Tag Archives: roux-en-y

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 20 – RNY 20 Weeks out

Been an interesting last couple of weeks.

First, my weight loss has slowed or stalled out. I’m not sure if this is normal or not, but, frankly, it sucks.

I’m getting back into the swing of things in my work. I’m involved more, have more energy, I’m doing more things that are mentally stressful, and I’m traveling, speaking and keeping my schedule off-balance enough that it’s difficult to stay in a routine. Usually when I’m busy and stressed, I just go through a drive-thru, pick up a 2,000 calorie meal, and absentmindedly eat it while watching Oprah or something. That don’t work any more even if I wanted it to. Of course, I’m sure I could always still try to make it work. With enough practice, I could probably end back up where I started.

I have increased my intake. While I don’t get the overpowering physical hunger like I used to, I do feel a kind of emptiness in my pouch that’s like hunger. Enough that it calls me to eat. I believe this is a result of my blood sugar dropping.

The bad news is, without a valve at the bottom of my stomach, I’m basically eating directly into my small intestine. This means, I think, that my blood sugar should be even more sensitive to spikes than it used to be. Kinda seems like a step backwards, eh? So my guess is that watching sugar intake for a RNY patient is very important.

So what I ended up doing last week is eating a protein bar sometime within the 2 hours after I’ve had a meal. I’m not sure whether to count this as another meal or not. Should I use the 30-30 rule? Or is it just a solid version of a protein shake. So I haven’t been paying attention one way or the other. Sometimes I do the 30-30 thing. Sometimes not.

So that adds 600 calories to my daily diet right there. It probably puts me around 1400-1600 calories a day — 600 from protein bars, 360 from protein shakes, and 600-700 from three meals.

I’m just not going to worry about this. If I’m hungry, I need to consume something. Protein or water really are the two choices here. Perhaps I should be drinking more water. Don’t know.

The other piece of bad news is that I have decided I hate my exercise program, which basically consists of getting on the elliptical machine several times a week.

In my life there have been several things that I find I have a hard time hating. These are usually things that people tell me are good for me, that I know I’m supposed to like, that I really want to like, but that I just can’t stand. So I end up doing this thing where I keep telling myself that I “want” to do something, then I half-assed do it, or I put it off, or I quit too easily.

Last week I found myself just not caring about my workout anymore. The week before I had moved my target pulse up a bit, and increased my workout time to 65 minutes. It was enough to get me a bit winded, but it didn’t seem too bad. Then, after a few workouts, I just lost interest. I’d get on, go for 10-15 minutes, then just not feel like doing it anymore. Usually the toughest part is the first 20 minutes, where your body is first adjusting to the intensity, but heck, even after 30 or 40 minutes I’d be ready to get off. I wasn’t feeling like I was getting anything accomplished. Just standing there sweating. It was like being on an endless treadmill that stretched out as far as the eye could see. A lifetime of standing in one place and sweating while I played cards on my iPad.

Not so much.

So I gotta mix it up some. Take a class. Start jogging. I really, really, really need to shift gears. But for now, I’ll probably just go back to the elliptical. Bah.

On the good side, my energy levels are coming back close to normal, and I’m getting to an understanding with my lower bowels. We have had our problems in the past few months, but plenty of liquids and more solid foods seems to make things fine there. Enough said.

So with all of that negative energy, I was pretty down about the whole thing the past couple of days. Five weeks ago I was 220 pounds. The next week? 219. Then I was 217. Then last week 217 again. Then the exercise problems began. My eating increased. It was not looking too good. I was really tempted to start drinking caffeine and alcohol again. Tea in the morning and a few drinks on Friday nights. These things helped me maintain an equilibrium. But they also were highly influential in making me eat too dang much.

Did I mention one of my clients is one of these new high tech companies? They have an open kitchen with all the food you could want to eat provided — free. There’s beer in the fridge. There’s a popcorn machine. I was looking for salt the other day and found an entire cabinet dedicated to fine teas. Yikes!

Not. Helping!


So I resisted the urge to go back to bad habits. At least for now. I made it home, hit the sack, then got up this morning and weighed.

I was down 4 pounds, to 213. That’s a total of 7 pounds over the past four weeks. Not terrific, but about 2 pounds per week. A few months of that and I’ll be at my target weight, plus 2 pounds a week is actually an optimum rate to lose. Perhaps I really should be easier on myself.

I think it’s easier for you, the reader, to consume this. You’re probably reading from the distant future. You already know how it’s all going to work out. “Oh, this is chapter 20 in the book where the guy loses 150 pounds” you might think. Gee, don’t know what the big deal was. He simply had a plateau for a while. Or you could be thinking “This is the blog entry for that guy at work. You know, the one that lost all that weight then gained it all back? Looks like at one point he was almost 210 pounds. Wonder what the heck happened to him? Guess some people just aren’t ever going to get straightened out, huh?”

From the future, this is all fairly simplistic, even trivial. What was this schmuck obsessing over so much, anyway? Doesn’t he know that he gets hit by a bus the following month? All that worrying and fussing isn’t going to change anything.

Living it, however, is a different can of worms. I didn’t know until this morning that I had lost 4 pounds over the past week. Before I got on the scale, looking at all the eating I had been doing, and the lack of exercise, my best guess was that I had gained between 1 and 2 pounds. When I saw the loss, I was as surprised as I could be. Now, of course, I can say “Sure was great losing those four pounds. Sometimes you just have to take a break from exercising and let your body catch up” But 1 hour ago it was a different story.

Things always look different in hindsight, and there are many things we do not understand about weight loss, no matter what the books and TV shows will tell you. So I think it’s always going to be a struggle. I’m just not sure I want to spend my life struggling so much.

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.

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.

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.

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!

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 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 15 – End of Summer Review

Wow. What a Summer.

When I started this summer, I weighed 311 pounds. I wore a size 54 pants, and I had borderline high blood pressure and high cholesterol.

Now that Labor Day weekend is here, I looked at a scales this morning and weighed 231 pounds. I’ve lost 80 pounds over the Summer. My waist is somewhere around 42 inches. My cholesterol and blood pressure are well within the normal range — the first time they’ve been like that in ten years or so, probably.

I spend a good deal of my time feeling my body. It seems so very different than it was just a short while ago. Luckily I don’t have big, hanging flaps of skin, but it’d be okay if I did. WLS is for health, not for looks.

I keep reading and participating in my online support group each day. Since there are so many thousands of people in the group, everyday it’s some new problem or worry. When I first joined, I thought, “Damn, these weight loss folks are a whiny bunch!” I probably wouldn’t even have considered surgery had I spent much time there listening to all the problems. But then I realized that there are tens of thousands of weight loss surgery patients. There’s almost ten thousand in the group I’m in. Most of those folks are probably worried or concerned about something. So of course it’s going to look like there’s a huge amount of problems. It’s just part of having so many people participate.

It hasn’t been all fun and games, though. There have been a lot of little things that I could have complained about. They just didn’t seem like such a big deal. But I thought I would mention them anyway.

First, I had a very low pulse rate in the hospital and after getting home. Part of my body adapting to losing so much weight. I’ve also been light-headed when standing up suddenly. This is something I’ve experienced before when losing weight rapidly so it was expected; although it is a little strange to be having the feeling for more than a month! I guess I’ve never experienced rapid weight loss for this long of a time before.

Pooping has been more of an adventure than I expected. One of the first things people ask after hearing I only eat about a cup and half of food a day is “How much do you poop?” which, I guess, is natural.

I poop about every other day. When I was at the hospital, I had very weak and runny bowels. It was a terrible feeling, as if I had a bad stomach flu. To this day I don’t know what the heck was going on. Later, though, I started not going to the bathroom at all — constipation. Since I had nothing to compare my bowel habits to, I wasn’t really concerned. Then, after straining one day, I got a hemorrhoid. Not a pleasant experience! Definitely not something I was expecting or knew much about.

So now I take a laxative every other day. Keeps things soft and moving along.

I’ve also started to lose some hair. Hair loss is one of the most dreaded side-effects of Weight Loss Surgery. From what I understand, your body isn’t so great at metabolizing protein at first, so it tries to skimp on things requiring protein. Your hair is the first thing to go, so many weight loss patients see a temporary loss of hair, beginning sometime around 3 months. Although annoying and perhaps stressful, most everybody sees it start back within a year, though.

Of course, I’m a 48-year-old guy, so I’ve been expecting, dreading, and planning for hair loss for a long time. Can’t say I’m crazy about it, but going bald a little quicker isn’t high on my list of things to worry about. In fact, I’m letting my hair grow out in protest. One last “hurrah!” for my future follicle-challenged self.

Having said that, some women get disturbed by hair loss — although I don’t think anybody actually loses all of their hair. It just thins up quite a bit for a while. And there are plenty of coping strategies for that.

There’s a lot of little stuff like this; stuff you could get upset about but in my mind is more of a nuisance than anything else. When I think of carrying so much weight around, perhaps dying many years before I should, what’s a little thin hair for a year? While something to consider ahead of time if you’re thinking about the surgery, it just doesn’t come close to being important. At least to me.

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WL 14 – Cooking up a Sweat

Homemade Salsa! Yum! Loaded up with a bit of habaƱero heat.

Homemade Salsa! Yum! Loaded up with a bit of habaƱero heat.

Had a blast in the kitchen Friday morning cooking up stuff.

It might sound strange for somebody who doesn’t eat that much daily to enjoy cooking, but I always have enjoyed creating meals from scratch. I wish I knew more about cooking, because it’s so much fun. I always said my dream job was working in a sandwich shop on the beach. People walk up, they ask for a sandwich, I make one, and they walk away happy. What a great way to live.

Today I made homemade chili — loaded with beans, meat, and spices. I also made my special habanero cilantro salsa, which the family is crazy about. Had to make a quadruple batch because four other people wanted some too. Perhaps I should consider opening a salsa shop!

These meals, of course, will last a long time. What with my new containers, I probably have enough chili and salsa for three weeks of meals. I’m thinking about boiling an egg for breakfast. Then my daily schedule would consist of exercise, homemade protein smoothie, vitamins, breakfast (an egg and some salsa), water, lunch, Isopure shake in the afternoon, then supper, which for the last couple of weeks has been half of a chipolte bean burger with some salsa and cheese on top. I also add a few pieces of fresh fruit to each meal just to have something a bit sweet to finish on.

Taking a couple of months off to get in the groove of things was a really good move for me. I can’t imagine some folks who head back to work after just being off a week. The eating schedule alone is a bear to get straight. I slept late one Saturday and had some unplanned things to do and then spent the rest of the day trying to sort out that I had the right amount of protein and water. While screwing up one day isn’t a huge deal, it’s been very helpful to have several weeks to get into a system before I start screwing around with it. I remember one of the first weeks I was just happy to be able to drink 4 swallows of water at a time. You build up a bigger set of habits by starting with the little ones and adding on.

Speaking of habits, I heard something interesting in the support group this week. Somebody said that the first six months after RNY is considered the metabolic miracle months, the time where hitting the exercise as hard as possible can make for big differences in the total weight loss. They said that this is the time where with good exercise habits you can easily add an additional 20-40 pounds of loss that you’ll have to really work hard to get later. I’m not sure if that’s true or not, but I’m continuing to work out once a day. I must admit to thinking about trying twice daily.

Our elliptical trainer

Our elliptical trainer

One of the things that I haven’t talked about is home fitness equipment. Although we have a gym membership, I’m finding my time on our home elliptical trainer to be an easy way to make sure I’m keeping my muscle mass. Every day I’m exercising for an hour at my optimal heart rate. Having a machine that measures my heart rate as I go is an enormous help. I actually prefer getting outside and doing things like walking or hiking, but that’s not always easy to do — or perhaps I’m just not dedicated enough yet :)

Of course, the really tricky part of all of this is how to act when everything is moving around — the dog is sick, you have an unplanned visitor, you have to go help out at the local charity, and you are stressed out about a relationship issue. Now that I’m coming up to 3 months post-op, I believer it’s time to find out. Time to start mixing things up!

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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.

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Weigh Loss 12 — Becoming a Smoothie Ninja

Vitamix 750

This Vitamix 750 is a monster blender. It could probably turn other blenders into a smoothie

Got the go-ahead last week to start adding solids to my diet, and also talked to my nutritionist about making smoothies. Wow, I’ve been missing out on some fun stuff!

When I knew I was going to have surgery, I bought a Vitamix 750. It wasn’t very cheap, but it was supposed to be one of the best blenders around and I figured I definitely wanted things blended well after my surgery.

It works great. I find I can replace one of my Isopure protein shakes with a homemade smoothie. Tastes better, I get to make it just the way I want, and cheaper, too. This morning I’m having a smoothie that has an half cup of Greek yogurt, a cup of frozen strawberries, some protein powder, a few Goji berries, a bit of citric acid for more twang, and a bunch of Splenda. Yum! Strawberry milkshakes!

At first I didn’t know how to treat these smoothies. Were they meals? Were they protein shakes? I finally decided on the latter. Even though they contain things I might have for a meal, they’re a drink, not something meant to fill up my pouch. Their primary purpose is delivery of protein — that’s why it’s important to add a bit of protein in with each shake. You don’t want to miss out on your 70-80 grams of protein required each day. If you do, you can become extremely cranky! And it’s bad for your health too.

The hiking continues along this week, although at 48 I’m not able to bounce back as quickly as I could at 28. I took a couple of months off for this surgery, spending my time at home on projects instead of traveling and working with clients all day. One of the things I worried about early on was my ability to be able to stay at work all day without running out of energy. Yesterday’s long hike assured me that I have the energy for a fairly full day — as long as I plan ahead of time for staying hydrated and having enough protein and food. This is not very difficult at all, but it’s not like it used to be. It used to be I’d just swoop in on a McDonald’s and eat whenever I wanted, for as much as I wanted. Now I’m pulling out three peanut butter crackers for lunch and eating them very slowly, then waiting another hour or so before I start back in on hydration.

Things change.

Everybody says the main difference in weight loss in folks that have surgery in the long-term is between people who exercise and those who don’t, and that the secret to sticking with it is to find something you do that involves exercising but isn’t just going to the gym. For now that’s going to be hiking for me. Later on I’d like to get my bike out of storage. After that — perhaps — think about starting to jog in the the mornings. I have plenty more weight to lose before that’s possible, though.

This past week I lost five pounds, which is much more than I expected. Most of that was probably water weight I lost yesterday on the mountain, so next week it would not surprise me at all if I only lose a pound or two. Still, the weight loss continues on. I figure I have about 20-30 more pounds to lose before I can seriously think about running again as a sport, but it’s something I think about quite a bit now. Funny how things that seemed ludicrously impossible just a few months ago currently look like they’re within reach.

Daniel hiking holding Isopure

The hike yesterday with the kids was about 6 hours. The Isopure shakes come in very handy when traveling.

I’ve been watching my online groups to see what kinds of questions other folks have, and I’ve quickly found out that I’m doing very well. Even though the percentage of people with problems is low, the surgery has become very popular, and that amounts to a lot of folks having problems. Then again, so many people seem totally unprepared for what they’re getting into.

Just wildly guessing, right off the bat, any kind of surgery has around a 1 percent mortality rate. That is, around 1 percent of folks that get put under deep anesthesia have some sort of problem either during surgery or afterwards and don’t make it. Believe me, this was a big consideration for me when thinking about my decision. Another ten percent or so have complications but end up working everything out. Just guessing, I’d say another ten percent of folks have some kind of emotional problem that surgery is not going to fix (though with all the modern psychobabble around weight loss, I bet a lot more people think they have some deep-rooted emotional problems with food than actually do). This is why the psychological screening is so important.

I’m seeing so many people ask questions in the room that were covered multiple times by my classes and handout materials. Somebody told me once that many doctors don’t have all of the safeguards and tests to run before they cut on you. One month you’re meeting them and the next month you’re getting an operation. As much as it got old driving back and forth to my doctor’s place for more tests and classes (four hours each way), after reading questions from many folks I’d much rather have it work this way than the other way.

One lady had surgery a couple of weeks ago and is already back eating all the same things she did before the operation! I’m not sure how this is possible with such a reduced-sized stomach pouch. I imagine she just went to one of these fast food places, bought something she loved eating, and sat down eating as much as she could all day long. Her complaint was that she hasn’t lost any weight yet, and wanted to know what to do. No wonder! The group suggested she go immediately back to her doc and fess up. Tell him everything she has been doing. This is really bad behavior. She could end up in deep trouble acting like this. There’s a reason they put folks on a mushy food diet for a couple of months after WLS. Your incisions need time to heal.

If you’re spending months planning for major surgery, going through all of that, feeling sick and sore from the work they’ve done, then immediately jumping into trying to eat like before? There’s something else going on. I’m under no illusions here — over time I expect the world around me to win out over the modifications I’ve made. Eventually I’ll return to the natural way of eating more than I need. Most everybody does in our society. I think the key question is: how much are you going to work on this after you’ve gone to all the trouble to do it? For many folks, weight loss surgery is viewed as a quick fix: go have the doctor sprinkle some magic fairy dust over you and then you won’t have to worry about anything.

Not me. Even though I’m not an optimist over the long-term, I’m prepared to work at this chance I’ve been given. Weight loss surgery isn’t a magic fix, it’s a “reset button” that allows me to develop better eating and exercise habits. Sometimes if you keep these habits for the first couple of years, they’ll stick with you for life. Most people end up gaining weight back — but only 20-30% or so of what they had lost. Some folks don’t lose at all, or gain it all back.

This is like being a kid, and always wanting to play football even though you’re not athletic. Finally, somehow, you get on the football team. One day, after many games of sitting on the bench watching others, the coach puts you into the game and you get the football.

Your job isn’t to run for a touchdown. You might not even make it five yards. Your job is to grab that football and run as hard as you can, to give it the best shot you can, and not worry about how it’s all going to come out. This is your chance. Take it. Run your little heart out, kid.

So even though I’m not blind, and I know the situation and the way things are, I don’t think I can worry about the big picture, my odds, or any of that. I’ve made my decision, I have the ball, and now I need to maximize the benefits of it as much as possible. After all, I’ve already done the hard part.

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