Holiday Eating

Happy Thanksgiving, US residents!

Holidays are here, and with it another reason to overeat. Holidays are tough. For those of us having to adjust to new portion sizes, holidays are no longer the excuse to overeat that they used to be. Normals splurge occasionally and because of their lifestyles, the weight evens out. If post-ops overeat, we're talking pain, quick visits to the toilet, or violent retching. Not fun.

I'm spending time with my in-laws and my parents (as well as my own family, of course). We're all packing into a van and heading to my parents house for a turkey and the trimmings.

I'm well aware that we're supposed to be able to eat "normal" food, with the exception of maybe the pumpkin pie, as long as it's in moderation. I don't like that because I simply suck at estimating portion sizes. As a result, I'm sticking to my original plan; I'm taking a tortilla and some turkey slices and I'll stuff it with some stuffing. A Thanksgiving Wrap, so to speak. If I find some sweet potato maybe I'll put that into the wrap too. I've found that the wrap is pretty good for making acting as a natural portion limiter. I'm sure it'll draw some ire from those around me because it's not traditional. I'm used to the looks and the dirty thoughts. I try not to let it bother me anymore. I'm doing this because I know what works for me. If I start partaking in the old ways, I just know that I'll gradually slip into overeating again. I don't want to worry about that.

New foods? I still have to be careful. It appears that even innocent things like trying a small Sam's Club sample of chai and a bite of a glazed ham slice on a toothpick was enough to trigger digestive upset (I noticed after the fact that the chai mix at Sam's Club had sugar as a primary ingredient...surprise!). So mixing up foods at a family event is not something I really feel like experimenting with.

The point is that holidays are hugely focused on eating as part of the ritual, and for some people it's a really bad idea. These type of holiday events encourage overeating. Normals may not have a problem with this. Some people like me will have to stick to our guns even if it means looking weird at the table eating prepared foods. I've worked too hard and suffered too much to give up now just because it upsets someone who doesn't walk in my shoes and wear my floppy excess skin.

Good luck to any post-op reading this, I bid you the best in getting through the holiday time. Find something to be thankful for to get you through these wonderful family gatherings without wanting to curl up in the corner and cry. If you can't, at least be courteous enough to stay out of my corner...

Food Workers Spitting in Your Food?

I was reading an article about being choosy about the restaurants you visit. The author had been on the receiving end of food poisoning. The gist of the article can be summed up thusly: If the bathroom is dirty, the kitchen is most likely filthy as well. Leave. Quickly. Or risk having a big plate of contaminated food.

On the surface this is just good advice. Heed the advice and you can feel better knowing that the Red Lobster you're eating in is probably not going to give you food poisoning. Or at least the chances are no worse than they would have been if you made the meal in your own kitchen.

But coincidentally I ran into this link regarding restaurant safety as well. The information in it was not pleasant to read. I hope the link is still good if you decide to read it.

For some extra information on that link, it goes to a site called Reddit. It's a site where you normally find websites linked to and commented on; different user vote stories up or down based on how much the enjoyed or hated the story. If something is big and full of buzz, it's normally at the top of Reddit.

But there's also a number of "comment" posts that people can enter, where they ask questions or ask for advice. If it's voted high enough it travels up the list to the top and other people find it and it draws more comments. That link was one of them asking whether people in the restaurant industry have or know of people spitting in the food.

The comments are...well, disconcerting. The concensus seemed to be (at the time I read it, which is a disclaimer since the questions can be edited and altered as long as the story exists on the site) that it does happen, primarily to customers that were real pricks to the staff. It wasn't a common everyday occurrence but it happens.

And there were cases where some employees just did it to do it.

Spitting in food. Stirring drinks with male anatomy.

Some said there were non-"dirty things" that were standard procedure with many restaurants and could make your skin crawl. Example: dropped chicken wings on the floor, the cook scooped them back up and dropped them in the fryer. "The dirt and bacteria are all cleaned off by the heat". I remember seeing that in a documentary about a restaurant, so I know that the comment isn't all that far-fetched.

Thinking about it is one of those things that gives me the heebie jeebies. I won't be able to go into a restaurant or fast food joint without thinking about it.

There are many things we ignore or conveniently tuck away into the recesses of our minds because the "truth" is rather disconcerting and uncomfortable. Examples: where your hamburger comes from. The truth behind the top one percent of the population having eighty percent of the wealth. The odds of you actually winning at the casino or lottery (probably not all that different from each other). Even the number of people that die every day on the streets in car accidents, or the number of people that are driving while distracted by their cell phones, texting, or reading a freakin' newspaper behind the wheel.

So how are you supposed to react? Shun all the things that a modern society gives us because of the risks associated with using these conveniences? Or just file these things away and suspend the knowledge that these things are happening?

Progress Update for November 4th, 2009

After another plateau period I am down a pound today from my November 2nd weight level. Quick stats...
Weight: 263.5
Weight loss since surgery (4/7/09): 112.5
Weight loss total (1/1/09): 194.5

Most lost since January: 195.5

So I'm a pound away from my lowest weight (so far?)

My bariatric doctor said there's no way I'd hit the "healthy weight" in the sub-200 pound range in his experiences. Bariatric surgery patients just don't get into the "normal" range. They lose (for Roux-en-Y) typically lose somewhere in the neighborhood of 60 to 70 percent of the excess weight.

I don't know what exactly is going to happen, but I looked at the weight chart for the past 12 months on Fitday where I've been tracking my weight to find possible trends...

You can see how the chart starts off strong with a large drop, then bucks a little near April (when I had the surgery), then starts falling again. But the slope of the line is dropping, meaning that the rate at which I'm losing weight is slowing down.

The doctor had reiterated that what typically happens is a big loss then a gradual loss of weight as the body readjusts to the new calorie intake. What usually happens is the heavy nosedive turns into a series of "steps" (known to we fat people and chronic dieters as plateaus) where, as he said, the body will level off or gain a slight amount of weight for about a week or two then suddenly drop down anywhere from a pound to five pounds and level off again.

I wanted to believe that it wouldn't happen to me. The difference between kids (and teenagers) and cynical adults is that I understand that wanting to believe isn't the same as reality, so could it be that my irritating, frustrating, and demoralizing "plateauing" stage is coming due? Or would a change in my diet habits create another set of weight drops?

I guess I'll have to just keep an eye on my weight over time and see what happens.

When Bad Things Happen To Good People

I logged into my account this afternoon and found a disturbing post from my loyal reader, Lee. He, too, has been going through a weight loss surgery journey and blogging about it. I don't really know him personally, only through his blog posts and messages here, so I can't speak for him (just what he has already shared in messages and posts, if I may be allowed to do so).

On his blog he posted that his wife has breast cancer and because of various complications may not survive this time around. They have time to live together and celebrate their lives for awhile, but I imagine it is still hard news to bear.

I have wondered about my death. Like Lee I pretty much accepted that my obesity was a death sentence. I enjoyed my eating habits, and since weight and lifestyle takes months or years to change rather than a day or two it seemed as if losing weight was out of reach.

I basically accepted I was going to die early. In some ways I almost looked forward to it; no more aches and pains, the potential insurance payout could help my wife and kids get out of debt a bit more, no more dealing with the stress of my day job and waking to the dread that I would never find a better source of job satisfaction; all I hoped for was that it would be quick and relatively painless.

But I eventually took the steps to get the surgery and added some hope that I might see my young son grow up and maybe even grow a little older. I temper this with the realization that I could be killed in a car accident or some other freak incident as happens to hundreds or thousands of people every day.

Lee found the surgery and then changed his view to accept that maybe he, too, would buy more years with his wife and children and grandkids. And so you can imagine the irony of me finding his news posted today on the eve of my own birthday that I didn't know I would see.

I don't know what to say to him, really. Because of my Asperger self I am afraid to say much because I'll probably say the wrong things so normally I don't say anything. Better to be seen as an unfeeling jerk than a cruel moron incapable of relating the way other people normally do. After a lot of thinking I posted a comment to him for moderation; I hope that since he's followed so many of my own posts he'll understand what I mean, even if I'm not the best at conveying my thoughts on emotional topics.

It led me to thinking about the question of what would happen if you knew you were going to die in a certain span of time? I really liked the movie Krull; it had a character that was a Cyclops, and in the realm of that movie the Cyclopian race was cursed with seeing the when and where they would die, so they knew how long they had to live.

I know at the rational level that I could die at any time. A family friend just had an aneurysm but looks like he'll survive. I had an uncle that survived as half the man he used to be for several years after a stroke. I had a roommate that killed himself in college. The loss of weight doesn't mean I'm home free of strokes and heart attacks, and of course there is a possibility of fire or car accident killing me as well. Unpleasant, but those are the facts. I actually had a fixation on the thought that after my six month or twelve month followup to the surgery I'd be given a "green flag" that all was going well with no complications only to be in a pileup on the way home.

So would one rather know when they were going to die, or that they had a certain time to live? We have our mortality looming over us every day, and unlike the Cyclops we don't have any certainty when our lottery numbers will be drawn. Every day is an opportunity to spend living or dying. Most of us get so caught up in our constant routines of life that we get into a rut and don't give it a second thought. Some people get hit with the news that they will soon pass away and they suddenly find a new meaning to their lives, like the inspirational story of cancer victim Randy Pausch who ended up unintentionally becoming an motivational hit with his Last Lecture (which I highly recommend watching on YouTube and reading the resulting book).


I suppose the question is, what would you do? Would you want to know when you're going to die, or remain ignorant of it? Would you rather believe that you make your own fate every day, or know when it's time to buckle down and make the most of your days as the time draws near? So many people face this question every day in oncology departments in hospitals that it's become an invisible question for those who aren't directly affected by these issues.

My best wishes go to Lee with this challenge in his life. I hope anyone else that stumbles on my little corner of the blogosphere could also take a few moments to share their wishes with Lee as well, since he and his wife will no doubt look forward to some good wishes from others as well.

Loose Skin

Some of this may not be pleasant. If the show Dirty Jobs makes you squirm, you might want to skip this entry.

Here's something that doesn't seem to occur to a lot of people in regards to dieting. That something is loose skin.

Um...the title of the post probably gave it away, didn't it?

I'm perpetually mystified by the number of people that crawl from the shadows saying they had the surgery (or more often, their sister/cousin/in-law/mother/aunt/friend had the surgery). It seemed that half the ward I was recovering in when I had the surgery were post-ops.

And when I hear that people who want to have the surgery are sometimes 50 pounds overweight...that's all? Really?

I started out at around 458 pounds. On my last weigh-in on 10/9/2009 I had lost 190 pounds. That's going from "super obese" to just "obese".

But one of the newer demons someone in that position has to confront is loose skin. People losing twenty pounds got nothing on me. Taking dramatic measures to lose the equivalent of a large bag of dog food? Why?

What I have isn't just the wobble under the arms that you find some older people tend to develop, or the small flap under the arms from moderate weight loss. Not just stretch marks on the sides, or the slight bit hanging from an oversized panniculus from, say, childbirth.

Losing the weight that I've recorded means that under my arms aren't just hanging loose skin but rather wings. See this? I can do that without the suit. Just me in freefall with the arm flab flapping in the wind. Not that I've actually tried it. That would be crazy.

The panniculus...an apron of fat hanging off the stomach post weight loss...is a constant reminder of my dietary mistakes. It's big. Like you can take handfuls of it and not find any muscle definition. I don't wear button-up shirts because it's awkward to tuck the shirt into my pants over this thing. It gets rashes. It has a life of it's own.

I am a bassett hound. Ever see one of them? When I turn around, I stop and two seconds later the rest of me stops. I swim in skin. If I get into a pool I wouldn't be able to dive below the surface because of the bouancy of the excess skin. On the plus side, I could probably survive most body shots from a small caliber weapon.

These are just some of the thoughts that pass through my mind when getting dressed in the morning. I avoid looking in the mirror for fear of seeing more than I have to.

It. Sucks.

There's surgery available. There's a couple things working against me, though. One, it's classified as a cosmetic surgery. It's for looks, not necessarily health reasons.

Two, insurance companies are evil.

Three, I'm told I can't even consider the surgery until I'm at least a year out from the surgery.

Four, I don't know when or if I'd have the sizeable copay that my current insurance company supposedly would charge for the surgery if they were to decide I could get it in the first place. Remember point number two.

It's tough. I know I did this to myself. It's my fault. And I have a constant reminder of my misdeeds. Every time I pass a mirror, every time I tug my sleeves down to hide the stretched flesh, every time I press on my skin and see my fingers sink and sink into the surface. And it's extremely depressing.

I sometimes wonder how much this excess skin weighs, and wonder if the surgical removal of the skin would see another five, ten...twenty pounds?

If anyone tells you that the skin is flexible and will heal, they're not dealing with this kind of weight loss. I already had one plastic surgeon tell me that there's no way the skin would ever "heal". Skin has a certain amount of resiliency, but nothing like what I'd be asking it to heal from in this case. The connective tissue has been ripped to shreds.

"Exercise! Build up some muscle to fill that space!"

I have been exercising. First, the amount of skin to fill would mean I'd have to become a professional bodybuilder. That would be excessively difficult given my new digestive challenges and the fact that a pro body builder consumes something on the order of 4,000 calories a day. Plus there is a significant genetic factor to how much muscle you can build up.

Also muscle is more dense than fat (the claim that muscle is heavier than fat is bull. A pound of feathers and a pound of sand are both a pound...) so it would take a lot more muscle than fat to fill the skin.

In other words exercise isn't the key to helping this flab.

Right now it looks like I'm stuck with this current...look. I'm stuck with the daily reminder and the pained wince when I glimpse myself in the mirror.

It's another thing to cope with, I suppose.

Should You Fear the Hamburger?

This article is more than a little scary. It's nearly as long as my rambling posts, but if true, it certainly is informative.

The video on the site is especially scary.

The story has two facets; the human interest story focuses on young Stephanie Smith, a dance instructor who is now having to use a wheelchair, possibly for the rest of her life. Why? Because of the scary story. She ate a contaminated hamburger.

That's right. She ate a bad bit of hamburger and so she might never walk again.

Every day hundreds of thousands of burgers are eaten and the vast majority of people have no issues.

When there is an issue with food poisoning, it is rarely worse than your average flu. You end up with the crappers or stomach ache, maybe with a bit of yarking thrown in for good measure. You feel lousy for a couple days and that's it.

But this video is a reminder that there are two things you never want to see the process of being made; meats, and the law. This one only covers meat.

It runs through the industry standard lack of throughness in inspecting our meat supply and the lack of accountability in preventing outbreaks of illness. It's amazing to me that more people aren't sick from their food.

This story highlights how the hamburger you get in your grocery store is often mixed with cuts of fat and castoff, less than premium meats in order to cut costs. It isn't well inspected. It isn't cleaned thoroughly. The hamburger that made Stephanie sick was actually a mix of crud from Nebraska, Texas, Uruguay and South Dakota. Yes, one of those isn't a state in the continental US, for those of you that are geography challenged. The hamburger from your local grocer could very well be a mutt of varying pedigree and chances are you have no way of finding out.

We take it for granted how our food is handled. We just get this end product and assume that a cow went in one end of the slaughterhouse and the red matter came out the other side, gets packed, shipped to the store and we buy it. Not so! What you're getting is a fine mix of varying quality meats meant to mix meat with fats in a way that is the lowest cost to your producer.

Fast food, for all the artificial stuff added to the foods for preserving it and enhancing flavor, isn't immune to the good old poisonings. E. Coli first made mainstream headlines with the public with an outbreak from a Jack In The Box, going to prove the workers in the kitchen blowing their noses on the grills to watch it sizzle isn't the only danger lurking in fast food and also proving that there is indeed some "real" food mixed in with the fast frankenfoods.

I have to say that this story was a little frightening. My current habitual diet is comprised of sliced turkey and sliced ham; it's not a pressed or mixed meat like hamburger (and I'm desperately hoping that there's at least a slightly better margin of safety to those meats), but we did find out that the stuff we buy comes from one of the largest meat companies that also happened to be paying for this woman's medical expenses...Cargill.

Hippies and tree huggers and general nuts with berries on the brains like to be very vocal in their advocacy of organic, natural foods, and denouncing anything from a wrapper, be it fast food or stuff off the grocer's shelf, as being beyond evil for the temple of the body. There are so many claims of how horrible everything we ingest is that it's hard to know if this poisoning in meat is something to worry about or if it was a fluke, and I'm merely disgusted by the stripping of ignorance behind what brings the clean and abstract food from the grocery store to my plate.

We already hear, repeatedly, about the ways foods will kill you.

• chemicals added to fast food.
• saturated fats
• sugars and empty calories in cakes, cookies, brownies, etc.
• high fructose corn syrup.
• artificial flavors and enhancers
• high sodium and calories in restaurant foods
• pesticides lacing vegetables and fruits
• maximum allowance of generally considered non-food items...like, for example, insect parts...in peanut butter, cereals, etc.
• most of the mcnugget isn't meat. It's corn. Surprise!
• portion sizes are sky-high
• diet drinks may actually increase your weight
• mercury is found in seafood
• workers in restaurants and fast food joints have been known to take...liberties...with your order. Especially if you ticked them off in some way.
  
• etc, etc, etc...

Now there's the scary way our meat is actually not closely inspected between slaughter and dinner plate. You can't trust anything you didn't grow and prepare yourself. Unfortunately that's probably not feasible for most of us.

So...is this something to worry about? Or do we just keep living our lives in willful ignorance? Sometimes it really is true that ignorance is bliss.

Hearts are Funny Things

I went to the hospital on Friday for a quick errand to the lab. A ten, fifteen minute job at most. I had let my boss know I'd be out a few extra minutes that morning, he nodded and said it was fine, and so I headed there first thing that morning.

Now here's the fun part. For the past few weeks I've been having this feeling of hollow thumping in my chest. I feel it for about five seconds or so, maybe less, then it's gone. It's annoying. And sometimes worrisome. No pains, no dizziness, no bouts of extra sweating, just...palpitations.

My next appointment with my primary care physician is in December. Since I've been having these little bouts more frequently I decided that while I was stopping at the lab I would stop at the receptionists station and make an earlier appointment.

"She has a slot free on Monday at 3:00...what is it for?"

I explained. She had a weird look on her face. She then looked up some more information on the computer and said, "Rather than let it go over the weekend...we have a Dr. ### and his resident free in half an hour. Would that be okay?"

Apparently they don't like letting chest problems go. The issue was annoying to me, but never enough for me to tell my wife, "C'mon...I need to go to the ER." I hate the doctors office, but not because of the questions or the poking or the prodding or the blood drawing or even the feeling that I'm being called to the principal's office for eating too much. I hate it because of insurance companies. And paperwork. And screwups. And uncertainty in billing.

If I could cut myself off of all the obligations I have to my creditors and billing issues, I'd go off grid for all but my Internet connection.

But I agreed to see the doctor and resident. My 20 minutes visit ended two hours after I walked into the hospital. I had a long consult with the resident (he spent a good deal of time correcting my medical records for medications; that morning I sat down as I took my daily pills and recorded every name and dosage and printed them out). He went through checklists. He checked blood pressure. He found no reason for my palpitations in the medications.

The doctor that oversaw the resident then came in. Friendly as friendly could be, and he smelled like a pleasant fragrance in soap. I notice those things when you have someone leaning in close to check, again, the chest and back for breathing and heartbeat and pulse. He concurred with the resident for a plan of action. He told me that from my history...which was narrowed down a bit thanks to the surgery, since I only drink water now and follow a bland diet of personal choice (and is the reason I have a bariatric tag on this entry)...the most reasonable explanation was that I was suffering from STRESS.

Yes, my job may be shortening my life and is killing me.

I've been told this as an aside from my therapist and my primary care physician at different points when my blood sugar started going wild at certain points when certain things were going on at work.

I was scheduled to go to the blood lab early next week, and as soon as I went to reception he scheduled me with Cardiology. I had an EKG done (took five minutes. Literally.) and then the tech fitted me with a 24 hour wearable monitor.

The great irony? Because of events outside my control, the day was one of the least stressful I've had in weeks. The heart monitor will have had no idea what my average day was like. And otherwise these palpitations occur almost every day; I don't find it strange to have at least 2 episodes over the course of the day. A little more irony sprinkled on came from the fact that I couldn't exercise Thursday due to scheduling issues, planned to do it Friday, and couldn't because if I became too sweaty the leads wouldn't stick. So I'm on the stationary bike while typing this entry to make up for time.

I'll find out more after they get to analyze the EKG and the results of the recorder and the blood analysis.

I'm kind of torn in that I'm afraid they'll think I'm making this stuff up if I don't show anything on the results, but if they do find something I think that heart issues are usually not something to take lightly. I want validation that I'm not imagining this. But the reality of not imagining it could be extremely frightening...I suppose this is one case where I'd rather have nothing to worry about even if I look like an idiot.

I'm not a hypochondriac. I felt a couple hard thumps during the monitoring but not like my usual mini-episodes. So will it have found anything out of the ordinary? No idea.

Perhaps if Captain Irony wants the last laugh I'll finally get close to an ideal weight...near the time I finish my final draft of the novel story...and then have a heart attack as one final F-U. It's like paying off all your debts and running out of the post office with a giant grin on your face just when a bus hits you.

While I haven't thought these weird palpitation feelings lasting only a few seconds at a time have been enough to justify the anxiety of paperwork and billing and waiting at an ER I also think I worked too hard to try turning my health issues around to not have tried seeing my PCP earlier and have her check me out for potential cardiological issues. I didn't know my 15 minutes to the lab would turn into two hours of diagnosis and taping gel-covered leads to my massive hanging clumps of flesh, but it certainly did make the day more interesting.

At any rate I'm still alive and the monitor is now in an envelope to take back to Cardiology for analysis. I hope to know more about the results later in the week.

Reflections on Bariatric Surgery and Eating Changes

After the surgery there was a lot of emphasis on water.

Not as much emphasis as what I'm eating, mind you, but there was more attention on drinking adequate amounts of water than before.

Like so many other things I've discovered in my research regarding weight and diet and exercise, your intake of water has some mixed messages thrown in there. I could see some concerns after a shift in my eating habits both before and after the surgery.

With regards to drinking I had to give up my favorite drink: the soft drink. The doctor was specific on this. For months before the surgery I had to give up sodas. I was a soda fiend; I could slam 1-liters of diet Pepsi like candy. I usually drank at least three a day. Notice I said diet Pepsi. I at least tried to watch calorie intake, although today there is a growing chorus of people saying that the additives in diet soda have other health effects. I guess it doesn't much matter to me anymore.

I gave those up at the beginning of the year. Apparently carbonation in the new stomach pouch is bad.

I can't drink through a straw. Air bubbles or something like that regarding the pouch.

I'm not supposed to drink for a period of time before and after a meal.

I was told to avoid alcohol. I later found people who had the surgery and do drink some alcohol. There's supposedly a growing number of post-ops becoming a alcoholics, substituting an addition to the firewater for their addiction to food.

The hard part for me is that I tend to go by the numbers. I need solid evidence and instructions to feel comfortable with things. Even when I'm supposed to be creative with something, I usually need some way to feel like I have permission to take the reigns before taking over something. This gives me problems because with the surgery there's a certain amount of individuality that figures into the equation, and that's added to what is apparently subjective information from the doctors themselves.

For example: when I had the surgery, I was warned I could only sip water. I'd be lucky if I could ever drink a half liter of water at a sitting. The one other guy who had the surgery near the same time I did would come in and talk about having to crush pills into powder and taking hours to drink an 8 oz glass of water.

He was saying this as I was finishing half a liter of water that I had started maybe twenty minutes beforehand.

Every morning now I'm taking nine different pills, uncrushed (one is split in half because it's a whopper of a calcium pill), with a 1/2 liter of water before walking out of the house in the morning. That's downing it in fifteen minutes without any discomfort.

I told some of the team overseeing me about my concerns of stretching the pouch. They kind of dismissed it as a non-issue right now; as long as I wasn't eating to discomfort habitually, as long as I was mindful of how much I ate, I'd be fine. The body will tell you.

I can drink like a fish and it doesn't bother me.

Drinking through straws I thought was supposed to be a no-no. It can cause pain due to air getting into your system, and burping isn't as pleasant as a post-op. I accidentally drank from a straw shortly after surgery. It was just me being absent minded.

Nothing happened.

I was warned that as a post-op I would have some horribly stinkstarded gas. I mean the kind that will make my wife pass out when it billows from under the covers.

Post surgery I can't pass gas to save my life. I thought I had to and my wife said she thought was I was going to do more than toot.

Of course some changes make logical sense, but others I question what I'm being told. Doctors are human, after all. They're not infallible. They simply have more authority on the matter. (I'll also note that I don't put it past doctors to lie a bit just to get patients to cooperate a bit more. The only thing keeping me from having ice cream and cake at a birthday party is the fear of utter pain and agony from sugar crashing from my digestive system into my bloodstream and flooding my brain...look up "dumping" if you want to know more of the nasty part, but if you thought the writing about gas was bad you probably should avoid it).

Example: sugars are bad. Avoid processed foods and sweets...candy, cakes, brownies...basically the good things in life that fit in your piehole (why do you think it's called a piehole if it's not meant for pies?). I can't have barbecue sauce either (I've found many online horror stories from post-ops who tried ribs and ended up curled in the fetal position afterwards).

But I have had some honey mixed with oatmeal. Not bad. I'm not mainlining honey but it does contain a natural sugar.

So..am I being told to avoid sugars in general because for most patients it's easier than educating them on the specifics, that some forms of sugar are bad while others aren't? Is it possible my body still has some amazing tolerances? Maybe instead of not tolerating sugars, post-ops can only tolerate certain amounts over which I end up a twitching, crying baby?

I am not supposed to drink before and after meals. Why? Is it because there's not enough space in the pouch, so I won't eat enough nutritionally? Will it help empty the pouch faster, preventing proper digestion, thus reducing my calorie count more (which I'd think is a good thing...)? Is it for my own good, avoiding pains and discomfort?

I was also told to listen to my body, and that it would signal hunger and satiety. I can eat then drink within five minutes and there is zero discomfort. No pains. No felt side effects.

I was also told that I could be satisfied with just a dixie cup of food three times a day. Surgery was about five months ago and I can tell you...no. I definitely feel like more. Head hunger? Or physical hunger? I definitely eat less than I used to. But a dixie cup...no. I eat approximately six ounces of food (I weigh it out on a kitchen scale) three times a day plus some peanuts during the day, and so far I'm losing weight. No pains. No other issues that I know of, at least until I get blood test results saying I'm malnourished.

Is something wrong with my pouch? Or is it just the individual effects of the surgery on my body? Everyone reacts differently but I sometimes wonder if I wasn't fed a few bits of misinformation along the way. I wonder if I've "damaged" the pouch but from what I was told that's basically a non-issue, or I'd know about it if I did something like that.

There were times I really wondered if something was wrong so I pushed my meal sizes early on. It was a glorious day for me when I had a little too much at Panera one day and felt pain. I knew that meant that yes, my stomach was indeed smaller. I've had this happen to me maybe four times in five months; not agonizing pain, but just a twinge uncomfortable enough that I would have to stand and walk it off or sit and twist around a lot until it passed in about fifteen minutes.

Those times were reassuring that something did still work.

Maybe sometime I'll get more of the full story on these issues. In the meantime I'm still curious if much of what I'm told isn't the dietary equivalent to telling children about the Boogeyman coming to get them if they didn't pick up their rooms; "If you eat a brownie, you'll feel pain that makes you wish you had DIED!" Most of what they're telling me seems an awful lot like a conspiracy to make me eat less and make more healthy choices in what I eat, to eat more sensibly under threat of digestive retribution.

Then again, maybe that's what it takes for some people to lose weight. Fear.

What Has Wings and an Apron? Me.

One of the more difficult things to cope with after weight loss surgery are the reminders of your fat body.

That means waking up every day to a large mound of flesh hanging over your waist and pubic region because some of the excess fat may be gone, but the flesh doesn't go away. The connective tissue is too damaged to "bounce back".

I can't count the number of times people suggested going to the gym or just waiting and the skin would just magically recede. It doesn't. It's damaged. Period. It's one of the casualties of the lifestyle that led me to be nearly 500 pounds, and it doesn't just go away (it won't go away on it's own at all).

I hide it with my clothing. Longer shirts. Pants that cover my waist as well as my hanging apron of flesh. Then I try not to see it, pretend I don't feel it when I sit down or shift the wrong way.

Just when that's out of sight, though, my sleeves creep up and the massive pendulous wings of fat under my upper arms starts swinging madly like a six year old learning to hit a baseball. Sometimes if I'm reaching for something it hits me in the head. I wince just thinking about these things.

I'm the oldest basset hound on the planet.

My wife tells me that my insurance company will cover a panniculectomy and maybe even surgery to remove the underarm skin. I think they may only cover it if there's complications...skin breakdown, rash, infection,...whatever it takes to interfere with life so that the procedure isn't just for cosmetic reasons.

Which, of course, gives them all the leeway in the world to turn it down.

And that's assuming that I have the same insurance down the road and that their terms don't change. And, finally, I have the couple grand available to pay the surgeon's copay. Right now I don't even know if I'm going to cover all my bills.

It's really depressing, but it's not like there's much choice. I either get out and once again slog through the day dragging this extra fat and skin around or...well, there's an alternative that involves just not getting out of bed, I suppose. Just being conscious allows me a reminder of this alien landscape that shifts and rolls without my mental commands, as if it has a mind of its own.

I remind myself that it's a reminder of what not to do again. But it doesn't help me feeling like a freak in public, trying to quickly jerk my sleeves back down over the flesh fudge of my upper arms. I look forward to Winter's long sleeves and jackets and sweaters.

I am keeping my eye open for something to use as a pressure garment over my arms. I tried bandages, those wraps from ACE? They work for about fifteen minutes. Then my skin starts to bulge through where the bandage edges fold mid-wrap, creating some weird scene like the Blob breaking through a barn or shed where the heroine is seeking refuge, the gelatinous goo pulsing and bubbling through the thin crevices between the wooden slats. No matter how much I adjust the bandages they just don't hold.

I hate it. If I'm not covered enough I won't even look into a mirror. I'm afraid of what it would look like underwater...I'd probably be mistaken for some kind of jellyfish with wings.

My Little Guy's Eating Habits

How do we raise our kids to eat well?

Is it by example? Or are their habits for eating innate?

I've been worried about this with my son lately. Up until shortly before my surgery we were big on fast food. We went to breakfast on Sunday mornings at McDonalds, and several times a week we would go to get dinner at McDonalds or some other fast food outlet.

Slowly my own habits had changed; it was done out of necessity and then later in justification through reflection of having to make the changes. Since I have to consider my diet when planning out the day I end up pre-fixing most of my meals and taking them with me. Even if we're eating out I'll have my little plastic container with my cheese/meat wrap. The only food I'll normally have outside my three sub-6 ounce meals is probably what amounts to a total of 1/2 a cup of lightly salted peanuts or a spoon of peanut butter; I found that having some of those helps stave the feeling of "off" that sometimes hit me during the day, especially after I started trying to exercise.

I've weaned off milk and now only have water to drink. It seems like I'm constantly drinking water and still I had test results back saying my kidney function showed I need more water in my diet. Sheesh.

For my anniversary my wife got me a camel pack, the backpack with a tube and water bladder for drinking. It's meant for people who hike or ride bike. I think it's the only way I'll get enough water during the day.

My son is pretty consistent when it comes to what he wants for his meals. He wants a cheeseburger or chicken nuggets for dinner, small french fries, diet soda. Other occasions he likes Macaroni and Cheese. Sometimes he likes pizza or one of those ready-made Lunchables packs.

Lately he's been asking for cereal or a cheese sandwich. Sometimes as a snack, or he'd have it as a post-dinner meal.

At the same time he sometimes won't eat much for lunch or breakfast. He may, for all practical definitions, skip a meal. Just not hungry.

I know that kids, especially young kids, go through periods where they'll eat the same things over and over. I still do that. What I'm worried about is whether he's overeating, or how to curb the bad habits of relying on fast foods for meals. It's not that you can't eat sort-of healthy foods at fast food joints, at least from a weight control viewpoint. A cheeseburger (his favorite meal staple) is only 300 calories at McDonald's. But relatively speaking food from restaurants (and fast food joints) tends to be higher in fat and sodium than stuff made at home.

I'm also worried because when my little guy goes to visit grandparents I get the distinct feeling that he's given more freedom from food restrictions; if he wants candy or more helpings of macaroni and cheese or a hot dog, it's always ready for him whereas we would be more inclined to tell him he's had enough.

Part of me thinks I'm just more focused on it because of my surgery; it's a side effect, when you constantly focus on your own eating habits and issue, to start looking at what other people do and get into and start passing judgement on their habits. I look at how food interacts with other people and how people interact with their food. Are they eating this or eating that much because they're hungry, or because they're looking to that meal as an emotional crutch? Will my little guy be eating like this because it's associated with reward or security or love?

More often than not we impart these views on others without even knowing that is what we're doing. What if that's what I'm allowing or doing to my own son?

This is a constant source of anxiety for me. I don't want to rob my son of a "normal" (or semi-normal) socialization; I don't want to turn him into a food freak unwilling to try new things or constantly worrying about his weight. At the same time I know that I was overweight and had issues with food for my entire life, and as a result was robbed of many of the interactions that Normals take for granted growing up.

I also don't want to make others around me worry about their own habits around me or my little dude. My wife made comments recently that reminded me she is conscious of the fact that I eat less now and it makes her feel unusual with what she's eating even though for me my situation is different and it doesn't bother me that other people are eating more or talking about food. In my perspective it's a social habit that people are conditioned with making them feel self-concious about social eating around people who aren't eating as much as I am.

So what is really normal eating for younger kids? Should I be letting him eat pretty much what he wants as he's hungry and be careful not to encourage him to "clean his plate" or worry about leftovers, or should I be trying to limit how much he takes in and risk making him self-conscious?

I had hoped that the overweight cycle would be broken by my now living by a better example. Maybe it will have some kind of effect. I'm really hoping it will...but there's far more influences in the world my little guy lives in than just his daddy.

Troubles When Eating Out

Going out and about while finding food is a challenge for me.

If you've followed my blog posts you know that I'm very much set into routines. It's an Asperger thing. Or maybe it's a me thing. I don't know, but it's the way I am.

There are a few places I am comfortable going to because I more or less know what to expect. For example, we go to Panera Bread and get a sandwich because I normally can eat half a sandwich and take the other half home without feeling uncomfortable or overfull. I had at one point cut down to eating a McMuffin at McDonald's for breakfast once a week...turns out they're 4 ounces...but eventually I decided that there was a little too much fat and sodium in the fast food I was eating and so when we now go there I pack something for my breakfast to take in with me.

I started getting little sushi rolls...picnic rolls, they're called...at Wegman's. They're pretty good. The primary problem is that they aren't too high in protein. They're mainly rice and vegetables; some of them have a fake crabmeat in them, but that's really it. Because of the restrictions that come with my surgery I need to be a little more mindful of getting protein an calcium in my diet, so then I started using the picnic rolls as an accompaniment to other foods like a chunk of cheddar.

Unfortunately there's something like 16 mini-rolls in a tray. I end up having to eat them for the next several meals or I risk them spoiling and then wasting the money buying the food. I utterly hate wasting food (or money on food because I waited too long to use it).

I later discovered the turkey wraps at our local "Super Walmart". They don't call them wraps, but that's what they are. The wrap is cut into four parts and the size in ounces divides them up nicely so I can eat half without going over my portion limit.

I love Wegman's. I utterly love it. But their wraps...too big. The net weight on the container is one pound, so that would mean that half the wrap is 8 ounces. I try to limit my food to 6 ounces or less.

Damn.

The other night we ended up stopping at a Walmart to get some food and groceries, and discovered that that particular Super Walmart didn't have the turkey wraps. I was extremely disappointed since trying something else would mean risking side effects or having to figure out how much I could eat without causing problems.

We stopped at a Wegmans and I took their wrap and purchased a 7.5 ounce container of their picnic sushi rolls. I ate 1/4 of the wrap which should have come out to about 4 ounces, and then 4 of the sushi rolls which should be about 1.8 ounces (7.5 divided by four, since the tray was in four rows of four). Anyway, I hoped it would come out to about 5.8 ounces in theory, and I didn't have any problems after eating it so I guess it worked out well enough.

But obviously you can see the kind of hoops I have to jump through to get the mental math to work out just to get a meal when I don't have it pre-made.

When I'm not careful enough I have other issues. When we ate out at a restaurant for our anniversary I had issue with the chicken (again, it happens sometimes but not always). My wife didn't think I ate too much. I didn't think I ate too much. But I obviously did something wrong; if it wasn't eating too much it must have been something with what I ate.

It was a chicken breast with pilaf topped with a cherry and brandy (it was some kind of alcohol, I'm not sure if it was brandy or not). I ate a portion of the meal and had the rest boxed but it was too late.

My stomach had that over-full feeling. Slight but constant pain. Not a horrible one, but enough to annoy me.

In addition my thigh muscles felt...the best term I could use to describe it is spent. Not tired. Not cramped. Just weary, bordering on numb. Wobbly?

I didn't know if it was the alcohol not entirely cooked off the cherries on the chicken or what. All I know was that despite the meal being very good, I had a definite issue at hand...I ended up hanging out in the bathroom and walking around a bit, touring the restaurant while trying to work some of the digestive problem out.

There was no extreme pain, vomiting, or nausea. It slowly glubbed away and I was fine after about ten or fifteen minutes.

Again, you can see that this can be an issue. The place was unfamiliar to me, the drive was long...if I did have other issues that could cause a mess,...well, the thought of it was a source of great anxiety.

This is something that I as a post-operative bariatric patient must learn to live and deal with though. Once the RNY (Roux-en-Y) procedure is completed there's no going back. Having to deal with this is just...part of the new me.

Hopefully the tradeoffs...anticipating better health and energy, for example...will be worth the price I have to pay.

Fat is Fat...And I'm Reminded of It

If you follow my stories you probably know that as part of my surgery requirements the insurance company required visits to a psychiatrist. I recently had an appointment that got me to thinking about the state of being "fat".

See, he asked how the weight loss has been going. I told him that I was a little frustrated because for the past four or five days or so I've been plateaued at 232 pounds. He asked how much I lost so far. I told him that I lost about 135 pounds since January, with maybe 50 pounds or so of that since the surgery. My wife said that I was focusing all the time on the plateauing and not considering that I lost 50 pounds in two months or that I've lost 135 pounds since January, which they say is really quite a bit.

I think it goes back to the idea that you have no idea what it's like until you've been there. My entire life has been focused on weight in some way.

I've spent my life worrying about things that normals take for granted. Will this chair hold me? Can I fit in the arms of this chair? Is that creaking of the floor more than just a creak? Seatbelts? You have no idea how annoying modern cars are with that now that there are sensors in the seats to determine and adjust for your weight. Toilet seats are a challenge...will it break? Beds? Staying at other people's homes, riding in their car and staying in hotels can be stressful for these reasons and others that normals just don't have occur to them. Even wondering about clothes...going on a short trip? Better make sure you have all you're going to need, since you can't just run to Walmart to get replacement pants if you stain them over dinner.

And other people know. This was always in the back of my mind...they're thinking rude things but are polite enough not to say it. But you seem almost paranoid knowing that they're thinking these things. My parents bought a furniture set for their dining room not too long ago. Mom found that one of the parts of the wooden chair was loose, then it broke. They took the chair back since it was brand new...the sales guy asked if her son had sat in the chair because they may not cover that. They were angry enough to say that they're never going back to that place again...but this was a sales guy asking this. I would have been shocked if I was actually present when this was said, but I know that if I was there this probably wouldn't have come to light. But it confirms that this is what people are thinking.

But Barry, you've lost all this weight since then!

First, that doesn't make it right. But dealing with issues like anger at how fat people are treated by society is a different topic.

Second...yeah, by the numbers I guess I've lost a significant amount of weight. What I haven't mentioned was that the day my son broke his arm falling off his bike, my wife related a story to me. I was riding my bike around the building. We had gone over in a minivan, and there were other people around, mostly taking advantage of the parking lot and playground for some recreation. My wife wasn't riding bike. At the time she was watching my son on the playground.

I headed out on the bike, riding away from the minivan. She said some young girl...not really a young kid but not an adult either...said out of the blue to my wife that someone at school told her that fat guys always drove minivans.

She said she just sort of nodded her head in a disbelieving, "Um...okay..." gesture. I hadn't known about it at the time. In retrospect it makes me think that while I was enjoying the day (before my son's fall, of course) I was just looking like a fat ignorant fool; as if I have no business being around in public.

This is what the public thinks.

I had lost 100+ pounds. But to people who know absolutely nothing about me, I'm judged anew each time as a lazy, ignorat fatass, the same as I'd be with the extra weight.

These thoughts stay with me constantly. I constantly worry about how much I'm eating now...too much for the pouch? Too many calories? Exercising enough? These clothes seem to fit but the number seems way too low for me...I should be in 58, not 48 pants. Chairs can't possibly fit me or they'll break, despite the fact that I'm having this thought while I'm sitting in the chair in question.

It's hard. It's hard sometimes to convince myself to get out of bed, to leave the house, to face these issues all over again another day. Then I shift from my personal demons to knowing, and in some cases despising, the public because of the way they look at me and I just know what they're thinking, why they're glancing back at me or watching from the corner of their eyes.

So yes, I do focus on the short term. I grow more and more frustrated at my plateaus as I have them. I worry about the surgery failing, that I've screwed it up again, that I've failed again. I can't even think of the significance of what I've supposedly achieved because before all the health concerns I think I was a non-advocate but still follower of the Fat Acceptance movement; I accepted myself just as I was, probably because I didn't see why I should worry about something that at the time looked like I couldn't be successful in fixing.

Part of living nearly a short lifetime with this mindset is that I can't tell weight on myself or other people. I can't estimate other people's weight...I hope that I never witness a crime and have to estimate the perpetrator's stats. I told the therapist that I don't know if he's 70 pounds or 140 pounds. Normals seem to find this surprising. Don't be. I've actively not cared about people's weight because it would be another source of depression or fixation on my own problem with weight. Nowadays I've noticed when other people lose or gain a significant amount of weight, but I don't know how much or even what they currently weigh. That's about it.

Somewhere in me there will always be a fatty. I'll be overweight the way alcoholics are always alcoholics, even if they're sober for years. And part of that is accepting the fact that the fat voice will always be in my mind, will always be urging me to fix a cheese sandwich as a snack or saying that one little brownie probably won't hurt me, and I'm always struggling to make sure that I don't slip from trying to lose weight and keep it off, and there will always be that voice telling me that I can't do it.

And I'm coming to the realization that no one else really understands my particular situation.

It's very lonely. In college we had a saying...college is where you discover that even when surrounded by people you can be totally alone.

Addiction Transfer

I first learned of the name for this phenomena at last night's support group meeting, but there doesn't seem to be a lot of information about it. Maybe because it's a fairly simple concept.

Basically, for weight loss surgery patients, it means that you substitute your addiction to food with another addiction.

The underlying cause is probably the same as the reason the surgery "fails" for some WLS patients. You didn't treat the reason you're fat. It's a head game. The patient was fat because they were medicating their underlying problem...depression, stress, anxiety, abuse, addictive personality, whatever the underlying issue is...and weight loss surgery helps give them a tool to treat the symptom, obesity, but the patient neglects to get treatment for the underlying issue along with the physical ailment WLS helps.

So as you lose weight you discover that your post-surgical digestive system makes one glass of wine feel like ten. Woo hoo! Soon you're no longer feeling (depressed, stressed, etc.) because a couple glasses of alcohol makes the world feel wonderful. Congratulations. You're no longer a food addict. You're an alcoholic. This is what happened to Carnie Wilson two years after weight loss surgery.

Other people turn to having affairs, becoming sex addict. Others run to shopping addiction. Or gambling addiction.

Weight loss surgery is a way to rip off the cover off an underlying problem. The next step for the patient is to decide if they want to cover it up with another form of security blanket or deal with the issues exposed.

I found a few sites discussing addiction transfer, but they were all basicallygiving the same information. Well, I take that back. There were two flavors. The first was taking the stance that you need to deal with your underlying issues and probably really really need to seek therapy...sites like InteliHealth, LocateADoc, and Psychcentral.

The second flavor is from the WLS naysayers, people who advocate that you can heal just about anything with herbs and chiropractic care and wellness coaching and overall positive feelings and support. For some people this may work...but in my experiences, this is another form of head games. But if it works for you, hey, run with it. Sites like Ezinearticles.com and NaturalNews basically hold the view that if you just figured out why the person is fat and fix that, they'd lose the weight naturally and in a healthy way, while weight loss surgery maims you for life and is pushed on you by "clueless" conventional medicine advocates looking for easy fixes.

This kind of neglects the fact that, A) if you've reached the point of actually needing the surgery, you're probably on borrowed time...blood pressure, diabetes, etc. are taking a toll on your body every day. And B) you've damaged your stomach. I think people seem to think like the people that are telling me my "batwings" can be fixed by just exercising more. I've already had a surgeon tell me that the connective tissue in the skin is damaged. It can be toned some, it can improve some, but it won't be fixed without cutting off the excess. Similarly, the stomach is stretched out. This means the obese, or formerly obese person, will always have hunger issues and hormone issues (yes, the chemicals that influence hunger are related to your stomach size and "fullness"). Weight loss surgery helps fix it by making the pouch smaller.

But this is off the topic. The point is that in order to fight addiction transfer patients looking at WLS or even non-patients that are just trying to fight obesity issues should probably focus on why they're turning to food for comfort. Seek therapy. Seek intervention. Seek anything but that delicious creamy filling behind the Duncan Donuts counter.

Mmm...donuts....

Loose Skin and Rashes...

It happened before the surgery a couple times, and this is the first time since the surgery that I've noticed it.

There's some kind of a wet rash under the fold of a section of skin.

It's uncomfortable and annoying. I don't know if it's just a rash or some kind of infection...but I do know it's annoying.

I'm hoping some powder will help with it. Supposedly a few years down the road, if there are infections, I can try getting loose skin removed. As pointed out at weight loss surgery coach once you reach a certain point in weight gain the ability for skin to "snap back" is most likely lost...so exercise will not help this particular problem.

In all likelihood, the sweat and friction will make it worse.

Any other patients out there experience this and try home treatments that seem to work?

Bariatric Surgery and Death

We often go to McDonald's for a Sunday breakfast. It's a bit of a tradition thing for the family, a bit of a familiar routine in which I take comfort and the family accepts as a quirk of my own (although I think my son is simply a fan of the scary clown-man mascot).

We've been there enough that the morning manager knows us. But the sad parenting and horrible habits implied by a weekly trip to a fast-food joint for a meal notwithstanding this has led to finding yet another person with a connection to bariatric surgery.

When the manager found out I had had Roux-en-Y surgery she told us about her brother in law. He died four years ago the night after having the surgery.

We're told before the surgery that there are risks. We're warned about them, but I don't htink the numbers really don't sink in. We're bolstered as we hear about the success stories and meet many other people that we never suspected had the surgery...I mean, probably half of the nurses attending to my recovery in the three days post-op said they had the surgery and never regretted it.

This was the first time I had heard of a death of a patient from someone we know.

To be fair it was a complication of the surgical procedure that could have happened to anyone who had surgery. She said that he had sleep apnea, undiagnosed, and basically that night had vomited in his sleep and choked to death.

I couldn't imagine it happening in my case; I was hooked to monitors up the wazoo, I had nurses on rotating shifts checking every hour, I had excellent care fresh from surgery with a one-on-one nurse until I was transferred, eight hours later, to a room...

My wife said that this was four years ago and it's possible that in that time things have significantly changed in procedure, or maybe it was a per-hospital thing that made the difference, although this hospital where it happened is a rather big name for our state; one that if you lived in our state or in a nearby state I'd bet you've heard of them.

I was aware of the chance of dying. I think you'd be unhealthy not to have some fear of it going in...especially faced with the knowledge that someone is about to wrap his fingers around your intestines. Not even my wife can say she did that and we tend to have been pretty intimate with each other. But I also realized that if I didn't have the surgery I was facing a slower death from the comorbities of my obesity...diabetes, heart attack, stroke...all of which carry a greater chance that I'll die prematurely. Essentially there was a slim chance of death by surgery vs. the very high chance I'll die later but prematurely compared to a successful surgery.

I was also aware that the surgery carries a risk that there will be complications not just during and soon after the operation, but years down the road something could happen (such as twisting of bowel or blockage in the digestive tract); the more time that goes by the further from the woods I would get, and right now I'm probably in a pretty safe place.

So if you're considering the surgery you do need to educate yourself on the risks and at the same time put them into perspective. Things can and do happen. Bad things. And you'll definitely not have a necessarily simple path to follow. As I've written before here this isn't a magic bullet and it's not simple...even my own surgeon doesn't have all the answers on how this works with the body's reactions to food and weight loss, and now, nearly two months down, I'm still struggling with issues like figuring how in @#% I'm eating less than a cup of food three times a day and still my weight is "stuck" at a plateau (stupid body...fighting weight loss...retaining water?...but that's going off topic again).

Where was I? Oh yes. Educate yourself. Be aware that there are risks. But put them into perspective. Perspective was the saving grace that got me out of bed the morning of the surgery and told me not to run away down the hallway with my gown flapping in the wind before the doctor could pull his favorite scalpel out and get to work on me.

Panera Smokehouse Turkey Sandwich

My family had to get some last-minute items for my son's upcoming birthday party. While we were out we stopped at my wife's favorite dinner/lunch spot, Panera Bread.

Knowing that I can't eat too much anyway, I told her to get a Pick-Two soup and sandwich and just surprise me, since she usually remembers what I like better than I remember.

I was sitting with my son at a table outside and enjoying the warm early evening weather, listening to large gulls squawk and beg from other customers, when she came out with a small bowl of French Onion soup and a 1/2 Smokehouse Turkey sandwich.

Okay, here's the warning part...I picked off most of the crust, as that was kind of hard from the toasting, and I picked out a piece of bacon after I had pulled a couple pieces of gristle out from a slice I bit into. I focused on getting most of the meat eaten; the bread was relatively soft in the center and the cheese, a decent protein source, was pretty good.

But then it happened again...pain. Not as bad as the episode I had previously, but it was enough that I felt it. The pain probably wavered for about ten minutes and disappeared.

Was it something added to the bread or cheese, like an oil or butter of some kind? Was it just that the bread was overtoasted, too hard for my stomach to like? I don't know...what I do know is that next time, we're ordering it un-toasted.

I asked my wife about how much she thought I ate and she estimated it was around four ounces, which was close to what I thought it was as well after I had picked out bits of the bread and some of the meat. So I didn't consume over my limit...it was definitely something with the sandwich.

That's your word of warning for the day. It's not necessarily the quantity of something that'll cause pain. Sometimes it's the nature of the food!

Bariatric Pain in the Gut: Good News!

I finally had something go wrong!

Well, not really wrong, per se. But it was unpleasant and wonderful!

Okay, here's the story...my wife had fixed some chicken breast fillets for dinner a few nights ago on the grill. They were small, probably four or five ounces a pop; I took one and cut it in half and the two pieces easily fit into a one-cup storage container with space to spare.

I reheated it in the microwave and began to partake in the protein goodness. I noticed that the edges were a little tough, dried out; I thought I chewed it adequately. I didn't.

I felt full before going through 3/4 of the breast fillet, so of course I stopped. The problem was that right about then the apparently too-tough-to-eat-easily part of the chicken hit my stomach.

The pain wasn't excruciating, but it was very uncomfortable. Every time the pain subsided and I thought it had finally passed another wave would hit me. I picked up the trash can in case I threw up; I was unsure for a few moments if that was what it was going to come down to.

The pains lasted for somewhere between 20 and 30 minutes. When it was over, I finally knew that yes, there is some of the warned negative feedback in my "new" stomach. All the times I had wondered if the surgeon had actually done anything to my stomach size was finally answered in one glorious bout of pain pulsating through my torso.

I don't know if this did any damage to my new pouch, stretching it or pulling it (for a few moments I worried that I had ripped something out). I of course am desperately hoping not. But now at least I know that it should be working to some degree the way the operation was described to me!

I know, it's weird, taking relief in this pain episode. But now I know for sure that maybe this surgery can help me. Plus I know that if meat isn't tender and juicy, if it can't be chewed until it is mush, don't eat it.

See? Negative reinforcement is working already!

Fear Of Success

I work in technology. To be more specific I work in technology support; if the users need software installed, corrupted profiles fixed, systems moved or mice cleaned I end up having to head out to fix it. I also monitor servers, configure servers, try to keep electronic point of sales systems running and field calls from users complaining about forgetting passwords or slow login times. Overall if it's plugged into the network and someone has an issue with it I may get the call for working on it in addition to maintenance chores on equipment users usually aren't even aware exist unless one of them malfunctions.

After many years of dealing with various issues that go with the job...often repeating myself over and over...hearing the same issues crop up every month...the job wears on you. Issues of satisfaction in the workplace are a whole post or two if their own.

What I have found myself doing, however, is wondering about what it would be like to switch careers. I have two or three other interests which I've seriously considered trying to move into and so far have not taken the leap. The problem is that there are always perfectly legitimate reasons not to pursue them; I make decent money for my area (although career guides say I'm underpaid for my job and education...it is a problem with the industry), jobs are difficult to come by now, I have become used to things like a roof and heating and food, change is hard..

All of these are, from what I can tell, legitimate reasons to hesitate moving to a different career.

But in my times of introspection I have asked myself if these are the real reasons I don't try changing. They are certainly factors, but the reasons I don't?

The answer I find myself wondering if it isn't the true bug in the soup is what if I'm afraid of finding out that I'm not good at those things?

I've failed to lose (and keep off) weight. I am not a big financial or social success. I worry constantly about bills and raising my kids correctly. I don't even know if I can lose weight with the surgery without failing at that.

If I don't try to do these other career pursuits then my fears of failing are just fears, not confirmation of my ineptitude.

As time passes though I have a little more reminder of why I consider a career change. At some point I may end up with more need to escape than fear of failure. Have any readers made career shifts voluntarily and not necessarily out of necessity? Where you scared to do it and if so how did you face and overcome those fears?

Lost in Thoughts on Portions, Emotional State

I am in an unusual place right now. I had a checkup with my surgeon today, and I'm just replaying in my head that conversation along with what I had previously understood from other information, sources, meetings with nutritionists (current and previous)...

The fact is that people are different in their reaction to this kind of surgery. So there is no clear-cut answer. My obsessive personality is coming up with two stumbling blocks in this journey. I keep asking for such answers, and their are none. I need one though. I need it spelled out. I need clear- cut guidelines.

The first is, how much do I eat?

I previously thought I was to find what was tolerable, to get in touch with my stomach's feedback, to realize when I was "full". I have been experimenting a little on that front. I am starting to find an amount where I start to feel some discomfort, and quit eating. I never packed more than a cup of food into my lunch/breakfast container (and since solid foods aren't usually a liquid form, even if you "filled" the container it was less than a cup by volume).

My wife said that, no, it was less than that that I was supposed to have. Only a half cup at most.

So, have I been screwing this up the whole time?

Stretching the stomach pouch? Ruining everything I've suffered a month for?

The second...if the food amount is only a quarter to half cup, what is the use in dirtying dishes and silverware and bothering to make anything? The leftovers, the waste, the effort...in my mind, just not worth it. I was told not to skip meals but it seems to be such a waste, and I am having a lot of trouble getting over this mental stumbling block justifying the work on making food that I'll essentially be barely doing anything wish. The time and effort would be better left to doing whatever would have been interrupted getting the meal in the first place.

Overall it just makes me depressed. The situation just makes me plain frustrated. Am I supposed to be trusting the body and trying to figure out, relearn, how the body is supposed to work so I'm eating and acting in a more normal manner? Doing that seems to be incorrect...the surgeon wants me eating essentially what fits into a dixie cup. Fixing food that fits in a dixie cup is hardly worth the time it takes to fix something. So why bother?

I guess there's some block in my head that says it would simply be better if I did nothing instead of wasting the effort in making a sandwich just to refrigerate three-quarters of it, and have another quarter later for another meal, and maybe another quarter that night. And have one left over for breakfast or end up throwing it out.

Another part of me tells me that this is temporary, these thoughts. I simply have to adjust. These thoughts that I'm dwelling on are simply another stage before acceptance and adapting.

It's the other voice that bothers me. The other voice tells me things like, "You stretched the pouch." "You screwed up again." "Another attempt to lose weight and you blew it."

So which voice is right? Or is it a mix of both? The rational feeds me some self-serving forgiveness, telling me to accept and adapt and move on. The emotional side tells me that...well, I said what it tells me.

I suppose these swirling thoughts have to be simply meditated on, so to speak. Tomorrow I'll hopefully find more of a rational place from which to approach this situation.

Stupid Body

Every workday I get up and shuffle out to the living room and take my medications.

I pack up two 1-cup size ziplock containers, one for breakfast, one for lunch. I try to put a calcium and protein source into each; often this includes cheese and ham or some chicken. But these fit into 1-cup containers. If the foods were pureed they would end up taking up less than a cup.

At night I have approximately a cup or less of food. Sometimes a mini-sandwich, or some kind of a soup. Leftovers. Again, meat and cheese often fill the meal. With birthdays and such coming up we've been eating out and I've had a small portion of the food before packing the rest into a box to take home. Recently my wife and I were at Olive Garden for lunch and we had an entrée split between us, and we each ended up eating half of our meals and taking the rest home, so we had about a quarter of a lunch entrée as meals.

I drink water, I drink water with Kellogg's black-tea flavored protein powder mixed in, some milk during the day, no soda, no alcohol, no juices.

And yet for the past several days I gained a pound and a half and at this point have lost a pound of it. I have been taking my weight once every other day and since maybe the 7th or so I gained a pound and a half and slowly lost a pound of it. Maybe if I repeat it enough it'll make sense.

I'm eating a cup of food three times a day, no snacks, and I've gained weight. Huh?

How does that work?

How can I possibly have enough calories in me to sustain a 340-something pound body weight?

Is there food just slowly percolating through the intestines, thus adding weight?

Is there sodium causing me to retain fluids?

Is there some really screwing form of plateau going on, or the body adjusting to foods, solid foods, in the diet?

Am I really that screwed up?

I'm hoping this is something kind of "normal" in adjustment. I need to find a support group at my next doctor's appointment which happens to be coming up in two days. Am I supposed to just "stay the course" and hope the body finishes adjusting and continues losing weight? I can't see how, possibly, I can maintain my current body weight with my food intake.

If anyone else out there has had the surgery and knows what I'm talking about or has had this happen to them, please let me know. I'm a little over a month from surgery; a month and a week, almost, so why would I be plateauing now??