June 27, 2005

Since WLS Eating Makes Me Sleepy. Why?

Have you noticed since your WLS and return to regular eating a meal often causes you to become sleepy? Seriously sleepy. Drop your head in your plate sleepy.

This happens to me all the time. And there’s a good reason for it. When we eat the body produces a rise in blood sugar and a surge in insulin production. This chemical activity sends tryptophan to the brain where it becomes serotonin that signals the body “Take a nap!” Here come the nods, the yawns and the blinking eyes. WLS patients are highly susceptible to post meal sleepiness because of the shortened route to the small intestine. From there the tryptophan has a fast ride to the brain shouting almost like Paul Revere “The Sleepies are coming! The Sleepies are coming!”

Now, I don’t want any of you emailing my husband, but quite frequently I dramatically play the “I’m so sleepy” card and go to bed after dinner leaving him with the dishes and evening chores. (Feel free to try this at home!) In fact, he's in the kitchen now doing tonight's dishes!

This is fine for the evening meal, but what about a noonday meal? For example the business lunch. How can we socialize at our mid-day meal and not become a victim of the “Tryptophan Express” to Sleepytown?

A wise nutritional strategy for maintaining a sharp mental edge after lunch is to eat foods that give a gradual, steady release of food energy throughout the afternoon while placing only a light burden on the digestive system. Consider these strategies:

1. Emphasize healthy protein choices, like cold-water fish, beans and legumes, or a non-cream-based main dish soup or stew. Consume 60% of your volume from this group.

2. Choose a minimal serving of low-glycemic-index carbohydrates, like green salad, root vegetables in their skins, mushrooms, green leafy vegetables, broccoli, asparagus, or artichoke. Consume only 20% of your food volume from this group.

3. Be sure your food choices contain healthy fats, such as cold-water fish, flaxseed oil, olive oil vinaigrette (the vinegar helps slow the release of food energy), nuts, seeds, or avocado

4. Absolutely avoid sugary, starchy, or fatty foods like soft drinks, non-whole-grain pasta, fried foods, and rich or creamy sauces and dressings

5. Skip dessert.

Rest assured, (pun intended) by making wise food choices we can be alert, responsive and LivingAfterWLS! Just say no to the Sleepies by making wholesome healthy food choices.


Monday Message From Kaye

Monday, June 27, 2005

Welcome Back from the weekend everyone! And to the many new subscribers who jumped aboard the LivingAfterWLS boat this weekend - thanks for joining us – glad to have you aboard as we try and stay afloat in the crazy world after gastric bypass.

Today I’m pleased to present Kim Stover’s article, “Tastes Like Candy” in our guest contributor column. You may remember Kim from her inspiring success story. Today she shares her quest for protein bars – Kim's article is full of information, personal experience and good dose of humor. Great way to start the week of right! Thanks Kim.

Speaking of success stories, I’d love to add yours to our site. We have many pre-op subscribers who need some inspiration and reassurance as they enter their new lives. When you're ready send your story to share with and inspire others.

Topics on deck to cover this week are:
  • Men & WLS-The Social Stigma
  • A Comparative look at Post-Op Programs
  • Examination of Artificial Sweeteners

In addition our weekly “Kabuki’s Kitchen” feature will be posted Thursday. On Friday look in your Inbox for the July edition of “You Have Arrived” our exclusive subscriber newsletter. Don’t miss it! I have an exciting new addition to the WLS community to tell you about! Subscription & Privacy Policy.

Normally on Monday I send a call-out for well wishes for community members having surgery this week. My database pulled no names, so if I’ve missed someone please let me know. In the meantime let’s all send warm thoughts to one another as we are LivingAfterWLS.

Have a Great Week,

Conventional Diet Advice That Works For Us After WLS

In many cases conventional dieting wisdom simply doesn’t work for WLS patients – we’ve changed the rules. For a refreshing change take a look at what Stephen P. Gullo, PhD, President of the Institute of Health and Weight Sciences in New York City and author of Thin Tastes Better has to say. I believe you’ll find the counsel he gives his patients works well for us too:

1. Know your behaviors, not just your calories. If you find that you’re constantly regaining weight you’ve lost by abusing the same types of foods, either stop buying them or find replacements for them.

2. Remember that weight loss is about liberation, not deprivation. It’s about a change in perspective. Eat fewer calories and cut down on the amount of fat you eat in the spirit of liberating yourself from the discomfort of the pounds that you’ve been carrying instead of depriving yourself from certain foods.

3. Don’t forget that being thin is a life management skill. It’s normal to experience setbacks and periods of feeling defeated. But in the future, when you turn 40 or 50 or 60 at a healthy weight, it won’t be by accident, because aging well is not an accident. It’s the gift that those who care deeply give to themselves. It will be because you planned and honed your skills at weight management.

WOW! This is a must-print post and a read it soon book! Thanks, Dr. Gullo, for your insight. (Quoted from “Prevention’s Ultimate Guide to Women’s Health & Wellnes” 2002, Rodale p. 94).

Sunday, June 26, 2005

Got Food Cravings?
Try a Little Exercise

Studies show that while you work out the body suppresses digestion and release glucose and fatty acids into the bloodstream for energy. This prevents a person from feeling hungry. In fact, after exercise you won’t feel (physiologically) hungry until your body reaches a state of rest and energy fuels are back in storage. If you find yourself hungry from boredom get up, take a walk, move, stretch & bend. Physiologically you’ll curb your appetite, and hopefully that will help with the “head hunger” too.

Give it a try – can’t hurt!

“Tastes Just Like Candy!”
My Affair with Protein Bars
by Guest Contributor Kim Stover

Mmm…tastes just like candy! Well, sort of. This was my reaction when introduced to my first taste of a protein bar. The WLS pre-op support group that I was involved with held a “Protein Potluck”. Everyone needed to bring some form of high protein supplement. There were ready-to-drink shakes, powders, bars and some homemade goodies as well. This was the best meeting yet! I was still pre-op, so quantity consumed was a non-issue.

I started in on the left side of the table and worked my way to the right…sort of like an all you can eat buffet. At 373 pounds, I was exhausted by the time I got done working the line. Now I had to scope out the armless chair in the room. Found it! I plopped myself down and started in on all of my samples. Some bars were chewy, some chocolaty, some crunchy. The shakes were chalky, thick, gritty or just plain icky.

The homemade goodies were good, but I’m a good cook and have made better deviled eggs in my own kitchen. Okay, back to the bars. As I started in on these little bites of “candy”, I thought to myself…recovery will be a breeze if I get to eat these all day long. Perhaps not. After consuming what was on my plate, I went back for seconds. Then thirds. Okay, I’ll admit it; I probably ate a pound of the darned things by the time the meeting was over. And I suffered from the excessive consumption of sugar alcohol shortly after the meeting. Let’s just say that I didn’t make it home in comfort.

Lesson one. Protein bars have many components. First and foremost being protein. Protein is a gastric bypass patient’s best friend. Second, they also contain either sugar or sugar alcohol. Third, most of them are vitamin packed and some even contain fiber.

Lesson two: Learn and understand what your own body needs and can tolerate.

One of the MANY rules that my bariatric nurse set for me was that I was to only eat three meals a day. The only thing that I could snack on in between meals was protein bars with less than 5 grams of sugar. No limits. Her theory was that nobody ever binges on these low sugar protein bars. She was correct in her theory. Usually by the last bite I’m glad to toss the wrapper in the trash. They satisfy me and assist me in getting the much needed protein that I need on a daily basis. Right after surgery, I survived on protein shakes. As soon as I was on solids, I made the switch to the bars and have had them for a snack every day for a year and a half.

There are hundreds of protein bars out there on the market. If you follow the “less than 5 grams of sugar” rule, it narrows down the playing field of choices. I had the benefit of a protein potluck to do my sampling, but since there seems to be a new bar on the market every other day, I’ve done some shopping and studying on my own. I went to my local health food place and stood in front of the wall of bars that were on display and read the fine print on buckets of bars.
It is important to know how much sugar alcohol you can tolerate. I know that the most that I can stomach is 12 grams.

So now I’ve narrowed down my choices quite a bit. Some of those bars have 25 grams of sugar alcohol! A person with a normal stomach and gut would have a hard time handling that much sugar alcohol in one sitting. Usually the bars with gooey caramel stuff are the ones that are packed with the sugar alcohol. I also like to stay away from trans fats. These are bad, as we have all heard. My final criteria is the source of protein. I prefer whey protein over soy protein. I’ve read that whey is a higher quality protein source. Soy can end up causing gas and I try to stay away from anything that causes me to be any gassier than I already am! I don’t look at calories, fat or sodium. You might want to, but to me these are less important at this time in my weight loss progression.

At this point in the sampling game, I can see that I’ve got about 8 different brands and flavors in my basket which I take up to the checkout. Most of these bars run about two dollars a piece, so it is going to be a small initial investment to run your own potluck. Are you worth it? You bet you are! Once you find which bar works best for you, I highly suggest shopping around the internet to find better prices.

The one thing that I’ve learned with the online shopping is to ask what the expiration date is on the bar. I discovered this when a box of Atkin’s bars that retails at my local Trader Joe’s for $27 was selling online for $12. I bought 5 boxes since it was such a great deal. When they arrived at my house, I discovered that they were going to expire in two weeks. Lesson learned. If the price sounds too good to be true, it probably is a short coded product.

There isn’t any perfect protein bar. It’s all a matter of personal preference, so get out there and do some sample shopping. But don’t over do it on the sampling when you get home…just cut off little pieces to taste and if you like that particular bar, drop it in a Ziploc baggie and save the rest for your next snack. If you gag when you try one, throw it away and write it down as being a “never buy it again” so that you don’t forget. I have three of four that I really enjoy. I have yet to binge on them and I have satisfied my protein needs every day since my surgery.

Happy sampling!
Kim Stover
LivingAfterWLS Guest Contributor
© 2005 Kim Stover - All Rights Reserved

Saturday, June 25, 2005

After Surgery: What’s Your Incentive?

We have several brand-new post-ops visiting this site regularly. A few of them have written to ask, “How do you deal with the loss of food?

Do you remember the first few weeks out of surgery when all you could eat was Jell-O or protein shakes or broth or whatever your center recommended that was bland? During the post-op healing phase most of us didn’t feel well enough to do anything and so it was easy to focus on the foods we loved but were now divorced from.

How did you distract your thoughts from food? Here are a few suggestions, why not add a few of your own strategies and let’s help our “Newbies” get past this stage!

  • Read fashion magazines and daydream about your new body in the season’s latest fashions.
  • Practice accepting compliments graciously so you are ready when the cheers start coming your way.
  • Read a book about nutrition so you are well informed and ready to take care of your new body.
  • Visit gyms in your area, meet trainers and consider how you are going to exercise the minute you get released.
  • Read the LivingAfterWLS websites for information & inspiration. (Ok, so I had to plug my own site – SMILING!)
  • Network with other WLS people and share your common experience.
  • Begin a journal of your weight loss experience. Be sure to include statistics like weight, BMI and measurements.
  • Begin your walking program – most patients are instructed to start walking the day after surgery.
  • Enjoy yourself! This bland phase of eating is the start of your brand new life.

Add your suggestions by clicking the comments link! Thanks, Kaye.

Reminder: Calcium
Have you taken your supplement today?

Most Americans do not get enough calcium in their diets; the average daily intake is 500 milligrams shy of the RDI (Recommended Daily Intake) of 1,000 to 1,500 milligrams.

Gastric bypass patients are even more unlikely to intake adequate dietary calcium and without supplementation they may become calcium deficient which ultimately results in osteoporosis. Weight loss surgery patients are limited by the volume of calcium rich foods they may consume. In addition, the malabsorption issue resulting from gastric bypass presents another problem. Since the bowel does not readily absorb calcium and the stomach is drastically shortened there is limited opportunity for the calcium to be absorbed in the body.

Calcium is the most abundant mineral in the body – we have two or three pounds of it, most of which is located in the bones and teeth. In addition to building bones and teeth, calcium is an electrolyte required for transmitting nerve signals, water balance, acid/alkaline balance and maintaining osmotic pressure. It helps the blood to clot and is necessary for the heart muscle function. It’s long been known that calcium will aid in the prevention of osteoporosis, but new studies are identifying calcium for it’s anticancer actions within the colon.

Most dietary calcium comes from dairy products but can also be found in sardines, canned salmon, green leafy vegetables and tofu. The National Academy of Sciences has raised the calcium guideline to 1,000 milligrams a day for people under 51, and to 1,200-1,500 milligrams a day for people over 51.

Gastric bypass patients can do three things to better assimilate calcium in the

First, take a chewable calcium supplement twice daily.

Second, exercise consistently.

Third, enjoy sunshine every day.

Chewable supplements taken twice daily will more rapidly dissolve and assimilate into the body than hard pills. They should be 500 milligrams each; the body cannot absorb more than 500 milligrams at a time. The best supplements are calcium citrate, calcium carbonate and calcium lactate. Some nutritionists believe that calcium citrate is the only acceptable supplemental option for gastric bypass patients, however opinions vary among bariatric centers. Some centers also recommend new post-op patients take chewable antacids with calcium in the first month following surgery.

Our LivingAfterWLS affiliate, Puritan's Pride, carries a variety of calcium supplements that are gastric bypass friendly. I've been taking the chewable calcium, 500mg, twice daily since surgery and my calcium stats and bone health are very good. Here is the link to Puritan's Pride calcium products:

Puritan's Pride Calcium Products

Next, studies show that people who exercise regularly better assimilate calcium into the body than sedentary individuals. Even though US Astronauts take calcium supplements in orbit, they return to Earth calcium deficient; NASA believes lack of physical activity prevents their bodies from assimilating the calcium.

Finally, get some sunshine. Twenty minutes a day of direct or indirect sunlight will give the body plenty of natural vitamin D, the “sunshine vitamin”, which is necessary for calcium assimilation.

Doing these three things will make you feel great today and will contribute to healthier aging. Osteoporosis is an epidemic in this country and is directly attributed to calcium deficiency. We all know that when an elderly person falls and breaks a hip death is imminent. Osteoporosis is nearly always the reason why hipbones break when older people fall. In the case of osteoporosis there is nothing the body can do to defend itself from the loss of calcium associated with aging. Supplementation is necessary throughout adulthood to prevent chronic calcium deficiency.

Get Low Prices & Quality Vitamins@Puritan's Pride®

Friday, June 24, 2005

Why the Inactive Stomach Growls

If you’ve been enjoying life after gastric bypass surgery you will know exactly what I’m talking about. That rumbly-tumbly stomach growl that’s more bark than bite. It’s the inactive tummy talking, the lower part of the stomach that was bypassed. And it growls at the oddest moments seldom accompanied by hunger pains. My inactive tummy is particularly talkative at bedtime, I think it remembers the refrigerator front bedtime binges from my previously life.

Remember the surgical diagrams you studied before surgery: a tiny stomach portion we call the pouch was separated from a larger portion, which is the inactive or bypassed stomach. In the gastric bypass procedure the stomach is left in place with blood supply – it is still and active organ yet no longer a reservoir for food. In some cases it may shrink slightly and the muscles may atrophy, but for the most part it remains unchanged. In fact, the “inactive” tummy is quite active. The inactive tummy is an around-the-clock chemical factory keeping your body in balance.

And for all it’s hard work what do we do? We don’t feed it. No wonder it’s talking!

The lower stomach still contributes to the function of the intestines even though it does not receive or process food - it makes intrinsic factor, necessary to absorb Vitamin B12 and contributes to hormone balance and motility of the intestines in ways that are not entirely known. So when you hear that rumbly-tumbly stomach growl you can smile happily knowing your body is hard at work keeping you chemically healthy and well.

Does your inactive tummy talk? Can you feel the difference from when your pouch talks vs. the inactive tummy? Ever been embarrassed by a tummy-growl? Click Today’s Topic and share your thoughts.

Great Responses: Snacking: Fear & Greed

We’ve had some great responses to the “Snacking: Fear & Greed” message thread we started last Friday. Take time to click over and read some very insightful thoughts. Be sure to add your own ideas as we continue learning about living after weight loss surgery.


Link to the original article.

Published Today:
You Have Arrived Independence Day Issue

Our third edition of “You Have Arrived” the LivingAfterWLS newsletter was delivered to inboxes today. This subscriber’s only special Independence Day issue includes three WLS friendly menus for celebrating our country’s independence. Enjoy!

Subscription & Privacy Policy

Thursday, June 23, 2005

Kabuki’s Kitchen:
Romantic Anniversary Dinner

Today is Thursday, which brings our weekly feature Kabuki’s Kitchen – thoughtful WLS specific recipes from our contributor Kabuki Dancer. Tomorrow is Kabuki’s 27th wedding anniversary and I’m confident she and her beloved will celebrate many happy memories and toast to many good years to follow. Read what Kabuki wrote about relationships and her marriage:

“You know the key to a good relation is communication and realizing that intimacy does not begin in the bedroom but in the sharing and talking and doing for each other, way before one takes one's clothing comes off for the big sex act. It should be a culmination, rather than an end of itself. Loving someone is not just a feeling but an action. And only by actions can one really show love. Feelings remain in the giver's head but it is in the actions that true giving takes place. Love is wanting the best for your beloved. There is no defense for higher love than to just keep loving. Liking your mate helps a lot too---I am smiling. We met when I was 17 and he was 21. We waited till we were both out of college and then married 6 weeks later. We celebrate 27 years next Friday. The time has flown and yesterdays have become memories. Marrying him was my pivotal hinge moment in my life and I believe his also. He is a good person and he cannot help being a perennial "normie" slim man. hmmmm!!!”

Happy Anniversary Kabuki Dancer!

Today I present two special occasion recipes from Kabuki’s Kitchen, a main dish and a dessert. I belive they will pair well to create a satisfying romantic anniversary dinner. Enjoy!

Curried Chicken and Nectarines

Carrot Cake Muffins

Wednesday, June 22, 2005

Suffering From Gas & Bloating?
Sugar Alcohol May be to Blame

Sugar intake is a real concern for people who’ve had gastric bypass, in fact most patients fear sugar. The foremost fear isn’t weight gain, it’s dumping. Foods containing sugar pass too quickly through the small pouch, they are rapidly absorbed and cause insulin levels to drop resulting in dumping.

Very unpleasant. Instead of taking chances with sugar many of us reach for “sugar free” sweets or diabetic candy to satisfy our sweet tooth. Many of these products contain sugar alcohol, a natural sweetener derived from fruits and berries. Unlike artificial sweeteners that contain no calories, sugar alcohol has about half the calories of sugar. Diabetics are able to have food with sugar alcohol because it’s converted more slowly to glucose and require very little insulin to be metabolized.

While sugar alcohols are low in calories and slow to convert to glucose, the down side is they can cause gas, bloating and diarrhea. I learned this the hard way. One day that devil we call temptation seduced me into buying a bag of sugar-free jelly beans. Jelly beans are dangerous because they are little bites of soft food which means a gastric bypass patient can eat too much volume. I ate the entire bag in about an hour (true confessions of the closet snacker). I soon became uncomfortable with a small tummy ache. The tummy ache turned to bloating, cramping and gas. Extreme cases of all three symptoms. Painful “take me to the hospital I think I’m gonna explode” symptoms. It took a couple of days for my body to return to normal, a couple of stressful and uncomfortable days.

The jelly beans I ate contained Mannitol, a common sugar alcohol extracted from seaweed. I know they contained Mannitol because I read the package mid-way through the crisis. The package contained this warning, “Warning: excessive consumption can cause a laxative effect” Fine time to be reading labels I told myself! Mannitol is found naturally in pineapples, olives, asparagus, sweet potatoes and carrots. It’s about 60% as sweet as sugar, so more product is needed to replicate the sweetness of sugar. “Mannitol lingers in the intestines for a long time and therefore causes bloating and diarrhea.” Yup! That’s exactly what happens all right.

What other names are sugar alcohols called?
From the Yale-New Have Hospital Health Advisor here’s a list of common sugar alcohols:

Sorbitol is found naturally in fruits and vegetables. It is manufactured from corn syrup. Sorbitol has only 50 percent of the relative sweetness of sugar which means twice as much must be used to deliver a similar amount of sweetness to a product. It has less of a tendency to cause diarrhea compared to mannitol. It is often an ingredient in sugar-free gums and candies.

Xylitol is also called “wood sugar” and occurs naturally in straw, corncobs, fruit, vegetables, cereals, mushrooms and some cereals. Xylitol has the same relative sweetness as sugar. It is found in chewing gums.

Lactitol has about 30-40 percent of sugar's sweetening power, but its taste and solubility profile resembles sugar so it is often found in sugar-free ice cream, chocolate, hard and soft candies, baked goods, sugar-reduced preserves and chewing gums.

Isomalt is 45 - 65 percent as sweet as sugar and does not tend to lose its sweetness or break down during the heating process. Isomalt absorbs little water, so it is often used in hard candies, toffee, cough drops and lollipops.

Maltitol is 75 percent as sweet as sugar. It is used in sugar-free hard candies, chewing gum, chocolate-flavored desserts, baked goods and ice cream because it gives a creamy texture to foods.

Hydrogenated starch hydrolysates (HSH) are produced by the partial hydrolysis of corn. HSH are nutritive sweeteners that provide 40 - 90 percent of the sweetness of sugar. HSH do not crystallize and are used extensively in confections, baked goods and mouthwashes.

Should Gastric Bypass Patients indulge their sweet tooth with sugar alcohol?
The American Diabetes Association claims that sugar alcohols are acceptable in a moderate amount but should not be eaten in excess. In addition, weight gain has been seen when these products are overeaten. Personally, I’m not dipping my sticky fingers into sugar-free candy again. For gastric bypass patients generally the key, as in all eating, must be moderation, not a full bag of jelly beans. And of course, we can always rely on the old advice of conventional dieters, “Hungry for something sweet? Reach for a piece of fruit.”

Good luck with your sweet tooth!

Have you had experience with products containing sugar alcohol? Post your story to Today’s Topic!

Special Edition "You Have Arrived"
Coming Friday to Inboxes!

The next special edition of LivingAfterWLS newsletter "You Have Arrived" will be delivered to inboxes Friday, June 24. This Independence Day special features three WLS specific menus for summer celebrations including Summer Holiday Brunch, Picnic/Barbecue and Romantic Dinner for Two. Also a special essay, "Let Freedom Ring". Don't miss it! Subscribe today.

Subscriber & Privacy Policy

What’s for Dinner: Kaye’s Swedish Meatballs

Here’s a great recipe for meatballs using ground turkey and pork with the added nutrients from yogurt. Complete the meal with steamed broccoli or carrots – it’s quite satisfying and there’s no need to include a starch. Enjoy!

Our Vision, Our Future

Lately I’ve been studying “how-to build a web community” because that is the long range plan for LivingAfterWLS. In my studies I read it is important to keep the audience, you my loyal readers, informed about future plans. I sent a newsletter earlier this week to the subscriber list, but if you are new and didn’t see the email here’s a little summary of where the site is going.

We say it all the time, "WLS is only a tool." Lots of times we resign ourselves to thinking it’s the ONLY tool we have in weight loss and weight maintenance. But actually, our best chance for long-term success is when we use many tools including the support of our family and friends, the counsel and support of our bariatric centers, and the involvement of our primary care physician and mental health community.

It is my goal and dream that LivingAfterWLS will become a multi-purpose tool in the on-going battle against obesity, against self-loathing and against self-sabotage. It will also become a source of celebration and validation one with another. It will be a place for bonding because we are all in this together. While the site may seem young and crude at the moment I anticipate it becoming a full-fledged community by early 2006.

  • LivingAfterWLS Vision:
    To provide an online safe haven community where members can support, interact and celebrate one with another in this LivingAfterWLS life. The community will include:

    Public forums

    Personal messaging

    Public and/or private journalizing

    On-line chats

    Private and/or public profiles

    A comprehensive food/nutrition database whereby members can track caloric intake, protein and nutrient intake

    A vitamin minder to ensure we are taking the vitamins we need for health/wellness

    An exercise diary for tracking calories burned, sets/reps and overall exercise progress

    A health diary to record vital statistics including blood pressure, Diabetes readings and annual blood test results

    A comprehensive library of WLS specific articles, links and resources

    A national directory of WLS Centers and Support groups

    A news source for up-to-the-minute information regarding obesity, weight loss surgery and general health

    A collection of WLS Success Stories

    A database of WLS specific recipes and products

    Health and fitness calculators

It is my hope, my dream, my passion that LivingAfterWLS becomes one of the tools you use to succeed in this, your new life. So, that’s where we are headed. Thanks for joining me early in the process, I’m glad each and everyone of you are here.

If you have an idea for something you’d like to see in the emerging LivingAfterWLS community please send me a note. I will be taking a rough plan to the web developers next month and would love to include your ideas/suggestions.

Thanks again & Happy LivingAfterWLS!


Tuesday, June 21, 2005

We're Affiliated: Puritian's Pride Quality Vitamins

I am pleased to announce LivingAfterWLS has affiliated with Puritan’s Pride Quality Vitamins. This is exciting for two reasons:

First, I have been taking Puritan’s Pride vitamins since my gastric bypass in 1999. My husband has taken Puritan’s Pride vitamins exclusively for many years. Prices are reasonable (Check out the Buy 1 Get 2 Free Sale) and service is consistently efficient. I am a believer in the Puritan’s Pride product and attribute my state of balanced nutrition in part to my Puritan’s Pride supplements. For quality, consistency and value you can’t beat Puritan’s Pride.

Buy 1 Get 2 Free at Puritan's Pride

Secondly, an affiliation with Puritan’s Pride will generate revenue for the site which will support continued growth as we expand our community into a full-fledged interactive community tool for living after weight loss surgery.

When it’s appropriate I’ll link to Puritan’s Pride products that I know are effective nutritional supplementation after gastric bypass. Be assured I will only recommend products in which I have personal knowledge and faith. Please link through the site and give Puritan’s Pride a try. I think you will be quite pleased.

Best Wishes,

Summer At Last!
Celebrating the Longest Day of the Year

As some of you know I live high in the Rocky Mountains on a country ranch with my husband. It’s a beautiful place and I can’t imagine myself anywhere else, although I think I’m a city girl at heart. The high mountain winters are long here sometimes lasting 13 months out of the year! For that reason today’s Summer Solstice is cause for celebration at our home.

I love the legends and lore associated with this time of year. As quoted from “The Longest Day: Traditions for the Summer Solstice By Virginia Johnson “June has long been associated with marriages, and much midsummer lore has arisen from the greening time. The act of silently gathering nine kinds of flowers and placing them under a pillow is supposed to reveal in dreams the identity of the person to be wed. The honeymoon to follow was originally a time when the newly-weds would share foods prepared with honey so that their lives together might be sweet.”

I hope to spend some time in the gardens perhaps collecting some magical flowers and herbs. Ms. Johnson writes, “Herbs and flowers harvested on Midsummer Day were believed to have magical qualities. Specially gathered fern seed was believed to make people invisible and guide them to buried treasure, and wreaths and garlands of flowers were created to bring health to households and ward off evil.”
In the past my husband and I have hosted great feasts, in the Nordic tradition, to celebrate Midsummer Day. This year we’ll celebrate with a romantic evening, cooking dinner on the grill and enjoying every last drop of warm sunlight until darkness falls and stars twinkle in the sky.

Whatever you do today, please take time to celebrate. Celebrate summer, celebrate your health and celebrate all that is right in your world.

Best wishes,

It's A GIRL!

We have exciting news from our member, Maxine! Her daughter had a baby girl yesterday. Maxine writes,
"Hi Kaye..we are so estatic to learn that less than an hour ago Jen gave birth to a healthy baby girl..they named her Maya Elizabeth...and according to Eliz who was present for the delivery she is just the prettiest little thing..I am just so happy that mommy and baby are doing fine."

Our happy grandma is also Elizabeth's mother, another community member who had her surgery a few weeks ago.

Please join me in heartfelt congratulations for Maxine, Elizabeth and the whole family!

Monday, June 20, 2005

Reminder: Meal Process & Fluid Loading

Our darling reader/contributor, Kabuki Dancer, sent me a great article this morning titled “Pouch Rules for Dummies”. The article is a bit dated (1980s) but the fundamentals have not changed. It was good for me to review the “Ideal Meal Process” and “Fluid Loading” topics as I have fallen into the habit of taking fluids with meals. Take a look and consider this process against your own eating practices. Thanks Kabuki!

IDEAL MEAL PROCESS (rules of the pouch):
1. The patient must time meals five hours apart or the patient will get too hungry in between.
2. The patient needs to eat finely cut meat and raw or slightly cooked veggies with each meal.
3. The patient must eat the entire meal in 5-15 minutes. A 30-45 minute meal will cause failure.
4. No liquids for 1 ½ hours to 2 hours after each meal.
5. After 1 ½ to 2 hours, begin sipping water and over the next three hours slowly increase water intake.
6. 3 hours after last meal, begin drinking LOTS of water/fluids.
7. 15 minutes before the next meal, drink as much as possible as fast as possible. This is called “water loading.” IF YOU HAVEN’T BEEN DRINKING OVER THE LAST FEW HOURS, THIS ‘WATER LOADING’ WILL NOT WORK.
8. You can water load at any time 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness.

Fluid loading is drinking water/liquids as quickly as possible to fill the pouch which provides the feeling of fullness for about 15 to 25 minutes. The patient needs to gulp about 80% of his/her maximum amount of liquid in 15 to 30 SECONDS. Then just take swallows until fullness is reached. The patient will quickly learn his/her maximum tolerance, which is usually between 8-12 oz.

Fluid loading works because the roux limb of the intestine swells up, contracting and backing up any future food to come into the pouch. The pouch is very sensitive to this and the feeling of fullness will last much longer than the reality of how long the pouch was actually full. Fluid load before each meal to prevent thirst after the meal as well as to create that feeling of fullness whenever suddenly hungry before meal time.

Article written by: Mason. EE, Personal Communication, 1980. Barber. W, Diet al, Brain Stem Response To Phasic Gastric Distention. Am J. Physical 1983: 245(2): G242-8 Flanagan, L. Measurement of Functional Pouch Volume Following the Gastric Bypass Procedure. Ob Surg 1996; 6:38-43

Sunday, June 19, 2005

Fish! It's What's For Dinner Tonight

You have got to take a look at Kim's LowFat Tilapia recipe - easy fixin', easy clean-up, delicious high protein goodness. She even threw in some healthy vegetables. Try it tonight! Thanks Kim!

Warm Thoughts & Wishes Needed

One of our members, Joanna, is having her surgery Monday, June 20. Please keep warm thoughts in your heart for her this week.


Saturday, June 18, 2005

Aloha! Kel’s Hawaiian Chicken

Click on over to WLS Recipes and give Kel’s Hawaiian Chicken a try – WLS Friendly AND her family loves it too! Thanks, Kel, for sharing with us. Kel had her surgery March 3, 2005 and is doing great!

Reader Feedback: Snacking

Yesterday's article "Snacking, The WLS Tool, Emotions of Fear & Greed" seems to have struck a chord with many readers. Turns out many of us are struggling with snacking: understanding what motivates it and trying to find a better way to use our tool.

Readers have posted some insightful and honest feedback on Today’s Topic forum. Here are a few snippets – be sure to click over and read the complete dialogue – and then add some thoughts of your own. Together I think we can better understand and tame the Snack Monster.

Anna said, “I snack out of greed. I tell myself I deserve a treat or a snack. My internal dialogue says, "go ahead, one snack won't hurt, you deserve it". I also deserve to be healthy, happy and not ashamed of how I look or how others see me. Sounds easy, but it is not.”

Kabuki Dancer said, “I used to think I was being "bad" or "good" and that is no longer so. Food is just that, at my will to sustain my body and sometimes to sustain my mind.”

Kim said, “I've gotten to within arms length of grabbing that brass ring only to knock myself out of the running by bingeing and calling it quits.”

Click over to Today's Topic to read more.

Have a great Saturday!

Friday, June 17, 2005

Snacking, The WLS Tool, Emotions of Fear & Greed

Do you remember nodding your head with understanding during your pre/post WLS seminar when the speaker said, “Gastric bypass is only a tool, the rest is up to you.” I nodded my head to the nurse dietician as she spoke to the room of fresh-out-of-surgery gastric bypass patients. We thought we understood “only a tool.”

But the words “only a tool” are vague. It would be more accurate to tell new patients, “I’m sending you back into the very world that made you fat. Nothing in your environment has changed. In fact, the only thing that has changed is you – every external force that acted upon you 10-days ago is still out there. You are going to have to claw and fight your way in that same world resisting the habits and instincts that caused you to be obese in the first place. The only weapon you have is a little stomach and impaired absorption system – this is the tool. You will still have emotional highs and lows, days of self-doubt and days of celebration. There will be food pushers, saboteurs and cheerleaders along the way, but the burden is on you to use the tool.”

“It’s only a tool.” Frankly, sometimes I get sick of hearing that and sick of saying it.

Financial planners say people manage their money with two emotions: fear and greed. They fear losing money or fear not having enough money. Greed manifests when they want more money or presume they never have enough money.

I suggest in many instances we use the same emotions to manage our eating behavior, before surgery, after surgery, regardless of the fact that we have “the tool.”

Fear could be about wasting food, betraying friendships, damaging relationships. We fear the discomfort of stress, boredom or loneliness and manage those emotions with food. In addition, WLS patients are known to fear weight loss success because we’ve never really accomplished massive, lasting weight loss before – success is an unknown place to be.

Greed could be about always wanting more, one more taste, one more bite, one more piece. Greed could be the frantic collection of a snacking-stash for “just in case” moments when we really “need” something fast. Greed results from “worthiness” – I have done my exercise so now I deserve a reward – which often is a snack or treat.

By managing our emotions with fear and greed we caused, in part, our obesity and ultimately that led to morbid obesity. Given thoughtful contemplation I am certain we can list the fears and the greed that got us to the surgical table.

But what if fear and greed could work in our favor if we teamed them with “the tool”? Would fear and greed, emotions we love and hate, be a good thing? Consider this:

What if I fear dumping/vomiting/weight gain if I eat Nutter-Butter cookies? Or popcorn? Or crackers? Or, or, or.

What if I fear the co-morbidity of Type II Diabetes returning if I engage in mindless snacking?

What if I fear the cruel things people will say (and they will say cruel things) if I regain my weight?

What if I fear having to buy bigger clothes because I’m snacking and regaining weight?

What if I fear having to return to the surgical table for a revision surgery because I couldn’t get a handle on my eating habits?

What if I’m greedy and want to live long and healthy to see my children and grandchildren grow-up?

What if I’m greedy and love the pleasure of active living that weight loss has given me?

What if I’m greedy and don’t want to spend money on prescription medicine for ailments I no longer suffer because I’ve lost weight?

What if I’m greedy and want to hear more compliments about how healthy and fit I look after achieving massive weight loss?

What if I’m greedy and unwilling to sell-my-soul to the guilt-monster for a lousy indulgence?

Fear & Greed & Only a Tool: Can we make them work together in our favor? Add your thoughts to Today's Topic.

You decide.

I’m going to spend a lot of time considering how I can make these emotions work for me because I’ve got to conquer this snacking habit before I’m doomed.

Best wishes,

Nutritional Intelligence:
Eating to Enhance Natural Beauty

“I tell people that they should look at eating as an opportunity to enhance their natural beauty. Every time you sit down at the table, you have a chance to make yourself feel and look better – so use it wisely! We call it nutritional intelligence, and it’s about knowing how the food we eat affects you both inside and out. Nutrients play a big role in the health of the body, and the health of the body is reflected in how the hair, skin and nails look.”

- - Kathie Swift, RD, Nutritional Director, Canyon Ranch, Berkshires

Quoted from p. 69, Bobbi Brown Beauty Evolution by Bobbi Brown with Sally Wadyka, HarperResource 2002.

Thursday, June 16, 2005

Computer Problems: My Apologies

I've been experiencing "technical difficulty" with my ISP and the server that hosts LivingAfterWLS. This has caused a delay in issuing the newsletters to new subscribers. Please accept my apologies for the delay. If you subscribed to the site and have not received your newsletters drop a note to and I'll re-send. Thanks for your patience, Kaye

Introducing: Kabuki's Kitchen
Weekly Menu & Recipe Feature

It is with great pleasure I introduce Kabuki’s Kitchen: a new Thursday feature to our LivingAfterWLS. Kabuki has generously shared her recipes from her own collection titled: "I Am So Tired of Baked Chicken". She wrote to me, “Food is needful part of survival, I’m just so grateful now that it is enjoyable and in perspective.”

In addition to sharing recipes I have come to love and admire Kabuki for her calmness of spirit and her wisdom of the soul. Her thoughts and impressions are profoundly beautiful and strikingly sincere – please enjoy as I share them here:

“I have lost 60% of my weight that I need to lose and I am enjoying a new found life in both quality and quantity, albeit without the quantity of food. I know happiness comes from within, but having an acceptable body certainly lends itself to contributing to peace of mind. This world judges us on outward appearances and inasmuch as my health has improved due to the weight loss, having a body that I am not ashamed of has been such a blessing.”

“Today, your topic about body dysmorphia really hit home. That is me to a tee. I am so glad that others share my crazy head. It is humbling and healing to know that we are all just colorful threads in the same huge tapestry.”

“I was just thinking that the highest form of play is in the fun of the now. So often as a former fat girl, I was always living in the future, waiting until I lost weight to do this or that, to try something new, to go somewhere etc. I have come to realize that the moment is all we have and to embrace the moment and to live in the now. I have to remind myself of that even now but it is getting so much better.”

“Do remind all the readers that the wise person inside them is the only one who knows if the recipe works for them. Just because I use it does not mean it is magic or a law or potent in any other way except that it might work for them too. I just want to tickle their palette. “

“Inasmuch as my body might change, it keeps me humble remembering I am a "fat girl" at heart and to work at living in moderation. I am tired of hitting my head against the corridors and enjoy the moments when I can walk in the sparkling middle ground. WLS has helped me achieve that most of the time and I am so grateful.”

Each Thursday we will feature of dinner menu from Kabuki’s Kitchen. I know you will enjoy her recipes – I’ve had a sneak peek and they are scrumptious while being mindful of our very specific dietary needs. Please leave your comments for Kabuki here so she knows how much we appreciate her.

Menu for Thursday, June 16, 2005:

Luscious Lime Shrimp
Dilled Salmon Cakes

Tropical Frozen Treats

Tuesday, June 14, 2005

Snacking Continued:
Why Do I Work So Hard to Defeat My WLS?

LivingAfterWLS reader feedback indicates snacking is the single biggest problem for people after having gastric bypass – the problem being we snack on unhealthy items, we sabotage our weight loss or weight maintenance and we spiral back into the self-loathing that is so much an emotional part of morbid obesity.

None of us goes into surgery expecting to be the one “who lost all that weight and put it back on.” None of us goes into surgery expecting to become sneak eaters. We all believe we can beat obesity with our “tool” and we all expect to become healthier, more active, and yes dare I say more attractive and happier after WLS and massive weight loss.

Then why do we work so hard to defeat the system? To abuse the tool?

I spent time this past weekend perusing my personal journal that I’ve kept since weight loss surgery and I discovered some interesting things about myself and my snacking habits. See if these sound familiar to you:

- Five PM is a trigger snack time for me because I grew up having an after school snack (hungry or not) and when I walk in the door at night from my grown-up job I become a school kid and I want/need/crave my “after school snack.”

- When I opt for healthy high protein, low fat, low carbohydrate snacks I am remarkably satisfied and pleased with myself. These snacks include cottage cheese, a hard-cooked egg, deli turkey, sugar-free gelatin, beef jerky, almonds.

- Most often I opt for soft food snacks: crackers, trail mix RitzBitz, wheat toast with peanut butter, and worst of all, Nutter-Butter cookies. When I indulge in these snacks I am not satisfied, I feel sluggish and I become self-loathing.

- Most of my snacking is done covertly – I purchase a single serve pack from the convenience store and eat it in private; never at my work desk, never in front of my family. This covert behavior is reminiscent of pre-WLS days and causes me to be disgusted with myself. “Who in the hell are you hiding from?” I asked myself in one entry.

- It never occurs to me to snack on carrots or apple slices or berries, oh no! I’ve convinced myself that roughage stuff will just tear up my tiny tummy. “Can’t have that”, I say shaking my head with much willpower and determination.

- Consistently my entries about snacking or self-loathing and remorseful filled with negative self talk like “ate mindlessly, AGAIN”, “nervous snacking today,” “carelessly ate a box of animal crackers, never tasted a bite and then got sick: I’m an idiot”, “I was shoving food in my face like a junkyard dog – how ugly that must have looked”, “I made stupid food choices today and then ate chocolate cake with frosting and dumped; it was like I was trying to punish myself and I did.”

- Consistently my entries about exercising are positive filled with words like “felt great” “could have ran another mile” “feel so strong” “tons of energy” “fantastic workout” “strong lungs feel phenomenal”. Yet I more consistently reach for the snack bag than I do my running shoes. Why can’t I get it through my thick head what a remarkable thing exercise is for me and that I really do enjoy it and I like myself when I move my body? Why is that such a hard concept to grasp? Why do I prefer to snack and engage in self-loathing?

- If I see the scale going up I panic and then I snack – almost as if I’m sending the message “This (weight loss) was too good to be true; better hurry-up and defeat myself.”

- Sometimes I snack just because it’s there – just like before surgery.

- I could not find a single entry that read “I was actually hungry today so I had a snack.” That tells me I never snack because I’m hungry. Honestly, I seldom feel hungry so why am I snacking?

Do these behaviors sound familiar to you? Are they some of the demons you are fighting these days? Comments and emails are always welcome,

Tomorrow we’ll look at the snacking triggers and try to identify some strategies to help whip the snack monster and move toward better living after WLS.

Best wishes,

Sunday, June 12, 2005

What the hell am I doing to myself?

In the special pre-op edition of the LivingAfterWLS newsletter published Friday I wrote:
“I should have NEVER broken the "no snacking" rule. For the first 7 months out of surgery I never snacked. Not once. Then 100 pounds were gone and I was cocky and I had a "just this once" snack. And then another "just this once", and then another. Within a week I was full steam ahead in the snack habit. I believe I would have been far better off to never break the rule the first time.

And truth told I have yet to snack because I’m hungry. Sincere, honest gut hunger. I’m disgusted with myself when I snack. I snack from boredom or nervousness or "because it’s there." I snack to soothe a bad day or to celebrate a good day. Snacking is my downfall. I’m renewing my effort to not snack but I know I will struggle with this for the rest of my life. Why was it so easy to not snack that first seven months and now it’s so hard to kick the habit?”

The “snacking habit” hit a nerve in our LivingAfterWLS community. From reader emails I learned, I’m not the only one who has returned to snacking and I’m not the only one who regrets it. Seems like the “Snack Monster” is the most fierce and resilient monster we fight in our new lives.

Sitting at my desk I opened an email from Cyndie, one of our loyal readers, in which she said, “I am 2 years post-op and struggling with the snack bug.” And while I was reading her email I was shoving a Nutter-Butter cookie in my face.

Talk about humbling. What in the hell am I doing to myself?

Another insightful reader, Rob, who is only 10 months out of surgery, wrote, “But snacking has crept back in on me as well. I’m trying very hard to remember to substitute water when I get snack cravings. And, like you, I find that I’m so much more likely to snack when I’m not busy. And after snacking, I frequently find myself thinking, “What kind of idiot would go through a potentially life-threatening and costly surgical procedure only then to sabotage the whole thing with some overpriced piece of nutritionally-void, sugar-free (thus often gas-causing) piece of candy?”

I spent a lot of time this weekend evaluating why I snack and the kinds of food on which I snack.

I’d love to tell you I snack on carrots or sliced apple or a hard cooked egg or even a piece of low-fat cheese. None of these things cause me to dump, vomit or gain weight. These are nutritionally good things to eat.

But, in the spirit of true confession I reveal my favorite snacks (in this order) are Peanut Butter Ritz Bits, Nutter-Butter Cookies and Cheese Nips. I can purchase these three items from vending machines or at the convenience store. I would never be so blatant to purchase them at a supermarket and keep them in my home – oh no! My snacking is covert. And here’s the worst part: when I elect to snack on these items I take a look at the nutritional data on the back of the package. Not to see how much protein or fiber I can consume – but to see how much sugar the product contains. My self-question is, “Can I get away with this without dumping?” My self-question is never, “How will this product meet my nutritional needs?”

Pretty pitiful don’t you think?

And the worst part – I have yet to snack because I’m hungry. In fact, I can count on one hand the number of times I’ve actually been hungry – feel it in my gut hunger – since WLS. I never eat for hunger. We’re talking true confessions here.

So, what to do?

On Friday, humbled and ashamed, I announced to my husband “I’m done with snacking. The party’s over. I’m not doing it anymore.” He looked at me in disbelief. But I assured him, "I’ve quit before, I can do it again." I felt like an addict making a false promise for recovery.

My husband is a smart man. He said, “I support you in your decision.” But secretly I think he is skeptical. Of course he is – he’s watched me come in the house at 4 PM and hunt for my “after school snack” – that’s what I call it because that’s how I was raised. At 4 PM one must have an “after school snack” hungry or not, it was part of the daily ritual. The daily ritual of an obese family.

I’m convinced that my snacking is a habit triggered by boredom, nervousness or the clock. I do not believe there is a physiological need for in-between-meals eating. So, I’m going back to the basics: protein at all meals, no snacking, daily exercise and lots of water.

Wish me luck! Tomorrow we’ll look at good snacks vs. bad snacks. Click over to "Today's Topic" to reveal your snacking habit.

Best wishes,

Well Wishes Needed

We have two members of our LivingAfterWLS community who are having their surgery this week. Please send warm wishes and good thoughts to Jennifer and Cori as they embark on their new lives.


Saturday, June 11, 2005

A Must Read Success Story

I am honored and pleased to present Kim Stover's WLS success story. Kim has achieved significant weight loss since her surgery in September 2003. Link to read her poignant, honest and insightful story. She illustrates beautifully the feelings of "fraud" we have after massive weight loss and the body dysmorphic tendency to continue seeing ourselves as morbily obese - even when we aren't.

Thanks Kim for generously sharing your story with LivingAfterWLS. Best wishes for your continued success.

Friday, June 10, 2005

My Silly Little Weight Game

It’s the weekend! Time for some fun!

You might be surprised to know that I am still extremely sensitive about my weight. It is painful for me to remember my pre-surgery number and painful to think about how much weight I actually lost. I guess the shame of having been obese won’t ever diminish.

So, I invented this little trick as I was moving down the scale after gastric bypass surgery.

Gone to the Dogs!

Rather than dwelling on a number I celebrated losing a dog – you know, kind of like “dog years” only “dog pounds”. For example, in the first 10 days I lost 16 pounds, or in my Dog-Gone-World, I lost a Pug. By 3 months I’d lost an Old English Sheepdog. And by the time I reached goal weight I’d lost the Sheepdog AND a Golden Retriever. Pretty clever, don’t you think? Ok, maybe a bit silly too!

Here’s a list of 12 purebred dogs and their weights. What dog(s) have you lost? If you’ve lost a dog that’s not on the list go ahead and use it! You’re invited to post your “Dog-Gone” in the comments section!

3-7 lbs. Pomeranian
6-9 lbs. Toy Poodle
14-18 lbs. Pug
18-24 lbs. Dandie Dinmont Terrier
24-48 lbs. Cocker Spaniel
40-65 lbs. Basset Hound
44-70 lbs. Chow-Chow
60-100 lbs. Old English Sheepdog
65-75 lbs. Golden Retriever
90-110 lbs. Rottweiler
110-120 lbs. Great Dane
110-200 lbs. St. Bernard

Link for a complete listing of purebred dogs and their weight.

(PS – If you’re a cat lover go ahead and post how many kitty’s you’ve lost).

Say "Cheese!"
Helpful Hints for Gorgeous "After" Pictures

I clearly remember how much I loathed having my picture taken when I was morbidly obese. Actually, I didn’t mind having the picture taken, it was seeing the picture of the sad fat lady that bothered me. I suppose most of us are that way.

As we are now LivingAfterWLS we are likely to be more actively engaged in life and more photo-ops are occurring. One must-do photo is a great looking “After” picture. I did some snooping and found some hints for looking gorgeous in photographs.

The best advice for a great “after” photo - wear form-fitting clothes instead of blousy ones. Form-fitting clothes show off your new shape where blousy clothes make you look bigger. Didn’t we spend enough time looking bigger – and we all know the camera adds 10 pounds. Next, select a flattering neckline whether it's a V-neck, scoop neck, or boatneck. And stick to darker shades; they tend to recede in photos, having a slimming effect. What to avoid: Bold, bright prints.

Next let your happiness show with a genuine smile. Rather than focusing on posing the perfect smile think about all the good things in your new life. Appreciate and glorify in how far you’ve come. Let your eyes sparkle and your happiness radiate naturally and unrehearsed.

Finally – check your posture. Avoid facing the camera straight on – this can be unflattering. Position yourself in a ¾ pose so you’re facing the camera at an angle. This pose will show off your new waistline and healthy body and make you look sexy and svelt!

Special Edition Newsletter Published Today

June 10, 2005 Announcing:
“You Have Arrived - Special Edition for Pre-Ops"

"The Window of Opportunity & Other Things I Wish I Understood Before Weight Loss Surgery"
by Kaye Bailey

Exclusive newsletter available only by subscription. Link to the Subscription & Privacy Policy for LivingAfterWLS. To subscribe through Bloglet enter you email in the subscription box on the right. Bloglet will deliver you daily updates from

Thursday, June 09, 2005

Reader Recipe:
Quick & Easy Cheesy Ham Breakfast Bake

One of our darling readers, Kabuki Dancer, shared a scrumptious recipe today. It's called Quick & Easy Cheesy Ham Breakfast Bake - YUMMY! And, high-protein, low volume! Perfect for Living After WLS.

Kabuki had her surgery January of this year. Her outlook is so positive, read what she wrote:
I am enjoying a new found life in both quality and quantity, albeit without the quantity of food. I know happiness comes from within, but having an acceptable body certainly lends itself to contributing to peace of mind. This world judges us on outward appearances and inasmuch as my health has improved due to the weight loss, having a body that I am not ashamed of has been such a blessing.
Thanks for sharing with us, Kabuki. We look forward to hearing from you often!

Bat-Wings After WLS: Saggy Flappy Arms

Continuing our discussion of plastic surgeries following massive weight loss, today we discuss the dreaded “bat-wings”. You know what I’m talking about - that upper arm skin which hangs like bat wings if you spread your arms wide ready for flight. Wave your hand and the bat-wing waves too. For some after massive weight loss there is so much skin it’s difficult to find shirts with sleeves that fit, and worse, it’s embarrassing to wear sleeveless shirts.

What to do?
The first line of defense is to do weight or strength training during the phase of rapid weight loss. Many patients report satisfactory skin shrinkage of the upper arms when they’ve incorporated light exercise during weight loss. Arm training takes minimal equipment (2 light dumbbells 3-5 lbs each) and limited space. It should be noted, the younger the patient and the fewer times they’ve seen significant weight change, the better chance they have of toning and shaping their arms with exercise. Now, that doesn’t let older patients off the hook for doing exercise - it just gives a bit more encouragement for younger people who undergo WLS. (See the bottom of this post for two effective upper arm exercises.)

The next, but not very plausible option is liposuction. Lipo is only appropriate when there is a lot of fat and the skin is tight. The lipo sucks out the fat and allows the skin to shrink. This isn’t plausible for most WLS patients because they’ve already lost the fat leaving an empty balloon of upper arm skin.

The last resort is the $5,000 arm lift called brachioplasty Brachioplasty is a surgical procedure that eliminates excess skin from the upper arm.

Incisions and Scars in Arm Lift
Scars are the greatest drawback of this operation. They will extend from the armpit to the elbow, along the inside of the arm. This operation exchanges one cosmetic problem (loose skin) for another (scars). In general, those with very loose saggy skin are most likely to find this exchange worthwhile. Those with a small amount of looseness will probably not want the scars.

The Upper Arm Exercises

To shape and tone use a 3-5 pound free weights and do three sets of 12-15 repetitions.

1. Bicep Curls
Stand with feet parallel, hip-width apart, knees soft. Hold a free weight in each hand palms facing forward. To work the lower range of motion, keep elbows tight to your sides and exhale to lift the free weighs as high as your elbows, your forearms parallel with the floor. Lower weights back to your sides and repeat 12-15 times per set.

Next work the upper range of motion, exhale to raise the weights from the elbow (forearms parallel with the floor) to the shoulder. Again, repeat 12-15 times per set.

2. Triceps Kickback with Support

Place left hand on a chair back for support and take a staggered lunge position, left front knee bent over the ankle. Hold a weight (3-5 lbs) in right hand. Keeping spine straight, bend forward from the hip. Bend the right elbow to 90 degrees and raise the upper arm so that it is as parallel to the floor as you can get it. This is the starting position.

Keeping you abdominal muscles tight, exhale while extending forearm behind you so that your arm is straight. You’ll feel this in the back of the upper arm. Pause and squeeze the back of the upper arm. Inhale to return slowly to the start position, keeping the upper arm stationary. Repeat 12-15 times per set. Then reverse sides and work the left arm for the same number of repetitions.

To review some of our early discussions on plastic surgery after massive weight loss click the links below:

Tummy Tuck
Neck Lift

Wednesday, June 08, 2005

Reader Recipe:
Broccoli & Cauliflower Summer Salad

Our reader, Dana, shared this recipe today and I tried it tonight. It's fabulous! Fresh vegetables, cashews & bacon combine for flavorful low-fat, protein rich goodness. The vegetables are finely chopped making them easily digestable for gastric bypass patients.

Thanks, Dana, for sharing. I hope you will all try this and Enjoy!

Goodbye Self-Loathing! - Hello Self-Loving!

You won’t believe what happened to me today!

I was getting ready for work and saw myself naked in the full-length mirror and I didn’t hate what I saw! I actually gave myself an un-rehearsed self-compliment “You look good today.”

The reason this is monumental is because most of the time when I look in the mirror I do not like what I see and I give myself harsh criticism. I suppose after years of self-loathing that it is more comfortable to degrade my appearance than to appreciate it.

Many patients report hyper-judging their bodies after weight loss; it seems the thinner we get the more judgmental we are of our bodies. These days I’m critical of thighs that seem a bit jiggly and some very unattractive cottage cheese dimples on my rear end. Loathing these body parts keeps me from appreciating a thin waist, toned arms or those curious collarbones that were in hiding for so many years.

We’ve discussed body dysmorphia here before – it’s a mental image many victims of anorexia nervosa have that tells them they look fat, even when they are emaciated. Morbidly obese people and bariatric patients can suffer from body dysmorphia as well.
One reader, ThereseD, posted this message regarding body perception:

“Body Dysmorphia is REAL! Over five years after my open RNY gastric bypass and I got hit with it again just last night, when I was cleaning out my closet. My daughter commented that my new shirt, which I was so proudly placing at the front, was too big and needs to go in the "go" pile. I checked the label and sure enough, it said "Large". Following my revision surgery of April 18, 2005, I still have my bandages and I'm probably wearing a size 4 Petite . . . and still I put on a smart and stylish new top in a size that's just too big for me! Oops!”

When we were morbidly obese our emotional coping mechanisms kicked in and many of us were able to convince ourselves we really weren’t that big. It is emotionally kinder to avoid body criticism. The whole issue of obesity seems hopeless. In fact, many morbidly obese patients will say they see themselves normal sized. That is until rude moments remind them they are not normal sized: a skinny chair, a turnstile, a bathroom stall, a flight of stairs, a photograph. This false perception is a subconscious coping strategy to protect us from the brutal truth, the truth about how big morbidly obese really is.

After surgery, there is a tendency for the body dysmorphia to reverse. Before surgery we denied how big we were, after surgery we judge ourselves critically – like the anorexic – and fail to see an honest reflection. One woman, down from size 24 to size 10 wrote, “I feel fat daily. I never felt this at 248 pounds – I saw a thinner person in the mirror than I see now. I look at my size 10 jeans and they look like tents. I don’t feel as attractive as I did when I was heavy. I don’t understand it,” she continued, “but I think it has to do with learning to accept yourself fat so you didn’t see all the fat. Now I just have to learn to accept myself as thinner.”

In previous discussion I’ve suggested that dressing in stylish clothes that fit is one way to beat the body blues. Another idea, as Therese suggested, is having a bystander who will be honest about our appearance. Therese wrote, “My daughter's the number one person I go to, when I need to cure the myopic view of myself that I've developed.”

I wish I knew what magic happened this morning that I accepted and appreciated my own body. If I could package that magic I would personally mail it to every reader of LivingAfterWLS – we ALL deserve to love and appreciate ourselves. It’s time for the self-loathing to end and the self-appreciation to begin.

Please consider commenting on Today’s Topic "What are you doing to appreciate your new body?” I’d love to learn from you.

Best wishes,

Protein Shakes:
Reader Input Urgently Need

Dear Readers:

Help! We have a lot of "newbies" out there asking for suggestions on protien shakes. When I had my surgery in 1999 my bariatric center discouraged the use of protein shakes - I've never tried one. I know the thinking has changed and many bariatric centers now recommend a protein shake as a meal replacement or snack. Can those of you who use them answer a few questions for our newbies:

Favorite brand/flavor?
Where do you purchase? Cost?
How often do you substitute a shake for a meal?
Any other information you have?

Please post your comments to this thread, it's easy and you can remain anonymous if you like.

Thanks a bunch!

Tuesday, June 07, 2005

America’s Beef Producers
WLS Friendly Recipes

I’ve been pushing beef as an excellent vitamin rich protein choice for our LivingAfterWLS community. For some great recipes and a chance to win a one-year health club membership click on America’s Beef Producers website - it's the "Beef It's What's For Dinner" site. From the main page you can click a link to several on-going "no purchase necessary" sweepstakes and also a great recipe link.

From the website here’s a recipe I tried yesterday – It’s fabulous freshly made and great lunch leftovers today! I hope you’ll enjoy it too:

Beef Flat Iron Steak with Balsamic Pepper Sauce

Monday, June 06, 2005

Lost Weight with Gastric Bypass
Now You're Regaining
Fix It Fast!

One of our readers suggested this topic - regaining weight after WLS. For suggestions or experience with weight regain after WLS see Today's Topic:

I’ve talked to quite a few fellow gastric bypass patients recently and we all have one thing in common: About the third year after gastric bypass we get hungry. And we eat more. And weight starts to creep back on. In the worst case a patient regains so much weight a revision surgery is required to again reduce the stomach size and facilitate weight loss. In the best case, the patient catches the problem early and reverses the trend.

In my third year out when this happened to me and I saw the scale jump ten pounds I called my counselor at my bariatric center. She told me “Get Back-to-Basics immediately.” She recommended that for ten days I eat like a post-op newbie. Jell-o, chicken broth, soft-cooked eggs. No solids. Lots of liquids. No snacking. Take my vitamins. Drink lots of water.

I was so terrified of regaining the weight that I followed her directions exactly. She told me, “You have already done this once when you had surgery. You certainly can do it again, and this time you are much healthier.” She was right!

The first day was hell. I was hungry and crabby. The second day was not as painful. By the third day Back-to-Basics was routine. By the tenth day my weight was down 7 pounds, my body felt lighter and happier. I felt unpolluted. Best of all, my tiny pouch seemed to be tighter and less tolerant of over-filling and that’s a very good thing! I was eating like a newbie again, recommitted to following the four rules and succeeding after weight loss surgery.

Now, to be honest, I’ve had to employ this technique more than once to get myself back on track and avoid weight regain. Sometimes I’ll go Back-to-Basics for a long weekend, just to refresh and rejuvenate my body. I like the power the mindfulness of Back-to-Basics gives me, the complete awareness of my body and it’s needs. I like being able to remind my mind and body of this powerful bariatric tool. I like that when I do see a weight gain I can quickly get it under control by employing past practice that I know works.

Are you in your third year and hungry? Give the Back-to-Basics a try.

Sunday, June 05, 2005

Need an Energy Boost? Try Deep Breathing

We all do it and we don’t think about we. We draw oxygen from the air into our lungs and we exhale carbon dioxide. We breathe. Most of us take our breathing for granted.

But we shouldn’t. Our need for oxygen is even greater than our need for water and food as our cells cannot survive or function properly without oxygen. Some patients, prior to weight loss surgery, had such poor respiratory systems they were tethered to oxygen tanks for their very survival. After surgery and after weight loss respiratory systems strengthened and assisted oxygen was no longer necessary.

Oxygen is essential for energy. In the past (before surgery) when we experienced an energy low, many of us reached for a sweet treat for the sugar boost. We can’t do that now and we won’t do that now. We have a better method of boosting energy – deep concentrated breathing.

The benefits of good breathing are vast. Good breathing floods the cells and tissues with dynamic oxygen, which has the power to stimulate cell metabolism and boost cell turnover. The benefits are immediately noticeable in the freshness of our skin tone and the brightness of our eyes. Good breathing causes us to feel more alert and alive.

Now, don’t go thinking I’m some crystal-clutching mantra-chanting new-age-witch who is going to tell you hocus-pocus about breathing and meditation. While those things are fine and good, all you really need to know when you run out of steam is take a few moments and feed your body some oxygen. Here’s how to get a great energy boost that’s cost and calorie free:

1. With eyes closed rest hands on the abdomen and breathe in gently, pushing against your hands as you do so.

2. Breathe out, lingering over the outbreath until the need for another inbreath naturally arises. Do not exaggerate the inhalation or the exhalation – the quieter the better.

3. Continue to observe your breathing until this deeper, slower rhythm has become automatic. Stop when you feel your strength returning.

The body, the amazing machine that it is, has an alert mechanism for when more oxygen is needed: we call it yawning. Generally thought to be an indication of boredom yawning is actually a call for more oxygen. If you find yourself yawning try the above breathing technique and feed your body some oxygen.

Respiratory Tonic:
Do you feel like your lungs and respiratory system aren’t functioning at their best? Give this tonic a try. It’s made naturally with ginger and honey. Ginger, which has a strong affinity with the mucous membranes in the respiratory tract, will liquefy excess mucus and keep the passages of the nose and throat clear. It is also known to clear the sinuses and reduce asthmatic tendencies.

Recipe: To one cup of warm water add 6-7 drops freshly squeezed ginger juice (peel a small gingerroot, grate it and press it) and ½ teaspoon of honey. Drink on an empty stomach. (This really works. Prior to surgery my breathing and asthma symptoms were severe. Combined with weight loss and healthy respiratory practices I no longer suffer from breathing related illness.)

All About Ginger: A Healing Root

For most of my life I thought “ginger” was all about bread and houses. Warm gingerbread to eat with a dollop of whipped cream and Gingerbread Houses to decorate at the holidays. Turns out there’s more to the little root than holiday confections.

Ginger is revered in Asia as both a stimulant and relaxant. For centuries various forms of ginger have been used to quell nausea. Several studies have investigated this effect, and in Germany, ginger is approved as a medical treatment for motion sickness and heartburn.

In the article about healthy breathing we posted a respiratory tonic made from freshly squeezed gingerroot. The recipe bears repeating:

Ginger Respiratory Tonic:
To one cup of warm water add 6-7 drops freshly squeezed ginger juice (peel a small gingerroot, grate it and press it) and ½ teaspoon of honey. Drink on an empty stomach.

(This tonic is effective for reducing nausea – a daily symptom reported by many gastric bypass patients.)

Buying & Using Ginger:
You will find fresh ginger in the produce section of most supermarkets. Look for a “hand” of ginger. It should be smooth and very firm with glossy, pinkish-tan skin. It should never look shriveled.

To prepare ginger cut off a knob or “finger” as needed. Pare it with a vegetable peeler. Then grate, chop, mince or sliver as recipe directs. For ginger juice first grate the desired amount of ginger into a small bowl. Extract the juice by squeezing the grated ginger with fingers, press it in a tea strainer or wring it in a square of cheesecloth.

Friday, June 03, 2005

Glowing in LivingAfterWLS Reader Comments

In May we welcomed many new visitors and subscribers to the Living After WLS community. Many of you took time to send emails or leave comments about the site and it sure boosted my spirits to know someone out there was reading about this topic so near and dear to me. It is reassuring to know so many people are trying so hard to do their best Living After WLS.

Here are some reader’s comments that touched me:

On May 22, 2005 Chris wrote, “I have been searching all over the internet for something like this! Thank you!"

On May 29, 2005 Susan wrote, ”It is just barely over 6 months since I had my Gastric Bypass Surgery. Everyday I wake up and thank God for this gift and every day I swear to myself that I will never abuse it because I will never forget how I felt both physically and mentally before and now after. Ever since day one after my surgery I have felt like I got a second chance at living my life the right way and that is what I am doing. I have lost 114 lb. and when I look in the mirror, sometimes I can hardly believe it is me - I almost don't recognize myself! But it is a brand new, healthy person who now takes control and responsibility of what is put in this body. The surgery has made all the difference - I couldn't do it without it. I am looking forward to all the information I can find now on how to live this out successfully for the REST of my life.”

On May 30, 2005 Cindy wrote, “Your site is refreshingly honest and down to earth.”

On May 12, 2005 Pam wrote, “I'm grateful to find your website. On January 19, 2005 I had lap Band surgery. I have been very successful to date with a loss of 25 pounds. Recently I've realized that my "affair" with food is attempting to regain my attention. I'm doing everything possible to give that "infant" tummy the same attention today that I did the first 10 weeks. Finding your story has reminded me of my intentions and has helped me come back to reality. I finally have my body on my side and I want my mind to follow!”

Thanks for stopping by LivingAfterWLS. I appreciate your support and encouragement as this site grows into a caring and compassionate support community.

Kindly yours,

Thursday, June 02, 2005

Beef Sirloin – It’s What’s for Dinner

As life-long dieters generally the first low-fat protein we think of is boneless skinless chicken breast – a dieter’s best friend. It seems to me in the phase of rapid weight loss after gastric bypass I relied quite a bit on the poultry staple for my primary protein source. YAWN!

But there is a nutritional powerhouse called Beef Sirloin that shouldn’t be overlooked by WLS patients who are losing weight or maintaining their weight. Beef sirloin packs a whopping 25 grams of protein per 3 ounce cooked serving (4 ounces raw). But that’s not all: you get 17% of your daily dose of iron; 40% of your daily B12 and 36% of your daily Zinc. And if you are paying attention to calories you get just 195 from that small protein packed serving.

Remember, WLS patients are at risk of iron-deficiency anemia which can result in fatigue, irritability and lowered immunity. A recent study of women found that when equal amounts of iron were consumed, women who included red meat in their meals absorbed more iron than women who ate only chicken or fish.

At the market you can find four cuts of beef sirloin: round bone, flat bone, pinbone and top sirloin. All cuts are lean but tender enough to be broiled or grilled. Buy “select” cuts which are lower in fat than “choice”. Chose meat that is bright red with a small amount of white fat around the edge. Before cooking trim this fat.

See the Recipe Section for some WLS Friendly Beef Sirloin Recipes:

  • Deviled Ground Sirloin

  • Double Pepper Steak

  • Grilled Herb-Rubbed Steak
  • Wednesday, June 01, 2005

    Saying Goodbye to Signature Lines

    A reader recently wrote to ask why I don’t include my weight statistics in my signature line. A great observation and excellent question.

    Typically in on-line weight loss communities a signature is written with starting weight/current weight/target weight – so for me that would be (287/146/140). For a long time after WLS I did carry the weight stats on my signature line – it was part of who I was and a measure of progress.

    But the day came when I didn’t want to be measured by those numbers any longer.

    One of the most difficult things for me to hear is, “I heard you used to be really REALLY huge!” Ouch! I also used to be a newspaper editor and I am accomplished pianist, yet somehow that never gets mentioned. It seems, however, there are plenty of people around to remind me that I used to be really REALLY huge.

    So one day unannounced I dropped the weight stats from my signature line. It was time to move forward from defining myself as a person who used to be really REALLY huge. Certainly I have not forgotten that person and I am humbled today by my small size and my good health. But I don’t need the numbers on my signature line to define or remind me anymore.

    I don’t object to others using the signature stats and applaud each pound that is lost in this after WLS living. But I submit that one day others, when the time is right, will say goodbye to the weight stats in the signature line – moving forward and onward in new and better lives.

    My signature line reads, “Welcome to Your New Life: You have Arrived.” And that’s how I feel each and every new day when I wake in my healthy, trim and fit body. “I have arrived”. This motto is the name of our official Living After WLS newsletter: You Have Arrived! My wish for our community here is to always wake with the fabulous feeling “I Have Arrived.”

    Best wishes,

    Tell us what's on your signature line at our forum Today's Topic.

    Warm Thoughts Needed

    June 1
    Update from Elizabeth's mother, Maxine:

    "Elizabeth's surgery went well, we are all so thankful! Although she
    was in a great deal of pain she was very determined to do what was asked of her
    and managed to get up and walk as well as sit upright in a chair."

    Please continue to send warm thoughts and good wishes her way.

    May 31
    Dear Living After WLS Friends:

    One of our newest readers is having her weight loss surgery today. Please send your warm thoughts and good wishes to Elizabeth as she begins her journey.