A Commentary Four Years Out

I know a bunch of you haven't known me long enough to know this, but I haven't always been this weight. Occasionally I jump on the blog and give an update as to how my weight loss process is going since realistically, we've all got a morbid sense of curiousity about these sorts of things, don't we?

"Did she keep it ALL off?" "Is she a failure? We'd better go check. Let's take our magnifying glasses to search for signs that she fell on her face."

 So to catch everyone up, four years ago today, I had Roux-En-Y gastric bypass surgery in 2013 and added that to a total lifestyle and movement overhaul. In my first year, I blew away the clinic's goals and my own. I lost what in retrospect was too much weight, and we equalized it some leading up to my three-year update. 
So what do I have to say about my fourth year?
Well, lots, and nothing all at the same time.

You see, 'maintenance' is both the most exciting and most boring thing in the weight loss journey.

In the honeymoon period of weight loss, we can distract ourselves with the scale, and all the awesome non-scale victories. It can be so very motivating. Enough to temporarily override the desire to cope with difficult emotions with food.

Challenge is though, that the hard stuff keeps happening. Paired with the honeymoon ending, that's some rough road ahead.  Real life has a way of continuing to happen on us, doesn't it? Sometimes our stress is caused by other people's choices and the best we can do is choose to try to manage our part as well as we can. When we are overcoming the impulse to stress eat, that's gonna affect our weight loss journey.
There are quite a few hard things I've been through this past year, but they include people whose stories I can't tell, so we will move on to the things I can talk about.

This year has been particularly interesting for me. We've had a goal of maintaining of all of the tools I had to use before:

CALORIES: Still trying to keep in the 1500 calories per day range. 
PROTEIN: My aim is 80-100g protein per day which helps balance my energy levels and curb cravings. There is much more room in the stomach than there was, so this is really pivotal.
FLUIDS: Over 16 cups of fluid per day.
FITBIT-: Yes I'm still wearing that thing, and I get moving. I chose to upgrade to an Alta, and I've been pleased with it. I need to work more on my steps. 
TRACKING: when I don't I am much more prone to do whatever feels good. So yes, at least intermittent tracking is going to be a life-long tool for me. My current goal is to track three times per week.
MENTAL WORK: Balance is really important. It's really easy to go back to the mental gymnastics and diet mentality.
SUPPORT: I have "been there, done that" kind of people who can speak sense to this situation and encourage me. I am ever so grateful for these people. 

But I've had to add more tools.

My year included some new medical diagnoses. I'd like to preface this next section by saying that none of the following is caused by gastric bypass. If you are currently considering Roux-En-Y as one of your tools, this is not something you need to be afraid of.

This year I was diagnosed with Sjogren's and severe osteoarthritis in my back. That, to be added to the veritable smorgasbord of hypothyroidism, Raynaud's and chronic migraine that we already knew about. I'm not throwing a pity party, please hear me, I bring it up to bring light to the fact that maintenance is going to include some really hard to manage things. Things that are going to complicate things more than for the average person.
Fortunately, my medical team is happy to help me try to manage things with nutrition and vitamins; medication when needed.

So I've had to work to find out what kinds of things make my body angrier, and try to do less of that, and find the things that make my body happy and do more of that. Simple math right? I can "Math". Well, maybe I can "Science" better than I can "Math" because there is still a lot of experimenting going on.

But I digress.... I was talking about tools. My medical team and medication, and new strategies for health, for pain and stress management, have become part of my toolbox.

In fact, the weight loss has most definitely improved my situation. And that, my friends, was exactly the point of it in the first place. That and to be more present with my kids. I'm so glad my endocrinologist spoke up and was straight with me about this being necessary to take my life back when I wavered.

Is stress eating still a thing for me? In short, yes. Add to that, I'm smack in the middle of the 'bariatric brat' stage, and my "I don't want to" about good habits sometimes yells like a two-year-old whose sandwich has been cut the wrong way.

Here's the thing. Weight loss surgery isn't a panacea. It's just a tool. So those sorts of things are not going to magically disappear. And it takes a lot of effort to keep working all the tools day to day, under pressure. Has there been regain? Absolutely.  Am I still fighting? You betcha.

 Now there are going to be people out there who like to be critical and focus on that 'look what's been regained' part of this. I'd encourage a more positive, hopeful view.

So here is my regain list.

I've regained:
My Fight- There was a time when I just plain wanted to give up because the goals were too big, too hard, too beyond me. Now I know that just plain isn't true. I'll eat elephants one bite at a time if I have to, but I will do it. Some goals are just going to take more time.

My Perspective- It doesn't matter what the number on the scale says particularly for me now. My most important measurements are now not scale related.

My Confidence in my 'Gut'- There were some situations that I've been through where my gut made one call and others around me were telling me "It isn't so". Circumstances this year have come about in such a way that confirmed my gut in more than one area. I won't second guess my gut again. On the surface, it sounds unrelated to weight loss, but this one, for me, was pivotal in the personal growth journey.

My Willingness to Face My Fears- I repeatedly continue to share my story despite the fact that sharing the hard parts puts me open to criticism. That's not easy. But I've decided to "do it afraid" anyway, in the hope that it helps even one person rethink giving up on their efforts.

Weight? Yes there is that too.
 I have maintained a loss of more than 100 pounds.

If you want to talks specifics, at my highest I was 307.
I went too low and dropped to 157 at one point.
Last year I was 178.
After an incredibly hard winter where I've had to manage some very difficult things, I had reached 207, but have turned it around and have lost 5 pounds of that regain so far.
I will choose to work for loss in five-pound increments, assessing how I feel as I go, and I am pleased to say I am back in spitting distance of Onederland again.  I think I'll go for that next.

So while I don't quite have this maintenance thing all figured out yet, I'm working hard. I could honestly relate to Edison who said: "I have not failed, I have simply found 10,000 ways that do not work." I was thinking about that and then something rang like a little bell in my head. Something I'd heard before. What was it?

Oh yes, that's it!


Ironically, that number where I'm sitting RIGHT NOW is in the statistical window that the Bariatric Center of Excellence's clinic set for me in the first place. So they still consider this a success on a purely numbers basis. Who am I to argue with that?

I'm dreadfully curious to see what the next year brings, aren't you?

For your amusement, my "before" picture with a picture of me teaching 

Science-related classes in our local Homeschool Co-op. See? I can "Science".

A Two and Three Year Update On Weight Loss via Gastric Bypass

I had Gastric Bypass Surgery, in conjunction with a total lifestyle and movement overhaul a little over three years ago now. I hit and exceeded clinic goals and my own. Makes for good reading, right? What's that? You're noticing that there's no 'Two Year Update' on the blog? Well, that's true.

I didn't do a two-year update and here's why: in having hit maintenance, I did as so many do and I floundered a little. Didn't know what to do with not having a 'goal' anymore. The day to day goal that it was suggested I take on wasn't meaningful enough to keep me motivated.  Moving into the weight maintenance part of this is HARD.
Don't get me wrong, I set myself to other goals, and succeeded little by little at those too. They were measurable, attainable. Things were moving on that front.
But this was a year where my use of the tool was put to the test: winter, vitamin deficiencies, three deaths in the extended family, medical and interpersonal challenges, kids and their eccentricities, and just plain old life rolled into one. It was a serious opportunity to fall back on my old habits of eating for stress relief and comfort. For a while,I bought into the lie that if you stumble, you're failing.

I won't lie, it was tough. Because I really like Peanut M&Ms, and cheesecake.
 But I want to keep what I have more than I want to go back to where I was. It became pretty clear I'd have to fight for it like anyone else that loses weight and wants to keep it off. You see my dear, as I've always said, weight loss surgery isn't a panacea. It's just a tool. And it takes a lot of effort to keep working all the tools day to day, under pressure. It made me a discouraged body, especially since it fell in that period of time where people stop giving such lovely feedback on the work you're putting in.

So what was a girl to do?
Well, I needed to invest myself back in the process. To make sure that I continued to give back to the people coming after me in this process, so I didn't forget where I came from. I needed to keep plugged in with the people who'd cheered with and for me during the pre-op and weight loss phase. They would now be the ones with whom I'd fight in the trenches for my maintenance.
When a fellow group member suggested we start a maintenance support group satellite and asked me to help admin, I hopped on board, both for motivation and accountability.

I ran a back to basics informational series, facilitated discussion topics for them and would you know? I was very much not alone. Turned out, we were all suffering in silence, until someone spoke up. And when one spoke, then others found the courage to speak as well.
The courage to talk about the hard things like 'not keeping off 100% of the weight'.
To discover how it's 'normal' to experience 'bounce back' to a degree after massive weight loss.
To give voice to the unspeakable fear that we'd gain it all back.
To realize there are actually two challenges to manage about regain: recognizing regular bounce back, and then allowing that to be worsened by black and white thinking that says "I gained some back, it's all coming back.  I can't do this."
To manage the reality that surgery doesn't solve all the problems.

To use the support we provide each other to formulate a game plan that would make it possible for that not to happen. 

To give a little context, I think it's important that you have a recap. In 2013, I started at an all time high of 307 pounds. On my surgery date, I was 286, after two weeks of medical fasting. And I worked it that first year. Wasn't sure where I'd end up because well, frankly I always wondered in the back of my mind if this would fail too. Mini goal by mini goal I inched my way down, surpassing the clinic's goal and then the one I'd set for myself. So much so that at my first-year appointment I was 162 pounds and clinic told me to stop losing weight.


But I was ever so close to 150 total lost. Silly me, I have a thing for round numbers. So I pushed it a little further and by my birthday that year, I registered 157, a grand total of 150 pounds lost. Where I stayed for all of a week. It wasn't maintainable, and I was physically miserable. But hey, most people were cheering me on, so it wasn't a problem, right?

By two years I'd had the 'bounce back' occur. Mentally, it's hard to gain weight after you've worked so hard to lose it. I was so concerned about negative comments. People can be cruel. Especially when you use a tool that carries some stigma, and they wouldn't mind seeing you fail. I was so concerned about criticism that I didn't even want to do a blog update. No celebratory pics to showcase how much of my loss I'd maintained. Nothing inspirational to see here. Move along folks.

But, get this... I was a little bewildered when the clinic wasn't at all worried about me at the two-year appointment. No negative comments at all. They considered me to be doing well, and perhaps that should have been a clue. But I didn't really register that at all.What I did do though is decide to continue the  mental work this past year to make maintenance a reality.

  It has paid off, but when it came time to have to get on the scale for the medical records again this year I wasn't less pre-occupied. It's kind of surprising how after all this time, the scale can still take up a lot of mental space. I suppose I can be like a dog with a bone that way.

Do you know? I attended my three-year appointment recently, and I had conflicting feelings because my weight had been bouncing around recently, and I had a pleasant surprise. My two-year and my three-year numbers were only three pounds apart. At the two-year mark 175, and at the three year 178. Maintaining within an acceptable range .

Remember, they only had documented the first year at 162, They never saw me drop as low as I did. In their perspective, I am well within the expected range of bounceback and I am now maintaining well. When I asked the dietician about it all he shared with me a point of interest: It is completely normal to gain 1-2 pounds from aging alone with no other changes. With all the other things I've got going on right now, I'd say that's kind of exceptional.

In retrospect, I should have stopped losing weight at 170. I was 170 when I got married in 2000, and I've put six term babies through my body since then. But none of that occurred to me at the time, when things got hard. I had the projected acceptable 'bounce back', but because nobody was talking about it, I thought I was starting to fail. Having to add different foods back into my diet in order to avoid the dizziness turned out to be a mental trip too, and trying to adapt to 'normal' life not so very easy either.
To be frank, it's a little like living in the twilight zone. Like 'normal' people, but not at all, because I constantly have to think about how what I put in my mouth will affect me.  I don't tolerate 'lots of sugar' so well. Also, the line has moved as to how much I can take in before dumping sets in, but there is still a strong punishment for poor food decisions.

So my adjusted weight range is 170-180- this keeps me from dizzy spells and I move well and feel generally well. Could I lose ten more pounds and be at the bottom of that range? Yes. But what woman my age doesn't want to lose ten pounds? Oooops my 'normal' is showing. Normal, what is that anyway? It's a dryer setting!

So what does all of this mean? If I were to choose the middle of my acceptable range as my 'goal weight' and compare it against how much weight I've lost, my weight today, I have lost 98% of my excess weight. Shut the front door! I guess that's not too shabby after all.

On a bloodwork level, last year my vitamin D was low and that seemed to have righted itself with appropriate supplementation in my vitamin regime. Iron is the going concern now, and we're investigating a little further because the numbers came out a little wonky.

What tools am I using to maintain?

CALORIES: Still trying to keep in the 1500 calories per day range
PROTEIN: 80-100g protein per day.
FLUIDS: Over 16 cups of fluid per day.
FITBIT-: Yes I'm still wearing that thing, and I get moving. I use it to justify my lack of gym time. If I can hit 10,000 steps I don't care about the gym. I've got a whole bunch of coloured bands for it. It's kind of funny actually, matches the warbrobe. Probably looking to grade to an Alta eventually.
TRACKING: when I don't I am much more prone to do whatever feels good. So yes, at least intermittent tracking is going to be a life long tool for me.
MENTAL WORK: Balance is really important. It's really easy to go back to the mental gymnastics and diet mentality.
SUPPORT: I have "been there, done that" kind of people who can speak sense to this situation and encourage me.


I talked before in other posts about needing to reset my defaults. I really don't eat well naturally. I have to maintain the habit.  So what is the best plan? The plan I'll use for life. If it's not maintainable, I'll stop doing it and I'll gain weight. Period.
So, ironically, I'm working every tool that even the people who don't choose Gastric Bypass have to work in order to succeed. Could I have done it without including this tool? Internist said nope. Not medically likely. So I work all the tools together. Shoots that whole 'easy way out' argument out of the water, doesn't it?

There are lots of things gastric bypass won't fix.  Having had gastric bypass complicates treatment of some of the things I have going on medically also. Fortunately, I've got a good medical team that is willing to work with  me on treating as many things with nutrition and vitamins as possible. That's really invaluable.

So  I've been all over the map on this journey.
 It begs the question: What does success look like? Well, I think that will vary depending on whatever life throws me at the time. But I will sum up the current view of success with a set of pictures.

I had someone once suggest  to me that perhaps I don't want to post my pictures (as frequently as they do) because I've gained back so much that I'm ashamed. Yes, it was a low blow, and hardly supportive. They were several steps behind me in the process and hadn't quite hit the maintenance stage and all that it brings with it yet, to be fair. That honeymoon period is a pretty big sweet spot and can make a person think 'regain can't happen to me'.

Well, I figure that posting infrequently to make more of an impact is the better way to go.

I'd like to address the above thought, so I chose to wear clothing I was wearing at my one year mark for my three-year photo updates. I still own both the pink cardigan and wear it occasionally, but my kid wanted to wear blue for the family photos and Mark and I had to wear blue to accommodate. So the black cardigan you get. I figure that being able to wear this at three years out served as commentary enough.

Help! I've fallen and I can't get up! (A commentary on falling 'off the wagon')

I wrote this as a response to a post in my weight loss support group, but I'm CERTAIN that more than one person needs this today. So edited for your reading pleasure:

You've fallen off the wagon and you're panicking. You think you've gained weight. You think all is lost.You're wondering where you go from here. You ask "What do I do now?!"

 So here's what you're gonna do.

First, take a deep breath. This is not an emergency.
I know it feels like it, but it's not. In the context of things, you've been here before and you can get out of it again. Your tool is still intact. It still works. Remember gastric bypass was never a cure-all. It's just one of many tools you work. So pick up your tool and work it.

Second, remember that it's not 'all or nothing'. You have the ability to decide that you are not left behind, and that you're not running from something (being fat, fear of regain etc) but running TO something (health, mobility, the feeling of comfort in your clothes.)
Make all your choices through that lens

Third, get rid of the junk food. The temptation is too large. Remove it from the house while you choose to get back to basics.

Fourth, get back to basics. Review week six of the surgery manual; if you lost yours, get another one.  The diet for life is your friend.
Track your food, there is just something about having to write it down that makes you think twice about eating the junk. Don't forget to measure. Portion sizes get big fast when we 'eyeball' it. Seriously.
For those of you reading this post that haven't had gastric bypass, this part won't make much sense to you, but suffice it to say there is a specific diet we adopt for long term health. The main theme of this thought is to get 'back to basics', and eat a diet appropriate to your situation.

Fifth get moving. Physical activity will help give you some exercise high and burn some calories. Both good toward your goal.

Sixth, revisit where you've come from. If you took 'Before' shots and measurements, and you are not as high as you were at your highest, this is the time to take them out...... forget what happened in the middle of your journey. You are likely still ahead of where you were.

If you are not, all is not lost. Not even a little bit. Repeat steps one through five until you get back to seeing results. In the meantime, make sure to work your support systems to their fullest. If that includes psych for depression parts of the journey, don't feel one iota of guilt. Just make the call and get an appointment. No shame. Make sure to get all the help you need to get healthy.

You've got this.

Head Games, and Goals, and Regain! Oh My!

When I left my all time high of 307 pounds, I had lots of thought around 'goal'.
What was that going to look like?

Would I stop at 230? (The weight I couldn't ever pass through)
200? (Clinic's forecasted thoughts on the matter)
170? (My wedding weight, that I never thought in a million years, would happen?)
160? (My want list number?)
157? (To make it an even 150 lost)

Oh the head games.

I *did* make it to 157- for all of a week. I earned my bragging rights, but my butt hurt to sit, and I looked 'too thin'. I thought so, others seemed to, also. It was affecting quality of life to have gone this low.

I called 'goal' at a range of 155-165, to keep me from losing my mind with all of the trying to decide what goal looked like.

But you know where I've actually levelled out for the time being? (at 22 months)

170.
You know. My 'impossible' number.
It seems (for the moment) where my body is happiest, without removing the excess skin.

It would seem that my 'unreasonable' number wasn't so unreasonable after all.

It's not a 'normal BMI'.
It's not everyone else's view of perfection.
I could decide to be discouraged about regain.
Or I could decide it's maintainable with the current laundry list of health issues I'm facing. That I am maintaining a loss of more than 135 pounds, and there is nothing unimpressive about that.

Inadvertently, I built regain into my goal, and balanced out. No guilt required.
Now, to behave myself and stay here.

Just thought I'd share that for anyone struggling with the concepts of goals and regain.

Half The Girl I Used To Be: The Sky is the Limit

I followed up with the Bariatric Clinic, today, so I wanted to submit my One Year Appointment Update:

 I have a couple of vitamin deficiencies, none of which are major, and all of which are things that can be easily repaired with close attention. I get to work on making sure to get ALL of my vitamins and minerals in. All the time. No slacking off!

I have to get in with my endocrinologist or family doctor, because my thyroid medication dosage is now TOO HIGH!!!
I'm thrilled, because this was my only medical issue pre-op that was measured by medications I needed to take. It was also the basis on which the internist told me I'd never be part of the 3% that get off this amount of weight and keep it off, without surgery. So for comparison purposes, I've been on a really high dose for years. To need it reduced is really awesome. For me, comparable to the diabetic who wants desperately off their meds, and manages a serious reduction in medication needs.
It's quite possible that I'll never be entirely off the meds, but to know my system is behaving closer to normal, and will need less help to do so, is priceless.
( We'll see with re-assessment how much it's reduced by) 

All about the food

They have upped my calorie counts to prepare me for maintenance. I'm now officially aiming for 1200-1500 calories per day. I know. It seems low to the average person, but remember I've worked my way up from  15 mL cups, taken every ten minutes, and worked each stage, to get to this.
Some people think that once you're where you want to be, you can go back to what you were doing before. To keep what I've got though, this is likely where I will rest for life. (Give or take for exercise allowances) Discipline doesn't stop at one year. Clean eating and lots of  movement has to stay a good habit.

My protein is okay to stay at the levels I'd had them at, which was aiming for 80-100 grams per day.
I get to food journal at my new levels,  and come back in two months.  If nothing else more exciting comes up, I will then continue on to yearly appointments, until the five year mark.

Have we arrived?

They told me to consider myself at goal. Can't quite wrap my head around that one. It's been a year of driving toward what seemed like an impossible goal. What to do with transitioning toward maintenance?

Well, the new goal is daily compliance to the program, that's what.

 The excess skin, they said should be considered to be in the 10-15 lb range, so some of that weight I'm carrying' doesn't really count'. It's almost like the expectation should be of an adjusted BMI because of the skin. It's not a pretty side of going through this, but I can hardly complain. 

 I was reassured, that as far as goal was concerned, BMI is not a great tool for picking a number goal for weight. (We all knew that though, right   BMI doesn't take muscle into consideration.  Arnold Schwarzenegger would be considered obese.... pshaw.)

 Walking in to my appointment today, I was still pretty uncertain as to what my ultimate goal should be
The mental portion of this roller coaster still remains, as far as mentally thinking of myself at goal, but they say I'm there. I'm guessing they know what their talking about and now it's up to me to get my head in line with that.

A friend says that it's just like having graduated. Maybe she's right. Doesn't mean the work stops here, but man it's a great place to enjoy the achievement.

Now on to the exciting part. Everyone wants to know about the numbers, right?

I am down 147 pounds and they consider my results *not typical*.
Typical, they expect to be 30% of total weight loss.
My number was a hair under 48%.

So, for me, this is a good day. It took a lot of work, and a lot of great support to get me here, so I want to express a big thank you to all of you, for your support on this journey. I look forward to days ahead, and long term healthy maintenance.

A Pocket Full of Victories

It's so amazing the difference one year can make.

I recently attended our annual Home School Picnic event. It's a celebration for some of us finishing our year, and for others a fantastic opportunity to get together with friends before continuing on with summer studies.

It was a ton of fun, and as a leader for the local group, it was so nice to be able to get to meet new people, and to get to connect faces with names, since I have the opportunity to get to know many of the people via social media long before I get to meet them in person.

I was however taken back down memory lane, because it's been a year since I really started in earnest down my weight loss journey road, and it was a marker moment, where I could look back and see the differences from one year to the next.

The proximity of the release of my one year blog post about having had Weight Loss Surgery to this picnic naturally brought up some conversation as to my success. The acknowledgment for my hard work has been wonderful, for certain. But something far cooler happened that day.

I had a person ask me an innocent question. "So were you this out-going before losing the weight?". My initial gut response was "No". Which I said at the time.

But the answer was actually much more complicated than that. You see, I was overweight as a teenager, but didn't start piling on serious weight until I got married. Then the babies came and the thyroid was diagnosed as problematic.

What I hadn't realized until later than day, is that my answer should have been "Yes". At one point I was this outgoing. But my battle with weight had taken it from me. Or rather, I threw it away with both hands, well over a decade ago, and had forgotten one more thing, that I didn't know I'd lost.
Not until it came back.

So to that innocent asker of the question: Thank you. You gave me a gift on Friday. A gift of realizing another part of my life that I have been able to take back. You know who you are.

You want to know another really cool thing that happened?
Look back up at the top.
See that picture?
See me standing there, with my shirt tucked in? Wearing a BELT?!

Yeah. That hasn't happened since roughly 2000.
That my friends is just one more in my pocket full of victories.
I am ever grateful.


(Thanks also to Rachael DeBruin of Diamonds in the Rough for taking the picture for me.)

The View from Here: First Year Anniversary of Weight Loss Surgery

Some of you knew me before, and many of you didn't. Either way, I've been told by people that they didn't recognize me upon seeing me for the first time in a long time. It's been a pretty big year, with some pretty big changes. As you read this blog post, you'll see words that link to the other blogs posts from the series I've written. Feel free to catch up by reading those as well, if you missed them. It definitely gives more perspective to the before and after pictures.

June 17th, 2013 I took a leap, and changed my life by combining Roux-en-Y surgery to my tool box of tools to aid me in my weight loss struggles. So I am one year out from having had gastric bypass. It has been quite the year. This is a really good spot to take stock, of where I am now, and where I am going. This for sure though, is not the destination. 



When I began I was over 300 pounds, and have lost 145. I have literally lost a whole person. I have dropped from a size 26 pants, to a size 8. My shirt size went from a size 4x to a size large.

Now all of those numbers are impressive, but what really counts is the following:

1.  I am no longer in constant pain in my back, hips, legs, knees, ankles, neck
2. My balance is improved. Before losing the weight and increasing my movement, I couldn't right myself.  If I tripped over something, I went down.
3. I now rarely wake up tired, before I woke tired,  trudged through the day tired, and often needed to nap when my children napped, just to get through the day.
4. Where before, I was so miserable that I wasn't able to be the person I am down deep inside,  now I am experiencing the joy that comes with being able to participate more fully in life.
5.  I can keep moving with no troubles now.

I have a ton of what we call Non-Scale Victories, and if you missed them, you can read them here in Non-Scale Victories: A few of my Favourite Things. There are so many things I got to take back during this process.
 
Changes I never anticipated

Sure, I knew I would lose weight. I knew I'd be raising the chances of being around for my kids. I knew I'd be able to move better. I was taking a fighting chance of gaining everything that actually ended up on my list of victories. But so much came out of this that I had no way to foresee:

1) My ideas about this tool were challenged.
I had to challenge everything I thought was true about gastric bypass. I found out just how much was under the surface, beyond the pretty and inspiring before and after pictures.  I had to make a pretty complicated choice  I had to challenge my, and other people's ideas about gastric bypass being the 'Easy way Out.' I talked about it in two posts here (Where I talked about the pre-op process) and here  (Where I told the story of my early post operative period). Now I know that there is a lot that goes into the process, and that this is a tool to be used in conjunction with other tools, to give the obese a fighting chance to get the weight off. There is no shame in using this tool. There is nothing easy about it.


2) Changing social circles completely.  

 I had friendships change for the most wonderful reasons. I began to chase down the opportunities to spend time with positive and inspiring people. People who shared my vision, and could see my goals, and chose to help me approach them with hope in trying to reach them. Some of those people were reaching for the same goal. Some of them were in-person, and some solely on-line. That made all the difference, to have the privilege of walking beside them.
I also had some people that chose to show unconditional support to me during that time, and it was such a gift. 

3) How differently people would treat me.
I had my suspicions and ideas in advance of surgery as to how people would respond to my surgery. Because I was afraid, I chose to keep it quiet until after it was done. The only people that got to know in advance were on a need to know basis.
I didn't realize some of the fat bias until I was being treated differently. It's just plain weird how fast chivalry from strangers comes back when you're not huge. How much smarter you're given the credit for being (or maybe it just removes the stereotype of being dumb and lazy when you lose the weight- who knows?)

4) How differently I would treat me. 
I was down right mean to me at times. I said negative, self-defeating things to me. I didn't believe anything positive anyone said about me. I chose to believe negative things that others said about me, true or not.  My misery had affected my outward behavior and it wasn't until I lost some weight, and started being happier, that I realized what an unhappy person I had become. When I started to be happier, people also responded to that, I think. 

5) How much this journey had everything to do with my head.
My focus changed- I developed a focus on being healthy and stronger, instead of being self-destructive. I became happy about not only every ounce I lost, but also in regaining the little things.  These things are now a novelty to me. Things that most people, never having been morbidly obese, take for granted.

I learned that I need to stop caring what others think so much. 
I talked about this more here in Don't Submit to the Court of Public Opinion 

How much gratitude would become one of my daily tools. 
I decided along the way that I never wanted to go back to where I came from. I appreciate the woman that got me to this point, but I need to maintain the growth. 
 That required taking inventory on many stops along the journey. I had the wonderful opportunity to share each of the small 'wins' with my support system.  I was so grateful that they played along, and not only cheered me on, but started sharing theirs as well. 
We were able to measure success in more ways than just our relationship to gravity.


It's one reasons I took so many pictures during the journey. I needed a reminder at each of the stops along the way how far I had come.

I'm enjoying the view from here, and looking forward to the work of maintaining what has been achieved.

Gastric Bypass- The Easy Way Out?! Part Two

Last post, we started talking a little about the underside of the proverbial gastric bypass iceberg. The largest part. The part that no one sees. If you missed the first of this two parter, get caught up by clicking here.

Today, I want to carry on and let you know what work and elements go in to the early post operative period, by describing a little of what it was like for me.

Before surgery, I did so much research, and I really got to feel I knew what to expect.
I know that I felt much more settled, after I'd made lots of changes, and satisfied myself that this was the choice to be making.

I'd had my food funeral, I'd  gone through my two weeks of Opti-fast, and two days of clear fluids.
I'd filled my prescriptions, packed my bags. I'd made up a duotang with everything my mother in law was going to need in the coming weeks while she came in and looked after my kids for me. (What a wonderful gift of both her time and resources.)

There is something pretty sobering when you get to the part that you have to talk with your husband about what happens if for some reason you don't make it through surgery, but we had that talk too.

I was ready.

 Ready to jump into the unknown and take all the changes that came with it.

I happened to have a morning appointment for surgery, so I reported to day surgery unit, and checked in. From there I have made ready for surgery, gown, hat, IV and all.
My husband could only go so far with me, so we parted ways.
I didn't have long to wait though. I went through to the OR, met my surgeon for the first time and transitioned to the operating table. Not long after that they put the lights out.


Waking up brought some fun challenges. I had some pain to manage, some from gas left over inside, and some from the re-routing of my intestines. We are expected to get up and walking shortly after surgery, so that the gas will work its' way out, and to prevent blood clots, so that is number one on our to-do list. We get to race around the halls like snails in agony. I'm thinking I looked like one, anyway :)

The IV wasn't too bad to deal with, but I did find myself very nauseous. We were expected to transition from IV to taking fluids by mouth, and we had medicine cups to take fluids in. Imagine getting to pour all your efforts in to taking these tiny cups, and feeling completely full. It's complete culture shock.


That isn't all though. We get to shoot ourselves with a blood thinner shot for about a week after surgery. After a couple of days you get to go home and the real work begins.

The clinic wants you tracking your intake, walking, taking your vitamins, and working on getting as much protein as possible, in the form of protein shakes. They also want you getting 2 litres of fluid per day; going at a pace of about 15 ml. per ten minutes. Sip. Sip. Sip. It takes up a LOT OF TIME. It's really all you can think about for quite some time. It's a time that is taken over also by a need to continue dealing with your food issues, and handling any head hunger, because you're not feeling physical hunger just yet.

The cup on the right holds a little more than the amount we drank at a time early post op on full fluids.

The bowl on the right is a one cup rice bowl, my now typical meal size at a year out.

Moving around can be challenging, but they give you decent medication for pain relief.
For the first 6-8 weeks, they have lifting restrictions on you, nothing more than ten pounds.
You also refrain from doing strenuous exercise for that same period of time while you recover. But that's okay, you're busy with walking, and learning to eat again anyway.

There were clinic appointments early out, and we were well looked after, with some early opportunity to see our weight going down, and this was motivating. Motivation is something we need, because for quite a while the diet is kind of depressing. We spent two (or more) weeks on Opti-fast, and after surgery we need to be kind to our newly healing pouch. That means a gradual and slow reintroduction of foods. The first two weeks were full fluids. Are you tracking with me here that this is a minimum of a month of fluids? For those two weeks, our meals consist of 1/4 of a cup of fluid, and over that time, we stretch ourselves to 1/2 a cup. It doesn't sound like much,but seriously, most of us have to fight to get it in.

Imagine two more weeks of milk, low fat strained cream soup, and pudding, or sugar free jello, along with protein shakes.

Weeks three, four and five are much for interesting. After so long on fluids, you almost want to cry for joy when you re-introduce low fat cottage cheese, baby food textured meat, and egg salad, with no celery or onion. Even oatmeal and cream of wheat are pure heaven. But you still can't get much in volume wise. The portion sizes kind of look ridiculous to the average eater, and even to us. We can't believe that an amount that small would be satisfying, but there it is.
Week four brings back peanut butter. Mmmm pure heaven.
Week five, you get to reintroduce lean deli meats,  low fat cheese, and other meats. Bread products come back then as well. But only toast and things that break down well.

It isn't til about week 6 that bread itself comes back. Bread is where I found one of my problem foods. Sits like lead. Chest pain ensues. it's a bad deal. But as long as I respect my limits, usually things go pretty well.

After that what?

Week six begins the diet for life. We pretty much adopt a low fat, high protein, low sugar type of diet, that keeps the healthy stuff a priority. We're supposed to stay away from the sugar laden foods, that pre-op used to call us with intensity of a blinking neon sign. With good reason. Our new systems can not process it the way it could before we were altered. Should we overindulge, we have all sorts of lovely experiences, that could include dumping. Dumping is kind of like having rapid onset flu symptoms that last a couple of hours. If you're lucky, you bring up what offended. If not, you get to wait for it to work its' way through your system and exit quickly, to put it delicately. Best thing you can do is lie down and sleep it off.

It takes a while to reintroduce foods. You become careful about trying foods for the first time post-op any where other than home. It gets better though. After a big learning curve, you end up figuring out what you tolerate. You figure out what you don't.... but sometimes your delicate system decides to play tricks on you. So you learn to take a protein bar with you almost everywhere you go and not try anything you suspect might cause you trouble. Especially if you need to drive home ;)

On going, it's important to never forget where we came from, to track our food and exercise, and to keep it up for life. We proceed knowing that gastric bypass is just a tool; the one that made the rest of our tools work. The tool that gave us a fighting chance.

So, when I began this series, did you have any idea that this much went into it all?
Or did you think that the awesome 'before and after' shots were really all there was to the story?

To counter balance this, I need to tell you it's all worth it.

I lost 100 pounds in 6 months, and the non-scale victories started wracking up. (click here if you missed my list of favourites) You can't not feel motivated to keep up with all the necessary steps when you are getting immediate and marked results like that.
The 'flashing sign' demanding you eat all of your trigger foods is turned off for a while, and it is blessed relief, I am telling you. It didn't stay off forever, but it gave me a fighting chance for long term change.

I hear stories all the time in gastric bypass circles that people's success  is shot down by those crying foul that we took the 'easy way out'.The effective way out, maybe, but not easy. The farther out I go in this process, the more I realize that that 'easy way out' is really code for 'willing to pay a higher and more permanent price than anyone else for a chance to take back their health'.
In that case, I take it as a compliment.

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Gastric Bypass- The Easy Way Out?!

Gastric bypass is only used by lazy people who can't be bothered to just 'put down the fork' right?

Remember that iceberg I posted to the Eccentric Encounters Page the other day? Yeah. Well about that. We're gonna talk about the under the surface stuff today. 

I want to preface what I am about to say with the comment that I have had wonderful support from people that know that I have had gastric bypass. I haven't had any derogatory comments leveled at me that I know of. At least, not to my face.
I do however, have a community of Weight Loss Surgery people that I love, who have had their hearts broken by people making comments to them that belittle their process and efforts. So, because I have this platform to speak from, I want to bring a little awareness. I'm sure I'm preaching to the choir here, but it's entirely possible that you know someone who doesn't know how much 'blood sweat and tears' go in to this process, and could benefit from knowing. Feel free to share this post as much as you like!

Since some of my friends have chosen to stay anonymous about their choice I'm speaking on their behalf. In the hopes of a little kindness being sent their way. Because if we only knew what people struggle with sometimes, I'm sure we'd do differently. 

So what's the big deal about what gastric bypass patients go through? I'm so glad you asked: 

1. It begins with a mental roller coaster, sometimes lasting years, that requires you come to the conclusion that you need help. Help that no simple diet can provide.
2. Then, you have to become willing to humble yourself and ask for that help.
3. You've tried so many things in the past, some had success, but later sent you back exactly where you started, and some didn't work at all, and you worry whether you will be taking on failure again, this time just at a higher price point.
4. You get yourself referred, only to find out the wait times are very long, which makes you feel like it'll never happen for you. 
5. Some people (locally) are routed to the wrong clinic on the way, rather than the Bariatric Registry, the way it is required to do in Ontario, due to their doctor not being aware of how the process works in our Province. Unfortunately, when you finally do get to the right place, you're still at the bottom of the list. 
6. When you finally get on the list, you will begin a long list of screening appointments and tests, designed to make sure you are both fit to stand surgery, and mentally ready to take this on. 
7. These will include appointments like an orientation session, so you can determine whether this path may be right for you. 
8. Assuming you are still willing, because not everyone is willing to pay the prices involved, then back in the actual line you go.
9. Then you will begin rounds of appointments will bring medical assessments. A Nurse will take your full medical history. They will weigh and measure you. This can be particularly humiliating for someone with weight issues, and yet they must find the courage to overcome the fear. (These happen to include: consults with a dietician, social worker, psych, and internist, and finally the surgeon who gives the a-okay, and puts you on the surgery list. 
10. You also have the supreme pleasure of receiving testing along the way for various medical issues, so they can clear you before you continue: blood work, gastroscope- both ends, medical questionnaires, food diaries, personality questionnaires (mood, beliefs etc), ultrasound, seep studies-if needed.)
11. The dietician will cover the expectations of what you will be giving up, and what new things you will have to take on: a strict vitamin and mineral regiment, water intake, 6 small meals during the day, tracking your food and exercise.
12. Psych wants to check our your mental fitness, talk about your background, make sure you've got supports at home, and to generally make sure you're working through your food related issues so they don't get in the way of the journey towards health.
13. You get to go through Pre-op, which takes a last minute snap shot of the picture taking you into surgery. They prepare you for the nitty gritty and on we go to the actual surgery.
14. Last, but not least, if you make it through all of that, you then get to do a two week liquid fast. (Possibly three or four weeks if your medical case requires it) This will shrink your liver in advance of surgery to make it safer. Don't forget the two days of clear fluids to make sure you're ready for the main event.

Lots of hurry up and wait in this process.

Are you surprised at all by what has gone into this so far? Yeah. I was too when I first did my digging. It's not just about putting down the fork.

But that's not the half of it. Tomorrow I'll talk about the early post op.

Then you'll really get to see why it's the easy way out!

(If you happen to be a pre-op you likely already know what you're getting into, because of how much research I know we all do during this process, but in case you are very early your journey, stumbled on to this one post via net search without the context of the whole series, and this is scaring you just a little, please know something. I went through every bit of this and more, and would do it all again in a heart beat. Hope is coming in the future posts, so keep following. You'll get to see the victory that all this 'hard' leads to.)

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Because I was afraid- Why I said nothing about Gastric Bypass until after it was over

I have no doubt in my mind why it is that The Bible has so many admonitions to not be afraid.
Fear is a huge motivator.

 It can be so powerful that it locks us away from trying new things, from continuing on in the good things, and even from leaving the toxic things in our lives.

Being so overweight was definitely toxic. Both as a result of habits, but to my body itself.

So once I came to the decision to go ahead with surgery as one of my tools, in conjunction with all the other tools I was already using, a lot of fears came to the surface:

1. What if this, like everything else, fails too? 
2. What if I blow it? I mean, it's not a magic bullet. Long term maintenance of good habits is required so we don't gain it all back
3. What is everyone else gonna say when they find out?
4. Will they judge me? 
5. Will they try to talk me out of it?
6. Will they write me off as lazy? (an irony, because I realized later that so many people have already written 'fat people' off as 'lazy', so what did I really have to lose?)
7. What is the criticism of others in this area going to cost me this time?
8. What if I have to hear a lot of hurtful things?
9. What if I never get to eat anything 'fun' again?
10. Am I going to be subject to every Gastric Bypass horror story that comes out of the wood work, like when I was pregnant and had every labour horror story related in freakish detail. You know. Just to mess with my head. Cause the decision wasn't hard enough ;)
11. Can I really pull off following this set of rules for life that I'm being told are necessary to do this?
12. What vitamin and mineral deficiencies will I face?
13. How is this going to affect my marriage? (The stats on divorce post gastric bypass) aren't good, gentle reader.)
14. How will my new lifestyle affect my friendships?
15. What about excess skin?
16. What if I succeed?

Sounds ridiculous to be afraid of success doesn't it?

But there it is. The honest truth.

So I had to shield myself for just a little longer. 

This was a HARD choice. A choice that I had to know in the hard moments I made for myself. That I could sustain by myself. That if not one person stood with me, I knew my reasons for having made this decision.

I couldn't do that with the simply based on the approval of others, and I certainly couldn't do it if I allowed myself to be talked out of it.

So I kept doing my research, making my lists of why I needed this, and quietly relied on the reassurance of my husband in the moments of weakness and doubt.
He was my rock when I wanted to run scared from this process.

And I worked on a need to know basis. The angel of a mother in law, that gave up 8 weeks of her life, to help run my household as I recuperated, and leaned how to eat again got to know.
And at the end of my 14 month wait, a couple of weeks before I actually entered the hospital, a few others outside my surgery support group got to know.
Again, it was a pretty short need to know list.

But I entered the hospital that day knowing it was my choice. That no one talked me into it, and no one talked me out of it. No one to take the credit, no one to blame.

No passing the buck.
Taking charge of your life and choices is a very powerful place to be, when you take what everyone else thinks out of the equation.

I had no idea that both the best and the worst of both worlds was about to come.

A Complicated Choice

I started when I was pretty young with my weight loss battles.
Medicated myself with food, when I was younger than to know what I was doing.

It wasn't until a bit further down the road that my coping mechanisms for stress caught up with me.
Unfortunately, by then, my body had decided to defend my higher weight.
Body chemistry had kicked in to sabotage me. Didn't matter what tools I used, none of them could be used for long enough to get down in weight.

And hope failed. And the weight rose. And the pain came. Then it got worse.

None of these took a break while I was carrying on with life. We added babies to our family. I still had to try to carry the work load. With a body that felt like it was failing me. Betraying me.

Endless dieting, Calorie counting, trying to keep moving when my feet, ankles, knees, hips and back were in mounting pain. Bouts of Sciatica set me back as well.
And the exhaustion of lugging around an extra 150 pounds.
It started to feel like a seriously losing battle.

There had to be a solution. It seems everyone else knows what you should do:

We're told if we give up snacks, or fast food, or our favourite things, we could achieve our goals.
Some have suggested that if only we have enough faith, God will help us with our plight.
Diets are touted, as a rite of passage, and you just have to find the right one to 'get it right'.
We're told that if we just put the fork down, and move more, we would be able to lose weight.
We're told that we just need to use self control.
If only it were that simple.

When all of that fails, then what?

Well, for me, that became complicated.
Because you see, it had been suggested by society that gastric bypass surgery was for the lazy. The people who couldn't be bothered to try hard enough.
That it was the easy way out. Shameful. I cringed, dying inside because I knew what this would mean.
Choosing this would be tantamount to a failure of character, because of the way I had been taught to think.

But I also saw the hope in people when they posted their 'before and after shots'. I heard the stories, of people that were able to get off medications, that were able to achieve their weight loss goals, and some of them talked about how it felt to not be in pain any more.

To not be exhausted, because of the constant pain.

There was a part of me so conflicted at weighing my choices.
How do you think it feels to stand at the edge of a cliff, knowing that if you told anyone what you were thinking, they'd try to talk you out of it?

It feels lonely. And scary. Like there is a whole lot of unknown.

Fortunately, I was able to find a great support group where I could get my questions answered. They were patient with me.
And I decided that I would take a step.

I would place myself on the wait list for surgery.

I knew that it would be a year, before I had satisfied all the requirements of the clinic.  I would attend all of my appointments and continue as though I was planning on surgery. I would endeavour to make a last hurrah, in order to avoid surgery, but I would put myself on a timeline. If it was at all possible to pull this off, it would be done. I was motivated.

And I did everything possible.
And the weight loss stalled yet again.
There was a set point that my body simply would not go below for anything. I struggled, beginning to know that there didn't seem to be any other way out.

It was during the appointments for the clinic, and in that year that two important things happened: My endocrinologist was very supportive when I suggested that I was considering the surgery. He really encouraged me to go ahead with it, based on having watched another patient of his regain his life.
Also, the internist was one of the mandatory appointments. She told me essentially that there is a very small percentage of people who every pull off this type of weight loss without the surgery. My thyroid condition set me squarely NOT in that percentage.

Do you know what happened in that moment? I had been granted a permission slip to put away all of the society driven criticisms. I was granted a medical reason to consider this tool on its' own merits. There was something very freeing in that.

Paddling like the Dickens Below the Surface: A Gastric Bypass Primer

As many of you know, I had Gastric By-Pass Surgery, coming up on a year ago now. I've been blessed to have been one of the super-responders that do really well when combining eating, exercise and coping strategies, with my tool of surgery.

I've been grateful to be part of a Weight Loss Surgery support system that allows me to see the good, bad and ugly of WLS.

The most fun is seeing so many people have triumphs. Seeing people take back their lives. We see 'Before and After' shots. The side by side comparisons of where they have been, and where they have come to. They're amazing. Sometimes it's hard to even recognize the person when they've made a metamorphosis.

It looks easy. Effortless even. Right?
Well, there is only so much you can see in that snap shot. The work it takes to get there, isn't part of that snap shot.

I know first hand  that this process carries with it, a lot of dynamics that remain unseen to the general public.  I'd like to take the time to take you through a bit of my process in the past 3 years, because really none of this began with my surgery date. It began with so many other things that led up to that date.

I have the feeling that so many people minimize people's results after gastric bypass because they don't have an appreciation for the height, depth, breath and complications of the process. I'd like to take the next couple of weeks to demistify the process a little.

Much in the same way that we can observe a duck on the surface of the water, and know that although it looks like the duck is relaxed, serene, and appears to all the world as though it is effortless for them, but under the surface a tremendous amount of work goes on to get that result.

Ever seen those cool pictures flying around the net with the huge iceberg, and 90% of it is below the surface of the water? We see this itty bitty bit of ice sitting atop the waters edge. We can't see the full depth of what is really going on.

The same is true in the Gastric bypass world. There is no easy way out, and there is a whole lot more going on behind the scenes than you'd think.

I'm planning to paint you a picture of what goes on under the water's surface.

I'll be updating my progress with some pretty cool updates closer to my 'Surgaversary', so stay tuned and follow this blog via Google Plus, E-mail, or on my Blog FaceBook page, to keep up with where I'm about to go with this series!

Stay tuned.