Armpits

..just starting to form.

70 Pounds Down..And A New Scale

 I just got this fabulous scale!  Isn't it tech-y?  It measures everything:

• Body fat %    (37.1%  Normal = 23-33%)
• Visceral fat level     (8  Normal = 9 or lower)
• Skeletal muscle %    (28.6%  Normal = 24-30%)
• Resting metabolism  (1561)
• Body age  (50.  Ugh!!!)
• Body weight  (176.8)
• BMI  (28.6  Normal = 18.5-24.9)

More data = more motivation for the next 40 pounds. 

Holiday Weight Gain

Oh man!  I gained a solid 3 pounds in the last week of December due to an unbridled love affair with chocolate truffles.  Damn you, sweet treats and your bitter consequences!

I went in for a nudge of a fill today.  I'm oh-so-very conservative with my band and prefer the "satiety with smaller meals" philosophy achieved with tiny fills vs the "restriction" method of larger fills to prevent over-eating.  I'm more willing to do the hard work of eating smaller, smarter meals in slow, small bites rather than go for broke and have my food choices restricted by what can fit through a too-small stoma.  Not for me.

Part of the strategy behind this latest fill is to combat the recent 3 pound gain and address the hunger I've been feeling 60-90 minutes after a small meal.  I'd like to be back at my pre-holiday weight in three weeks.  I'll create another ticker under the "Challenges" tab on the right.  Let's check back on 1/24/11 to see the progress!

And speaking of progress.. I'm staring down the barrel at my one-year "bandaversary" in six weeks.  If I stay on target with a 1 pound loss per week, I think I can hit a 68 pound loss since having the band placed last February.  Onwards...

NSV - An Emptier Closet

Two weeks ago, I got rid of all my size 20s, 18s, XXLs and many XLs.  

That empty closet must contain a methaphor for other parts of life that now have more space.  For what.. ?

I've got one and half more weeks to lose one and half more pounds to leave the obese BMI category.

Onwards...

Feeding Fat vs Feeding Muscle

While listening to an interview with Lou Ferrigno today on the Adam Carolla podcast, Lou mentioned training intensely now as he did during his body-building days, both with the amount of weight he lifts and how he watches what he eats.

He said something very simple that made a lot of sense:  "Do you want to feed fat or do you want to feed muscle"?

When I make decisions about what to eat, I know I can stay within my energy limits by making nutritionally dense and and muscle-feeding choices, or I can feed fat by eating sliders.  

So, this week, I'll practice Lou's simple, mindful check-in before I eat and ask "Do I want to feed fat or do I want to feed muscle?"

9 months banded.  57 pounds lost.

New Challenge

9/13/11: Lose 11 lbs in 14 weeks (by December 23rd) to achieve a BMI of 29.9 and no longer be obese.  A Christmas present to myself.

Happy Birthday to Me!

It's Monday; it's my birthday!

As of this morning, I weigh 42 lbs less than my birthday last year.

Also, I nailed my mini challenge of losing 11 lbs in 11 weeks.  Accomplished three weeks early.  Booyah.

Happier and healthier.  It's a good thing on your birthday.

Lose It! I Love This Tool!

I've been using a fantastic program to log calories and exercise called Lose It! http://www.loseit.com/  Thank you Sharon for turning me on to this fantastic website! 

I noticed I often eat 2/3 - 3/4 of my daily calories after 4pm.

I sometimes eat 1/3 - 1/2 my daily calories in snacky foods. 

So, going forward this week, I'm trying to:

1) Make sure 2/3 of my calories are consumed before 5pm.  That means less night snacking and figuring out what I need to do during the day to decompress instead of waiting until night to flop out with a bag of sunflower seeds and popcorn to unwind.

2) Replace some of my typical snacky foods with other choices.  Like what you ask?  Aforementioned sunflower seeds and, get ready for it... chocolate-covered gummy bears.  Or really, gummy anything.  My kryptonite.

And an update:  I've lost 49 pounds since December 20, 2010 and am now under 200 pounds.

Vacationing With The Band

http://www.intuitiveeating.org/

I'm vacationing in the beautiful San Juan Islands (Washington State) and flying completely blind with no scale in sight.  Vacation strategies:

• Focus on intuitive eating.
• Watch for the soft signals, those advance warnings of impending fullness.  Lately, my soft signals have been nasal congestion and runny nose.  Nice signal, huh?  When you can't breathe, stop eating!
• Have fun and relax.  I have no pressing or immediately impending work activities and no projects that need immediate attention.  I left my house in immaculate shape before leaving and all is well.
• Read for pleasure.

A Fill Appointment In Pictures!



The ferry ride to Bremerton, WA.



Surgeon's office

Fluroscope for precision guidance.



The RN who performs the fill procedure.  A medical
technician is also present to run the fluoroscope.



Locating the port.

  



 

Inserting the fill needle. 



First, the fluid is removed..



 


Swallowing barium to check flow-though rate
 between upper pouch and lower stomach.

 

The view on the way back to Seattle

A Fifth Fill?

The view arriving in Bremerton, WA via state ferry.

I'm on route to Bremerton now for a fifth fill appointment.  My satiety seems to have decreased in the last 2-3 weeks and I'm far hungrier about 1.5 hours after meals.  I have absolutely enjoyed the ability to enjoy any type of food, breads, pastas and rice in the last month with no untoward affects.  However, I'm willing to give that up to remain satisfied 3-4 hours after meals.  So, off to Bremerton I go.

My bariatric surgeon has two offices, one in Olympia, WA  and one in Bremerton,WA. 

First Challenge Goal Down!

I made my first challenge goal today that I set six weeks ago:  Lose 1 pound per week for six weeks.  Done. http://myquatto.blogspot.com/p/challenges.html

Since my last post in late May, that's about 12 lbs down. 

August is a big vacation month.  I'm planning to continue a 1 pound per week loss throughout the next six weeks, but without the assist of a regular schedule with regular, planned gym workouts and regular, planned meals.  Onwards.. 

Gaines Burgers AKA Brown Rice Power Patties

Remember Gaines Burgers?  That's the name I'm giving to  Brown Rice Power Patties, a fantastic recipe my mother sent me to combat the afternoon sugar cravings.  They are delicious.  Heres' the recipe so you can make your own Gaines Burgers Brown Rice Power Patties:

Brown Rice Power Patties

231 Kcals, 10 grams protein each.

2 cups cooked brown rice

4 ounces sharp Cheddar cheese -----grated

1 1/2 cups finely-grated carrots

1/2 cup raw sunflower seed

1/2 cup raw or toasted sesame seeds

3 eggs

1 teaspoon dried basil

1 teaspoon salt

1/2 teaspoon freshly ground pepper

1 1/2 cups toasted slivered almonds or dry roasted peanuts

Preheat oven to 350 degrees. Mist a baking sheet with non-stick spray.  In a mixing bowl, combine cooked rice, grated cheese, carrots and seeds.  Combine the eggs and seasonings in the food processor and blend for about 5 seconds. Add nuts and process another 5 seconds. if using dry roasted peanuts you may need to process them an extra 5 seconds. Don't over-process the nuts; their texture is important. Add to rice mixture and mix thoroughly.

Use a 1/4 cup measuring cup to scoop mixture onto baking sheet, and form into plump patties about 3/4 inch thick. I pack the measuring cup firmly and rinse it between scoops so that the mixture drops out more or less cleanly formed, ready to be patted our a bit more and shaped the rest of the way. Bake at 350 degrees for 15 minutes, then turn patties over and bake 10 minutes more. Transfer patties to rack, flipping them so their toastier side show.

If you're not eating them the same day, keep in the refrigerator. They will easily last at least a week if kept cold and stored in an airtight container.

Monitor Measure Manage

Today:  I will

*  Monitor my hunger signals

*  Measure my Kcals & protein

*  Manage my stress.

Off for a walk around Greenlake (2.8 miles) ...

4th Fill, NSVs and Compulsive Eating

I'm riding the ferry back from my 4th fill appointment and have some time to reflect on what's been going on this last two weeks. 

First, a couple of NSVs (non-scale victories). 

• I'm getting the hang of smaller bites, slower eating and stopping eating without needing that "full feeling".  I found it I don't wait until I'm ravenously hungry, I can manage these new eating techniques, which, with continued practice will become my usual eating habits.

• I have a couple of tops and dresses that are getting big.  Or, am I getting smaller? 
• Significantly less knee pain and stiffness. 

Second, the 4th fill:  The fill technician predicted I'm likely getting close to the "sweet spot" that might hold me for the next 6-8 months.  I'll still need to check in monthly, but I may not need as many fills in the next several months as these first three months.  In the last two weeks, I certainly did feel hungrier sooner (1.5-2 hours instead of 3-4 hours) after eating.  I found myself ruminating and over-planning meals last week as well..a near-certain precursor to compulsive eating.  And, a little sugar craving has popped up between meals, especially towards the end of the day.  Game plan:  After these next two days of liquids (always mandatory after a fill to allow the stomach to heal and settle), I'm going to increase protein in the afternoons with some really great fiber (almonds, apples) to see if I can kick the sugar cravings in the evenings.

Third, and speaking of compulsive eating, I was trading stories with the fill technician about our greatest feats of compulsive eating.  We both agreed that sometimes, for whatever reason, one's brain is wired to just EAT.  Whatever and whenever, with no signals or guidance from other parts of the body.  Silly brain.  So competent in some areas and so defective in others.  It will likely always be this way.  Just like managing a disease or a birth defect.  There are work-arounds and scripts and practices that can help make up for the deficit.  It reminds me of advice adult Aspergian John Robison gives to parents of young children diagnosed with Asperger Syndrome:  "Give them the social scripts they need to be successful in the world.  It doesn't matter if you don't understand why you need to look someone in the eye and say hello when you enter a room.  You just do it and it makes life easier for you."  So I suppose the script for us compulsive eaters is:  "Slow down, taste your food, stop when you feel just barely full but in no way stuffed.  Take little bites.  Eat small meals and make sure they are nutritionally dense so you'll stay satisfied for 3-4 hours.  Deal with stress and feel emotions instead of smothering them with anesthetizing food.  It doesn't matter if you don't understand why.  Just do it.  Your life will be easier".

"You Cannot Manage What You Do Not Measure"

This is a quote from Dr. Simpson's Book "Lose the Last 30 lbs" .  This is the same bariatric surgeon who wrote the excellent article on appetite suppression vs restriction. 

The most successful gastric band patients learn how to be satisfied with a cup of food.  They learn to walk away, regardless of being able to "eat more".  The let their bands "fool their brains" into thinking they had more food and thus, get appetite suppressant for several hours on just a cup of food.

"The band goes around your stomach, not your lips and not your brain".

Dr. Simpson's recommendation is to track volume and measure what you want to manage.  I've been measuring calories and protein, but not necessarily volume.  I'll make that my next 4-day win beginning tomorrow and track when my hunger returns after eating a cup of volume.

(I wonder:  If one is used to large volumes of food, likes large volumes of food and thoroughly enjoys that "stuffed feeling", I wonder what the process was like getting used to 1 cup of food at meal times?  Is there grieving at that big lifestyle change?  I've heard some WLS patients will take up other addictions (drinking, gambling, shopping, etc..) to fill up what is now missing.)

Excellent Article on Using the Band Successfully

It's not about fullness and restriction, it's about appetite supression. 

http://drsimpson.net/fills/Lap-band-eating/lap-band-not-restriction/lap-band-and-restriction.html

Thank you, Heather for posting this link!!  Visit Heather here:  http://heatherslapband.blogspot.com/

Open Door

Something has changed in the last two days.  The tightness of my band from the fill last week seems to have loosened significantly.  The first thing I noticed was a return of hunger about an 60 - 90 minutes earlier than I'd expect and the ability to eat a greater quantity at once.  Secondarily, food seems to "slide through" more easily instead of remaining in the upper stomach, creating stretch, fullness and satiety.

So.  What to do?  When the door is open, should you step through?  When the band is feeling quite restrictive, it's impossible.  The door is locked.  Now that the door is open (about 1/4 way), it obvious that it's time to engage the brain.  Those that have gone before me talk about the band being a tool but not the solution.  The solution is me.  I get to choose what, when and how much to eat.  The band gets to be the band.  The bumpers in the bowling lane gutter.  It can't throw the ball for me. 

Strategies for the next 4 days:
(Why 4 days?  Check out the 4 day win )

1.  Watch and hunger and fullness cues carefully.  Be careful of getting too hungry and then over-nourishing as a result.

2.  Focus on primary rather than secondary foods (this is based on integrative, holistic nutrition.  Check out http://www.integrativenutrition.com/primaryfood  or http://primarynourishment.com/my-approach

The Bus

You ticket to incidental exercise!  Getting an extra 2 mile walk in today since I'm bussing from Phinney to Capital Hill.  That's good.  Ever notice how can smell what the person sitting next to you last ate?  That's bad.  What is that smell?  KFC?

Analogies & Experiences

Having too loose of a band, or, how I know I need a fill right away:

• This feels much like driving with a very loose parking break on:  You feel something kinda dragging on you, but you can pretty much drive as fast as you want.
• You over-plan eating and ruminate about the next meal.  Thoughts of food dominate your consciousness.
• You feel like you need to satisfy your hunger as soon as you feel it.
• Letting your hunger build also makes your anxiety build.
• Easy to eat over 2000 Kcals a day.

The green zone, sweet spot, or perfect fill level

• Weirdly satisfied with about 1/4 or 1/2 of what you'd normally eat.  (This is still novel and on occasion, I still over-fill my plate.
• Little rumination about food between meal times.
• No physical need and less emotional need to graze and snack.
• 1200 - 1500 Kcals feel about right.  It might be difficult to eat too much over 2000 Kcals.
• Feel like bowling with bumpers:  You still have to throw the ball straight to get a strike, but the bumpers will prevent you from rolling a gutter ball (or totally blowing it by over-eating).

Band too-tight

• Hurts to drink water.
• Takes an hour or more to finish 20 ounces of protein drink
• Hard to get 900 - 1000 Kcals
• Feel like there's a parking boot on your car.  You're not going anywhere and if you try to drive, you're going to damage your car.