The Slack Diet

I got up this morning just knowing that I had failed this week.

Our calorie numbers crept upwards all week long, with several days ending above 1,000 Calories. I didn't get out and really exercise every day like I should. We slipped up on carb levels several days. I had a really bad experience with some chicken nuggets leading to 2 hours spent within 5 feet of my bathroom.

So, all things being equal, I just knew that today's weigh-in would reflect my failures for the week. Instead of holding steady at 224 like I have for the past 3 weeks, I was going to have gained weight. I would be the first recorded example of a weight loss "honeymoon period" that lasted less than 3 months after surgery.

So, of course, when I weighed myself this morning, I came in at 221 pounds.

Isn't it the damnedest thing? For weeks, you work your ass off, watch everything you eat, exercise religiously, and the scale won't move.

Then you have a week where you blow the whole thing off, and you lose 3 pounds.

Makes you wonder about the "weight regulator" in your brain, really. Like, are you encouraging me to be a slacker? 'Cause that is sure the impression I am getting here.

Yes, yes - I know. Changes in metabolic processing, serotonin levels, body adjusting to new intake levels being forced out of "Starvation Mode" - I get it. "Correlation does not imply causation" as the folks with pocket protectors and lots of letters after their names like to say: The fact that my weight loss re-started at the same time as I was peelin' it does not mean that the two things are in any way related.

But, man, it sure feels that way. Maybe I should try the "lethargy diet" - sit at my desk playing World of Warcraft and eating ice cream for the next week, and see what the numbers look like. You know, for science.

Oh, right - honeymoon period. There is every reason to expect, now that the weight loss has fired up again, that I will lose weight lying on my back and eating Twinkies.

Damn. And it sounded like such a good plan, too.

But, in reality, there is nothing to do but buckle back down this week, hit the weights and the cardio religiously again, be more careful about our meal planning and execution. Get back on that horse and work on the plan we committed ourselves to.

But if I get to next Monday and hit another stall as a result of my "good behavior" I may just tear my hair out.

And I don't have all that much hair left at this point.

Happy To Finally Be 80 Pounds Down,

- Hawkwind

The "Expanded" Menu

Image courtesy of Marinela Wood

There has been quite a bit of discussion in our household over the past few weeks about the results of my surgery vs. the results of Lor's. For the first two weeks post-surgery, Lor was unable to drink protein shakes consistently, had trouble staying hydrated, and was extremely uncomfortable. Heck, it took her three weeks of recovery before she was even able to finish a single container of yogurt.

I, on the other hand, have had no such restrictions. I was able to down a full yogurt container the day after I got home from the hospital. I am able to drink an entire water bottle in under 10 minutes (if I am not paying attention) without any discomfort. I even re-started several oral medications a few days early (with my surgical staff's permission, mind you), again, without any kind of feeling of blockage.

Being myself, I developed a fabulous conspiracy theory: I had not actually undergone the surgery. They had just taken me back to the operating room, punched 5 holes in my abdomen, pumped me full of gas, and then left the OR for an early lunch. It was the only reasonable explanation for why I was having none of the diet-related side effects I had been warned about (and that Lor was experiencing.)

Silly conspiracy theories aside, it was obvious something was different between the two of us, so I went into yesterday's appointment full of confidence and optimism. Maybe I wouldn't even have to go through the soft foods phase since I was doing so well! They might put a little gold star on my chart and release me into the world of steak and lobster!

Turns out Dr. Tyner was not so impressed with my abilities to power through liquids like a boss. His theory was that I was being affected by luck, not extraordinary healing skills. People's internal organs swell at a different rate post-surgery, and while he thought Lor had gone through a normal "swelling" phase, I had gone through a reduced amount of swelling, giving enough room in my innards for liquids to shoot right through the system, I was going to run into a serious roadblock the minute I tried solid foods, even soft ones.

I left the doctor's office with the clearance to start on soft foods and a firm admonishment by our nutritionist to really bear down on protein intake - things had gone so easily for me up to this point, I was really going to have to change my thinking about intake. I left with my head held high, confident that my previous experience of the last 2 weeks was going to repeat itself, that no matter how much I ate, I would be able to handle it.

Turns out that there is a reason that I am not a doctor and Dr. Tyner is.

My first soft-foods meal, 2 tablespoons of scrambled eggs and ricotta, with a tablespoon of mashed banana, had the exact effect I anticipated - no problem ingesting, no feeling of fullness. I began to privately speculate about potentially ingesting more than the mandated "3 Tablespoon" meal size.

Then dinner arrived. 2 tablespoons of salmon, and 2 slices of avocado. I obeyed all the rules, putting the fork down between bites, chewing thoroughly, waiting at least a full minute between bites. I noticed immediately that the salmon had some texture and density to it that my first meal hadn't. 2 Tablespoons took me over 20 minutes to eat. But I still wasn't full! Gleefully, I dove into the avocado.

2 bites in, I suddenly had a problem. I literally felt as if someone had pushed a cork into my esophagus, right where it enters the stomach. I instantly was aware that, not only could I not have taken another bite, but it was going to take some serious focus to not revisit the last 20+ minutes worth of work heading the other direction. So, apparently, I had undergone the surgery after all. Bummer.

To complete my disheartening discoveries, I punched in my day's intake into my Bariatastic app and found out some really bad news. My new "soft food" diet had resulted in only 35 grams of protein all day long. Epic fail.

I guess protein shakes and I haven't broken up yet after all.

Not Entirely The Results I Was Looking For,

- Hawkwind

Fear of Failure at the Finish Line

Photo Credit: schiiiinken via Compfight cc

After another grueling 8 hours across the desert (including 4 different multiple-mile construction zones) we have returned home. Arizona is safely behind us, and we will not return until the average temperature drops 20 degrees.

At least.

An interesting (and discouraging) shift took place while we were there, though. Throughout the process of switching to a low-carb diet, I have rarely actually been hungry. Even the first 6 days of the liquid diet didn't make me hungry - just cranky and stupid. Oh, I have had cravings, of course. But real, live hunger? That had not been an issue. 

Until our first day in Tucson. 

Since our arrival there 5 days ago I have been ravenous. I have never been closer to breaking diet protocol than I am right now. I am so ready to throw it all away so I can go have a waffle. Topped with blueberries and whipped cream. With 6 fried eggs, and maybe 12 pieces of sausage. And a cheeseburger for dessert. That kind of hunger. My stomach has literally hurt constantly for 5 days straight.

This is not only discouraging, it is frightening as well. I am afraid of "falling off the wagon" and eating so much that I regain enough to disqualify myself for surgery. (Not sure how I would regain 53 pounds in 4 days, but who said fear is rational?) I fear sneaking out behind Lor's back to go binge somewhere and then lying about it when I return home - you know, addict behavior. I am even afraid to be in proximity to pretty much any "real" food right now. When Lor threw away half a boiled egg last night that she couldn't finish, I almost cried.

The real fear, though, is what happens after surgery? I know that removing the greater curvature of the stomach takes with it the majority of the ability to produce ghrelin - the hormone responsible for hunger. But I can't wrap my head around how that will feel right now. My biggest fear is that I am going to come out of surgery and feel exactly the way I feel right now - that my whole life post-surgery is going to be a constant, gnawing hunger that I am fighting off 100% of the time. I know myself well enough to know that I won't succeed in that case. And then all this, including having the majority of one of my major organs removed, will have been for nothing.

Lor keeps trying to encourage me, pointing out the fact that I have been taking in only 600 calories (plus or minus) a day while expending more than 3000 a day in moving activities every day that I have felt this way. I am difficult to encourage. I just know that I have 4 days left until surgery, and I don't want to fall flat on my face, here within sight of the finish line. 

87 hours until I cease eating entirely for surgery prep (at 10 pm on Sunday). Wish me luck in keeping the faith until then.

Dying For A Quarter Pounder,

- Hawkwind

Slow And Steady Wins The Race

Photo Credit: Antonio Ciriello via Compfight cc

It is a story most of us heard growing up. The slow and patient turtle wins a race against the quick and agile bunny by virtue of putting his head down and continuing to keep moving while the bunny screws off doing a multitude of things that are not related to winning the race. While I always questioned why the bunny didn't finish the race first and then go amuse himself, the example holds true even today, in our pursuit of long-term weight loss.

Consider this: this is not my first rodeo when it comes to trying to lose weight. I have tried Weight Watchers, Nutrisystem, Atkins and a version of Paleo (back when it was still called "The Caveman Diet".) I was always able to lose 10 - 20 pounds fast. After that: nothing. I would then embrace my guiding philosophy: "If at first you don't succeed, quit." Needless to say, the weight instantly returned.

Now, making dietary and lifestyle changes in preparation for bariatric surgery, we have had more success that ever before, mainly due to the slower speed of our weight loss. Lor's sudden weight loss spike since her surgery notwithstanding, we have actually been  maintaining a pretty decent rate of "healthy body recovery" (also known as "weight loss".) It has been 22 weeks since we started this process with my terrifying discovery that I weighed over 300 pounds back on February 2. As I mentioned yesterday, as of this week we have collectively lost 100 pounds. Do a little math (something like 100 divided by 22 weeks then further divided by 2 people) and it turns out that we have been losing, on average 2.27 pounds a week. According to the CDC, this number falls right into the "healthy weight loss" category.

Other demonstrations of "slow and steady" progress? Back in February, it took me around 25 minutes to walk .44 miles a day (the exact mileage of walking the dog around the block one time.) This would leave me covered in sweat, gasping for air, and exhausted for the rest of the evening. Today, in 45 minutes, I can cover 2 miles. The runners among you may be chuckling at this mile every 22 minutes speed, but remember:  back in February I was managing the brisk pace of 1.05 miles per hour. 4 months later I am almost up to average human walking speed of 3 miles an hour. As far as the 45 minutes goes - that is as far as Vixen's furry little legs will take her. We have discussed, once Lor is back in fighting trim, hauling the dog once around the block, then dropping her off at the house and walking another 45 minutes or so, to get in a full hour of walking a day.

Our walking speed should also increase from not having to stop while Vixen sniffs every bush, bag, and foreign object that looks like it might be edible.

Even Misdirected is showing the results of slow and steady. Maintaining a posting schedule of 4 posts a week, every week, we have grown from about 20 occasional readers to almost 50 daily readers. We will occasionally have really big spikes (like the day of Lor's surgery), but nearly 50 people are checking in on a daily basis to see what is happening here. This is with no marketing as such - any readership increases are coming strictly by word of mouth, people sharing the fact that there is some dude talking about he and his wife going through bariatric surgery.

Patience has not been my strong point over the years. But, maybe, learning to re-adjust to a changing body and diet is what it takes to learn to wait for other positive changes in life. Maybe this is a sign of developing maturity and spiritual awareness?

Nah. I still hate driving in the slow lane.

At Least I Passed That Lazy Bunny,

- Hawkwind 

Another Appointment Closer

Patient Progress: Lor managed a half mile walk last night (logged above by Map My Walk). 5 days out from surgery, mind you. She is setting the bar impossibly high for my surgical recovery, I have to tell you.

In the midst of all the commotion surrounding Lor's surgery and recovery, it has been pretty easy to forget that I am going through this process as well. For example, last week when Lor dropped a whole 8 pounds around her surgery? Yeah, I gained 2 pounds. I am not holding it against myself - I ate more fast food last week than I had eaten in the previous 2 months or so. Hard to make good food choices when you are shuttling back and forth from a borrowed room in your parent's house to the hospital. In defense of the hospital, they did have high-protein, low-carb items available, like omelets and salads. They even had Muscle Milk protein shakes! I should've just stuck with eating there.

These are the lines I am rehearsing, as today I have to go into meet my nutritionist for my final dietary meeting. After today, I will have seen her a total of 6 times - 3 visits with Lor, and now a total of 3 for me. I am not sure there is a heck of a lot left for her to say to me at this point that we haven't covered in the previous 5 meetings in one way or another. But, it represents one of the final 2 steps before I begin my 2 weeks of liquid-only diet to prep for surgery in July, so I want to make sure I make it to the appointment, even though I do have a surgical patient recovering at home.

Luckily for me, another one of our friends has stepped up and offered to come hang out with Lor during the hours when I will be gone today. What we ever did do deserve the support we are getting from our friends and family members, I do not know. I am constantly reading horror stories about bariatric patients being forced to go this alone, due to lack of support from those closest to them. I honestly do not know how they succeed at this, and my hat is off to them.

Tomorrow is also my 46th birthday, which makes me feel a little weird. Why? Because I will weigh less tomorrow (267) than I did ten years ago on my 36th birthday (285). I am reminded of the Bowflex commercials from a few years back: "I am 44, and in better shape than I was when I was 24!" Heck, for that matter, next year at 47 I may very well be in better shape than I was at 27.

How's that for a brain bender?

No special plans for the birthday either, despite all the emailed coupons for free pancakes, free stir-fry, free ice cream and free pizza. This year I will just stay home with my lettuce wraps and chicken salads, and try to work off the 2 pounds I earned last week. I don't want two weeks in a row of bad dietary choices, right?

Mmmm....Lettuce,

- Hawkwind

Scary Stories

Photo Credit: Magda's Maggots via Compfight cc

I spend a LOT of time (probably too much) hanging around on message boards and forums relating to obesity surgery. I don't input very much - after all, I am not a "vet" yet, have not earned my surgical scars and all that. Every once in a while, I will put up a link to here on Misdirected if I feel it is especially relevant, but other than that - I lurk.

There are quite a few encouraging tales to be found out there. Formerly 600-pound men who are now avid wilderness hikers. A previously obese woman fitting into her wedding dress for the first time in 25 years. A grandmother getting into a swimsuit for the very first time in her life. The stories can be really heartwarming and encouraging to those of us just getting ready to take the plunge.

But I have recently been paying a lot more attention to those "other" stories": 

• "I lost 100 pounds but gained it all back..."
• "I am going through a bad time in my life and can't stop eating..."
• "My husband just left me and all I want to do is cry and eat..."
• "After 5 successful years, I am regaining again and I don't know why..."

Entry after entry of people whose surgery is not working out for them for one reason or another. Scary stuff.

I have not gone out of my way to look into relapse numbers. Normally this is the type of research I would be all over like stink on expensive cheese, but here I have held myself back. I couldn't tell you exactly why, only that it didn't feel right to be investigating failure before I have even started the process. I have been wanting to prepare myself for success, not for failure.

But the truth is out there: relapses happen. And it is scary to think that all this work, (and rearrangement of my innards) could go down the drain if I don't watch my step.  So, I have been carefully reading these relapse stories, and looking for common elements. I keep finding 3 common themes coming up time and again:

1. Lack of accountability. Most of the desperate pleas of those I see talking about their failures online are for someone to "straighten them out" or "tell them off." At home, these individuals are not getting the support they need. Maybe they live alone, maybe their family is disinterested, or maybe (most frightening) their support system is working actively to sabotage them. But they need someone to call them out, and tell them to get back on track.

2. Lack of exercise. This seems to be a major issue. I have yet to read anyone's story about how they are suffering from massive regains while they are still exercising regularly. Just about all the horror stories I have read talk about how the pressures of life, or exhaustion, or just laziness have kept them off the street, away from the gym, and placed them on the couch.

3. Emotional turmoil. The big push that starts the plummet of the cliff of a major regain seems to frequently be an emotional trigger of some kind. A lost job, the death of a loved one, the breakup of a long-term relationship (sadly common for those who have gone through bariatric surgery) all seem to be things that have forced these individuals to seek comfort where they have always gotten it in the past - from food.

Lor and I are lucky. She has me to hold us accountable to our diets, and I have her to push us when it comes to exercise. As far as emotional turmoil - we have each other to rely on if something goes wrong in either of our lives. It isn't like we're going to get divorced again. Been there, got the T-Shirt - it didn't fit.

For anyone else, I would encourage them to find a family member, community,  or friend to act as an accountability partner. My other advice would be to do it now - while things are still going well. Looking for help while you are desperate leads to bad, bad choices. Get someone in your corner right away, and keep them there - when the storm clouds roll in, you'll have someone to run to before things get out of control.

This lifestyle change that we have undertaken is hard enough without handicapping ourselves by trying to go solo. Do it with a friend, find a support group, get plugged into a relationship with a trainer - anything you can do to make sure that one bad day doesn't turn into one bad week, or one bad month, or a disastrous relapse to obesity. One thing we know about life - bad times will show up. Make sure that you have planned ahead, and have the tools you need to come out the other side with your "new self" intact.

Being Prepared Aint Just For Scouts,

- Hawkwind

The Choices of the Unwise

Yesterday I made some poor choices.

And no, not the ones you are thinking I made. I did not stop off at Ronnie McDoncald's house then swing by the grocery store on the way home to buy a chocolate cream pie. No, instead, I sort of forgot to eat. 

The evidence is right in front of me, in the MyFitnessPal app set up on my phone. (An aside - if you are trying to lose weight, embrace MyFitnessPal. Not a kickback in it for me or anything - it is just that good.) Yesterday's breakfast is listed (Decaf, English Muffin with carefully controlled amounts of Peanut Butter and Jam, topped off with trail mix), but then, for the rest of the day...nothing.  Factor in the exercise I did last night and I netted a whopping 469 Calories for the day. Not good.

I can also guarantee that I didn't have enough water - I remember filling my 20 oz. water bottle one time. Tack that on to my 14 ounces of decaf (I have a BIG coffee cup), and I am almost 30 ounces short of my minimum intake for the day.

Far from being a "diet victory" (Yay! Under 500 calories!), this was a loss of massive proportions. For one thing, today I feel like crap. My head is pounding, my stomach is upset, and I could not force myself out of bed this morning. Hangover, anyone? I didn't even get to catch a buzz at the front end in order to earn the day after. 

But, the real problem is that post-surgery, this kind of behavior will get me hospitalized. Both dehydration and malnutrition are major issues for those that have gone through any kind of bariatric surgery. Pulling this kind of stunt after my sleeve is installed will be every bit as bad as binge eating, and more dangerous in the short term.

So, what happened?

To be honest, I am not sure. I diligently prepped all 6 meals and snacks for Lor yesterday, so it isn't like I was never in the kitchen. Since her liquid phase started, I have not been eating my "real food" at the same time she does, or in her presence, out of respect for her pre-surgical process. But yesterday, somehow, I just never got hungry, and never remembered to eat after I had created (blended) a meal for Lor. Despite a busy day,  I had plenty of time. I just never got around to it somehow.

And getting kickstarted this morning will be even more difficult! Ever tried to eat with a hangover? If you haven't, good for you - but the rest of you know what I am talking about. It isn't like I can have a Bloody Mary with an egg in it. I can't even have fruit juice. Instead, I am going to have to re-hydrate until I can eat something, then wait for my day to normalize. Joy.

The lesson we should all carry away from this? If you are dieting, especially if you are pre- or post- surgery, DON'T SKIP MEALS. It creates bad habits, and you won't like the short-term effects either. You have been warned.

Wishing I Could Put My Head On a Shelf Until The Feeling Goes Away,

- Hawkwind

The Slippery Slope

Several weeks ago, at the beginning of the diet-change process, a sudden craving struck our household. With elevated heart rates and embarrassed glances at each other, we headed to the local ice cream shop, and each got ourselves a sundae. After all, we rationalized, we had better do it now, right? It's not like we could splurge after our surgeries.

But, after the forbidden ice cream treat I felt...disappointed. Empty, almost. It had not really satisfied my craving at all, and I felt no desire for more. I told Lor, "Well, I guess that does it for ice cream.", and felt not only relief, but a curious sense of pride in myself - these dietary changes must already be working if my cravings were changing, right? I departed from our mutual diet failure with a sense of progress and accomplishment.

Fast forward to last week. Lor got sick - a head cold that left her drained and listless for days. Since she is the person who is in charge of our menu planning, and she had no real interest in eating, this created some confusion in the household. Especially when she demanded her favorite comfort food for getting through a cold - Green Chile Stew. Oddly, the best Green Chile Stew in our neighborhood is available from a chicken and barbecue restaurant, so I was dispatched on a quest to gather up the magical, sinus-clearing elixir. I asked Lor if it was OK if I got a meal as well. She waved her hand in dismissal, not being interested in what I did, as long as the Stew arrived quickly. On the way to the restaurant, I lectured myself on good choices, reduced carbs, and eating sensibly.

3 huge pieces of fried chicken, a side of mashed potatoes with gravy AND a side of Mac and Cheese later, I realized that maybe I wasn't as far along with these dietary changes as I previously thought.

In retrospect, the things I did wrong are pretty easy to spot. I should have agreed on a menu for myself before I left the house (2 pieces of baked chicken, maybe, perhaps some steamed broccoli to go with it.). I should have written it down, so I had something in writing to hold myself to, since my accountability partner would be lying on the couch several miles away, trying to breathe. But, mainly what I should have done is not take her illness as license to cheat on my diet. I should have gotten just the items that she asked for and then returned home, where we have tons of intelligent food choices already in place just waiting for me to prepare and eat them. It would've been cheaper, too.

I come out of the experience a little embarrassed and a little wiser. A single diet failure is not the end of the world by any means. But patting myself on the back for no longer wanting ice cream was a false achievement - there is no great accomplishment in giving up something I wasn't all that crazy about to start with, and I gave myself a false sense of security. I have now identified a true weakness (starchy carbs with rich sauces), and can start to work on making that change in my mental programming.

You don't give a thief a job guarding your bank, you do not leave the family cat unsupervised while there is food on the kitchen counter, and you don't send Hawkwind out to the fried chicken joint. It is not the course of wisdom.

Dreading The Weekly Weigh-In,

- Hawkwind