Tag Archives: bariatric surgery

WLS 22 – How I haven’t really lost anything in the past month

My last post was about losing 100 pounds in roughly five months. This post is about not losing weight.

Easy come, easy go.

I’m not sure why I’ve plateaued for the last month or so. They told me all along this would happen. “Your body will get used to the surgery” some said. “You have a natural weight that you will gravitate towards” said others.

Meh. What do they know? Don’t they realize I have plans! I’m supposed to lose another 40 pounds, damnit!

So here we are.

What to do now? Looks like there are four options.

1) Do nothing. Continue on with the plan. Exercise, use the 30-30 rule, and pre-measure your food. Even if you don’t lose any more weight, a few months of getting in the habit of eating right for this weight is a big win.

2) Do something radical. Some WLS patients do a “jump start”, where they go back on liquids for a week. This helps their mind reset portion sizes, and gives their body a bit of a shock. Then they add back in the foods, just like the first time around.

3) Measure everything. Write down everything you eat daily for a week. Look up the calories. One of the nice things about the previous six months is that I really haven’t been dieting. Sure, I’ve been severely restricted in what I can eat, but it’s not like I sat around counting points all the time. Do I really want to get back on the dieting and obsessing bandwagon again?

4) Do the same stuff, only different. Stop it with the elliptical everyday — forbid myself from using it — and only run and ride the bike. Move to liquids-only in the mornings, then solid foods the rest of the day. Do stuff that doesn’t change my activity or intake levels, but presents it to my body in a different way. Did I mention I still haven’t started running regularly yet? Sigh.

I probably should do #3 or #4, but for the next week I think I’m sticking to #1. I have a blood test on Wednesday, Thanksgiving on Thursday, and I’m back to the doc for the six-month checkup a couple of weeks after that. That’s probably a good time to go over my options with the doc and nutritionist and make a decision. After all, the “magic” part of my weight loss is over with. I’m going to stay around this weight and clothes size whether I start losing moderately or just stay the same — as long as I don’t go beserko off the program. So there’s no fire we have to put out. Remember, I got into this for the ten-year results. I have time.

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WLS 21 — I lost 100 pounds in 5 months

Weight loss surgery: the good, the bad, and the ugly

Weight loss surgery: the good, the bad, and the ugly

Posting the title today, it makes me feel like I’m part of some late-night infomercial. I lost over 100 pounds in five months! And you can too! Just buy my book, “Eat like a pig and gain all the weight you want, them have them chop your stomach out”

Act now! Supplies are limited! lol

People say that weight loss surgery (WLS) is “taking the easy way out” or “cheating”

Not so sure about that.

First, if you are overweight and killing yourself, what does the word “cheating” even mean? That you’re supposed to die rather than do something to save yourself? Saving yourself doesn’t sound like cheating to me. And what part of undertaking major surgery is “taking the easy way out”? I spent three months at home being sore and eating mushy food. I’m going to be on dietary supplements my entire life. The nutritionist says there are things I will never be able to eat again. I basically have a self-inflicted wound that’s something like most folks used to get in a war. Which was the easy part?

Yet for many it all boils down to 1) how much weight you lost, and 2) how fast you lost it. The first month I lost 45 pounds. That’s freaking incredible. Looking back on it, I’m still not sure I can make sense of what happened. I used to wear a size XXX Large. Now I wear just a Large. I used to worry about breaking chairs when I sat on them. Now I sit on the edge of a table and don’t think too much about it. I used to have sore muscles simply from standing and walking around for an hour. Now I can stand for several hours at a time without problem. Maybe run a mile or two when I’m done.

I’m the incredible disappearing Daniel.

I guess from the outside it does seem like cheating, or like magic, to have such a drastic change in such a short period of time.

It’s weird. Body language is all different now. I went to talk to my youngest son the other day and, joking around, stood arms akimbo and made some silly statement as part of a joke. Then I realized: hey, I can actually pull of the arms akimbo thing seriously without necessarily looking silly. I can maneuver around things much easier than I used to — don’t bump into stuff so much. I also can fit in easily and stand as part of a large group, instead of having to stand back a ways to keep from bumping into people.

At my 1-month checkup, there was a lady in the waiting room getting her 12-month checkup. Several of us started talking about how much weight we had lost. I said I was down 40 pounds. She kind of smiled and said “You know, it slows down. Those first few months you’re losing like gangbusters. But it doesn’t work that way later on”

Now I’m beginning to see what she meant. Over the last 6 weeks or so, I’ve gotten into the pattern of losing one week, then holding steady the next week. So one week I’m all happy and kicking butt and taking names. The next week I’m down in the dumps ready to give the whole thing up. Even though I feel like I’m doing the same thing.

What I’m finding out that I can’t change is this: we focus too much on weight, both as surgery patients and as a country. I was more happy about my weight when I was fat than I am weighing everyday and fretting over whether I’m losing or not. Even though in general I’m extremely more pleased with life in general without all the extra baggage to carry around! Life is about more than a number.

Need to make peace with this issue without either ignoring it or obsessing over it. I think getting out of the house and working with clients is helping a lot. After the holidays I I’m going to move my billable hours back up to 40+ hours per week. Get on the road and away from the scales during the week.

I realize that I’m very lucky that I work for myself and am able to flex my schedule. It also helps that I have disposable income to handle a lot of the money stuff. I didn’t expect that. Even with insurance, weight loss surgery has been expensive. There’s been vitamins, special foods, medicine, gym memberships, and sports drinks. I think you can get by cheaper, but it’s been nice to be able to try to deal with just the WLS stuff, instead of trying to deal with that and pinching pennies too.

Clothes have been an especially painful chore. You’d think it’d be fun to lose weight and have new clothes to wear, right? And it is. But also can be quite a hassle. I’ve kept all of my clothes over the years, so I have big plastic boxes of stuff in a storage building of all sizes. The trick is getting them all out and going through them.

So you dig out six or seven huge boxes and start sorting clothes. A good start is sorting by waist size, but as I’m learning, clothes manufacturers lie about clothes sizes to make people feel more skinny than they actually are. As a guy, this makes no sense at all to me, but that’s the way it works.

Fashions change over time, and what you need to wear changes, so even going through all the old clothes doesn’t necessarily make you have a new wardrobe. I went from size 52 pants to size 48. Then 46s. Then 44s. At the 44-inch waist size, I started running out of good dress pants and jeans. So I ordered new 42s when I reached that size. Some of the 42s were big, some were snug. They were all from the same manufacturer and were the same exact clothes, just different colors. Yet each fit completely different.

Now I’m down to 40s and it’s time to buy more jeans. I think I’m completely out of dress clothes. Hopefully with my weight loss slowing down this latest purchase will last a couple of months or more. But then again, I don’t want them to last too long! I still have a ways to go. Will I make it to 38s? 36s? Who knows? Wouldn’t it be good just to get it over and stabilize?

It was really cool finding stuff I hadn’t worn in 10 or 15 years! Some of those shirts I really missed, perhaps much more than my family did. I had forgotten that I got too big to wear them. And it kinda sucked only having a few weeks to wear some of that stuff. Some of those clothes I went through, sorted, tried out, found, remembered how much I loved them — then never actually had a chance to wear them. Now they’re already too big. Yikes!

Getting into this, I realized that I would be in for a long and bumpy ride over the next year, but it’s been weirder and bumpier in some ways than I have imagined. I’m really glad I did it, but I’ve also found that I’m a fundamentally different person than I used to be. I have a different attitude, I react to stress differently, I do things differently. I miss parts of the old me, and, like a swimmer testing the water with his toes before getting in, I’m cautiously experimenting with bringing back some of the parts I used to like a lot.

Many of the old bad habits are still there too, of course, lurking in the background. I’ve had stomach surgery, not a mind replacement. It remains to be seen whether any of this will last for a long time. I have to keep reminding myself, and others, that it’s normal to lose a lot, then regain some, then lose it back. Many gain it all back. A sizable chunk keep most of it off. Both in weight and lifestyle, I wonder how much of the “old me” will come back — or how much I want it to. But it has been a most enjoyable ride so far, and I’m extremely pleased I took it. Even with all the complaining. Because hey, if you’re not complaining, what fun is doing stuff?

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WLS 19 – 18 weeks out from RNY

Daniel Markham

18 Weeks out. Daughter Katrina enjoys grabbing all the skin around my face and making funny faces with it

The last three weeks or so have been pretty much a slog on the weight loss front. I’m losing about 2 pounds per week instead of 3, and I’m eating more sliders. Still sticking to the 30-30 rule, though, and I manage to eat less when I pre-measure everything. Still, I’m not doing as well as I used to.

The temptation is to blame exercise, which I missed quite a bit last week. If only I exercised more! I’ll think, and then plan out some brutal week of hard workouts to make up for things.

But if there’s anything at fault, it’s my eating more, which, I have to say, I like.

It’s great to have more physical food in my digestive system. I don’t think the nutrition value of the food matters much at all. It’s just nice to have volume. So I’m eating about a cup of food three times a day, usually a half-cup of some kind of vegetable/protein, like beans, and then a half cup of fruit or berries. I’ve also upped my protein supplements up to close to 100 grams daily. And I’m shooting for 4 liters of water, although I don’t always get this much.

As disappointed as I might feel at times, I have to remind myself that yes, I am still losing weight. And 2 pounds a week is probably a much more sustainable and healthy loss than that crazy 5 or more pounds a week I was doing there at the start. The trick is keeping things going at this rate.

Weight loss is a crazy thing. You are fighting your natural inclination, which is bad, and you are dealing with a system which you don’t understand, which is also bad. This kind of obsession could make you crazy. If nothing else it will twist your thinking.

I’ve also had to come to some kind of conclusion regarding my opinion on dieting. While I’ve tried a bunch of diets, I came into this thing not wanting just to diet all over again. On the other hand, I definitely don’t want to be one of those guys that gains it all back. So how to reconcile these two feelings?

My decision is twofold: 1) I will get into the habit of putting my food in containers ahead of time and eating only what’s in the container (mostly, aside from the weird social situation like a reception or party), and 2) I will discipline myself to the 30-30 rule. No snacking, and no liquids 30 minutes before or after eating.

Other than that I’m going to follow doctor’s orders, but I’m not going to get too wrapped up around the axle. In other words, I am not going to obsess over small details. Odds are I will stop losing at some point. Hopefully I can go another 30-40 pounds, but who knows? The important thing is to find a new system that can last ten years, not reach some arbitrary goal. I figure learning to package my food ahead of time and eating in a certain way doesn’t constrain me too much. After all, there are plenty of other habits and disciplines I’ve gotten into, like packing for a long trip or shaving every morning. This is just something else like that; something to be learned and practiced.

People might wonder what it’s like to have a stomach the size of an egg. How can I eat a cup of food? Well, it’s a funny thing. If I were eating a dry, chunky food like chicken, I could probably eat just enough to fill my pouch. Then I’d be full. But by eating “sliders”, the food just slides right out of my pouch and into my small intestine, so really there’s not much of a limit. I could sip on chocolate milkshakes all day long, drink gallons of the stuff. Sure, I’d weight 300 pounds again, but it’s possible.

Do I feel hungry and want to eat more? Not really. That’s also a funny thing. No matter how much I eat, it seems to fill me up. Yes, it’s easy to get into the habit of eating the sliders and such, but I know that if I went back to liquids for a few days, I could start right back over at a quarter cup a meal again. I’m not eating due to insatiable hunger. I’m eating more out of comfort and habit.

I had some unplanned eating events in the last few weeks that underscore this. One of the places I’m working with routinely feeds its folks on Fridays. They bring in some kind of buffet. Because I want to be a polite guest, I figure I should eat with the people I’m trying to help. So a couple of weeks ago I line up for a great lunch. There was chicken casserole, beans, and so on. Then I went and sat down outside to mingle.

Now with dry food like that, even a half a cup is pushing it, but I knew to chew my food carefully and listen to my body for signals it was time to stop. What happened, though, was that some really interesting people joined the conversation around lunch. We started talking about all sorts of fascinating stuff like hobbies, political views, and so on. I was engrossed in trying to learn more about their world.

And I found that I could not stop eating.

Somehow I have learned to associate nervousness with eating. So when the conversation lulled, or I had nothing to do with my hands, I wanted to find something, anything, to put into my mouth and chew. Even after I ate as much as I needed (of course my plate was full, one scoop of three items will fill a plate). So I’d pick at my food, pull off a little bit, and chew it. It gave me something to do while listening. It was calming.

And I ate too much. My pouch filled up and started to spasm. Yikes!

But hell, even then I kept going and ate 2-3 more tiny bites over the next 5-10 minutes. I just wanted to be doing something while engaged in conversation.

By the time lunch was over, I was in terrible pain. I spent the rest of the afternoon feeling like I wanted to throw up. If I didn’t consume anything, the pain was manageable, but the minute I swallowed anything the nausea would come over me in a terrible way. The pain kind of subsided for a bit, so I started chewing gum and went to a meeting. Ooops! Not so much. About ten minutes into the meeting I felt like barfing, so I ran to the bathroom. But no luck. Just a lot of spitting.

I waited for an hour. The pain subsided. So I tried sipping water. After a couple of sips, back with the nausea again. My body was not happy! Hello Daniel! We have some serious complaints down here! Are you listening?

Went out to the car, found a whole plastic bag of Papaya Enzyme, and ate all of them — about 30. Still no luck. I drove home feeling like I was going to throw up. It was not a pleasant experience.

Once I got home, I made some hot tea and sat down, prepared to drink all of the tea no matter what. If I threw up, then so be it. Something had to give somewhere. It’s impossible to live if you can’t drink or eat! While I knew in my heart the problem was going to work itself out one way or another, I still had to recognize that if it went on for more than a day I’d need to go to the hospital. That kind of gets your attention.

I sipped about half of the tea and the nausea hit again. I ran to the bathroom and my stomach convulsed, but I didn’t throw up.

That one convulsion must have shaken something loose because that was it. The pain was gone. I was fine after that.

So a week later I’m in the same exact situation. I’m at a dinner party before a conference I’m speaking at. It was a great dinner. All kinds of foofy food. I made a plate again, and again I sat down and started having a great conversation with some folks.

This time, however, I remembered the pain from last time. Once I started feeling full, I covered my plate up with my napkin and physically pushed it away. Even then, that would not be enough. I know myself well enough to know that I’d soon start picking at the food again as the conversation progressed. Fortunately Melissa was there, realized what I was doing, and took my plate to the trash while I continued talking. That’s what having a good wife will help you with!

Yesterday it happened again. Another catered meal at my client site. Another great conversation with one of the folks there. This time it was fried chicken, mashed potatoes, and green beans. (I skipped out on the rolls, pies, macaroni and cheese, and other stuff!) I really enjoyed the flavor! And the conversation was going well also. But sure enough, not five or ten minutes into the chat, I was full. There I was with a plate 90% uneaten, and my pouch was telling me it was time to stop. So I smiled, said “You know, this is extremely good food, but I’m completely stuffed. It was great talking to you!” and excused myself. Crisis averted. I dumped a full plate of food in the trash can. Felt like I was committing a terrible crime doing it.

Interesting thing about that is that 20 minutes later I still felt a little hunger. So I ate a protein bar. Much better to complete my lunch with protein than do a repeat of the eating too much experience.

Writing all of this, it occurs to me that maybe I haven’t been doing so badly after all. I am learning quite a bit — my pouch is helping me out, whether I like it or not. I’m learning why I eat, I’m learning some ways to control things. I’m also learning how easy it is to screw up, even with a modified digestive system. It’s not all stuff I want to know, but it’s stuff I need to know.

But I still feel uneasy about all of it, as if I’m resting on a house of cards that’s bound to crash sooner or later. From reading other folks who have had this surgery, this is a very common feeling.

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WLS 18 – Running my Ass Off

Two things happened this week. I ran, and my ass fell off.

First the running. On Saturday I went to the gym with my wife. I am getting tired of the same old machines all the time, so I thought I’d try something different. Ever since I started planning for my surgery, my dream has been to be able to run like I could when I was younger. Running when you’re heavy is a very tricky matter. Sure, I could run for short distances, but long-term running was out of the question. Or, as I told my exercise guy at the surgical group, until I lost some serious weight the only thing I was going to do was blow out a knee. Your joints can only take so much stress.

Now that I’ve been losing, the question is “When do I start running?” If I start too soon, I could end up with injuries. But if I wait too late, I may never start. I kept putting off starting, and I’m the world’s best procrastinator.

Saturday was the day — or at least the day to test the waters.

I started in on jogging, figuring that I’d do a very easy jog as long as I felt comfortable. No trying to run as fast as I could or none of that nonsense. Just loping along. I had a heart rate monitor so I could keep an eye on how I was doing.

Turns out I did pretty well. All that hiking and working out on the elliptical machine, along with this new naturally low heart rate I have, made me able to run for a while without my pulse getting too high. I made it easily over a mile — maybe close to a mile and a third — before I quit. At the end I even tried out a runner’s “kick”, where you sprint the final little bit before the finish line.

Wow! Didn’t see that one coming! I can run!

Still, I’m going to play it cautious. Even with my weight loss, I weigh 30 pounds more than I did when I was a young whipper-snapper, and old bones and muscles aren’t as limber and flexible as young ones. I’m thinking once a week I’ll try running under very controlled conditions — inside, soft track, and so on. After losing another 20 pounds, say in 2 months, I’ll move it up to 2-3 times per week and take it outside. But for now, there’s no rush. Just little baby steps. I’m in no hurry to get laid up for months with a sports-related injury, especially now!

The other big thing that happened this week was I noticed my ass fell off. I found this most disturbing.

One of the things people dread the most when thinking of weight loss surgery is looking like an old bloodhound. You know, they have a really wrinkly face, and these huge flaps that hang off from their arms and belly. Going into the surgery the docs are pretty clear on the fact that you’re there for health reasons, not cosmetic ones. The goal isn’t to get you looking like a superstar model, it’s to allow you to live an extra 20 years that you might not get otherwise. If you live that time looking like you need ironing? Well then that’s just the price you pay.

So I was clear on the terms going in, but I still wondered how it would all play out. Would I look all wrinkly? Would I have these huge skin flaps hanging off of me? Would my face look like a bulldog’s?

Walking around the house last week, my wife said “you know, your butt has fallen off”.

I found this a rather unusual thing to say, so I went to look in the mirror. Sure enough, instead of a large butt that stuck way out and knocked over lamps, it looked like somebody had pulled the plug out and my butt just, well, deflated. Instead of a bunch of cushioning, I had wrinkly skin.

I lost my ass.

I’m also seeing extra skin around my middle section, which isn’t unusual since I’m losing a ton of pants sizes very quickly. My face also looks completely different than it used to. And this jives with what I’m hearing from my online support group: people notice their weight loss first in their faces and then in their butts.

Losing your ass, as you might imagine, can be very uncomfortable. I put a wallet in my back pocket and after driving for an hour my butt hurts. Same goes for sitting on hard wooden chairs. Without that normal rear bumper, it can hurt when you sit.

I still have no idea how this will all turn out. For some folks with serious skin flap issues, more surgery is required to get rid of it. The doctors usually want you to wait a year or two after you’ve stopped losing weight, just to make sure you’re not going to gain a bunch back and that the skin flap is staying. Also there are insurance requirements to consider. Most insurance policies will not cover having skin flaps removed unless you can show several months of recurring rashes and skin problems associated with them. Finally, they say having excess skin removed hurts like the dickens. I’ve heard people say it was worst than the weight loss surgery itself!

I’m hoping that the skin around my waist will get reabsorbed into my body as I continue to exercise. My face should work itself out also. But my butt? I may just have to get used to having a skinny butt (in reality a flat butt), and not worry about it. After all, I’m a guy. I think the last time I looked at my butt was 1980.

Now that I’m busy running my ass off, maybe I can start running my stomach off too!

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Weight Loss Surgery 17 – back to work

This week was “Back to Work” week. I was on-site with a client most everyday. This meant traveling out-of-town, living in an hotel, and trying to make a good impression while meeting a bunch of new people.

In short, a stressful week.

I did well, though. I think because of three things.

1) I planned ahead of time. Before I left, I packed my vitamins AND my meals for the entire time I was there. That’s right, 15 meals, all in a big bag. Good thing I bought those containers earlier, huh? This way I was able to measure out everything. There wasn’t an opportunity for me to go “off the menu” and do something stupid. I simply kept eating the things I was already eating at home.

2) I exercised every day. Every morning I went to the nearby gym and did something, anything. Some days it was the treadmill, some days it was the stepper. I didn’t care about intensity level or anything. I just wanted to spend an hour working up a sweat. I’ve found that when I work out, it increases my ability to handle stress throughout the day, and I was going to need that ability.

3) I found something to do with my time I would normally spend eating in the evening. Usually when I travel, after work is a special time for me. I go back to the hotel, or go out, and I can have whatever I want. Over the years I’ve gotten into the pattern of getting stressed out during the day, then “relaxing” by overeating after work. I didn’t want that option this time, so in the evenings I went for walks on the local trails. (I was lucky to be in a town with lots of pedestrian trails). This kept me busy, got me outside doing something healthy, and was more fun than staring at the hotel walls.

It must have worked fairly well, because when I weighed today I had lost 7 pounds. If you’re keeping track at home, I’ve been averaging a little over 3 pounds per week for several weeks, just like clockwork. Last week, though, I didn’t lose anything. So instead of obsessing over the scales this week, I spent the week helping other folks and doing my thing. I kept on slogging away, and my weight took care of itself.

Today was also a big day because I went to my 3-month post-op follow-up. The nurse practitioner is a nice guy, and he asked some standard questions and looked at my bloodwork to make sure I was getting the appropriate amount of nutrition. My B12 and D levels were high. B12 isn’t much of a problem — a little too much and your kidneys will filter it out. D is more troublesome. Too much D can be damaging. So I’m laying off the D for a while.

In another 3 months I go back with more blood test results, see him, the nutritionist, and the exercise guy. They’re all great folks, but I kind of feel like I’m reaching the end of how much they can help me. It’s really all up to me now. A few more visits over the next year or so and then I’ll probably transition to follow-up work done by my local doctor. I have to admit, if the hard part is reading numbers on a lab test and adjusting my intake to make them normal, I’m not sure why there has to be a doctor involved at all. I should be able to just order my own tests and make my own adjustments. I may look into this.

The NP asked me, “So how does it feel to have lost 80 pounds in just over 3 months?”

I thought for a moment.

“I hear surfers say that the coolest part of surfing is waiting in the water until just the right moment, then hopping up on their board and realizing they’ve caught a great wave. I feel like I’ve caught a great wave, doc. I’m just riding it to see where it takes me”

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WL 13 – Public Speaking and Colonel Sanders

Should have never crossed paths with the Colonel

Should have never crossed paths with the Colonel

It’s been a week full of fast food temptations.

For several weeks, every now and then I’ve thought about fried chicken. Nothing obsessive, just every now and then.

Now I’m not a big fried chicken eater, but for some reason, I pictured myself eating a chicken breast from KFC and thought this would be a great thing to do. There’s really no reason I couldn’t do this. Once I was cleared for solid foods I was free to experiment with various things. In general, however, I’m supposed to avoid fried or breaded foods. But I didn’t think I would blow up or the world would end if I bent the rules a bit.

Sunday I had a chance to find out.

I was out driving the kids around Sunday afternoon. With both of their appointments running late, I ended up spending about 2 hours more in the car than I had planned. I didn’t have a protein shake, or water, and I was driving around right through my dinner hour. So I figured this was as good a time as any to see if the Colonel and I would get along.

I bought a chicken breast, original recipe. I thought it tasted pretty good — but nothing like it did in my dreams. I ate about five or six large bites of the breast as I was driving around. Again, more than I would usually eat and I was not “mindfully eating”

The taste was like sucking on a deep fat fryer. The chicken was much more oily than I remembered. It also started to make a knot in my stomach. Uh-oh, this is one of the signs that the food is not going down. Continue forward, Daniel, and you’ll end up barfing all over the place.

So I didn’t continue forward. I think I ate about a third of the chicken breast.

The pain subsided, and I drove around some more for an hour or two.

That’s when things got more interesting. When I finally made it home, I thought I’d have a sugar-free Popsicle as a treat, something I do about every night. After several bites into the Popcicle, I realize “Uh-oh, this isn’t going down either!”

What had happened was that I had stopped up my stomach with my KFC adventure and it was still stopped up. In fact, this was when the real discomfort began, with the esophageal spasms, the tightening of the throat, and so forth. Anybody that has had something “stuck” in their throat knows how this feels — not fun.

So I went to the cabinet, grabbed some Papaya Enzymes, and chewed four or five of those rascals. The pain went away within minutes. Those little guys are miracles!

So while I still reserve the right to try things if I want, I think I’m keeping KFC off my food wish list for another few months. It would also be a lot better to prepare for the worst-case scenario when heading out of the house. If I’m prepared, I don’t screw up.

The second fast food temptation came Tuesday evening during a very stressful event: getting back into public speaking. I’d taken several months off for my surgery, and it was time to climb back on the horse. So I set up a time to talk to some great folks, and we ended up with about 50 people in attendance. Since I’m a hacker and a nerd, of course we had free pizza. There was pizza as far as the eye could see.

Managed to sit on the chair without having to worry about breaking it!

Managed to sit on the chair without having to worry about breaking it!

Stress, public speaking, making new friends, and social tension? It’s a natural for eating. But, unlike Sunday, I didn’t try the pizza. (That’s a shame, because I probably could have tolerated the pizza much more than the chicken!) I had been running on a bit of adrenaline, and just before I was supposed to speak? I crashed. The adrenaline ran out and I started feeling cold and shaky. So here I was in front of a large group of people without having eaten in several hours, feeling like I needed some kind of sugar.

This is where all of that hiking and exercising paid off. This was not the first time I have felt this way since surgery. It will probably not be my last. But I’ve learned I can push through this. It’s nothing but a thing.

So I pushed through, and it worked out okay. By the time I was done a couple of hours later, they asked me if I wanted to take any of the extra boxes of pizza home. I said sure! And took a couple of pizzas home for the kids. I could have taken more, but two pizzas seemed like enough even for your typical ravenous kids.

On the way home I got out three peanut butter crackers and ate them slowly. This was my supper. And it was fine.

I'm sure the all you can eat buffet specials are in there somewhere

I’m sure the all you can eat buffet specials are in there somewhere

While I still think about fast food, I also am beginning to view it much differently than I did before. I don’t know if you’ve ever watched moves where they depict a red light district of a city — It’s a Wonderful Life where the alternate city has become a cesspool comes to mind — but they usually show a lot of flashing neon signs, people standing out on the street, and garish shops and displays. This is how I’m starting to feel driving by the local fast food row. I probably feel like an alcoholic does driving by a long row of bars. While I used to find comfort there, there’s also something prostitution-like in the way these places are set up. Big signs, pimping out the sugary foods, large people milling about, the bragging of how much each person can consume, and so forth. Not exactly a good influence on me right now :)

And yet through it all, the weight loss surgery still works. When I went off the menu, my pouch “caught me” and reminded me I was screwing up. When I ended up in front of a crowd having to speak, my exercising and experience with my pouch reminded me that things would be fine. And they were. At the end of the week, I’d lost another 2 pounds, which is better than I had expected.

All-in-all, it’s been a good week. Things continue to get better and better.

If you've read this far and you're interested in Agile, you should take my No-frills Agile Tune-up Email Course, and follow me on Twitter.

Weight Loss 11 — Feats of Strength

“So how have you been doing,” the doctor asked me this morning. It had been 8 weeks since my gastric bypass surgery, and I was there for the two-month checkup.

I looked around the room, then back at her. The only thing I could do was tell her the honest truth.

“Doc, I’m sore all over. Every muscle hurts. I could barely walk in here today”

I could see her concern — and the gears start turning. Was it a nutritional deficiency? A disease? Some side-effect of the surgery?

Before she could start asking questions, I hit her with the punch line.

“That’s because I went hiking yesterday with the teenage kids. I had a blast! Can’t wait to go again!”

picture of author and kids on top of the Peaks of Otter

Not everything that feels bad is bad, and not everything that feels good is good

It’s been a good week, a week to think about positive and negative rewards.

Most of the week, I wrestled with my sleep apnea gear. This prevented me from getting a good night’s sleep, and I woke up all through the night. So I got to see what I was dreaming about.

What was I dreaming about? In one word, “FOOD!”

I dreamed I went out for a steak dinner. I dreamed I was at a theater and bought bought bubble gum and sweetarts to mix together. I dreamed I was ordering at a Burger King drive-through. If this week is any indication, lately I spend a lot of my time dreaming about food.

And it’s not just dreams. I’m noticing food and food commercials everywhere. Every show on TV has commercials full of people pimping out food. Driving down the road, a good chunk of the billboards and signage is all about the food I could be eating. Even reading books, the authors pay close attention to who is eating what, and how.

My wife used to tell me a story about dieting when she was a teenager. Her mother told her that if she lost a certain amount of weight by summer, she’d bake her a cake!

Let’s face it, food is Mother Nature’s all-natural way to motivate people. When you were an infant sitting in your high chair, you wanted food, and if you made the right sounds, people gave it to you! Is that cool, or what?

I’ve heard people say something like this my entire life, about how we worship or pay undue emphasis on food, but it took “being away” from it for a while for it really to sink in. Our entire culture in the modern world is based on rewarding ourselves with food. Have a great business deal? Go out to dinner! Finish that big workout at the gym? Have a steak! Have you been driving with the kids for an hour or two and they’re getting cranky? Ice cream ahead, and who doesn’t like dessert?

We even begin to start associating the lack of food, hunger, with having done something wrong. Better not skip lunch! You could get hungry. I remember getting through eating one big meal and immediately starting to think “Wonder what would be good for supper?” Ten seconds later, and I’m planning the next meal because, after all, if I’m not careful about this I could end up hungry! Lack of food; the ultimate punishment.

We say we eat food for nourishment, but it’s obvious that’s a lie. Look around at all the other things we do in life because our body requires it. We buy toilet paper. Do you see TV commercials talking about the family buying toilet paper? Are there billboards for toilet paper? Do we spend time on Pinterest going over all the ways to arrange and use toilet paper? Going to the bathroom is a bodily function, quite necessary, just like eating. But we don’t treat it like we do food. Food stands alone as the ultimate natural behavioral control mechanism.

It’s the crack cocaine of being human. Once you’ve tried it, very early in life, you can never leave it. The best you can do is come to some sort of uneasy relationship where it doesn’t kill you and you can still function.

This is why I have such a contrarian view of dieting and fitness. I do not believe that fat people are doing anything wrong. I feel they are acting exactly the way they should: seeking out food and consuming it. There’s nothing more natural in the world. In fact, I’d argue that people who spend their lives fighting their nature and being mean and miserable (and many times ugly to others) are truly the sick ones in this entire equation. It’s not the fatsos that are broken, it’s those folks who think fat people are somehow inferior that have problems and that life somehow sorts good and bad people by how skinny they can make themselves.

Having said that, nobody wants to have a heart attack before he’s 50, so you just can’t eat your life away. This was probably the defining reason I chose surgery: if I can’t change the world around me to help me live longer, I would take steps to change my own physical nature to fit the world. I would get a digestive system more engineered for the 21st century than the 2nd.

Still, it’s good to keep these things in context. Surgery is not a magic fix. It won’t make you skinny the rest of your life. Heck, it might not make you skinny at all. It’s just a tool, redefining the size of your stomach and reducing your hunger cravings, to help you have more control over your life. Like any tool, you can sharpen it and practice with it and get really good at doing what you want. Or you can leave it in the garage and have it rust. Understanding and using the tool is up to you.

So today as I hobble around moaning and groaning with sore muscles, I have to remind myself: everything that feels good isn’t good, and everything that feels bad isn’t bad.

It’s all about context. And nature.

If you've read this far and you're interested in Agile, you should take my No-frills Agile Tune-up Email Course, and follow me on Twitter.

Weight Loss 10 — 7 weeks RNY post-op – slipping and sliding

Mixed news as I head into week 8, but most of it remains very positive.

On the “down” side, my weight loss has settled down. For the last two weeks I’ve lost 7 pounds. But this was to be expected. Every WLS (Weight Loss Surgery) patient eventually settles down into a sustainable loss pattern. It varies by person and metabolism. The national average weight loss for people having an RNY is 13 pounds per month, so actually I’m just becoming more normal. Still, it would have been nice to have a couple more 20+ pound loss months!

On the up side, and probably related, my ability to exercise has gone through the roof. I have a sneaking suspicion that increased muscle mass is cutting into my weight loss, but again, this was expected. I may even slow down to a pound or two a week if I get into heavy weight-lifting. But the difference is energy is incredible. While only a couple of months ago I would soldier on through 35-45 minutes of cardio on the elliptical, this past week I’m easily putting in an hour. I could probably go longer, but I want to ramp up slowly. I’m also looking to add something else into the mix. The elliptical has taken the place of my walks, and I know that’s going to get boring after a while.

It’s great getting my energy levels up past where they were before the surgery. Aside from the weight loss, it’s something else tangible. I can feel the difference all day long.

The biggest drama over the past couple of weeks has been my CPAP, the machine I wear at night to make sure I keep breathing. As I lost weight in my face, I found that my CPAP mask was not working well. My mouth would fall open. This causes all sorts of problems, including waking up a lot during the night and not having mental energy during the day. I found a new mask that works, but it’s going to take another few days for the vendor to get the right size in. Meanwhile? I’m tying my head shut with a scarf. Yeah, I know. It looks quite funny, like I’m living in the 1800s or something. But it works, mostly. So who cares how it looks?

My biggest problem remains with portion sizes. Although hunger doesn’t affect me like it used to, when I’m feeling like I should eat, and I’m measuring out food for a meal, I can’t help but think “Gee! I should be eating a lot more than that!” and it causes me to measure out too much food. I’ve been battling this for a couple of weeks now, and the only solution I can find is to buy a bunch of little containers and measure all of my food out for the week at one time. The weird thing is that it’s not like the amounts matter — at the end of the meal I’m just as full one way or the other. It’s the measuring that seems to be my problem. So, we find a way around it.

I think overall one of the main benefits of the surgery is that it gives you “breathing room” to work through problems like this. In the past, each week could become almost like a battle. My “old” way of eating was wolfing down whatever I felt like. Many times this would be something like a double Whopper with cheese and a couple of large fries. No matter what I was doing, there was always a tension between my diet and my old way of eating.

Here, that isn’t an issue any more. Yes, I can screw around with my portion sizes — up to an extent. But I can’t run off to the local drive-through. That’s not happening. My stomach size and new aversion to sugars is like a safety net. There’s no completely falling off the wagon in a bad day. Sure, I imagine over time I could train my body to go back to those old ways of eating, but it would take some time. The surgery gives me extra time to fix problems as they occur without making things all or nothing.

So I just ordered the containers, and next week will put them to work.

I was interested in why I could actually eat more, so I emailed my dietitian. She said some foods, like yogurt, chili, or soup, were called “sliders”. They were moist enough that they could slide right through my pouch, giving the illusion of my having a bigger stomach than I actually do. Some other foods, like tilapia, turkey, eggs, or chicken, is dry enough that once I eat my pouch size, I’m done.

So for these slider foods, and probably for the rest of them, I’m switching to a measure-ahead-of-time system. It’s really weird re-learning to eat. Sitting at the table, not being able to read, chewing my food thoroughly? My impatience is killing me. I feel like I’ve been bad in school and have been stuck in after-school detention! Maybe I should work on my patience a bit, huh?

It’s all good, though. At the end of next week, I go back to the doc and nutritionist. I should transition to solid foods and be released for air travel and whatever normal things I want to do. Within 3 weeks, I should be at my half-way weight-loss point. And in a couple of months? Can’t wait to start back running again! Lots of things to look forward to.

If you've read this far and you're interested in Agile, you should take my No-frills Agile Tune-up Email Course, and follow me on Twitter.

Weight Loss 9 – 5 Weeks Post Op. Support Groups and Bad Days


I bought some baby forks to remind me that I’m supposed to be learning to eat, not wolfing food down like a frat kid at a hotdog eating contest.

Last week I lost five pounds, had a bad day, and learned about online support groups.

The five pounds part was the easiest. I just did what I always do, loading up around 4-5 TBS of food three times a day for a meal. Old habits are hard to break: I find myself putting too much on my plate, thinking the more I eat the better off I’ll feel. Sometime in the last week I’ve began to feel a bit of hunger. Nothing much, and certainly nothing like it used to be. It used to be I would immediately start thinking about my next meal within an hour or so after eating. Hunger was a terrible thing that must be avoided at all costs. Now it’s much different. I could probably skip a meal if I wanted to, no problem. But once I try to start measuring out a meal, those old tapes start playing. If I’m feeling a little bit hungry, certainly I should put more food on the plate, right?

But my pouch catches me. Chewing slowly, I begin to feel full. If I don’t pay attention and keep eating, that’s when things take a turn for the worse.

Saturday was a bad day. Throughout the night, my mouth kept popping open while sleeping. Since I wear a mask over my nose to help me breathe, if my mouth pops open, I’m not breathing so well. It never used to do this. I guess now that I’m losing weight my head isn’t as fat as it used to be. Who knows. But the sleep was terrible. I would sleep for 10-15 minutes, kind of doze off, then wake up and shut my mouth. All night long. Going to bed at 11, II woke up around 10am feeling terrible. Anybody who’s ever flown a redeye flight knows how this feels.

It just went downhill from there.

Because I had slept so late, and because I can only eat at certain times, my schedule was hosed up. Instead of exercising after breakfast, I waited until just after lunch — a lunch which included some homemade beef stew that required a lot of chewing.

Lunch went fine, but slow. The exercise was okay. What I found out 15 minutes after getting off the exercise machine was that no, I was not going to be able to swallow anything. For a while. It felt like I had a huge hunk of food stuck in my throat, not going down.

So I wandered about the house, groaning and grimacing. I tried laying down. I tried walking. I tried sipping on some liquids (bad idea). A few times I came very close to throwing up. I decided that perhaps I wouldn’t be having fluids or anything else to eat today.

Then I remembered the Papaya Enzyme. I could see my nutritionist’s face clearly in my memory “One thing I can tell you for sure,” she said, “at some point, you’re going to have a knot in your throat and the food will not want to go down. This happens to everybody. When that happens, take some Papaya Enzyme”

Ok, sure. Sounds like this was the time. Where did I put those things?

In the back of the cabinet was a bottle. Inside were little chewable tablets. Why am I chewing up more stuff when I can’t even drink!  This made no sense. But I grabbed 3 or 4, chewed them up, then gingerly swallowed.

Within 15 minutes all the pain was gone. One of the most amazing things I’ve seen in this whole experience. I am now a true believer in keeping some Papaya Enzyme handy!


Meet my new best friend, Super Papaya Enzyme.

Meet my new best friend, Super Papaya Enzyme.

 It’s amazing how all of the information you receive during the pre-operative stage comes back to help you later on. The piece of advice I had the hardest time following was this: get into a support group. People in support groups do better long-term than those trying to do it on their own.

This is a problem for me because I live 4 hours from my surgeon. There are no support groups around here. Sure, there’s the generic addictive support groups, but those don’t sound like they would specifically help folks who have had surgery.

Fortunately I found that there were a bunch of online options, so I joined a couple of Facebook groups dedicated to folks with lap bands, sleeve surgeries, and bypasses. I even found out for people with a bypass that gain back a lot of weight, they can give you “band overpass”, which is a lapband on top of your bypass. Yikes! Hope I don’t end up there.

These groups are great for learning about your options and the various problems you might have. Several times a day people post about how their experience is going. With thousands of participants, there’s always lots of stuff going on. One person can’t eat anything. One person is having problems losing weight. One person is 3 weeks out from surgery and spent most of her time crying — at one point crying about bagels. Everybody else in the room pitches in and helps out. It’s not all bad news, however. Several times through the day people post their before-and-after pictures, or talk about the scuba diving, hiking, or marathon running they’re doing now that they couldn’t do before.

It’s a great place to feel connected, but if you join there are some abbreviations folks use:

RNY – Roux En Y. Where they connect a small portion of the stomach to the intestines 3 feet down, leaving the rest of the stomach connected as before, creating a “Y”. This is what I had

GS – Gastric Sleeve. They chop off most of the stomach but leaving it in place. Instead of a big stomach, your stomach is left in the shape of a tube.

LB – Lap band. Taking a band and wrapping it around the stomach, reducing your ability to eat

NSV – Non-scale victory. Fun news that’s not related to an arbitrary number like how much you weight. “I ran up a flight of stairs today without getting out of breath!” “I was able to sleep on my stomach for the first time in ten years last night!”

WLS – Weight Loss Surgery

I’m really happy I’ve joined these online support groups. It makes me feel better seeing other folks work through their problems. It also keeps me motivated when I see what great results other people are having. I don’t feel like I’m doing it all on my own. If I have a problem, not only can I reach out to my surgical group, I know I have some friends online I can reach out to as well.

And that beats a stick in the eye any day of the week.

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Weight Loss 8 — 4 Weeks RNY Post-Op. New Shoes.

Remember the last new pair of tennis shoes you bought? Perhaps it was one of those high-end jobs made of leather.

These are some really nice shoes, and people love them, but when you first get them, it’s not unusual for them to feel a bit — funny.

You put them on. They feel okay. Maybe a little snug. Then you walk some. It feels good, but not the same as your old shoes, which have been worn in by many hours of walking and standing.

As you turn a corner, ouch! They pinch a bit. Not enough to take the shoes back, but enough to notice. You realize that this will go away with time, as you and the shoes “get to know each other” and get all the bugs worked out.

Over the next week or so, the pinching is much less noticeable. The leather begins to adapt to your body. Then, at times, you realize that these new shoes are truly awesome! They have a lot more cushion than your old pair. They’re in much better shape, and they’re stronger. They’re going to do great and last a long, long time.

This past week has been “new shoe” week for my bariatric surgery.

At the beginning of the week, I was feeling better physically, but struggling with mental energy. This reached the bottom on Monday, when in the afternoon I decided to take another dose of my B-complex vitamins. (You have to be careful about this. You don’t want to take too little B vitamins — they’re required after RNY surgery. But you also don’t want to take too much) I felt a lot perkier! The rest of the day was more fun.

Then the whole week opened up. I would exercise in the mornings, my morning routine was dialed in, and I had more energy in the afternoons. While several times a day I would do something that would cause a bit of a bad feeling, at times I am beginning to feel much better than I did before the operation. I can see myself having a LOT more energy, motivation, and time than in the old days. These new shoes are going to be awesome!

Of course, being 50 pounds lighter helps things quite a bit. As I got ready to step on the scales this morning, I realized I’m developing a new fear: I’m having such an easy time eating 1/4 cup of food per meal, and I’m feeling so much energy, there doesn’t seem to be any way I should still be losing weight! But there it was, lost another six pounds this past week.

Not only has it been a good week, it’s starting to look like this entire next month is going to be a load of fun.

If you've read this far and you're interested in Agile, you should take my No-frills Agile Tune-up Email Course, and follow me on Twitter.