August 4, 2012

Months since I have posted, but I am now a WARRIOR!

Did the Warrior Dash race in British Columbia today - a 5K, up and down (too) many hills, with obstacles such as wooden fences to climb over, barbed wire to crawl under, and muddy water to crawl through. Here I am, approaching the finish line, just prior to the mud crawl...





I must admit, I kind of sucked in terms of my cardio capacity, there were a LOT of hills to climb and I struggled a bit. But, I finished, which was my goal, and would not have been even a remote possibility for me at 284 pounds!

A couple more shots:
Not especially flattering, but this is me just after finishing- the immediate aftermath of my efforts!

Pre-race, getting my knee pads and elbow pads ready!

February 17, 2012

Celebrating 2 years since my surgery

2 Years Post-Op!

So, Wednesday February 15 marked the two year anniversary of my Vertical Sleeve Gastrectomy, and life continues to be pretty darn good! To "celebrate" I went to the doctor's office today to get a refill on my Nexium prescription and a lab order for blood tests.

Regarding the Nexium: 

While many people with VSG only need the Nexium for a few months and are able to stop taking PPIs, I have not been so fortunate. Every month I try to go without before refilling the scrip, and every month I find that just a day or two off results in pretty significant reflux. My reading has informed me that the shape and size of the VSG stomach tends to force the acid into the esophagus to a greater degree than with a normally sized and shaped stomach. It's a small price to pay for improved overall health, and the reflux is very well controlled, as long as I take the Nexium. I have tried over-the-counter PPI's but so far nothing else works as well.

Regarding Labs: 

I have a great relationship with my doctor, and he is very respectful of my knowledge about what tests I need and how often I need them. Now that I am a couple of years out, unless any of the labs are showing a downward trend, or are concerning in any other respect, I plan on having them done annually, rather than every 6 months. I feel pretty comfortable with this decision only because I have been tracking my labs consistently since immediately pre-op, and have not seen any concerning trends. I also am diligent about my supplements, so given that the VSG stomach doesn't have significant issues with malabsorption (with the exceptions of B12 for some people, and iron and calcium absorption being inhibited by low stomach acid, especially with the use of Nexium), it's not likely that things will go too far wrong, even in a year's time.

Maintenance

At this point, other than dropping the last 2-3 pounds of post -holiday weight, I am not really focussing on weight loss, but rather on maintaining a stable weight. This is a very nice place to be - and something that I didn't really think was even possible at the time I had my surgery.

In many ways though, maintenance is a bit tougher for me than the weight loss phase was.

Why it is tough
It's for life:
For one thing, although I "knew" that this way of life was going to be FOR life, we all have spent a lot of years living with a diet mentality - that is thinking that we eat and live one way when we are on a diet, and another way when we are not. This persists for a lot of people I think during the weight loss phase, and I am no exception. A few months into maintenance, and it sometimes seems that doing this for the rest of my life is going to be a long hard journey. At times I resent having to maintain a fairly restrictive way of eating (well, I have to if I also want to maintain my weight loss, anyway!) and want to be able to just eat what and when I feel like eating without having to always take into consideration the consequences of my choices for my health or on the scale.

No cheer-leading squad:
Another unanticipated thing with post-op life this far out is that you don't get the frequent reinforcement of watching your weight drop on the scale, or the pleasure of needing to replace your jeans with a smaller pair or two every month or so. The scale is as likely to show that I am a pound or two up as a pound or two down (normal fluctuations, and nothing to get all excited about). Despite doing weight training a couple times a week and looking a lot more tones, my measurements are not changing significantly and I don't actually NEED new clothes, because everything in my closet fits, and can't really afford to spend money on them anyway. My friends and family are now used to the smaller sized me, so I don't get all of the ongoing reinforcement from other people either. The work to maintain weight loss is about the same as the work to lose, but the ongoing positive reinforcements are diminished. Phooey!

Facing a couple uncomfortable truths:
1) My weight loss has left me with sags and wrinkles that sometimes I really don't like the looks of. I have to just deal with this and move on, but every once in a while I feel kind of sad and ripped off. I suspect some of this I would have faced due to normal aging anyway, but having been morbidly obese for 20+ years has certainly left its mark. Plastics are certainly an option, but they won't give me a perfect body either. Mostly I feel very good about my body, but there are certainly days when I feel a little down...

2) I don't think I will ever be able to eat like a "normal" person. I maintain on about 1000-1200 calories a day, even though I do exercise and do focus on quality and nutrition in my food intake. I am extremely grateful that my VSG allows me to tolerate this fairly reduced caloric intake with little discomfort or hunger, but do wish often that I was a bit more normal and could be a little more flexible.

What makes it better

Keeping food healthy and interesting:
As I mentioned above, the sleeve makes the dietary restriction possible and tolerable. I also do a lot of reading about low carb and primal/paleo eating and finding and trying new recipes keeps things interesting, although truth be told, our staple dinner is meat/fish/fowl and broccoli/asparagus/cauliflower, usually prepared either by sauteing, or roasting in the oven.

Finding other goals (body related, but not weight related) to pursue:
I have been doing weight training, (working with a trainer), and find that I can get very motivated about either increasing my weights (18 pound bicep curls this week!) or being able to do things that I couldn't do before (cable rows in a push-up position, jumping rope). I am definitely seeing a LOT more muscle definition in my calves and arms, even though my size is not changing much, and it is really, really good to be feeling strong and even a tiny bit athletic - not something I have felt in almost three decades.

Practicing gratitude:
Despite my undesirable tendency to whinge about the imperfections of my body and the restrictions of my diet I know these things:

Two years ago, I could never have imagined that I could possibly look and feel as good as I feel today. This body is functioning better and is stronger than it has been in decades, and I am grateful to be out of chronic pain, to be able to move through life with physical ease, and to have the potential for a longer and healthier life as I age.

Whinging about the need to be mindful of my food choices is a luxury. I have a more than adequate income, in a wealthy country, where my food choices are pretty much unlimited. I am grateful to be in the position to need to restrict calories, rather than, like many on this planet, facing malnutrition or starvation due to a lack of food resources. I am grateful that I have access to such abundance, that even with the need to restrict quantity, there is no restriction whatsoever of quality or variety in my daily diet.

I know that for many, this surgery is completely out of reach financially, or the wait list is impossibly long. I am grateful that I had the resources to find and access an excellent surgeon in a top notch facility for my surgery. I am grateful for the medical system in my country that makes it possible for me to receive and collaborate in the ongoing medical care required to keep me healthy over time.

I am so grateful for having had the opportunity to reclaim and continue to improve my health.

Here are some photos of me ready for my workout - no makeup, unflattering lighting and hair a mess, so beware!


January 27, 2012

Getting back on track. This is HARD sometimes!

So I mentioned in my last post that I have acquired a few extra pounds over the Christmas holidays - and sad to say, some of them are still with me. It is very frightening for a formerly morbidly obese person to see the numbers on the scale going up instead of down - a reminder of all of those years of not feeling in control of my eating or my weight.

During the month of January, having "gotten rid of" (actually eaten most of) the treats in the house, I had been gradually moving back towards my usual eating routine, but still was eating more carbs than usual, and since my preferred carbs are toast and popcorn, a lot of butter to accompany them.

I don't actually think butter is unhealthy, but I was definitely taking in more calories than was sustainable if I wanted to lose weight. I was also snacking on a lot of nuts, which again, aren't unhealthy, but ARE very caloric. In fact, although I had lost a few of the Christmas pounds, last week I put on 3 pounds in one week while eating fairly moderately, and continuing to work out, and I have to say I was pretty freaked out!

This was the motivation to dial it all WAY back and get back to eating in a pretty basic way until I was back at my fighting weight, and no longer craving the carbohydrates,

The good news is, the sleeve still works, even though restricting calories isn't the effortless process that it was in the immediate post - op period. When I went back to weighing and tracking my food intake, I found that I am still restricted to 2-4 ounces of solid protein per meal, and usually closer to 2 than to 4

 SO, I am being stricter than typical with my eating plan for a few weeks... in particular dialing carbs and calories down further than usual ... and remembering that for me, to fail to plan is to plan to fail.

One thing that I find essential for making good choices regarding food, is to make the good choice the easy choice. SO I plan ahead to have cooked, palatable protein items in my fridge and ready to go, as well as canned tuna and salmon for a quick salad if that appeals.

I actually schedule my snacks, so that if I am feeling really hungry at 2, but know that I have scheduled a snack at 3, then I am better able to tolerate a bit of hunger, have a glass of water, tea or crystal light, and wait it out.

I also plan ahead for those moments when I feel ravenous and am more likely to make less healthy choices - If I know ahead of time that faced with hunger I will first have 16 ounces of fluid, and then, if I am still hungry, 2-3 ounces of solid protein, I am less likely to be tempted by a slice of toast.

I think that one of the ways that planning ahead and recording any changes helps me, is that I get immediate feedback, in black and white, of the consequences to a plan that I think works for me if I graze or eat in any way other than mindfully.

So far so good, 3 of those pesky extra pounds are GONE!

January 17, 2012

Still working on it all!

LONG time no post. Life has kind of kept me busy, and my VSG life seems a bit uneventful these days. I did have some photos taken for my husband's X-Mas gift - (most of which I wouldn't put online since I am in my skivvies ;-), but here is one that I was very pleased with:






It was a LOT of fun having hair and makeup done, and then playing model for an hour - I highly recommend the experience!

I did manage to gain a few pounds over the holidays and am now working on getting them OFF. To this end I am working (have been since October) with a semi-private personal trainer - doing a lot of strength work and some short bursts of high intensity cardio in between weight sets. It is going really well, and I have been decreasing my body fat percentage since I began. In fact, although I gained weight over the holidays, I didn't gain any inches - a minor miracle really.

I have also been looking into a more paleo / primal diet - reducing or eliminating grains and eating mostly protein and vegetables. Really this is what I do most of the time anyway, the sticking point for me is artificial sweeteners, which I do not want to give up, and dairy. I don't eat a lot of dairy, but I do love my cheese, and also won't be giving up my whey protein. So - I am not a purist and any serious paleo eater would consider me a slacker!

Some recipes soon, I promise!

August 3, 2011

Things I can do now, that I could not do before losing weight

At the beginning of July I had a great time camping with my daughter and husband. I was able to haul the gear, set up the tent by myself, enjoy canoeing on the lake- not to mention, I actually fit comfortably in my sleeping bag!

All things that would have been difficult, embarrassing or impossible before I lost the weight.

Enjoying my coffee (with protein of course) our first morning in camp


Dinner for my daughter and I on the first night

Splitting kindling with my rubbish little hand axe


I am very vain - had daughter take this picture in the morning so that I could see how my hair looked!


Canoing

July 29, 2011

Body Composition Testing

I have been wondering for some time just what exactly my body fat percentage is - I had a suspicion that this might be a metric that would help me gauge whether I have in fact reached a healthy body weight. (I am still 2 pounds shy of "Normal" according to the BMI - meaning I an technically overweight).

***UPDATE*** 

Between writing this post and putting it up, I dropped a bit of weight - now at 161 - and officially a "Normal" BMI!

I have also, since my surgery, been mindful of the need to preserve lean body mass whilst losing fat - my strategies to achieve this have mainly been weight training and a low-carb eating plan. I was interested to see whether I had been successful - because it is entirely possible to achieve a "healthy" weight by BMI standards, but to actually be quite unhealthy in terms of body fat percentage.

A month or so ago I paid about $100.00 for a iDXA scan which provides a fairly accurate picture of fat, lean and bone - broken down by body area. My bone density was fantastic - indicating that I am very unlikely, even into old age, to suffer from osteoporosis-related fractures. This folks, is a benefit of the weight-bearing exercise I did all day, every day for about 20 years. Carrying 120 pounds of extra tissue around is a workout!

My body fat percentage is 36% - which is in the "Healthy" range for a woman of my age. Who knew?! I actually AM "Normal"!  It's by no means the body fat percentage that you would see in an athlete of my age, but not bad for someone who was considered morbidly obese less than 18 months ago!

The guy who ran the scan also talked a lot about nutrition, and he definitely promotes, for athletes AND for the rest of us, a high protein, high-quality fat diet with lots of vegetables and minimal grains, almost no sugar. He thought I might do better with closer to 120 grams of protein a day. I haven't really been tracking my intake recently - with vacations etc - but I do notice that when I push the protein I shrink a bit, even when I am not losing pounds.

Here are some images provided after my scan:


My body fat and lean tissue



My body fat% and where I stand in terms of health:


What the American College of Sports Medicine recommends (with respect to body fat%)


My Bone Density Results:
Pretty interesting stuff!


And hey! I'm NORMAL!!! I have PROOF!





July 28, 2011

Shrimp and Crab Chopped Salad

We eat a lot of salad + protein meals in the summer. They are very easy - often with no cooking required - and can be customized to suit the picky preferences of each member of the family.

Here is a recent success (with my husband and me at least - the child doesn't care for seafood)

It's just a bed of greens with strips of crabmeat and shrimp, tomato, bacon (leftover from a breakfast probably), avocado and red bell pepper. I think I made a homemade dijon mustard vinaigrette too. The plate below is my husband's - I could eat, maybe, a 1/4 of this amount.

July 26, 2011

NORMAL!!!

Today I finally dropped a pound, after being stalled for about 2 months, to 164 pounds. This means that my body weight now falls in the "normal" range according to the Body Mass Index (BMI). No longer morbidly obese, no longer obese, no longer overweight. WOOT!

The great news for me is I now have low blood pressure, low blood sugars, very low triglycerides, cholesterol in the "healthy"range, body fat in the "healthy" range, body weight in the "normal" range, no more arthritis pain, no more stress incontinence - in short, none of the health problems associated with obesity (save for the arthritic damage already in place at the time of my surgery.) I've been proactive about my supplementation, and about being tested for those vitamins that are sometimes difficult for WLS patients to absorb - so I have maintained good levels of calcium (as evidenced by bone scan), vitamins B12 and D, and iron.

What this means is that every single health problem that I had pre-op and that could be reversed or improved is now resolved.

And THAT my friends is weight loss surgery success!

Asparagus and Garlic Basil Shrimp

I have been working the last week or so on shedding a few pounds that I acquired while on holiday. Fortunately this has worked and I am down to my lowest weight, and probably going to drop a few more on my way to the goal I set way back at the beginning. (Just 4 to go!) To this end, I have gone back to more contained eating - lots of protein, a few veg, and very little else. HOWEVER, this doesn't mean I am not eating well!

We are also in the process of trying to clear out the fridge and freezer in preparation for moving to a new home next month. While foraging around in the freezer, I found half a bag of large peeled shrimp and a ziploc of chopped basil in olive oil - the remainders of some previous fresh basil that I couldn't use up in time to keep it from spoiling.

Inspired, last night I made Asparagus - sauteed in olive oil and sprinkled with sea salt and

Garlic Basil Shrimp

Enough peeled and deveined shrimp (thawed if frozen) to feed you and whomever you dine with (Tails on is fine, large size is best)
1/4 - 1/2 cup chopped fresh basil
2 cloves garlic, crushed
1 Tbsp grated ginger (optional)

1 tsp salt
1/4 tsp red pepper flakes, or cayenne pepper (adjust quantity to suit your preference)
Fresh ground pepper to taste
Enough olive oil to coat it all lightly - maybe 3-4 Tbsp


Combine all ingredients in a non-reactive bowl and let marinate for 30 - 60 minutes.
Heat large (big enough for shrimp to sit in single layer) skillet to med-high then dump the whole bowl into the skillet.

The shrimp only take a couple of minutes per side - cook until pink and curled, but not much longer or they'll be tough.

This was SOOO easy and my husband went nuts over the shrimp - really delicious, and you can change the herbs and spices to suit yourself - the method remains the same!

July 24, 2011

Thinking and Learning about Eating Well

This is a meditation on eating that I posted on Obesity Help - but thought I'd put it here too, for those who aren't on OH or who may have missed it. I've been thinking a lot about how I am and want to be eating as I move into maintaining weight loss, rather than working hard to lose weight. My apologies to those for whom this is a repeat - I do have some other posts in my head but just need to get them on the computer too!

As some of you know this blog includes recipes and thoughts related to this whole process of getting healthy with the assistance of my WLS. As I am now almost 18 months post op, it is really easy to eat whatever foods I choose, with no unpleasant after-effects. I still have great restriction, so it's really only quantity that is limited. This means I need to take responsibility for my choices.

In a prior life I was a professional chef, with several years as a pastry chef. I used to say that all of the extra pounds weren't just given to me - I had to earn them! The thing is, I was pretty determined going into this process to find ways of eating that would help me lose (and maintain my weight loss), and were nourishing physically, but also pleasurable.

For some folks it works very well to stick to a fairly strict routine in terms of what they eat. I do this sometimes when I need to drop a few pounds acquired on vacation ... i.e. protein shake in the morning, lots of fluids, and solid protein of some sort for my other meals, with some low carb veg on the side. For me though, this isn't a workable long term strategy. I like being creative in the kitchen and I end up feeling very bored.... which sometimes leads to unhealthy and/or bingey eating.

Also, I cook for my family as well. They are "normies" in terms of body weight and while they don't need a carby western diet any more than I do, they also don't need to restrict themselves to the same extent that I need to. I want them, especially my daughter, to see as "normal" a delicious varied menu that includes lots of tasty and healthful foods - and very little of the crap that has become the foundation of the American diet.

I really wanted to find a good balance between "Living to Eat" and "Eating to Live", neither of which serve me very well.

For me what this means is the following three goals for my food choices - all of these within an overarching preference for whole, organic, humanely raised, local foods.

1) I avoid foods that have things in them that I have found disagree with me. (Cause me to gain weight, feel sick, experience disregulated blood sugar, or have cravings for carby junk.)

I have made my peace with a few of the sugar-free sweeteners, although I know that for some these are no-go ingredients. Given that caveat, I almost entirely have eliminated white sugar, processed foods (other than cans of tomato paste or sauce), white flour, and trans-fats. I have very little wheat flour, corn, or pasta of any type, and very small amounts of whole grains and processed soy products.


2) I want my foods to not just be "not bad" for me - I want them to have things in them that nourish me.

I have found that I function very well on a ketogenic diet - The foundations of this, for me, are: lots of high quality protein, healthy fats, lots of fiber, and low carb veg - with small amounts of legumes, grains and fruit.

I include a little bit of lentils, edamame, other beans, quinoa and the occasional new or sweet potato. I eat lots of protein, lean and fatty cuts, from organic sources when possible, humanely raised and local almost always. I like eggs and also dairy - both organic and the eggs free-range. I eat lots of vegetables, mostly lower carb, but in general I don't eat a lot of quantity in veg, so I have whatever looks good at the market. Here again, I focus on organic when possible, local and seasonal. I primarily use coconut oil, olive oil, butter, and rice bran oil for cooking. I do eat small amounts of fruit in season, but am mindful of carbs in fruit, although I don't worry about these overly.


3) Food should be delicious

I think there is a lot of value in careful, thoughtful preparation of food. Frankly, if it doesn't taste good, I am not willing to eat it. Providing delicious nourishment for our bodies is a way of demonstrating my love for my family and for myself. To this end, I plan my week's menus, including the plans for the inevitable leftovers, to include lots of variety -in both flavour and nutrition. I use lots of fresh relishes and salsas. If I plan well, I eat well. Period. If I do not, I am inclined towards making the same lazy choices I always made in the past, and this doesn't serve my goal of eating well and living well after weight loss surgery!


Final thoughts - I don't think that it is very useful to me to get angry with myself if I do veer off track and eat something that is not in my usual plan - that's life really. My only rule is: "If I eat it, I own it" - no unconscious eating - I don't get to descend into a carby fog and pretend that I haven't just eaten several handfuls of trail mix - (the good kind, with the chocolate chips) possible washed down with a diet coke. Because, I am not a saint, and like many of us, I hate being bound by rules and regulations ... I have definite inclinations towards being a sinner ... and I just have to own this and do the best I can to limit my opportunities to sin and to make good choices the path of least resistance!

Also, I do love my treats. I have found that if I am careful, popcorn is ok from time to time and that  a couple squares of 85% dark chocolate don't turn me into a raging sugar zombie. I like my protein ice cream made from either a protein shake or Greek yogurt with sweetener and flavouring or fruit or chocolate.

June 15, 2011

16 Months since surgery

No change in my weight this month (well other than a lot of up a few / down a few throughout the month), but a bit of redistribution throughout my body - this process is still a bit of a mystery to me, but the good news is, I am continuing to shrink a bit, especially my back and belly. I find  since my legs have slimmed down, that in profile my body shape is similar to an egg on toothpicks! Not the prettiest arrangement, but a big improvement from where I started out!



This has been a fairly eventful and somewhat stressful month - all good stress, but stress nonetheless! I defended the proposal for my dissertation - NOT the actual dissertation which has not yet been written - just my plan and justification for the research. Even though it was just a proposal defense, it still involved a presentation to my committee and an external examiner, an hour and a half of oral questioning, and then a nerve-wracking wait outside of the examining room while the committee discussed the quality and content of the proposal.

At the end of it all the proposal passed, with no revisions required - the best outcome I could have hoped for. Now I "just" need to research and write the dang thing!

We also undertook a search for a home to purchase this month. In rapid succession we found a place, made an offer, negotiated the offer, had the place inspected, re-negotiated the offer and entered into the contract. Since then, I have been busy finding contractors and suppliers for new flooring and kitchen cabinets and picking out paint colours. It has been fun but busy! We don't take possession until the end of July, so once my contractors are lined up and materials have been ordered, there won't be much to do besides the preliminary packing that can be done ahead of time.

It is very easy when I am stressed, excited, and distracted to make poor choices about eating - especially now that I am pretty far out and can tolerate pretty much anything. What works for me is to have a few go-to items ALWAYS on hand at home, in my purse, and at the office. This way, the path of least resistance is to eat stuff that I have planned out. While I don't happen to believe that it is the end of the world if I have three or four chicken nuggets for lunch once in a while (50 calories each, BTW), I KNOW that doing this more than very occassionally is not the way to sustain my health or weight loss. So I make up two protein coffees or shakes every morning (LOVING my mocha protein slushies these days) along with two 20 ounce Crystal Lights - and pack these along with my vitamins. I keep ostrich jerky and nuts in my  purse and desk, and usually have a protein bar available in case I am unable to get to solid food when I need it. My weight loss is not spectacular these days and I could stand to drop another 10 or so - but I am maintaining an almost 120 pound loss pretty effortlessly - and I am happy with how I look and feel!

It looks like spring may actually arrive here in BC, possibly even before the beginning of summer next week... hope it is sunny and lovely wherever you all are too!

May 16, 2011

Just to show what is possible! Befores and Afters...

Back - Before


Back - 15 Months




Side - Before






Side - 15 months

Front - Before

Front - 15 Months