You've Had WLS, Now Get Tested... Demand It!

This is a story of a life changing decision, how the healthcare community has failed us, and finally redemption. I hope you learn from our mistakes and ultimately enjoy the roller coaster ride....

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As most of you are aware, my husband and I had Roux-En-Y Weight Loss Surgery in 2003 and 2002 respectively. Our surgeon was the only surgeon in town doing the procedure and our insurance at the time wouldn't cover for us to go to Nashville. We put our complete and total trust in this doctor. He has actually performed three different surgeries on me, operated on most of my family, and of course my husband. We had our usual follow-ups for the first two years that included weight, vitals, and a standard blood test focusing on B-12. The only nutritionist we ever saw was the visit required by our insurance company for preapproval. This was an in-house nutritionist at the hospital who admitted she knew nothing about Weight Loss Surgery. She read us a pamphlet distributed by the surgeon and said not to follow it but we did the best we could and got lots of help from the internet and online support groups. After the initial two years, all communications stopped except for an invite to the local Bariatric Center he created, and now has two other surgeons working with him.

In the meantime, we were seeing a Primary Care Physician who we adored. He listened to us, he spent time with us, he expressed genuine concern and did what he could to help us when we needed. Or so we thought. Blood work again was standard tests, glucose, B-12, iron, and in my case thyroid and rheumatoid. In 2004 he diagnosed me with Fibromyalgia with the standard treatments that never really worked effectively. He sent me to random local specialists over the years who would see me once and say "well, your primary is doing what I would do so go back to him." A waste of time and money.

In 2007 he sent me to a local oncologist/hematologist for an iron infusion. My ferritin levels never got above 15. The specialist he sent me to didn't understand Gastric Bypass Surgery and refused to do the infusion. Instead she prescribed 8 over the counter ferrous sulfate pills a day. The constipation and nausea made me sicker than I have ever been or ever would be. When I called him crying, his only response was to treat the constipation with Miralax and told me to follow the advice of the specialist. After 10 appointments and lots of money in co-pays, my ferritin level maxed out at 15 so she discharged me back to him.

Fast forward to 2010. Still no contact with our surgeon and our PCP is spending more time dealing with personal issues than seeing patients. Appointments are scheduled weeks in advance only to be cancelled an hour before. If we even made it to the office, the wait time was never less than 4 hours and the care was sub-par at best. After fighting with his office for over a year, in 2011 it was time for us to find a new PCP. My gynecologist of all people referred me to someone in Nashville. Thankfully our insurance now covers doctors in Nashville so I made an appointment for us to see her within 6 weeks. I needed my PCP one more time and my intent was to show him some respect and talk to him about leaving. I waited 7 hours in the waiting room to see him, 2 hours in the exam room, and that was the absolute final straw. I got what I needed and never went back.

Our new doctor is fabulous. We've been with her for two months and she didn't wait to address the pain issues and the iron deficiency. As is typical with specialists, the appointments weren't immediate but were timely enough. The first appointment that I went to last week was with a pain specialist. After some probing and making me really think about it, we were able to pin point that the pain started after having Weight Loss Surgery. Of course my husband was with me and the doctor was honest with us, he's not sure Fibromyalgia even exists. He's actually a neurologist that specializes in pain. His theory is that all pain originates from somewhere and the trick is finding where.

He also revealed something else. New studies show that those of us who had the early Roux-En-Y are severely malnourished, more so than we were originally warned. He believes that my pain and exhaustion is actually a response to a vitamin deficiency. I mentioned the chronic anemia and he said this is bigger than just anemia. He started naming what to me sounded like the periodic table of elements. Another aspect of my pain is centered in my hips and legs. Past MRI's show arthritis in my lower back and down so he is going to treat that pain. I have a nerve block scheduled for next week to see if some of the pain can be relieved and he sent a letter to my new PCP with his theories and suggested blood work. I am excited and livid at the same time. Excited because I may be able to shed the stigma that comes with Fibromyalgia, finally end the cycle of daily pain and exhaustion, and start living the life I have wasted the last 9 years. Livid because had my surgeon actually followed-up or my Primary Care Physician not become complacent in accepting the Fibromyalgia diagnosis, this could have been caught years ago.

Today I had an appointment with the Nashville office of oncology/hematology and the Iron Deficient Anemia was in full swing. I had a hard time staying awake even after a good night sleep and my breathing was labored, typical symptoms of dangerously low iron levels. After a brief interview and a look at my blood work, the doctor was pissed. I revealed that the doctor at his sister office refused to do the infusion which made him angry and the fact that I begged for an infusion for years without results made him just as livid as me. My ferritin level was 7 a few weeks ago and despite the acceptable range of 10 - 150, he's not happy with a level less than 100. While he was looking at my blood work he said "wow, you are really malnourished" and pointed out a few other test results that while within the normal range are not actually normal. He had me moved to the other side of the office immediately for a 3 hour iron infusion. I'm already feeling better and am actually unable to sleep tonight which they warned me would happen.

Then finally this afternoon my husband had an appointment with our PCP to discuss some odd symptoms he's been having. After a thorough exam and discussion, she is sending him to a specialist as well, one that will refuse to give up until she finds the cause and fix it. Even though I didn't have an appointment, she asked if I needed anything and I asked about the letter from the pain specialist and told her about the infusion. Before leaving, she had nine.. yes I said nine.. vials of blood drawn to check the periodic table we discussed the week prior. It's going to be several days before we get the results and I'll be on pins and needles until I get the call. After 9 years of misery we have finally found a group of doctors who will take us seriously and are working hard to find answers. I will come back next week to give you the results as well.

So the moral here is that this is a major life decision that you've made. Don't make the same mistake we did and become complacent in your care. If your doctor is only checking the basics or worse yet, not checking anything at all, demand a complete nutritional workup and if you can't get it, find a doctor who will. Vitamin deficiencies lead to more serious effects if left untreated and we didn't have this surgery just to fight with other problems later in life. Weight Loss Surgery is meant to give you a second chance at a normal healthy life, don't let a doctor take that away from you. Our next step is to find a nutritionist who specializes in Weight Loss Surgery so we can become the healthy active members of society we deserve to be.

Let me know your experiences, where you have been failed, and who your champions have been. By sharing we can learn from each other and enjoy this gift we have been given. Stay tuned until next week.

Much love
Angie

Thirtysomething is Almost Over

I haven't been here in awhile. I blame the mild Adult ADD but I felt the need to come back today. I'm going to go off topic for a minute but knowing me I'll find my way back to food or WLS somehow. Today (or rather yesterday since it's after midnight but hey, I'm still up) I turned 39. Let me start by saying I despise my birthdays. Always have since I was a kid. I'm sure a psychologist would love to pick it apart but I honestly don't know why. Some years are better than others but this one was especially hard. I've been horribly emotional all week and this morning was disastrous. I woke up at 1:00 am to find that my adorably evil cat decided to play with the flowers our daughter brought me and spilled the water on my laptop and phone. AHHH Panic ensued. The laptop seems to be okay but the phone was sizzling. It was on it's last leg anyway so I'm not even trying to revive it again. That took a couple of hours to clean up so of course I overslept. Work was the normal drama but I was anxious to just come back home.

Coming home never felt so right. My wonderful husband worked hard all day to make sure I was having a good day. He even raced home to get to the cupcake shop to get me a birthday cupcake (it's a waste of money and carb grams for two WLS post-ops to get a big cake - AND WE'RE BACK ON TARGET) only to find they had sold out for the day and were closed. So we've been sitting here tonight, listening to good music, enjoying each other's company, and talking about life.

A few days ago I received a Facebook birthday wish from an old high school friend. To say we were friends is probably stretching it a little bit but it's the best description of our relationship I have. We chatted off and on most of the day and I realized something that should have hit me years ago - I'm not the same person I was 10 years ago, much less way back then. I don't even remember who that 15 year old girl was but I can say the decisions she made had a huge impact on my life. I am stronger, more confident and assertive, more comfortable in my own skin than I remember her being. That 15 year old kid and I do have a few things in common. My best friend from then is still my best friend now. My friends have always been more like family than my real family and they still are. And when I love someone, I love them with everything I have. She did too. So maybe I remember more about her that I first thought. I made fun of my husband when he turned 39 that it was his last thirysomething year. It's not so funny now. I am thankful and blessed that this gentleman took the time to wish me a Happy Birthday because I honestly don't know if I would have spent the last couple of days processing this.

So what is the significance of this epiphany? Well first of all, it's the right time. Since I'm now in my final thirtysomething year, I'm not going to let it go to waste like I have the past several years. There are things I want to do with my life and I don't know if I can get them all accomplished before I get to play with 40 but I'm going to do as many as possible. That scared, confused girl is becoming distant memory and I really like that feeling. I was an obese child that grew up to be an obese teenager and adult, hence the need for gastric bypass surgery. Being an obese teenager is hard. Thankfully I had friends who loved me anyway and I am still friends with most of them now. What I find interesting is that I am the same size now that I was then but it's definitely not the same. I'm sure many, many years of therapy helped with that. I could go on a rant about teenage obesity but I'll save that for another midnight post.

One of the goals I want to achieve in the next year is to get back down to or close to my goal weight. I honestly don't think I could handle it the first time around. If you've had any of the weight loss surgeries, you should have been warned about the psychological effects of this decision. People treat you differently when you are thin than when you are obese, whether they realize it or not. That's hard to comprehend and even harder to respond to. I've learned a lot about myself and about people in the 6 years I've spent gaining some of the weight back. I'm ready to try again and now's the time to do it. This is a "if I knew then what I know now" kind of moment and I have the rare opportunity for a do-over.

39. Wow. I'm good at setting goals for myself, not so good at meeting them. Is 39 going to be my year? I'm going to do everything I can to make it sure that it's successful. Thank you to my new found friend for inspiring me and thank you to my husband for turning this birthday into the best birthday yet. I can't guarantee I'll share my journey but I will try if you'll stick around with me.

Talk to you again soon
Angie

Starting Over.. Week 1 Results

Here it is… the moment of truth. When I started this a week ago, I had some questions.   Exactly how healthy are my current eating habits? Where can I make changes? Was water retention an issue and could I tie it to food? Did I answer any of these questions this week? Well, yes and no. This is what I have learned this week:

YoYo Dieting is more than just a weight loss phenomenon; it seems to be a way of life. Too few calories one day lead to too many calories the next. Even worse, too few calories lead to too many calories in the form of the wrong foods. Consistency is a key. 

I have to be on a schedule. If left to my own devices, I will eat what I want, when I want.  I was concerned that weekends would derail what I did during the week and of course it has. I had reached my calorie limit by 4:00 yesterday afternoon. I started to get hungry and my brain just said “screw it; you might as well enjoy it.” Chinese style pork ribs and sushi rice for dinner was amazing. This was actually the first time I've cooked white rice in over a year. Of course that was followed a few hours later by a peanut butter and banana sandwich on low carb whole grain bread. I am paying for it today though. I woke up swollen, sore, and 6.5 lbs heavier. 12 hours later and I’m still swollen. Of course I haven’t been very good today either. I’m almost afraid to plug it in to see just how bad it is.

Carbs are not my friends. Not that this is breaking news. I have always been aware of subsequent pain caused by a diet of too many carbs, it's the bloating and associated weight gain that is surprising. The more I read about low carb diets, the more excited I am about making some serious changes.

Keeping a food diary really works. To be honest, I had no intention of dieting this week. I wanted to look at what I was eating and determine where I could do better. Keeping a diary and actually being honest about it made me self conscious about what I ate. I became obsessed with writing down everything, figuring out how many calories I had left to eat, and what I could eat with the few calories that were left. So do I know how healthy I was eating last week or last month? No, not really. I can only guess I would find too many calories and too many carbohydrates.

I still don’t know if my pain level is associated with diet, weight loss, malnutrition, the weather, or just because. That question may never be answered but I will continue to search. Here are my final stats for the week:

Open RNY Gastric Bypass: 10/22/2002

Highest Weight: 356

Weight at Surgery: 306

Lowest Weight: 156

Highest Recorded Weight Gain: 238

Weight on 05/29/2011: 224

Weight on 05/30/2011: 221.8

Weight on 05/31/2011: 221.4

Weight on 06/01/2011:  219.8

Weight on 06/02/2011:  219.8

Weight on 06/03/2011:  213.8

Weight on 06/04/2011: 212.8                              Total Weight Loss = 4.7 lbs

Weight on 06/05/2011: 219.3                             

Personal                  Actual 06/04                  Weekly Average

Calories:                    1301                        1858                                  1503

Protein:                     >80 grams                 107.8 grams                       98.2 grams

Total Carbs:              <100 grams               156.5 grams                     115.3 grams

Net Carbs:                 <70 grams                 122.5 grams                      96.4 grams

Sugars:                      20 grams                   35.9 grams                        26.7 grams

I loved being able to say that I had lost 11.2 lbs yesterday  but am happy with the final tally of 4.7 lbs.  This week has been an eye opener and I’ve learned more about myself and my habits than I thought I would.  I am fighting with my brain today. My brain knew I was starting this as a one week project and now that we are wrapping up Week 1, my brain thinks were done. Little does it know it has a fight on its hand. :-)  I will slip up. I will eat too many carbohydrates or not enough protein. I will not give up and take it one meal/snack at a time.

This week has proven to me that with a little tweaking and dedication, I can get back to a weight that I am comfortable with, that will keep me healthy, and hopefully reduce my daily pain level.  I am going to continue to log what I eat and keep up with daily results. I will also continue to weigh myself daily, at least for awhile anyway.  The next step is to take pictures and measurements. It’s interesting to see the inches drop as well as the weight, even sometimes in spite of the weight.  I will move the stats to the sidebar and update them weekly.

The fight with obesity is a lifelong battle, even with the help of weight loss surgery. Whether you have had surgery, are thinking about surgery, or are just trying to shed a few pounds, NEVER GIVE UP! Obesity is a medical condition that can be managed; the trick is finding what works for you. Keep searching. We all deserve to be healthy.

Thank you for spending the last week with me. Check back for further updates…

Angie

Starting Over... Days 5 and 6

Yes, I’m a slacker. Well if feels that way sometimes. Thursday and Friday were good days. I was able to keep somewhat of a schedule and learned that late at night is my worst time for grazing or even binging. I average 3-5 hours of sleep most nights which means I’m up and fighting the urge to eat something for 20 hours a day. Breaking up the day into 3 meals and 3 snacks is the easy part; it’s getting the right nutrients within the set parameters that I’ve set that is proving to be a challenge.

Open RNY Gastric Bypass: 10/22/2002

Highest Weight: 356

Weight at Surgery: 306

Lowest Weight: 156

Highest Recorded Weight Gain: 238

Weight on 05/29/2011: 224

Weight on 05/30/2011: 221.8

Weight on 05/31/2011: 221.4

Weight on 06/01/2011:  219.8

Weight on 06/02/2011:  219.8

Weight on 06/03/2011:  213.8

Weight on 06/04/2011: 212.8

Personal              Actual 06/02                       Actual 06/03

Calories:              1301                       1389                                    1231

Protein:               >80 grams            109.1 grams                       76.4 grams

Total Carbs:        <100 grams         100.3 grams                        102.9 grams

Net Carbs:           <70 grams           85 grams                             81.8 grams

Sugars:                 20 grams             30.2 grams                           30.9 grams

Let’s talk about nutrition for a second. If you’ve been following along, you should notice a slight change; my goals have been evolving through this short process. I’m trying to listen to my body and make decisions based on how I feel.

 In 2004 I was diagnosed with Fibromyalgia. Since then, as many of us post-ops have experienced, my blood work started showing deficiencies, mostly in Iron and Vitamin D.  Many of the symptoms of Iron and Vitamin D deficiencies actually mimic the widespread pain and fatigue, the basic flu-like symptoms of Fibromyalgia. Too many carbohydrates also cause extreme pain, especially in my hips and legs. Even though I have lost 11.2 lbs since Sunday instead of feeling better, I am actually feeling worse. I realize that 11 lbs is a lot and I expect that to level off soon, maybe even plateau for a few days. I’m hoping my body is just reacting to the weight loss and the pain will subside soon as well. My fear is that I am eating too much or too little of something that is causing the pain. Having a nutritionist familiar with Weight Loss Surgery would be fabulous right about now. Unfortunately that is not available to me yet so I have to rely on The Interweb for research and information. No two theories are the same and it’s hard to know which theory to take to heart. I have a Multivitamin, Calcium, Iron, B-12 sublingual, and Vitamin D that I should be taking daily but I rarely do.

Of course, this could just be a normal Fibromyalgia Flare-up and not related to the food changes and weight loss. How do I know? All I know to do is to find an eating plan that allows me to continue to lose weight and reduce my pain level. That is the ultimate goal in this; healthy and pain free. There are many situations in my life that I cannot control, what I eat is not one of them.

Stay tuned to tomorrow for a Week 1 Roundup. Oh and by the way… I’VE LOST 11.2 LBS SO FAR!!!  :-)

Happy Saturday

Angie

Starting Over... Day 4

Today’s entry is late. That seems to be the story of my life, I’m late for everything. I’ve been thinking all day about what I would write about and here’s what I came up with…

When I woke up this morning, I was disgusted with myself. My night last night did not end well. My dinner plans were derailed when I couldn’t get the vinegar I wanted to make sushi rice. You see, I found a fabulous recipe for black sesame crusted salmon and wanted to serve rice and a raw asparagus salad on the side. When those plans were scrapped, I spent the night grazing on Memorial Day leftovers then topped it off with a salad and a few lemon poppy seed muffins. 1666 calories total for the day and I felt like I had failed before I really got started. I jumped on the scale first thing this morning knowing that my mini binge had caused me to gain. I was surprised to find that I actually stayed the same. So here is where I am now…

Open RNY Gastric Bypass: 10/22/2002

Highest Weight: 356

Weight at Surgery: 306

Lowest Weight: 156

Highest Recorded Weight Gain: 238

Weight on 05/29/2011: 224

Weight on 05/30/2011: 221.8

Weight on 05/31/2011: 221.4

Weight on 06/01/2011:  219.8

Weight on 06/02/2011:  219.8

Since I’ve been thinking about this all idea, I had an idea. This is actually my normal eating pattern, not very hungry one day, starving the next. So the answer is to eat consistently. Don’t hate me because I have always cringed when I’d hear other people say it but… some days I forget to eat. I don’t get hungry and at 11:00 I’ll realize my egg scramble is still sitting there. Lunch is at 12:00 or so. The trick is going to be to put myself on an eating schedule and forcing myself to eat. I’ve done it before and it really does work. It takes a few days but I can only guess it normalizes my metabolism. After about a week, I’ll start getting hungry again, and at fairly regular intervals. And that’s where the problem starts. If I’m hungry, I eat, and more often than not I eat too much. How do I control that? Or better yet, how do I keep what little control I have now and build on it? If anyone has the answer, please shout it from the rooftops. One of the first changes I’m going to make is in my daily goals. My calorie goal of 1200, while quite achievable, is too low for me for the moment. I’m going to adjust it to 1301 as recommended by WebMD and lower my Protein goal to 80 grams per day. I’m not going to change the Total Carbs or Sugars just yet.  

WebMD                      Personal                    Actual

Calories:          1301                           1301                        1666 (Not happy)

Protein:            46 grams                    100 grams                 109 grams (Now that’s what I’m talking about)

Total Carbs:    130 grams                  50 grams                    133 grams (Holy crap!)

Sugars:              25 grams              20 grams                      29.3 grams (Ok, wasn’t expecting that.                                                                                                          Stupid banana)

While I’m still a bit disappointed in myself, I have a better understanding of my eating habits and am aware that a change needs to be made. Awareness is the first step towards change… or something like that.

Stay tuned for the next weigh-in, just a few hours away.

Angie

Starting Over... Day 3

Wow... what a difference a day makes. We were outside, digging up grass, for several hours on Monday. This probably explains the phenomenon I experienced on Tuesday. Monday I consumed 1608 calories and 94 grams of protein. Tuesday was a normal work day, back to a schedule, most of the day sitting at a desk, and I only ate 1138 calories (Ok make that 1254 – it’s midnight at the time of this writing and a mini sugar free lemon poppy seed muffin was calling me) and 81 grams of protein. Water is a major factor. I use Kroger In an Instant Light Sugar Free Peach Tea drink mix in my water. I realize that it’s not as good as plain water but by using these I can drink (8-10) 16.9 oz bottles of water per day. As I type that, I am aware how crazy it sounds. Starting today, I will substitute every other bottle with plain water.

So here are Tuesday’s stats:

Open RNY Gastric Bypass: 10/22/2002

Highest Weight: 356

Weight at Surgery: 306

Lowest Weight: 156

Highest Recorded Weight Gain: 238

Weight on 05/29/2011: 224

Weight on 05/30/2011: 221.8

Weight on 05/31/2011: 221.4

Weight on 06/01/2011:  219.8

WebMD                 Personal                 Actual

Calories:          1301                    1200                        1254 (Now that’s a happy medium. Go me!)

Protein:            46 grams             100 grams                81 grams (This needs to be a little better)

Total Carbs:    130 grams           50 grams                    87.7 grams (A little lower would be great)

Sugars:             25 grams             20 grams                 13.6 grams (Love that number)

A much better day that included a 1.6 lb drop for the day. I have a tendency to be a bit ADD so I like schedules.  I have learned how to fit breakfast, lunch, two snacks, and 4-5 bottles of water into an 8 hour day. I take my lunch every day so I have a lot more control over what I eat. Being at home I am more apt to graze and eat at odd times. I feed my cravings for both creating something new or different and consuming the final art piece (or flop. The odds are 50/50). I’ve tried off and on for years to schedule myself on the weekends but it has never worked.  My fear is that my days off in chaos are derailing everything I accomplish during the week.  I guess we’ll find out on Saturday.

Tuesday afternoon I started looking at what I had logged so far and what I had planned for dinner.  I’m getting a bit obsessive about it but not so much that I’m concerned. Not yet anyway. What I noticed was that I wasn’t eating any “Free” foods. If you’ve ever been to Weight Watchers in the last 30 years, you know that “Free” foods are food with little or no calories. This includes a few fresh vegetables, salad vegetables, herbs, spices… so with my leftover pork chop, I had a beautiful salad with baby greens, red onion, alfalfa sprouts, sugar snap peas, tomato slices, and shredded parmesan. It was just enough to keep me full without adding too many additional calories.

I did something to pamper myself after work Tuesday. I NEVER pamper myself and while this sounds like an every day event I got my hair cut. I received a style that I really didn't like last July. I have been letting it grow out and just never stopped to get it trimmed. Now that it’s falling out, it was starting to look unhealthy and I was no longer proud of what I consider my best asset. It looks and feels so much better and I’m amazed at how much better I feel about myself. A new do for a new me.

I’m really excited to see the 1.6 lb loss this morning. During my initial weight loss period in 2002 – 2003, I averaged losing a pound a day for the first 70 lbs and then it backed off to a pound every other day or so. I’m interested to see if I can stick to this and if I’ll consistently average a pound per day again. I'm not expecting those kinds of results the second time around though it would be nice. It’s really hot again today but I intend to add some activity to my day; taking stairs instead of elevator, walking around the block a few times, and maybe even a walk after work with my husband. 

I’m having fun with this and can’t wait to see what today brings.

Thanks for coming along.

Angie

Starting Over... Day 2

Monday was a good day. I wish all Mondays were like this one. It was Memorial Day and we had the day off. We started the morning with our daily turkey, egg, and four cheese Mexican blend scramble.

Turkey, Egg, 4 Cheese Scramble for One

           You can save calories by using Pam instead of butter. If you have a digital kitchen scale, use it for this until you can recognize an ounce of each on sight.

1 small pat unsalted butter (less than ¼” thick)

1 oz lean thin sliced deli turkey breast (I use Hillshire Farm oven baked), roughly chopped

1 oz shredded 4 cheese Mexican blend

1 large egg

Melt the butter in a small sauté pan over medium heat. Toss in the turkey breast and cook, stirring occasionally just until the edges start to turn a light golden brown, about 5 minutes. Crack the egg directly in the pan and begin stirring immediately. Stir constantly until the egg is cooked through but not dry. Remove from heat and stir in the cheese. Allow scramble to sit in the pan, off the heat, until the cheese is completely melted. Serve immediately or pack to stay warm. (I increase the eggs to 3 and the turkey to 2 oz during the week and we split it between us. We pack this every morning and eat them when we get to work.)

Nutrition:

Calories:  240

Total Fat:  16.3 g

Saturated Fat:  8.6 g

Cholesterol:  241 mg

Carbohydrates: 3.1 g

Sodium:  840 mg

Sugars:  1.4 g

Protein: 19.8 g

I know it’s a lot of fat, cholesterol, and sodium. I’m looking for a good quality reduced sodium turkey and cheese but I can only find reduced fat. We’ve been eating 2 eggs every morning for several years and our cholesterol hovers around 140. I’m ok with the nutritional information here.

After breakfast we went outside, worked in one of the flower/herb beds, mowed the yard, and grilled enough meat for a few days.  This stupor that I’ve been stuck in has kept us inside the past couple of summers.  It felt great to be in the sun, digging in the dirt, and working together to actually accomplish a goal. It was a really good day.

We finally grilled for the first time this season. We grilled (4) Hebrew National Jumbo Beef Franks, (2) Hamburgers made out fresh ground chuck from a local butcher, Guinness Extra Stout, and Low Sodium Worcestershire, (4) boneless, skinless chicken breasts, and (4) boneless pork loin chops, both marinated in Lowry’s Tuscan Sundried Tomato 30 minute marinade, over night of course, and both also from our local butcher. Throw in a pound of asparagus tossed with olive oil and balsamic vinegar, a head of garlic, and white onion wedges. I go into that much detail because quality has become a major factor in our food choices. One of the early post op habits that we continue today is chewing each bite until it’s mush. You become very aware of and develop an appreciation for texture. If food has random crunchy or rubbery bits, you know like bone, cartilage, silver skin, fibrous tissue, egg shells, unidentifiable debris, we notice it immediately and it completely ruins the meal.  After trying multiple brands we found that higher quality, fresher foods have little if any grit to destroy a beautiful dish. I admit it is more expensive but we don’t throw away near as much food as we did on lesser quality products. Watch for sales, coupons, and The Choppin Block, our local butcher who only sells All Natural meats in Choice grade or higher, runs specials on Tuesdays. The final price ends up being close to that of cheaper quality meats at the grocery.

(Disclaimer: I notice I’m using “we” a lot when this blog is supposed to be about me. My husband is my best friend.  And even though I am the only one experiencing excessive weight gain, our surgeries were only 14 months apart and we still share every aspect of our lives, including this adventure.)

We snacked on hot dogs (1 for each of us) while the other meat cooked and we continued to clean out the flower/herb bed. Dinner was a burger, 1/2 cup asparagus, a few cloves of garlic, and a TBSP of roasted onions.  Throw in a couple of South Beach Meal Replacement Bars throughout the day and a handful of berries and I was 83 calories over where WebMD wants me to be. That’s when the day went downhill.

A few weeks ago we discovered mini cupcakes made with Pillsbury Sugar Free Yellow Cake Mix. My darling husband has been asking me for Lemon Poppy Seed Muffins for months so I made them tonight. It was really simple;   just add a small packet of Sugar Free Lemon Instant Pudding and 1/4 cup poppy seeds to the cake mix before adding the ingredients on the box. Even though it’s sugar free, each mini muffin is 62.5 calories. Before I was done, I had popped 3 in my mouth, along with a handful of blueberries and blackberries tossed with Splenda and Sumner Crest Tennessee Blackberry wine. I overestimated the amount of berries to account for the tablespoon of wine but WebMD now has my calories for the day at 1625, 324 calories above their goal of 1301 and a whopping 425 calories above my personal goal of 1200. That’s 128 calories more than I ate yesterday. The goal was to reduce my calories while maintaining the protein, not the other way around. I’m only 2 days into this but that 1200 calories is being elusive.

So here are my stats for today:

Open RNY Gastric Bypass: 10/22/2002

Highest Weight: 356

Weight at Surgery: 306

Lowest Weight: 156

Highest Recorded Weight Gain: 238

Weight on 05/29/2011: 224

Weight on 05/30/2011: 221.8

Weight on 05/31/2011: 221.4 (Total loss since 05/29/11 - 2.6 lbs)

WebMD                     Personal                   Actual

Calories:         1301                          1200                        1625 (Are you kidding me?)

Protein:           46 grams                  100 grams                95.2 grams (Less than Sunday)

Total Carbs:    130 grams                 50 grams                 111.3 grams (A little less than Sunday)

Sugars:           25 grams                   20 grams                  27 grams (Almost the same as Sunday)

So with less protein and less carbs, where are the calories coming from? I still lost .4 lb which is good for one day but it also tells me that 1625 is too high. The Hebrew National Beef Frank is 275 calories and the hamburger is 345 calories. Those two items also account for 43 grams of protein. The South Beach bars add 12 grams of protein and 180 calories each. With protein comes additional calories. Interesting…

So what have I learned so far after day 2?

-      Protein = calories. If I’m going to watch my calories, I need to find alternative, lower calorie sources of protein.

-        I now understand what the disclaimer “not a reduced calorie food” really means.

-       Making a treat for the husband is not always the best idea

-      Be conscious of the food on my plate, concentrate on what I’m eating, and chew gum while cooking. Grazing is always a bad idea.

I’m really getting excited about what the week has in store. “Information is the mortar that builds and destroys empires” (Tobsha Learner, The Witch of Cologne) The same could be said about any aspect of our lives. The information I am gathering about what I eat and how food alone affects my weight can either help me succeed or give me an excuse to give up. I am reaching for success.

Until tomorrow...

Angie