All My Sleeve Wants For Christmas Is...

The activity on the bariatric surgery forums and message boards has been ramping up lately, which is great. I love to see new people joining the ranks, asking questions, and getting plugged into the community. However, any time you get a large number of new folks joining an online "community", there are going to be questions. And, recently, I am seeing the same questions posted over and over and over again: all varying versions of "when can I have/why can't I have (insert forbidden item here?)"

I get it - really, I do. Not every bariatric patient got to participate in the awesome nutritional counseling that Lor and I did with Albuquerque Health Partners. Some folks are forced to self-pay and end up getting their surgeries out of the country, meaning they might receive little to no nutritional info at all. So, in the interests of public service, I thought I would share a little information (and personal experience) about the forbidden foods most commonly asked about.

1. Bread/Pasta/Cereal: By far the most asked about food types on the boards, everyone wants to know why they can't have their favorite go-to-in-a-hurry foods any longer. There are a couple of reasons. First, grain-based products tend to have a very poor protein to volume ratio - 2 ounces (2 standard slices) of bread, for example, contain around 20 - 30 grams of carbohydrates and only 4 or 5 grams of protein. Our lives post bariatric surgery are going to forever be focused on increasing protein intake and minimizing carbohydrate intake, to avoid malnutrition. So, sadly, grain-based products tend to be a non-starter for us.

Secondly, once ingested, bread can expand in the stomach for many of us post surgery (myself included.) This can lead to major discomfort, illness and leads to the inability to ingest anything other than a couple of bites, leading to even bigger nutritional deficiencies. Prepare yourself for life without sourdough bread, lasagna, and Rice Krispies.

2. Bananas: Apparently a very popular subject, bananas hold an odd place within the post-surgery diet. They are a fruit (which the great majority of diets want you to be eating), but they make many bariatric patients ill. What gives?

Bananas, as it turns out, are a natural repository of huge amounts of sugar: one medium banana is worth about 25 grams of carbs, over 15 grams of which is sugar. Strawberries, by comparison, only contain about 7 grams of sugar per serving. Though every patient is different, the higher the amount of "pure" sugar one takes in, the greater the risk of "dumping syndrome": the rapid movement of food from your stomach to your small intestine. One can only find out where the tipping point is by experimentation, but I can tell you from experience that once you go over, you will wish you hadn't. Any high-sugar food, even bananas, needs to be approached cautiously.

3. Soft Drinks: Not a day goes by that I don't read on some forum or another "When can I start drinking cokes again?" Soft drinks may be the most evil and pernicious addiction the world has ever known. So, congratulate yourself, bariatric patients: you have kicked the habit. Because there ain't no goin' back.

Soft drinks, aside from being highly concentrated sugar delivery devices, are also repositories of carbonation, which can seriously compromise your reduced stomach size. How? Open a bottle of your favorite soft drink. Attach a balloon to the neck. Shake vigorously. See how that balloon inflates? That is what happens to your reduced stomach pouch any time you ingest carbonation. It inflates, just as it is designed to do, to accommodate larger-than-normal meals for our berry-gathering ancestors. Will one soft drink ruin your post-surgical condition? Probably not. But, I can tell you from personal experience, ingesting any form of carbonation will hurt like hell. You have been warned.

Now, pour your experimental soft drink down the drain. Don't expose yourself to temptation.

4. Beer: My greatest bariatric surgery regret is that I will never drink Guinness again. It hurts me, deep in the secret places of my heart. But it is a sacrifice I was willing to make, and one that comes up frequently in our discussions with other bariatric patients. So, why no beer?

Firstly, see "no carbonation" just above. Beer is delivered in a carbonated liquid, with all the same drawbacks as soft drinks. (Though better taste, in my opinion.) As much as I love the stuff, I am not willing to inflate my new sleeve repeatedly until I can eat half a cow at one sitting again.

Secondly, beer contains alcohol. (Duh.) And bariatric surgery leaves us very susceptible to the effects of intoxicants - in short, we become cheap dates. I used to be able to put away a 12-pack of beer in the course of an evening. A twelve pack will now most likely put me in the hospital. A single drink of alcohol will have an almost immediate effect, and will then wear off pretty quickly as well. I have yet to start experimenting with this myself but have been able to watch it in others. Be wary of any alcoholic beverage, and avoid any delivered in bubbles.

5. NSAIDS: Post-surgery, pain is a big issue. And many patients are dismayed to find out that their favorite pain relievers are no longer allowed thanks to the changes to their digestive system. Those that have previously taken things like Asprin, Advil, Aleve, Motrin, and other Non-Steroidal Anti-Inflammatory Drugs are informed that these are entirely off the menu and that they need to switch to acetaminophin-based products. Those of us that can't take acetaminophin (like myself) are basically just out of luck.

But, why?

The reduced size of the stomach pouch has many interesting side effects. The one that affects pain relievers is this: a smaller stomach pouch has a reduced size, meaning a smaller amount of stomach acid (for breaking down things like drugs) and a reduced amount of mucus (for protecting the stomach lining against the tissue-damaging effects of things like drugs.) This means that the corrosive side effects of NSAIDS can burn right through the reduced protective layer in your stomach and start directly affecting the walls of the stomach pouch, resulting in things like ulcers. In a large stomach pouch, the side effects are mitigated by the sheer amount of real estate. In our surgically reduced stomachs? Not so much. Switch to Tylenol if you can. If you can't, due to medication interactions like mine, you will have to learn to grin and bear it.

Hopefully, this gives everyone a little clearer idea as to why so many of our favorite things have been seemingly randomly removed from our lives. Just remember - there are a host of healthy food items out there that you have likely not even tried yet. Instead of pining over the comfort foods you have lost, go out and discover some new, healthier ones. I, for one, was happy to trade chocolate chip cookies for the ability to walk  several miles without being in pain. What are you willing to trade your favorite foods for?

Waiting To Trade Whiskey For Beer Next Year,

- Hawkwind

We Enter The Eye of the Holiday Storm

The ovens are empty, the dishes are (mostly) clean, and the family members have all returned safely home. As we enter the calm before the second chaotic storm that is the Christmas holiday, everything returns mostly to normal.

I had every intention of attempting to put up a post or two during the holiday. Honest, I did. I took my tiny laptop/tablet along with me and everything. But the driving to and fro, the assistance with cooking, the random tech support, and (most importantly) spending time with my nieces and nephews all conspired to keep my hands off the keyboard.

Now, on to the part you are all curious about - how bad was the damage?

Marginal, really. A little too carb heavy, but it was either eat carbs or eat nothing but turkey and ham. No meal weighed in at more than 6 ounces. Where I fell off the wagon was as expected - desserts. Berry, pumpkin, and pecan pies were all available, and I admit I indulged in small amounts of each over the weekend. To offset this we made sure to put in 2 miles every single day, even in the sub-40 degree Northern New Mexico wind.

The final result? I nudged upward 2 tenths of a pound, from 212.2 to 212.4. Nothing "statistically significant", as my father would say. Especially considering the fact that, over the weekend, I was given and fit cleanly into two pairs of 38-inch jeans. Essentially, I came out of Thanksgiving weekend with a smaller waistline than I went into it with. I will count that as a win.

Lor did even better: she actually lost a couple of pounds during the holiday. I ascribe this entirely to her participation in Black Friday - I am sure the crowds, the stress, and the rushing around madly did wonders for her metabolism. I was too cowardly to brave the crowds, and stayed home with my father in law and watched football.

We both are feeling pretty weighed down by the carb load, however, and will be starting a couple days worth of reduced carb eating, just to kind of reset things. Hooray. I fully intend to restabilise and then go into the Christmas holiday well under 210, and hopefully up to 3 miles a day. I have just under 30 days to make this stick. Then I can deal with the second round of Forbidden Foods.

P3s And Protein Shakes Await,

- Hawkwind

Fatbrain

Welcome to Thanksgiving Week - the official opening of weight gain season for the majority of us here in the U.S. Great food, lousy weather, and depressed energy levels are a killer combination when trying to stay true to your weight loss goals. It takes determination, willpower, and great mental fortitude to succeed. And many of us that have gone through bariatric surgery find mental fortitude to be in short supply.

This problem is widely referred to within our circles as "fatbrain" - the phenomenon that leads us to still perceive ourselves as obese even when we have lost tremendous amounts of weight post surgery.  We don't look in the mirror and see steady improvement in our health and appearance. Somehow, what we see reflected is the same person that we were before we started the weight loss journey. We take the evidence provided by our measurements, our scales, and the feedback of friends and loved ones, and discard it. We still feel overweight, therefore we must still be overweight, despite any evidence to the contrary.

This phase of fatbrain is insidious, and very difficult to overcome. Logging is one of our greatest weapons here - if we know that last year we were able to down a super-sized extra-value meal, and that today we can only manage a couple of ounces of cheese and deli meat, eventually the light begins to come on mentally. We need to pick a metric - a measurement unit that we really understand, and base our progress on that. In my case, I picked a size of clothing that was impossible to fit into in  (38-inch waistline jeans) and kept checking. Amazingly, this last weekend I was able to get into them. I admittedly had to hold my breath to do it, but, hey, 9 months ago I couldn't even get them up past my thighs. Tough to ignore that kind of evidence.

However, I personally have now graduated to a new version of fatbrain - call it Fatbrain 2.0. I now look in the mirror and see the ghost of my previously massive self looking over my shoulder. I am somehow convinced that one bad day will rocket me 90 pounds back up the scale overnight. This sense of dread and paranoia never leaves me. When I don't exercise, I am convinced that I have failed. When I do work out, I am positive I have not done enough. If my weight loss stalls, I am sure that I am done losing weight. If I do lose weight, it must be a coincidence. The wheels inside my head never stop spinning, orbiting forever around the obese identity locked between my ears.

(Sigh.) Ah, well. A little paranoia probably won't do me any harm over the holidays. Whatever it takes to keep me close to the veggie platter and away from the pumpkin pies and whipped cream, right?

Watching Myself Like A

- Hawkwind

The Fear of Tofu Casserole

Image of Tofu Broccoli Casserole courtesy of kirstenskitchen.blogspot.com.

As we get ever closer to the holiday season, the phone calls are starting to come in. Well-meaning family members, working on their holiday meal planning, dial us up, wanting to know what exactly we can eat.

Them: "Do you need anything special?"

Us: "Any high-protein items are usually fine, so are fresh veggies."

Them: What kind of protein? Anything special?"

Us: "Oh, you know - turkey, ham, beef are all fine."

Them: "And what kind of veggies?"

Us: "Anything not white is probably safe."

This is followed by a short pause as they digest (Ha!) this information. I can actually hear the disappointment in their voices when they say "Oh - so the same things we make every year?"

I just know my family was hoping to prepare quinoa cakes and tofu surprise in order to show their support.

Now, I am just teasing here - Lor and I are extremely lucky that both sides of the family are so supportive of our surgeries that they care enough to ask - many bariatric patients do not enjoy this kind of help from their families. But, the fact of the matter is, bariatric surgery does not prevent you from eating most things (carbonated beverages aside.) It just forces you to eat really small amounts.

At the end of the day, it will be Lor and I who have to monitor and control our intake over the food-filled holiday season. The rest of the time as well, of course, but the holidays will be tricky, just like any event where there is a whole lot of calorie-rich and nutrient-poor food waiting to be sampled. We've been getting in some practice with all the social gatherings we've been attending recently, so I am thinking the holidays shouldn't be too bad.

I am already planning on falling off the wagon in a few spots, admittedly. I will not go through the holidays without at least one tamale, for example - I do not care that they are 90% corn meal. If a pecan pie puts in an appearance, I will likely have to have a (very) small piece. Same for the infamous Chile Relleno Wontons at the Superbowl party - I will have one, and that will have to do. The watchwords will be Sensible Eating.

As much as I love holiday food, I love the idea of being down 100 pounds by January 1, 2017, even more.

So, let's skip the Tofu Casserole, and let me at those Green Chile Chicken Enchiladas instead!

Err...in moderation, of course.

Because A Life Without Tamales Is Not Worth Living,

- Hawkwind

Size Matters

Vixen watching football after her meal.

Among my (many) concerns lately, I've actually been pretty concerned about size. No, not THAT size - we've already covered that in another blog post. I have actually been concerned about the size of my stomach post-surgery.

As the weeks have passed since surgery, Lor and I have diverged in the amounts we can eat at one sitting. Lor had made it all the way up to 4 ounces at a shot, but has regressed a little, and can now only handle about 3 ounces at once without becoming uncomfortable. I, on the other hand, can now eat somewhere between 4 to 6 ounces at one sitting, depending on the consistency of the food we are eating. I've read horror stories about people stretching their reduced stomach pouches back out to pre-surgery sizes, and I have been wondering...is this happening to me? Do I need to do a "pouch reset" involving nothing but liquid foods for a week? Or is this normal?

In the midst of this concern about growing portion sizes and slowing weight loss, I was reminded that I really have undergone some significant changes to my digestive tract. The encouragement came from a very unusual source. 

Enter our dog, Vixen.

Recently, we decided to splurge and go to Subway. We would split a footlong Spicy Italian sandwich, throw away the flatbread it came with when we got it home, and eat nothing but the deli meats and veggies. It seemed like a good plan.

Halfway through my breadless "sandwich", I realized there was no way I was going to finish my 6-inch half. Regretfully, I prepared to throw the remainder away. But, a flash of inspiration hit me - I would slice up the remainder, mix it with hard dog food, and give it to Vixen in lieu of her usual soft food when I fed her for the night! I performed my prep work, put the bowl down, and returned to watching television.

5 minutes later, Vixen came in to see if there was anything else for her to eat. Flabbergasted, I went into the kitchen with her to point out that I had just served her a delectable meal of "people food". Lo and behold, her dog dish was empty.

My 6-pound Chihuahua had just out-eaten me. She managed half my "sandwich", all her hard dog food, and was now looking for more.

If I needed confirmation that my stomach really was smaller than it had been, here it was.

The moral of the story? I need to stop over-thinking these things. From hair loss, to personal appearance, to stomach size, my mind has been ablaze with things to worry about concerning the results of my surgery. As Vixen's demonstration pointed out, everything is coming along pretty much the way it is supposed to. I just need to stay on the train, sit back, and see where the journey takes me.

Thanks, Vixen.

Wondering If Vixen Needs A Stomach Reset Now,

- Hawkwind

Candyphobia

As the days grow shorter and we can begin to feel the bite of colder air, our thoughts turn to the upcoming holiday season. No, not Christmas - what, are you nuts? I still have plenty of time to think about that. No, actually, I refer instead to the most popular holiday in our household:

Halloween.

We are just about ready. The skeletons, pumpkins, and headstones have been pulled out of long-term storage. Lor has made some last-minute additions to our design elements. (See the gigantic arachnids above.) We have even begun looking at costumes, a rare event for the two of us. 

However, a shadow hovers over the household. A frightening subject that we shy away from in terror. A taboo that we desperately wish to break, one step waiting to be taken into the gaping maw of madness.

I am referring, of course, to buying candy for our trick-or-treaters.

In previous years, we would stock up. We get hundreds of trick or treaters at our home, so we would buy huge bags of candy from the local grocery store to be prepared. And we would get the good stuff, too: Twix, Reeses' Cups, Snickers, and Heath bar minis all made regular appearances in our bowl of goodies. No cheaping out on the kiddos for us, no siree.

And, invariably, we would overbuy. So, for a week or two afterwards, we would indulge in the remnants of our Halloween Candy Explosion, until it was finally all gone.

This year - yeah, not so much. The LAST thing I need is a whole lot of candy sitting around the house just waiting for me to eat it. Sign me up for one ticket to Bariatric Surgery Failure Island. Just not going to do that to myself.

So, instead, we have been buying other trick-or-treat items. Toys, stickers, erasers with spooky designs on them. We tried this last year as well. Lor was enthusiastic, I was skeptical. I was positive the kids would hate these little dollar-store items.

Which serves to demonstrate how little I know about kids. The toys were a huge hit - more popular than the candy by far. There are apparently Halloween scouting apps for smartphones that tell parents which homes are giving out the best stuff - and our house got listed as the best one in the neighborhood. Never underestimate the appeal of plastic fangs and spider rings.

However, I can't stand the idea of not giving out more traditional Halloween fare as well, so a day or two before the event we will head to a Family Dollar or something, and buy a big bag of off-brand candy. We will make sure that it contains nothing that we like whatsoever. We will allow each trick-or-treater to pick one piece of our off-brand candy and one toy, and fervently hope that we don't run out. Nothing worse than having to head to the store on Halloween night for an emergency supply purchase.

And, if any candy is left over the next day, we will immediately give it away to someone, so we don't learn to like whatever the remnants are. Prudence, you know.

Repeating "I Will NOT Buy Snickers" To Myself,

- Hawkwind

Here, Piggie, Piggie

Photo Credit: Madr@t Flickr via Compfight cc

The conversation last night was unusual, to say the least:

"Oh my God, I ate like a pig today."

"Me, too. I can't believe we ate so much."

"Man, we are going to have to do nothing but protein shakes tomorrow or something."

"Yeah, I totally feel you. We need to keep better track."

"Agreed."

So, what happened to cause this conversation? What horrible dietary sins did we commit? Did we visit Coldstone Creamery? Hit the all-you-can-eat buffet at one of our local casinos? Give in to temptation and each have one of the gigantic breakfast burritos from a local vendor?

In point of fact, no. We did none of those things. Actually, we cooked three meals at home, and each (barely) topped 1,000 calories for the day. Due to the high amount of fresh vegetables we ingested we also both went a little over 60 grams of carbs for the day.

It is a brave, new world that we are living in, post-surgery.

If you had told me a year ago that eating a thousand calories would make me feel bloated, overstuffed and concerned about over-eating, I would have laughed at you. No one can live on 1,000 calories, right? That is, like, anorexia territory, isn't it?

Yeah, apparently not. Once you've got somewhere between 1.5 (for bypass patients) and 4 (for sleeve patients) ounces of stomach to work with, the caloric intake suddenly becomes a LOT less important to you. Now, you are suddenly focusing on protein, protein, protein! (We did fine on our protein numbers yesterday, by the way - Lor had over 60, I topped out at 70.) Limit those carbs, raise that protein level, and the weight will just melt away!

Well, provided that you exercise every day. And take multivitamins every day. And make sure you stay hydrated, since you won't be getting much hydration from food sources anymore. And...

The total mind shift that comes along with surgery is really unexpected. They tell you that you are going to have to think about food differently, but it doesn't really hit you till that day after surgery when you are looking at a plate of 3 tablespoons worth of food and wondering how you are supposed to live on this. Until you keep having to smile and turn down a drink from a friendly waitress so you don't drink while you eat. Until you start carrying a phone app to track every single morsel of everything you ingest in a day.

And, suddenly, a few months later, you are wondering how you were such a pig as to ingest 1,000 calories worth of food. 

Mind. Blown.

Still Think I Need Those Protein Shakes,

- Hawkwind

Variety: The Lack of Spice

Photo Credit: emilybostic1 Flickr via Compfight cc

(Health Update: The results are in from by visit to the audiologist. I am suffering from mild to moderate hearing loss across all bands, with the problem getting worse at the frequencies get higher. Translation: I am going deaf, but am not yet deaf enough for hearing aids. Lor will just have to speak louder.)

We made our bi-weekly visit to the grocery store yesterday, and while reviewing the receipt afterward (ouch!) a thought struck me: this looked an awful lot like the pile of groceries we bought two weeks ago.

In the name of scientific inquiry, I went through the bags as we were unloading at home. Eggs: Affirmative. Many pounds of chicken: present. Several varieties of cheese: check. 10,000 containers of greek yogurt: yup. We didn't get any protein shakes, but only because they weren't on sale at the grocery store we visited yesterday. Same old, same old, really.

So. this is what I am going to be eating for the rest of my life. The only variety is showing up in the various fruits and vegetables Lor is picking - usually whatever is on sale. And even then I can always count on standards like tomatoes and cucumbers.

It isn't necessarily that this is a bad thing. But it is sort of like that day when you are sitting at your desk and realize that this job is what you've been doing for the last twenty years: so this is who I am. From here on out, my identity is wrapped up in tiny amounts of protein-saturated foods.

As identities go, it isn't a bad one to have. Quite honestly, food has really been shifted to the back burner (ha!) in terms of things we spend a lot of time thinking about. Though we do still have cravings from time to time (I drooled over a pecan pie for about 5 minutes yesterday), they aren't real cravings, if you know what I mean. My mind is craving the memory of something it used to really enjoy. My stomach could care less.

But, really, we are only a few months out from our surgeries. Getting the exact same thing every two weeks will surely lead to burning out eventually, won't it? I think we need to put a little more thought into our weekly meal planning, and make sure that we are injecting a little variety into these trips to grocery store. Substitute low-fat beef cuts for chicken once in a while. make sure we are cycling through different kinds of nuts. We are already doing a pretty good job of trying different cheeses every time. I have no idea what in the heck we will use to substitute for low-fat yogurt, though.

Just one more demonstration of shifting food away from the center of our lives, I suppose. We can start looking for variety in other places: changing up our daily routine, trying different exercise programs, doing new and unusual things for entertainment. We have quite a few more options with our reduced sizes and increased health, right? We need to seek the spice of variety in experience, and not in things like lasagna, beer and desserts.

Now if I can just convince my brain of that.

Wondering If They Make A Pecan Pie Flavored Yogurt,

- Hawkwind

Overwhelmed By Pizza

The upside to bariatric surgery is huge: improved health, increased mobility, enhanced self-esteem. Not to mention the whole "much more likely to live past 60" thing. At no time since I had surgery have I seriously wished I had not undergone the procedure.

But...(you knew there was a but, didn't you?), some days are a little more difficult than others.

Yesterday was the first full day of the 2016-2017 NFL season. Now, once upon a time, I used to be a football fanatic. But, for many years now, football has been something that I sort of enjoyed passively - whenever I could. I tried not to think about it too much. Other than our yearly SuperBowl blowout, I was no longer very involved with football.

Why? Because, since the onset of epilepsy, I have no longer been able to afford cable. No cable means no real football choices. In New Mexico, regular football programming means watching either the Denver Broncos or the Dallas Cowboys. Out of respect to my friends and family members who are die-hard fans of those franchises, let me put it this way: those two teams are not my optimal choices.

This year, however, things are different - my brother managed to wrangle Lor and I a DirecTV subscription as part of our cell phone service. This year's subscription just happens to include NFL Direct Ticket - meaning that I can watch any game playing on any given Sunday. Even my hapless Miami Dolphins. Yes, I am masochistic like that.

I have been so excited for football season this year. I joined a fantasy football league. I cleared my schedule on every Sunday from now through Christmas. I loaded up every single electronic device I own with various apps that would enable me to keep track of updates, scores, and injuries.  I even parked my laptop next to me so that I could write during breaks in the action.

Cause, you know, football is serious business.

Pre-game shows started yesterday at 10 AM, and I was there and ready. I got through the first segment, giddy as a schoolgirl. And then, the commercials began...

I have never noticed before the make-up of commercials during football games. I sure noticed it yesterday. Commercials were (approximately) 25% car commercials, 25% home improvement store commercials, and 1,372% pizza and beer commercials.

You know, pizza and beer. My two favorite foods, now barred to me forever by my altered anatomy post-surgery.

Cheese and pepperoni glowed seductively. Beer flowed endlessly into pint glasses. Happy, smiling people (all in much better shape than I am, I should add) enjoyed the forbidden fruits of my lost dietary loves. 

Halfway through the first game, I was ready to roll the dog in cheese, cover her in tomato sauce, and throw her in the oven. I resisted because I was not comfortable with looking up the nutritional information for "Baked Chihuahua". Seems like all that fur might have a high carb count anyway.

I made it all the way through the Dolphins losing to the Seahawks  in the last 30 seconds of the second game of the day, and then gave up. I was overwrought - completely destroyed by visions of Domino's and Negra Modelo. Which I used to be able to have. You know, like, at the same time. I sat at my desk, staring forlornly at my boiled egg (also known as "lunch"), and wondered how I had come to this: surrounded by advertisements for the foods I loved, unable to have any for fear of losing all the progress I have made so far.

I think, for next week, I will start recording my chosen channels about 2 hours early. That way, I can kinda fast-forward through all the commercials for forbidden foods. I will still see them, but only for a few seconds at a time, not constant series of 30-second spots. 

Or maybe I can have Lor fast-forward for me, while I keep my eyes closed.

Yes, I Had Food Porn Dreams Last Night,

- Hawkwind

Gone Forever?

"How Long Til I Can Eat This Again?"

The various "support group" message boards for those of us who have undergone bariatric surgery are interesting places. After a few weeks spent following the topics and concerns that get posted there, you begin to notice certain repetitive themes. "How long do I have to wait after surgery before I can start eating all my favorite foods again?" is a popular one. Another one that shows up regularly is some version of this: "Help! I am (X) weeks out from surgery, and I have only lost (Y) pounds! What am I doing wrong?"

But, the topic that tends to really catch my eye is the many versions of this: "I checked the scale this morning, and was down to (X) pounds!! That is (Y) pounds of fat GONE FOREVER!!"

Now, understand me here. Getting on the scale and discovering that you have passed a milestone weight is really exciting. Heck, my weigh-in this Monday put me under 230 pounds and had me smiling all day. But the second half of that celebratory sentence makes me a little nervous - "gone forever" doesn't really mean what many surgery patients seem to think it means.

The subject of recurrence of weight gain after bariatric surgery tends to be acknowledged but not really focused on by your surgical team. But the truth is out there: a high percentage of patients who go through surgery do suffer some amount of regain after the post-surgery honeymoon period ends. 

I really am not trying to be a Debbie Downer - if you lose one hundred pounds after surgery and gain 25 back, you are still 75 pounds ahead of where you were before you started and much healthier than you were to begin with. But the real problem is this: the "GONE FOREVER" mentality that is created during the initial 12 to 18 months of "easy" weight loss runs into the reality of the digestive system resetting after the surgical recovery period is over. Suddenly, that easy weight loss you have been enjoying ceases, and the numbers on the scale start to creep back up. Forever wasn't quite as long as you have thought it was going to be.

So, what causes regain? In a word: comfort. You get used to the easy weight loss of the honeymoon period and start to insert a few of your previously favorite foods here and there. You take a day off from your workout routine and it somehow turns into weeks away from the track or the gym. You stop diligently logging your food intake, and suddenly no longer have any real idea of what your intake is on any given day. There are many paths to regain, many traps along the road ahead.

What many of us fail to realise is that the obese person's body has actually changed over the years of carrying excess weight. Fat is no longer prioritized as a primary food source by the body, usually due to the high amount of carbohydrates entering the system. Fat cells have actually changed size - getting larger and becoming resistant to weight loss. Even our metabolism is in on the act, forcing periods of exhaustion in order to keep the activity level down. All of these things will work together to pounce and slap 10 pounds of extra weight back on our bodies the first time we stop paying attention. This weight gain usually leads to disappointment and depression. And we all know where we turn for comfort when we are depressed: comfort foods. It is a vicious cycle that can lead very quickly to undoing many months of hard, post-surgical work.

The solution? Don't ever look in the mirror and think "gone forever". Instead, be sure that you keep firmly in mind that your previous state of obesity is just waiting, biding its time, and hoping for the chance to re-introduce itself into your life. Keep moving, keep logging, and keep avoiding "empty" calories. You have not signed up for a "One Year and Done" solution. You have committed to a life long change in your behavior. The only forever will be the one you create on a daily basis.

The Correct Answer To The First Question Is "Never",

- Hawkwind

Summer's End

Happy Labor Day to the Misdirected family. I hope you are all out at the lake, or driving your RV, or drinking beer (but not all 3 at the same time) for this final blowout of Summer 2016.

While walking the dog over the weekend, Lor and I had a little chat about this summer. We didn't get to go camping at all. We had no resort weekends. (Hospital stays do NOT count as resorts.) We spent the majority of our time close to home: drinking protein shakes, recovering from surgeries, going to endless rounds of doctor's office visits.

And it was probably one of the best summers we've had in a long time.

Really, we got a lot done. We bought a house, for goodness' sake. We helped a friend move to Tucson. I began writing professionally. Lor restarted her crafting projects. And, oh yeah, there was that surgery/weight loss thing...

Seriously: Memorial Day 2016, Lor and I, as a household, weighed 486 pounds.

Labor Day 2016? 411 pounds.

When is the last time your household dropped 75 pounds over the summer?

Mainly what this summer has represented to us is an investment in summers to come. We gave up camping this year so that we could really enjoy camping and hiking in the future. We stayed close to home now so that, the next time we travel, we will be full of energy and joy. I have given up overeating as my main recreation of choice - meaning that in the future I will be able to enjoy things like swimming, riding bikes, and hiking longer distances. I went through surgery so that I will no longer be an anchor that ties those who love me down as they slow their pace down to let me keep up. Lor spent some time recovering from surgery so that she no longer has to deal with a daily chore involving needles and insulin injections. 

I think it was a good investment. It has certainly done wonders for our relationship: nothing draws you closer together than being accountable to one another for your new behaviors. We have become one another's coaches and cheerleaders. (And, in Lor's case, my fashion consultant.) Neither of us is wistfully watching the other succeed and feeling left out. We are succeeding together - which has made us stronger, and less apt to fall down on our faces.

Though, bad days like The Great Ice Cream Incident do still occur from time to time.

Thanks for dropping by and sharing your summer with us over the past few months. We've got even more exciting things coming up right around the corner, and are looking forward to what the remainder of 2016 has in store.

Heck, I am looking forward to having my picture taken at Christmas this year for the first time since EVER.

Next Stop: Halloween Costumes!

- Hawkwind

Energize!

As August winds down, the temperature begins dropping as we welcome the winds and rains of the monsoon. Children return to school, and family schedules slowly begin to normalize. Everywhere we go, we can feel the approach of fall in the air - that gentle slowing of movement and metabolism that heralds the oncoming winter season.

Except, of course, in my house. Here we are suddenly bouncing off the walls, getting out of the house more every week than we used to do in any given month. Drive-throughs have been replaced by home-cooked meals, though admittedly very small ones. Long-range planning has suddenly become a concept, where we usually used to only deal with whatever any given day had in store for us.

The schedule around here has certainly changed. I am now getting up around 6 every morning. We head out for a morning bike ride every day, and still walk the dog every evening. Bed time is now closer to 10 - 11 pm, rather than my usual 9 pm. 

It isn't just more time awake, though. Everywhere you look, there are signs of increased energy. Vixen is running around the house, growling and yipping and playing with toys as if she were a puppy again. Lor is pulling out arts and crafts projects that have lain forgotten for years and re-starting work on them. And I am now really writing: instead of hastily writing the blog and then going back to reading or gaming, I am now spending a minimum of 4 hours a day writing, 6 days a week. It is as if someone slipped a permanent vitality potion into our (high protein, low carb) breakfasts each morning.

A dietician will tell you that it is due to the complete shift in the protein:carbohydrate ratio in our diets. A personal trainer will inform you that it is due to the increased amount of exercise we are getting. A doctor might say that it is simply due to losing excess weight and stabilizing our daily nutrients.

I think that these are all at least partially correct answers, but ultimately I think it has more to do with mindset than anything: We are no longer resigned to living with the sedentary lifestyle brought on by my obesity and our other illnesses. Lor and I are suddenly interested in the world outside our front door because we no longer feel ourselves cut off from it. And Vixen is just spastic because, well, Vixen.

It is not all sunshine and roses, of course. Our increased energy expenditure has us now dropping down for naps for a couple of hours every afternoon. We do get to the far side of a long ride or day and look at each other, realizing that we have pushed just a little too hard and now are going to have to struggle to make it home. But this is no different than any other kind of resistance exercise - you push to failure, then next time you are a little bit stronger.

We still have lots of things we want to add - Lor wants to start an aerobics class, I desperately want to get back to the gym. But, I no longer look at those things with a resigned malaise as "may happen some day". I now know, with a little more time investment, we will actually get there.

More Naps May Be Required,

- Hawkwind

In Transition

(Transition Offense, for those who have no idea what I am referring to here.)

I got to spend some time at ABQ Health Partners Bariatrics yesterday for my 1-month surgical follow-up. My Nurse Practioner, Patricia, laughed at the "oops, I ate bread" story, expressed concern that my blood pressure was too low, and congratulated me on my continued weight loss. She then warned me that a stall might be coming as my diet changed, and then approved me to move to the "regular food" diet - ready to eat any food I wanted, provided I abided by the rules we have been getting hammered into us for the past several weeks. You know: protein first, no liquid before or after meals, less than 20 grams of carbohydrates with any meal in a day.

With that, she released me into the wild. Total time in the office: 19 minutes.

I stood blinking in the sunlight outside the office, my head swimming at how quickly everything took place, and then realized that I was, finally, able to start eating like a normal person again. Admittedly, a normal person who eats 4-ounce meals that take 30 minutes to ingest, but, you know, mostly normal. 

So...now what?

We briefly discussed going out to a restaurant to celebrate, but after the Panera disaster on Saturday I was not really feelin' it. Other than steakhouses and seafood joints, I could not think of any restaurants who specialized in high-protein, low carbohydrate fare, so I decided to just skip it. Instead, we headed to the grocery store.

Where I bought greek yogurt. With fruit in it.

I remember 6 weeks ago, Lor's absolute delight in wandering the aisles of Trader Joe's and buying all these items she had been missing, and felt kind of jealous. I felt no sense of joy, really. No overwhelming relief that the worst was past and now I could start enjoying my new diet. Mainly, I felt panic. How was I going to handle 60 grams of protein a day without using protein shakes? I felt like someone had taken the training wheels off my dietary bicycle, and I was now teetering precariously as I rolled down the street.

So, instead of a celebratory meal, I had a P3 instead:

12 grams of protein, and roasted meats, hard cheese,and nuts - all things that have been denied me for weeks now. That settled me down the way a stiff drink used to. Heck, eat three of these a day, with two yogurts for snacks, and I am already upwards of 50 grams of protein, right? Nothing to this 60 grams a day thing!

Then, for dinner, came Lor's secret weapon. It turns out she had been planning for weeks to make us a pizza to celebrate my return to real food. Not just any kind of pizza, though - a pizza whose crust was made out of baked ground chicken.

Yeah, let that settle in for a bit. It is a real thing: Chicken Crust Pizza.

Except, instead of going all "veggie friendly", Lor piled it with beef marinara, Canadian bacon, regular bacon, and fresh mozzarella. A single slice of this heavenly marvel came in at a whopping 23 Protein, with only 4 Carbs. The best way I can describe the taste of the crust is a deep dish pizza crust cooked in an oven at the same time as a roasting chicken. We (barely) managed a slice each. (Mind you, each slice is about half the size of a standard slice of pizza. So, yeah, pretty nutrient-dense.)

So, yeah, maybe this "real food" thing will work out after all.

Now I Am Ready To Go Back To The Grocery Store,

- Hawkwind

The Revenge of the Carbohydrates

In which I engage the ancient enemy of all bariatric patients.

Today brings us to exactly 4 weeks since I went under the scopes to have my "sleeve" procedure completed. I have not been at all unhappy with my progress. Mainly, I have found that life is now an exercise in patience. I still can not reliably ride the new bike any distance, so I am walking every day instead. I suffer from the problem of not being able to stand for longer than 3 hours at a time, but am informed that this is due to my current loss of muscle mass as well as fat, so I have to sit and rest frequently. My energy reserves are depleting quickly, thanks to my new, higher expenditures of energy, and I am having to nap for an hour or two every day to compensate. All of this still represents progress: while I was morbidly obese, I never stood or moved enough for any of these issues to come up in the first place. (Now, at 235 pounds, I am merely "seriously" obese.)

The area where I have not been very patient is with food - specifically, the kinds of foods that I am experimenting with. I am technically not released to a "normal" diet until two days from today, but that has not stopped me from having a nibble here and a taste there of various non-soft foods to see what type of effect they might have on me. Lor has been filled with dire warnings and ominous predictions, but I have found that just about everything I have tried has worked out fine. I am sure that this has been frustrating to her, since she is still working through re-acclimating to certain foods, but I seemed to be having no such issues.

This all came to a screeching halt on Saturday. For our anniversary, we went to a local event, went shopping at thrift stores, and then decided to cap everything off with lunch somewhere. We selected Panera, thinking that there were several menu selections that were fairly low-carb, or could be made so. Lor selected a chowder and a salad, I picked a turkey and avocado sandwich and chicken noodle soup, with every intention of deconstructing it when it arrived and only eating the shredded turkey and avocado. (I have discovered that shredded turkey is palatable if it is dosed with salad dressing or mayonnaise.) We also ordered large to-go boxes, knowing that we would have to take the majority of our meals home with us for consumption later.

However, once the dishes arrived, something came over me. The fresh bread (something Panera specializes in) looked and smelled delicious. Surely, I thought, I can have a bite or two of the entire sandwich? After all, nothing else I have tried has given me any kind of serious gastric distress, right? Emboldened by my self-justification, I took a small bite.

And chewed. And chewed. And chewed some more. No matter how hard I tried, or how long I chewed, I could not get this bread down to the consistency of "applesauce" that gastric patients are supposed to reduce their food to before swallowing. After a full minute of chewing, I realized I was going to have to make a decision - spit the food out into a napkin, or go ahead and swallow.

I am male - which do you think I did? 

The moment the bite arrived in my pouch, I knew I was in trouble. It landed with what I could have sworn was an audible "thud", and then I could feel it beginning to expand. Within a few seconds, I was sure I had swallowed a bowling ball. I was desperately afraid of throwing up at this point - because I was positive that this mass of food that had suddenly appeared in my stomach would never fit through the esophagus on its way back up. I did my best to sit very still, hoping the mass would settle, and not come erupting out of my chest like an Alien baby.

Lor looked across the table at me, concerned. "Your eyes are watering - are you ok?" she asked. I nodded, afraid to disrupt the delicate balance in my abdomen by speaking. She looked more closely at me, then shook her head. "It was too much for you, wasn't it?" I nodded again, wondering why on Earth I had been so stupid as to try this stunt.

After a few minutes, things did finally settle down, but the feeling that I had swallowed a rock would not leave me for several hours. I sheepishly packed up the remainder of the sandwich in the to-go box and had a few sips of my broth while I waited for Lor to finish her lunch. Graciously, she never said "I told you so" even once.

Needless to say, I later turned the turkey and avocado into something resembling tuna salad, and threw away the bread and lettuce in disgust. When our Nutritionist clears me on Wednesday, I will pay very close attention to my food restrictions, and do my best to not give myself a heart attack in public again by tackling expandable carbs like white bread.

That's what I am telling myself now, anyway.

I May Never Look At A Loaf Of Bread The Same Way Again,

- 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

One...Last...Day

So, let's give it up for protein shakes: they have single-handedly kept me from suffering the effects of malnutrition for the last 4 weeks + 2 days.

(/Golfclap)

Now that that's out of the way, let's have a chat about tomorrow, shall we?

I finally go in for my 2-week post-op exam tomorrow, the one that allows me to reintroduce "soft foods" into my diet. I quiver with antici-pation. (Either you get it, or you don't.)  I never in my life would have believed that I could be this excited about the theoretical concept of eating a scrambled egg.

Lor's recovery was a bit different - she really did not feel she had "arrived" until 4 weeks out from surgery, where she was able to return to a diet of normal foods. For her, a trip to Trader Joe's where she bought the next week's worth of real food was her finish line. (Of course, she is still working on eating that week's worth of food, 4 weeks later. Adjustment to new portion size comes slowly.)

Somehow, for me, tomorrow feels like it will be a major accomplishment. Maybe because my tastes are a little broader than Lor's, or maybe I am just more desperate than she was. She spent her two weeks of soft foods living on refried beans and frittatas. Those will also be a part of my diet, of course, but I am really looking forward to so many other soft foods:

• Mashed potatoes (not normally part of the bariatric diet, but perfectly legal for the next two weeks.)
• Creamy Peanut Butter (OMG, peanut butter, how I have missed you.)
• Soups and Chowders (Clam Chowder, here I come!)
• Canned seafood, like tuna and salmon. (Yum!) Even canned chicken is legal, though I have always thought canned chicken smells like cat food, so I am less excited about it.
• Vegetables and fruits, reduced to the consistency of applesauce. So, baby food, essentially. But I can totally get behind some mashed bananas and pureed nectarines. Pureed broccoli or asparagus - maybe not so much.
• And, the big one for me, soft cheeses. I will learn to eat cottage cheese, but I already love ricotta on just about anything. Protein boost + taste - what is not to like?

I am not sure if things like egg salad or guacamole are legal, but I will be asking about them tomorrow for sure.

The other BIG re-addition to the diet? Spices! I can start using mustards, mayonnaise, peppers, salt, cayenne, hot sauce...you get the picture. Finally, tasting my food will return to my life even if crunch isn't due for another couple of weeks. I am definitely at the point now where it doesn't even matter which protein shake I get out of the fridge - they all taste pretty much the same anymore.

Now, as to the protein shake diet around the surgery, I have to say this: it works. The day I began the liquid diet I weighed 261 pounds. Yesterday I weighed in at 241.

20 pounds in 4 weeks works out to losing 5 pounds a week. Those numbers are nothing to take lightly. So, despite my threats to eat the dog, and desire to gnaw my own arm off, it was worth it in the long run. Thank goodness. I would hate to have gone through this and gained weight.

The Dog Would Have Been Too Stringy Anyway,

- Hawkwind

Are We There Yet?

Image courtesy of NPR.

Now that the chaos and madness of the closing have passed, and Lor and I are officially home owners, we can return to the subject that really matters to me currently: food.

Specifically, the lack of it.

I am 8 days out from my vertical sleeve procedure, and I must admit that the "no chewing" thing is really getting old. I have been fortunate enough that I have not fallen into hating protein shakes, like many other bariatric patients do, but getting 100% of my nutrition in liquid form is really starting to wear on me. You know things are bad when you are feeding the dog and are speculating about the taste and consistency of her hard dog food.

See, that's the thing - I am not really hungry, per se. I am not craving food so much as I am craving texture. I want so badly to actually chew something, not just drink it. If I was given a handful of cucumber slices or almonds to chomp on currently I would think I had died and gone to heaven.

Following which I would probably end up in the Emergency Room of the closest hospital, of course. 8 days isn't enough time for your internal staple line to have healed up. I am not saying there isn't a reason for the "liquids-only" restriction. I am just saying that it is slowly driving me crazy.

I have started leaving the room whenever Lor eats her meals during the day - not because it bothers me to see her eat, but because the way I am staring intently at everything she puts in her mouth is making her uncomfortable. She is designing beautiful small meals filled with deli meats, cheeses, and fresh vegetables, and I am sitting there working on my 26th Muscle Milk shake in a row. (Believe me, I counted.) She cooked half a pound of bacon the other day and the smell filled the entire house. I almost ate a pillow to keep from crying in frustration.

But the real injustice of it all is this - Lor got to have her 2-week post-op appointment (the one where you "graduate" from shakes to soft foods) exactly 14 days after her surgery. Due to scheduling issues, mine will not be next Monday, as it should have been, but will instead be next Wednesday - 16 days after my surgery! I will be forced to spend 2 extra days sucking down protein shakes instead of moving on to semi-solid foods like scrambled eggs, refried beans, and Ricotta cheese. 

The injustice of it all is unbearable.

For those of you shaking your heads at me in amusement, go eat nothing but protein shakes for 22 days in a row. Then we'll talk.

If I See One More Sugar-Free Popsicle I May Scream,

- Hawkwind

Pre-op Prep

Day 4 of the liquid diet. I grow crankier and dumber by the minute, it seems. The weird thing is, I don't feel particularly upset at any given moment. But, whenever I am interacted with, my responses all seem to come out of the "annoyed" section of my vocabulary. Lor has been very tolerant, and has not cut my head off and buried me in the backyard.

Yet.

In the midst of this not-so-great emotional adjustment, I got to travel across town for my pre-operative appointment yesterday. This was a new experience for me - during Lor's pre-op appointment I was in a nutritional appointment, so I missed the whole thing. I imagined tons of highly technical information that I was going to completely misunderstand due to my current brain fog.

Luckily, the appointment was nothing more than a re-hash of all the experiences we just went through with Lor's surgery. On the day of the surgery, I will consult with the anesthesiologist and my surgeon. They will roll me back to a surgical suite and inject me with something that will put me to sleep. They will then inflate my abdomen like a beach ball so the surgeon has lots of room to work in. They will punch a hole in me to correct my hiatal hernia, then punch 5 more holes in me to perform to the removal of the "greater curvature of my stomach." I will then be returned to the hospital room to recover for 48 hours.

I was struck by how much the pre-surgical briefing minimizes the actual trauma they will be inflicting on you. True, they will not be slicing me open like a dissected frog in biology class. But they will still be leaving me with the equivalent of 5 shank wounds and a puncture from a belt knife. I have read many testimonials of people who say they were back at work immediately after their surgeries. Quite frankly, I don't understand how. Lor is only now getting back to where she can bend or flex at the abdomen comfortably, and she is 4 weeks out from her surgery as of yesterday.

Speaking of 4 weeks out, Lor got to have her 4-week post op appointment yesterday while I was having my pre-op appointment. (That is how closely we scheduled these surgeries.) She has been returned to the land of Those Who Can Eat Real Food. Her visit to Trader Joe's yesterday was a lot like a child being taken to a candy store. I have never seen someone so excited about the prospect of eating salmon, bananas, and kale chips.

After my 6 weeks without real food, I am sure I will have a whole different perspective on that too.

Ready To Have My Brain Turned Back On,

- Hawkwind

Wheels Up

Well, it is official. I've been through the classes, I've done the 3+ months of reduced carb diet, I've even received the letter from my insurance company telling me that I am approved. Only one thing left to do before surgery.

Today, the liquid diet phase begins.

For those who have joined us recently, the liquid diet phase means this: every "meal" I have, for the next two weeks, is a protein shake. To break up the monotony, I also get to have a few snacks every day: one cup of yogurt, up to 4 sugar-free popsicles a day, and/or all the broth I want. I also need to be ingesting at least 64 ounces of water a day, but I am an old pro at that by now - I've been doing it since March or so.

We have some very recent experience with this liquid diet thing - Lor did it just about 6 weeks ago. It is not pleasant - she was constantly craving the ability to chew anything. Plus, the adjustment of one's body to the reduced calorie load has a bit of a negative emotional side effect.

In other words, I can expect to be cranky as heck for about the first week of my 4 weeks on nothing but liquids.

The results are pretty profound, though. From the point where Lor started the liquid diet to where she exited the hospital, a period of 3 weeks, she dropped a total of 13 pounds - a little over 4 pounds a week. 

I've now been at this for 25 weeks, since I started the pre-surgery diet early, at the same time Lor did. I've managed to lose 41 pounds in that time, averaging about 1.5 pounds a week. Our surgical team constantly tells us not to compare weight loss numbers, but I am going to anyway - If I am down another 13 pounds at my post-surgical weekly weigh in, 3 weeks from today, I will have lost 54 pounds total.

I will be below 250 pounds for the first time since 2004.

When I weighed around 250, I looked something like this:

2002 - Somewhere between 240 and 250 pounds.

Yeah, I'll take that. 

Protein Shakes, here I come.

Wishing There Were More Interesting Flavors,

- Hawkwind