Can I Sail Through the Changing Ocean Tides

20120719-094629.jpgBefore I say anything else, I want to thank all of your for your overwhelming support for my last post. It really means a lot to me.

I wanted to take the time to address a couple of questions that were asked in the comments of that post.

Martymankins asked: “what are some types of foods that you cannot eat anymore after the WLS?”

Since I have very limited capacity now I eat mostly protein, because my body really needs it to function, so I severely limit my carb intake. Plus I’ve discovered that refined carbs make me either nauseous or go to sleep. I used to be a complete nut for pasta, but aside from a bite of the best mac & cheese ever while we were in Maui I haven’t had any in 6 months, and I don’t miss it.

There are some foods that I’m not supposed to have for the first six months while my body is still healing and I’m used to making sure I chew everything thoroughly – meats that are tougher to chew like steak, fibrous fruits & veg like celery and oranges, and nuts all can cause problems if I’m not careful so I’ve avoided most of them. I did add nuts to my diet a little prematurely because I was having trouble getting enough protein.

Foods I really can’t have because they make me sick are so far limited to bread and rich (buttery) things. Bread makes me just plain miserable, so I avoid more than a bite or two. A couple of times I’ve ordered fish in a restaurant and ended up feeling horrible, and the only thing I can attribute it to is the sauce because I eat a lot of fish at home. I avoid fried foods anyway and especially now that I know fats make me sick, although I will cop to stealing a two or three of Jason’s fries a couple of times.

The sickest I ever got though, was due to a sugar-free cough drop. Even though they are supposedly sugar-free they still contain sugar alcohols, and I’m apparently much more sensitive to those than I am to actual sugar. Now I check labels carefully for those when something claims to be sugar free because I’m pretty sure I used one of my nine lives on that one.

My diet isn’t perfect but I spend 99% of the time in my comfortable little protein food box and do pretty well.

Megan asked: “My lingering concern for you is swapping of addictions. Mitch’s aunt had WLS (don’t know which type) and then ended up with a pill problem. I’ve heard of gambling addictions, etc. after this surgery. Is that what the therapy is supposed to help avoid?”

Addiction transference is turning out to be a lot more common than was once believed, and the biggest problem is alcoholism for two reasons. One, since we can’t comfort ourselves with food we turn to something else to take the edge off. Two, because of our altered digestive system alcohol affects us much more quickly. It goes straight into our bloodstream so what used to take 2 or 3 drinks to get tipsy now only takes a half a glass of wine. The quick effect of alcohol makes it that much more enticing as a stress reliever. Most doctors advise avoiding alcohol altogether for the first year. Shopping and gambling, and pills are other problems that can come up too.

I started therapy for a number of reasons, primarily that I’m going through a really stressful time right now and I needed to keep myself healthy to deal with it. I chose my therapist because his office is the one who did my psychological evaluation prior to surgery, so I knew they had experience with people like me. He helps me find healthy ways to deal with stress so that I am less likely to turn to more harmful coping mechanisms. He also zeroed in on what is probably my main reason for overeating within one session, so I’m pretty happy that I finally seem to have found my therapy match after so many failed attempts.

I’m happy to answer any and all questions (that I can) either now or later. If they’re short I can address them in the comments, but these two seemed like they needed more attention.

And don’t worry. I didn’t start blogging again to bore you with this stuff. We’ll be back to more fun subjects like photography and crazy stuff I do in short order. I did have to get this out, though, before I could blog about other things. It seemed to be the cork in the bottleneck of words for me, so hopefully now that it’s out I’ll have more to say.

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That’s Not How I Want My Story to End

Most of my life, all of my adult life, I’ve had a weight problem. I am someone who really enjoys food. Food tastes good. Good food makes you feel good. Making good food for people you love makes you feel even better.

I was never a binge eater, I ate for comfort – good or bad. Have a bad day? I bet some nachos would make that better. Get promoted at work? Let’s celebrate! With cake! Break up with your boyfriend? This calls for booze AND cheeseburgers. And probably ice cream. With cookies.

Ok that sounds like a binge, but it wasn’t. I am a quality over quantity person. I make hugely bad but very tasty and comforting choices in not necessarily huge amounts.

Afterward I would feel better, whatever ailed me having been successfully buried under soothing fat grams and delicious calories. I could go on with my life, I just had to buy bigger pants.

But I am not without willpower. In fact, I have mad willpower skills when it comes to dieting and exercise. In the last 15 years I’ve lost huge amounts of weight, and I’ve done it in different ways. I have taken pills, I have Jenny Craiged, I have Weight Watchered, I have quite literally run my ass off, I’ve been in televised weight loss programs Biggest Loser style. I have been very successful at every one except Jenny Craig because have you tasted her food? Just no.

Over the course of my adult life I’ve lost enough weight to make an entire obese man over six feet tall. I’m not lazy, and I’m far from weak.

I’ve also sought out numerous therapists to try to get around the comfort food issue. Why was I driven to soothe all of life’s hurts with food? I had no traumatic childhood to point to, or anything else for that matter. Is this an adult children of alcoholics thing? And how do I break that cycle? No one had answers for me, so I stumbled around in the dark trying to fix myself.

One therapist actually said to me “when you feel like eating, just drink a glass of water instead.” Really? I’m so glad you spent all that time in school to become an addiction therapist. What, exactly, do you say to someone trying to quit heroin? Another one tried to get me to find religion.

Every time I lost weight I would hang out at a normal weight for a little while, and then it would start creeping back, slowly at first, but eventually fully and with friends. I would end up heavier than when I started. It seems that either I live on the edge of hunger at all times or I gain weight.

Over the years all this up and down action, along with the body chemistry changes that happen when you cross over that line of morbid obesity, has done a number on my hormones and metabolism. My body no longer even considers losing weight without extreme motivation – like dangerously low calorie intake and an exercise addiction. And I can do that…for a while, but no one can maintain that indefinitely and eventually I fail. And I feel like a failure, which if you’re a comfort eater is a vicious cycle.

After my Dad died my sister and I had to clean up his house, empty it and get it ready to sell. Scattered all over his once beautiful house was the evidence of the addictions that wrecked his body and made him old before his time. He was only 67 when he died, but he had the body of someone much, much older. It was obvious that he’d stopped caring for himself quite a while before we knew he was seriously ill, and that he’d been self-medicating for a very long time. When you live all the way across the country from the people who love you, it’s easy to hide these things.

I remember several different occasions when he quit drinking. He could go years at a time sometimes. Eventually, though, he would start drinking again. Like me, he started slow, limiting himself to only beer or wine. The condition of his house when he died made it obvious there were no limits at the end, and I still wonder what pushed him to that point. I’ll never know and it doesn’t matter. It was enough to remind me that we were very much alike. We were both passionate and artistic and people of extremes. And we both had a monkey on our back, they were just different. I wasn’t going to drink myself to death, but if I didn’t take action I was going to end up in an early grave myself. I refuse to go out that way.

On January 30 of this year I had Roux-en-Y Gastric Bypass surgery.

I am not ready to give up this fight.

I am not ready to resign myself to a (shortened) lifetime of Lane Bryant and being afraid to fly because what if I don’t fit in the seat and knee pain and foot pain and back pain and swollen legs and being short of breath climbing stairs and not being able to keep up with my very active and physically fit husband. My future included heart disease and Type 2 diabetes and seriously diminished capacity for anything fun. I wasn’t sick yet, but it was only a matter of time.

And that’s not the way I want my story to end.

But I couldn’t do it by myself anymore. No amount of willpower was going to overcome the metabolic changes that had taken place after years of obesity and yo-yo dieting, and isn’t the definition of insanity doing the same thing and expecting different results? I needed something else, and it needed to be powerful enough to break the cycle.

I told only the people closest to me about the decision I had made, and I got understandably mixed reactions. Some were glad I had made a decision that made my health a priority.

Some were very concerned for my safety, both immediately and long-term because everyone knows of someone who has had a bad outcome with this kind of surgery and they were, quite understandably, afraid for me. I did the best I could to reassure them that I was making an informed decision, and answered any and all questions they had because my intent was never to worry the people who care about me.

And then there were those who mentioned that this type of surgery might be cheating. As if weight loss and good health was a game, and that the only respectable way to go about it is the good old-fashioned “hard way.” I don’t even try to talk to those people about it because they hang on very tightly to their prejudices about obesity and weight loss surgery, and I have neither the energy nor the desire to open closed minds.

I made a conscious choice to not talk about it here, in part because of the third group of people. I didn’t know if I wanted to deal with the troll behavior that tends to come out of the woodwork when this subject comes up. I also didn’t want to turn this into a weight loss surgery blog, and that would have happened had I started talking about this in the beginning when it was consuming my life. And then talking about it here opens it up to just about everyone in my life, and I wasn’t ready for people to be watching every morsel I put in my mouth like some kind of sideshow.

So I waited until it changed from a new experience to my new normal; for a time when other parts of my life moved back into top priority, and how I eat and the number of vitamins I take is just a thing that I do.

And then I waited some more to see if I wanted to deal with the people who will tell me I took the “easy” way out.

It turns out that, after everything I’ve been through both with the surgery and everything else lately, that I have zero fucks to give for haters. They can hate…I rollin.

In point of fact, it’s true that it’s easier to lose weight when you alter your body so that you can only eat small amounts of food, and of that food you do eat, you only absorb a portion of the nutrients. That is a definite true fact.

In six months I have gone from a BMI of 44.8 to 33. Still considered obese, but I’m just on the cusp of being merely overweight, and it’s a short trip from there to a normal body weight. I am less than halfway through the “honeymoon” period where most weight loss surgery (WLS) patients lose 80% of their excess body fat, and I am more than halfway to my goal. So yes, surgery makes weight loss much easier.

But would I call this the easy way out? Not for a minute.

The entire process both leading up to surgery and in the first months after is arduous, and there are parts of it I will have to deal with for the rest of my life. Right now my hair is falling out in handfuls. That’s temporary. Speaking of handfuls, that’s how I’ll take vitamins for the rest of my life – by the handful – because while the caloric malabsorption part of this surgery is temporary (the 12-18 month “honeymoon” period), the nutritional malabsorption part is permanent. I can’t ever take certain types of medication again, which will really suck if I develop arthritis. If I eat the wrong thing I end up barfing up my guts in the Whole Foods parking lot. There are a lot of consequences to WLS, and the only one that’s easy is the actual weight loss.

It doesn’t even make maintaining the weight loss easy. Because my stomach will never hold the amount of food I used to be able to eat, and I don’t have to deal with the almost constant hunger I had before surgery, I have an advantage. But there are ways around all of that and it’s surprisingly easy for people who have gone through all of this to gain weight back. So maintenance? Requires serious lifestyle changes, therapy, is totally on me and not easy at all. Can I do it? I am doing everything I can to stack the deck in my favor.

So. There you have it.

Because I know I laid a bombshell right on ya with this Magnum Opus, and because I love each and every one of my six readers, I am glad to answer any and all questions you want to leave in the comments or email me about anything dealing with this subject. Just how many vitamins do I take in a day? What do I eat? Are there things I can never eat again? There’s a lot of misinformation and stigma and prejudice out there about the kind of people who have surgery in order to lose weight, and the whole process in general, and if I can dispel a little of that then it’s worth laying all of this out there.

Originally, when I first considered posting about this, I was going to remind people that since I pay for this space I get to decide what kind of comments stay or go, but now I think it will be interesting to see what actually happens. I have some pretty firmly defined boundaries regarding what I’m willing to internalize from the opinions and thoughts of people who aren’t me, and I’m the kind of believer in humanity that claps for Tinkerbell and still thinks the Internet has a soul. I think I’ll be ok.

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