Written by Dr. Nick Nicholson and B.A. Blackwood
Weight loss surgery isn’t the easy way out. Successful weight loss surgery requires a fundamental life change. It’s not about your weight; it’s about your head.
I was asked to review a copy of one of the latest books about bariatric surgery, Weight Loss Surgery: The Real Skinny. Written by Doctor Nick Nicholson, a weight loss surgeon, and B.A. Blackwood, an author and lawyer, this book is intended for people who are considering weight loss surgery, or are WLS post-ops looking for additional information.
98% of morbidly obese people fail at dieting, which only 2% are successful. For 20 years, I was in the diet boat, and felt trapped for so long. Most of the information I found about weight loss surgery was either a pamphlet at a doctor’s office or a website not detailed to give the whole story about bariatric surgery. I think there’s a real need in the marketplace for candid books about details about life before, during, and after weight loss surgery, and this book fits the bill nicely.
- How Did I End Up in This Mess and Why Can’t I Get Out of It
- Talking to Your Surgeon: No Time to Practice Lying
- So What’s Really Eating You – Get Ready to Find Out
- What Have I Done to Myself? The Immediate Aftermath
- You Enlisted But Your Spouse Was Drafted: The Impact of Weight Loss Surgery on Your Marriage
- Get In the Game – Dating After Weight Loss Surgery
- My Weight Loss is About Me, So Why Does Everyone Act Like It’s About Them?
- Breaking the Three Food Commandments
- Breaking Up With Your Ex For Good: The Maintenance Grind
- I’m Doing Everything Right, So Why Doesn’t My Weight Show it?
- When to Declare Victory: Managing Expectations
- Revision Surgery – You Don’t Want To Go There
- How to Choose Your Bariatric Surgeon
- Things Your Mama Should Have Told You
As for my review of the book, I wish that it had existed when I was considering surgery. Most of what I read was directly from medical/hospital websites, and the information was quite clinical. This book was very realistic and user-friendly for a pre-op WLS patient looking for a more personalized information set than you’d find on a hospital website. However, for me personally as a 2 year post-op, it was a little simplistic. I have been active in the depths of some pretty gritty and realistic support groups where I’ve had my questions about surgery and post-op life answered, and this book just skims the surface of the heavy emotional stuff. Not everyone wants or needs the “heavy” information like I do, so this book would probably answer the questions of most people interested in surgery. If people were to ask me to recommend books, I personally would suggest this book and “Stranger Here” by Jen Larsen.
“Losing weight isn’t easy, but then nothing worth doing every is. This is your one and only life. Shape it into what you want it to be.”
Disclosure: I was given a complimentary copy of the book to review for my blog from The Cadence Group. All opinions are my own and I did not receive compensation for my review.
February 7th was my two year “surgiversary” of my roux-en-y gastric bypass surgery. I’ve been trying to decide how to commemorate this anniversary on my blog for a few weeks, and nothing felt quite right. I’ve got lots of pictures on Facebook, Instagram, and my blog that show my weight loss progress, so I didn’t want to focus on my external/physical changes. I wanted to touch on some thoughts and feelings about how I’ve changed on the inside…and how I’m still the same.
Reflections of a Two-Year Post Op:
I would like to lose more weight, but I am happy with where I am at: When I embarked on my weight loss journey, I had the ultimate goal of losing 200 pounds. On my absolute lowest day, I had a total of 131 pounds lost. That means that I’m still 70 pounds overweight, and I’m not completely satisfied at my progress. But setting the scale aside, I like ME a lot better. I can look into the mirror and like who is smiling back at me. I can find clothes that I feel comfortable and attractive in. My weight doesn’t hold me back from things that I’d like to do (biking, skiing, swimming, 12+ hour days of walking during travel, etc). I’ve got my problem areas that are managed by shapewear, but I’m not horrified by my bulges and loose skin. I like ME, and even if I don’t lose any more weight, I feel like my surgery was a success.
I still have my taste buds: Just because I had surgery to restrict the amount of food I can ingest, that doesn’t mean that I care if it tastes lousy. I do care. I love food, and willingly admit that I focus a lot of time and money on good food. I tried to get into the mindset “Eat to live, don’t live to eat,” but it doesn’t work for me. I have an emotional attachment to food, and I don’t think that any amount of therapy will change that. I like to celebrate with food, I like to be social around food, and I make better food choices when I just accept those truths. I am not as restricted by the types of food I tolerate as I was right after surgery. I can handle a small dessert without dumping. I eat more carbs than an average RNY patient to avoid reactive hypoglycemia. I usually don’t feel sick after having something rich or fatty. I can’t rely on my “tool” to limit the foods I eat by making me feel sick, so I have to think about the foods I eat. However, now that I’m eating more calories per day, I MUST be active. I feel lousy on days that I haven’t exercised, and I know that eating too much will make it tough to keep my weight in check.
Weight loss doesn’t fix everything: Surgery and the subsequent weight loss have helped me get my blood pressure under control, reduced edema and helped circulation in my legs, and has allowed me to be much more active. But the major disappointment with my pre-surgery comorbidities is that I still have obstructive sleep apnea. I had a sleep study in November that revealed that I have significantly improved my apnea, but I’m still advised to use a CPAP machine (at pressure 5). I have struggled with depression and anxiety since my teen years, and weight loss hasn’t changed those mental health challenges. If anything, I think I have more problems with anxiety. I’ve had some nutritional deficiencies that require ongoing management. I had mono last year, which made me feel tired and lethargic all the time. I consider myself MUCH healthier than I was in 2012, but I’m still not normal or perfect.
Forgive regain, to a point: For the first 10 months after surgery, the numbers on the scale went down consistently. But since December 2012, I’ve been in a constant struggle with my scale. On my absolute lowest weight day, I was at 242. But I was working out like a maniac at that point, having RH crashes too often, and I felt weak. Once my RH was under control, I came down with mono. And peritonsillar abscesses. And I had to go on steroids. And I had surgery. And my doctor restricted my from rigorous exercise for 2 months. On my worst day with the regain from surgery and steroids, I weight 261, 19 pounds up from my highest. For the last 2 months, I’ve been hovering between 248 and 252. I could freak out about what I’ve regained, but I have other things to worry about. However, my RED ALERT weight is 260. If I hit it again, I will be fighting it like gangbusters.
Relationships change, friends come and go: WLS is like a magnifying glass on relationships – it makes the good things better, and the bad things worse. Taylor and I went through some tough times in our relationship prior to surgery, and I wasn’t sure how our marriage would fare post-op. Luckily, he has been an incredible support, I know how much he loves me, and my increasing health has only made our marriage stronger. But not all people can say the same. It’s been interesting to watch my friends go through relationship changes since WLS: divorces, infidelity, marriages, serial dating, moving across state lines to be with the ones who make you feel loved. Those in abusive relationships tend to finally have the courage to move on, whether it is a romantic relationship or just a friendship. I’ve lost friends, but have gained many more. And some of the friends I’ve made since surgery have already moved on. You have to do what is best for your sanity, and sometimes that means that you rely on different people than you did in the past. It’s hard to move on, and I’ve shed tears over people I no longer have in my life, but I am so grateful to the ones who continually support me.
I’m not ready for plastic surgery: With all of my blogging and social media connections to the weight loss surgery world, I’ve seen some amazing transformations over the last few years. For many of them, they hit their goal weight in less than a year, and have reconstructive plastic surgery soon after. I’ve been fortunate to have minimal skin sagging and need for major reconstruction, but that may change as I lose more weight. And I haven’t ruled out the possibility of having another child yet, so I will wait for any additional surgery until I have a baby or decide to keep my family as is.
I’m not sure where I’m going with my blog next: I’ve had some pretty awesome opportunities through blogging about my weight loss. I’ve spoken at conferences, I’ve been on TV, I’ve been featured on health websites, and have a loyal group of followers online. But I’m in a bit of a “blog life crisis” – I don’t always feel like blogging about my health, I get offers from brands to review products and want to take advantage of those opportunities, but then I get behind with writing for me. I will probably be writing here less and less. I’ve got a time-intensive job that demands my attention more than past positions, and getting back on a computer after work rarely happens. I’ll post when I have something important to say, and not pressure myself to post for the sake of posting.
The last two years have been such an amazing journey with my health. This week in 2012, I was beginning the pre-surgery diet to prepare for my gastric bypass. I lost 120 pounds in the next 11 months, with a pretty constant downtrend in scale numbers. Through 2013, my life was less restricted. I was able to eat more, tolerate more varieties of food, and started testing out the limits of my newly-regained healthy body. Despite the loss of weight, I still had health concerns and had to proceed with caution. I struggled with reactive hypoglycemia as I tried to become a more serious athlete. I had mono and peritonsillar abscesses, went on steroids, gained some weight, and then had a tonsillectomy. Two weeks later began a two month whirlwind of travel, packing, interviewing, and general life insanity to prepare for our move to Michigan.
Now it’s 2014. I feel like my health is back in my control. I got a Fitbit One for Christmas, and it’s helped me be more aware of my activity levels. January has been an incredibly involved month at work, I’ve worked a lot of overtime, and the Fitbit kept me motivated to walk a little more and take the stairs whenever possible. I haven’t been to the gym as frequently as I’d like, but tracking on the Fitbit stats often push me to go longer at the gym. However, no matter my activity levels, I still need to be mindful about what I eat.
ZonePerfect invited me to be a blogger for their 2014 BlogForward challenge. It’s a campaign for bloggers to make healthy resolutions in 2014, with challenges through the year to keep us motivated and on-track for long-term success. I have been a fan of their bars for several years, and I’m happy to act as a brand ambassador in this challenge.
1. Avoid mindless snacking by planning the food I bring on the go. Between long work days, too much time in a car, frequent travel, and other life unpredictability, I’ve begun to rely too much on junk and convenience foods again. A pastry or bag of chips at the gas station were almost a daily norm before surgery. When I don’t plan, I don’t make good decisions. I do best when I have a supply of nuts, jerky, dried fruit, and bars tucked in my desk or glove box.
2. Walk 3,000,000 steps. With the Fitbit being much more accurate than any cheap pedometer I’ve used, I feel like my efforts are properly documented. And seeing my number sync through the day help me add additional activity. I’ve calculated that to reach 3 million steps, it averages out to be about 8,500 steps a day. Most days, this is doable. And when it’s not, I’ll make up for it other days.
3. Work on my endurance to prepare for the Detroit Free Press International half-marathon. Through the encouragement of my friend Wendy, I’ve signed up to participate in the Detroit half, which is one of the only races that cross international boarders , going from the US to Canada and back.
4. Get below a BMI of 29. Despite losing so much weight, I’m still in the obese category. And by golly, I want to just be “overweight”!!! That means I’ve got about 40 pounds to hit that milestone. If I’m consistent, that’s just 3-4 pounds a month. It’ll be tough, but I think I can achieve it.
P.S. The Kidz Zone Yellow Cupcake bar is THE BOMB. I call it the “cupcake crack” bar. It’s soooo good. You’ve gotta try it.
Disclosure: I have agreed to be a brand ambassador for ZonePerfect as part of the Blog Forward Challenge. I have not received any monetary compensation, but I will be receiving shipments of free product through the year to enjoy and share with my readers. All opinions, good or bad, are my own.
One of the most important features of a support group is just that – support. When life gets tough, you might need help in unconventional ways. Bariatric surgery support groups are most common in person, usually offered through hospitals and surgeons’ offices. With my hectic schedule and so much of my time spent online, I prefer to participate in an online support group. I found the Bariatric Bad Girls Club around the time my surgery was approved, and I’ve come to depend on those friendships daily.
One of the dearest friends I’ve made through BBGC is Carla (AKA CC-BBGC). We’ve spent time together several times over the last 2 years, and she has given me encouragement and love when I’ve struggled through tough times. In August, we had plans to room together at the Obesity Action Coalition’s Your Weight Matters conference in Phoenix. On the flight between Norfolk and Atlanta, her husband Mike had a grand mal seizure on the airplane. After days of diagnosis and treatment, Mike was diagnosed with brain cancer.
Their last 4 months have been spent in chemotherapy, radiation, surgery, and various other treatments. Despite Carla’s infectious happiness and positivity, the stress she has been under to support her husband through the last few months has worn on her. I’ve sent messages of love and friendship, but it didn’t feel like I was doing enough.
When my husband was scheduled for a trip over Christmas, Rosie and I had originally planned to spend those days kicking back in pajamas and watching Christmas movies. But on the 23rd, after noticing that Carla’s posts on Facebook were particularly grinchy, I knew I had to do more. After a few travel arrangements, I decided to plan a quick 24 hour trip to Virginia. Rosie and I flew out to Norfolk on the morning of Christmas Eve to bring some Christmas cheer. We came decked out in matching Christmas jammies and silly hats. The smile on Carla’s face was priceless when we came out of security and each gave her a giant hug.
Carla was wearing a Christmas sweater at the airport in an attempt to be merry, but said that she had to go home and get into her Christmas gear. She dressed up as “Carla Claus,” brought Mike along, and we had some fun at Virginia Beach. We walked the oceanfront in our silly hats and outfits, talked, laughed, and got some exercise. When Mike was too tired to continue, he waited for us to walk further along the oceanfront. It was fun to see other people smile and comment on our “gay apparel,” and watch Carla briefly forget about the stress that cancer has brought into her life.
With all the stress that Mike and Carla have been under recently, it felt so good to help them laugh, smile, and divert their worries away from cancer for a while. We posed for funny pictures in Virginia Beach, particularly by the “anti-profanity” signs (Because in a Navy town, it’s common for everyone to “swear like sailors”).
After VB, Rosie said that she wanted to drive to the North Carolina border because she’d never been to NC before. So we hopped on the highway and headed to the border. We stopped at Border Station, which is a convenience store where half is in Virginia, half is in North Carolina, with a huge dividing line through the middle of the store.
For dinner, we drove to the marina where Mike and Carla keep their boat. There’s a lovely dockside restaurant called The Lagoon where we enjoyed Christmas Eve dinner. Our mutual friend Vivian, who is also in BBGC, met us at the restaurant to have dinner with us. We laughed, we ate, and had a dinner that was a little unconventional for Christmas. We joked around with the restaurant staff, sang along to the Christmas songs playing over the speakers, and enjoyed the view of the marina as the sun set.
When we got back to Carla’s house, we snuggled up on the couch and watched the ridiculously awful B-movie, “Santa Claus Conquers the Martians.” It’s one of those movies that’s so bad, it’s good. We laughed so hard we cried. Carla packed up a suitcase full of sugar-free Torani syrups (our favorite) to send back on the plane to Michigan (totally worth checking a bag).
Christmas morning was different than any I’d had before. We didn’t sit around a tree and open presents. We just enjoyed each other’s company as we ate breakfast and watched the parade on tv. Rosie and I had to be back at the airport fairly early to fly back to Detroit, so we said our reluctant goodbyes before 8 am. When Rosie and I got off the plane in Detroit, Taylor was waiting for us at the gate in between his flight legs. We snapped a quick family photo, gave each other a kiss, and he was off on his way.
Christmas 2013 felt merry this year, and it didn’t require a Christmas tree with a load of presents to open. It was about love, friendship, and celebrating the small joys in life. My greatest hope for Mike and Carla this year is that treatments will be effective and his cancer will go into remission. I hope to visit again later this year, celebrating the successful conclusion to chemo. Until then, I’ll be supporting Carla however I can online.
With all of the food and extravagance of the holidays, it can be difficult to stay healthy and make good choices. Many holiday gift guides I’ve seen have been for products that are grandiose splurges, and not necessarily mindful of a healthy lifestyle. In this post, I am highlighting gift ideas for a healthful life, both for weight loss surgery patients and their loved ones.
I am personally not a coffee drinker, and I am no longer able to tolerate most hot cocoas because of the sugar content. I like having a warm chocolately drink, but not enough to take a ride into dumpsville. Last year I discovered Crio Bru, which is a brewed cocoa drink that is delicious, low calorie, and unique. It is a natural appetite suppressant and gives you energy without traditional caffeine. It can be prepared in a French Press or traditional coffee maker. My favorite blends are Cavalla (cinnamon and coconut) and Maya (spicy chocolate). Most products are between $10-15, and are in the form of the Crio grounds, Crio Cocoa, and Crio espresso. And they have cocoa-coated cocoa beans. It’s available in many grocery and specialty stores across Utah, or online at criobru.com.
Along with the hot drink theme, I’ve also become hooked on herbal tea. I’ve recently discovered Tessara Tea, which offers natural herbal infusions to saturate the body with nutrients. Herbal infusions are made by steeping plants material in water, including roots, barks, leaves, berries and flowers. While steeping, the plant materials release their essential minerals and nutrients into the water, making it easy for the body to absorb and digest. They have 3 different blends: Awake and Alive, Nourish and Cleanse, and Rest and Repair. They are a local Michigan company that has just expanded out of the local market, and their teas can be purchased online at tessaratea.com.
Better’n Peanut Butter
Peanut butter is a great source of protein, but it’s high in fat and calories. With 85% less fat and 40% fewer calories than regular peanut butter, Better ‘n Peanut Butter is a tasty item for weight conscious people, and it tastes fantastic. I was introduced to Better’n Peanut Butter at the Obesity Action Coalition conference in Phoenix this year, where they had a booth. I sampled ALL of their flavors: original, chocolate, banana, cinnamon chocolate, coconut chocolate, hot pepper, maple bacon and more. It’s delicious, and feels like a splurge item without sacrificing too many calories. I’ve put it on sandwiches, crackers, pretzels,fruit, and mixed it into protein shakes. You can find Better’n Peanut Butter at select Target, Rite-Aid, and Trader Joe’s stores, or online at the Better’n Peanut Butter website.
Six Nutrition Vitamins for Men
Got a man in your life that needs quality vitamin supplements for an active lifestyle? Six Nutrition has a complete vitamin packet for men that pinpoints 6 key areas of health: heart, joint, sex, muscles, mind, and energy. Each day’s pills are packaged in a stylish foil packet that make it easy to stash in your pocket, briefcase, suitcase, or desk. My husband recently did a review of Six Nutrition Vitamins on my other blog, if you’d like to read about his experience. You can purchase Six Nutrition Vitamins from their website.
Fit Frappe Protein Drink
Since I had my gastric bypass surgery last year, I have been around the block and back on protein mixes. I seem to fixate on certain brands for a while, then get tired of the way they taste. Of any protein I’ve tried, I am happiest with Big Train Fit Frappe protein in vanilla. It is very versatile…you can flavor it with sugar-free syrups, add it into recipes and fancy drinks, serve it hot or cold, and get single-serve packets for when you are on the go. Another plus about this particular powder…you can add it into other protein mixes to make the more tolerable. I hate throwing away protein just because I don’t like the taste, and mixing in a little Fit Frappe seems to make everything taste better. Fit Frappe is also available in coffee, mocha, espresso, chocolate, chai, and vanilla latte flavors.
No matter how I plan my day, I tend to have a lot of meals on the go. I am good at packing some healthy high-protein snacks, but sometimes you need a meal replacement. My favorite product for taking a meal on the go is the classic 20 ounce Blender Bottle. It’s made of sturdy plastic, has a removable metal BlenderBall for easy cleaning, and the lid makes it easy to shake things up without leaking. I have several bottles in various sizes and colors, and I love stashing one in my suitcase with Ziploc baggies of protein powder for when I travel. They’re affordable, and can be found everywhere from GNC to Walmart to Amazon.
I haven’t felt like myself for months. Starting in May, around the time I went to Vegas, I began feeling extreme fatigue. I’ve dealt with fatigue several times before, but this was significantly worse. I though it was caused by a vitamin deficiency, so I got all of my lab work done. But everything came back unremarkable, and the rapid mono-spot test came back negative. My doctor ordered additional tests, and there was still no answer to why I was so dang tired.
I’ve struggled with depression and anxiety for years, and the summer months tend to be difficult for me. I will get into a summertime slump, and try my best to just make it through my seasonal mental health woes. This summer was difficult, but it didn’t feel like the past few years. I had a hard time staying awake through a full day at work. Despite my best attempts to focus and be productive, I felt like my brain was in a continual fog. I would get home from work, zone out, and not accomplish anything else for the day.
Stress was high because our family knew that a cross-country move was on the horizon. Taylor was transferred to Detroit in March, and it became evident that our family needed to relocate to be with him. I wore myself out trying to apply for jobs for months, and nothing was working out. I was discouraged, in addition to feeling like a blob of fatigue.
In late August, some friends invited me to try a yoga class. I’ve heard that yoga is good for stress reduction, so I figured it couldn’t hurt. I didn’t love the class, but I gave it a good effort. The next morning I woke up feeling toxic. Over the next few days, I started developing swollen glands and a one-sided sore throat. I don’t know if this was caused by the yoga, or the toxins released by the stretches, but the timing is suspect.
As the pain and swelling worsened, I decided to get checked out at urgent care. The rapid strep test was negative, but the swelling was large and abnormal. I was diagnosed with peritonsillar abscesses, which can be caused by both bacteria and viruses. I went through courses of IV antibiotics, antibiotic shots, two rounds of oral antibiotics, and a whole lot of steroids. I spent weeks in pain, in bed, and missing work. I visited with my ear, nose, and throat doctor, who said that if they abscesses didn’t resolve themselves on their own, surgery was the next step.
Over a weekend, things got worse. I was in more pain, the swelling increased, and I was very dehydrated. I went back to urgent care, had another negative strep test, and the doctor diagnosed me with infectious mononucleosis. He ordered a large battery of viral testing, told me to avoid contact sports and saliva contact with people, and urged me to get a tonsillectomy ASAP. A few days later, the results came back. I indeed had mono, even though my earlier rapid strep test was negative. I was positive for herpes simplex 1 virus and Epstein Barr virus, with an active infection for 5 months. The only way to resolve the mono was to get the tonsils removed. As soon as my ENT could get me in, I had a surgery date scheduled.
I will not lie. The tonsillectomy was horrible. I wrote a very detailed post about the nitty gritty of an adult tonsillectomy on my other blog. Two weeks of pain, discomfort, swelling, and misery. But it also was a turning point for me – I knew life was about to get much better. I started to feel a spark in me that had been absent for half a year. After months of unsuccessful job hunting, I started getting job interviews. And then I quickly was offered a job. Things were starting to fall in place for our family to move, and we’re now in the thick of the moving process.
I haven’t been writing about my weight loss surgery much because my other health concerns have been far more important lately. I feel like I’m in my groove as a bariatric patient, and there’s not a lot of new things to write about. I have gained about 15 pounds through this mono/steroids/surgery/moving debacle, and I’m looking forward to being back on a schedule once we’re in our new house. I still feel the effects of mono fatigue, so I’ve been very careful to not overdo it with exercise. I do some moderate walking, but avoid anything excessive. I have far too much stress to manage to push myself physically.
I apologize if my future posts are less frequent. I haven’t give up this blog, but I also have greater responsibilities to fill my time (like my new job). I still plan to lose more weight and document it here. My journey is far from over.
But for now, I’ve at least figured out why I’ve felt so awful for half of a year.