Time Keeps On Slipping Into The Future….

It turns out that when I’m not chained to a desk 40+ hours a week it’s about as easy for me to make regular updates to my blog, as flying a block of cheese to the moon. A lot has happened but I’m not going to dive deeply into most of it (in this post at least). I just realized that the 14th marked the 10 month mark from my surgery and that perhaps it was time for some sort of update.

Seattle, New York, and Sint Maarten were all fantastic. I’m not going to lie, and be totally accountable because I don’t want to say I do everything by the book when I haven’t. I broke down and had wine and dessert in Seattle. We went to a ridiculously delicious (but pricey) El Gaucho. I didn’t have to drive and was with my parents and enough strapping lads that if I got black out drunk off a glass of wine I would make it home in one piece. If I was a light weight before surgery I am like the cheapest date on earth after because one glass of wine is equivalent to drinking 3 or 4 cocktails now. I had bites of all the desserts that came out to the table (table side liquid nitrogen ice cream, cherries jubilee, from scratch keylime pie). Then in Sint Maarten when we went to the french bakery I bought a macaroon and eclair (I ate them over a few days). I also got black out drunk when I was in Sint Maarten because I drank a bottle of wine way too fast without food. I rallied and was fine within a couple of two hours to quote my friends “you went from passed out topless on our balcony to giving a concert (we went to karaoke) in like two hours with no hang over.” I am not saying you should go out and drink and eat sugar. I also don’t need a lecture on the risks of drinking before 18 months or at all after surgery. I am fully aware and rarely partake. Here are a couple of pictures brought to you by that bottle of wine.

I included this one because the other one make my stomach look bigger because my body is tilted toward the camera

I included this one because the other one makes my stomach look bigger because my body is tilted toward the camera

If you look at my top you can see where I dropped my self head first into the sand when I tried to drop back into wheel drunk.

If you look at my top you can see where I dropped my self head first into the sand when I tried to drop back into wheel drunk.

I ate pretty shitty as far as what I should be eating while on vacation, but we were on the go so much that I probably could have ate a whole cheesecake everyday in New York and still lost weight. I came home and everyone was like damn you look like you got much smaller while you were gone. Considering we were walking 15,000 to 20,000 steps everyday in NYC, and I was swimming everyday in SInt Maarten as well as working out a few days on the island my body was put in beast mode. The blisters on the bottom of my feet are finally almost completely healed and smooth.

I came home and had to face the music about not doing any homework on vacation and consequently have been doing work  non-stop to try and save my GPA. I really haven’t done anything or have seen anyone unless it involves something to do with school. This week has finally been the light at the end of the tunnel as far as the school load goes.

As far as a weigh update goes this morning when I did my weekly weigh in I weighed 169 pounds. That’s 144.6 pounds down from my highest weight of 313.6 in December of 2013 and 132 pounds down from the start of the 3 day liquid diet for surgery.

Everything had been going swimmingly until last week around this time I started experiencing abdominal pain right below my breastbone. It’s not constant and gets worse when I eat and radiates into my back/shoulder blade. This is all pretty consistent with gallbladder issues. I am going to wait this out as long as I can before I see a doctor for two reason. 1. I have no insurance 2. If you miss 3 classes in one quarter they drop you from your classes. If I end up having to have surgery not only is it going to cost way more money than I have but all of the work, money, time and effort put into this quarter will have been a complete waste.

So everyone keep your fingers crossed that this gallbladder thing will calm down long enough for the quarter to end, and for my ass to get on medicaid. I am not super hopeful however, the only reason I have a moment to update this thing is because I feel to shitty to do anything else at the moment.

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Rewind The Future

Since much doesn’t change on the weight loss front from week to week I thought I would share some of the stuff I have been working on for school. I’ll share some art but I only had one art class this quarter. I thought I would start with a paper we had to write for my critical thinking class.

The assignment was to choose a commercial or print advertisement and analyze the effectiveness of it. This particular ad goes hand in hand with my nightmare of what my future might have looked like if I didn’t have gastric bypass. Below is the ad and my paper.

The advertisement I chose to analyze was Children’s Healthcare of Atlanta’s Rewind the Future. The commercial was released on September 18th, 2013 as part of their Strong For Life campaign making it a little over a year old. The commercial is meant to create a shocking reaction that many viewers can identify with either personally, or through someone they know.Since this advertisement is being presented by the Children’s Healthcare of Atlanta, they are using ethos as its primary persuasive tactic.

The advertisement opens with a point of view shot from a 32 year old man on an emergency room table in cardiac arrest. As the doctors go over his vitals one asks “how does this happen?” We then begin to rewind as we see his eating habits through his life all the way back to his infancy where his mother is appeasing him with french fries to keep him from crying. The screen cuts to black and in writing says your child’s future; we then cut to an aerial shot of the medical staff cutting the patient out of his clothing and the words printed over it “doesn’t have to look like this.’ The screen cuts to black again, and we see the message “There’s still time to reverse the unhealthy habits our kids take into adulthood. We can show you how” followed by information on how to access their services.

While the intended audience is for parents with young children, or young adults, I believe it makes anyone who has been brought up with a similar lifestyle to think about the choices they make.  Even though I am not the intended audience for this particular clip because I do not have children, I personally identified with its message. I was brought up in a household where we weren’t told no to whatever we wanted to eat, and were raised on fatty, starchy Mexican food. At the time that I first saw this commercial, I had just begun the long process of getting approved to have Gastric Bypass. Upon viewing this it reaffirmed the reason I was going under the knife to

insure that I wouldn’t end up on an ER table at 32 under cardiac arrest. I think it’s a very powerful message for parents to see because part of the problem with my weight is I didn’t learn how to eat properly until I was 17, and the problem was out of control.

The advertisement has come under a lot of flack for being anti obese people, as seen in an article from the August issue of Good Housekeeping by April Rueb. I don’t necessarily agree with that viewpoint; I think it’s more anti a health issue, not anti a group of people. I would, however say that it does portray a couple of negative stereotypes. It makes it seem like every single heavy person is a walking heart attack, which is not true. All of my blood work prior to surgery showed that I was actually very healthy despite my weight with no comorbidities. I decided to go under the knife to make sure that I didn’t occur any comorbidities in the future. It also made it seem like every heavy person is lazy. I know many big people (myself included) who play sports, work out, and are active but have other conditions that make it hard for them to lose weight.

I thought the scare tactic was effective for this particular message. I feel like most of the time when advertisements come on about health or fitness that people tend to zone them out since we are constantly bombarded with them. Since the advertisement holds no punches as far as shock factor goes, it makes it successful in not only capturing the audience’s attention, but also making them remember the message. The use of the point of view camera angle was effective in making you experience what the patient is experiencing both on the operating table, and during the flashback sequence. The flashback sequence was effective in highlighting habits that parents don’t see as hurtful but really make an impact on the choices their child will make about food in the future.

The language used is a bit accusatory making it sound like unless you follow their tips that this will for certain be your child’s future. My one concern I would have as a parent would be the unnecessary stress this ad might have on my child. If my child was overweight it might cause them to be unnecessarily stressed out about keeling over at the age of 12 since children can’t always fully comprehend. Adversely it might cause a child who doesn’t have any weight issues to become unnecessarily obsessive about what they are eating.

Overall despite the few flaws I found with this particular campaign I thought  it was effective. They knew by being shocking this video would go viral causing lots of people to see it. In a day and age when according to the American Heart Association one in three teens is overweight or obese, which is triple the rate from 1963, perhaps Americans can use fright as motivation. I think this advertisement was so poorly received by some because we have become a society where everyone is a winner, so no one feels bad. We have also gotten to a state where we want to put our heads in the sand when it comes to anything that is unpleasant, making childhood obesity a big elephant in the room because parents would rather ignore the problem than hurt their child’s feelings.

The ad is certainly food for thought for anyone. The fact of the matter is for a lot of children raised on fast and processed food this will be their future. If it’s not a heart attack, it might be joint issues or diabetes. I think the ad has an important message that the best start that you can give to your children’s health is to teach them healthy habits as a child. Like the saying goes, you can’t teach a old dog new tricks. By the time a person is 18 and able to make their own decisions about food they might be so set in unhealthy ways that irreversible damage has been done. While scare tactics don’t always work, because it’s such a dramatic difference from the smiling faces we normally see on health ads, it makes a lasting impact with the viewer.

Sources

  1. Rewind The Future [Motion picture]. (2013). USA: Children’s Healthcare of Atlanta. YouTube
  2. Rueb, A. (2014, August 14). This Anti-Obesity PSA Sends a Powerful Message But does it go too far? Good House Keeping.

    http://www.goodhousekeeping.com/health/womens-health/powerful-anti-obesity-psa

  3. What is childhood obesity? (2014, August 1). Retrieved November 3, 2014, from http://www.heart.org/HEARTORG/GettingHealthy/HealthierKids/ChildhoodObesity/What-is-childhood-obesity_UCM_304347_Article.jsp

Food For Thought: How Our Dishes Influence Our Eating

I thought this was a pretty interesting post on the size of dishes and portion control. It only enforces my hunt for some new china to use post op.

Sacramento BMI

Today our very own Dr. Ruby Gatschet is our blogger. Dr. Gatschet joined our bariatric care team last year and we are so glad to have her on board! Read on to see how the plates and dishes we eat from actually affect how much we eat.

I first became interested in how dinnerware has changed over the years and how that has translated to our eating habits when I was admiring some Haviland china sets that had been passed down through my husband’s side of the family. Certainly, they were beautiful pieces of dishware, but they were amazingly small compared to my own set of everyday china. The serving pieces were the size of my regular dinner plates, and the dinner plates were the size of my salad plates. This observation led me to do some research on dinnerware sizes over the years, which in turn led me to…

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“I generally avoid temtation unless I can’t resist it” – Mae West

I have been trying to avoid sugar since January, and I have done pretty well considering I was a little out of control with sugar over the holidays.  I am very good at avoiding and buying sugary treats unless they are right there in front of and then I don’t have a whole lot of power to resist them.

However temptation island has made it’s way to outside my freaking cube at work. It started the week of Valentines when the guy who sits next to me put out 3 candy dishes full of Valentines candy. Up until last week the only thing I had allowed my self was two Hershey’s Kisses. However last week my arch nemesis moved onto the island and now all three dishes (which were almost finally empty) have been refilled with Easter candy (my favorite I think probably because of the colors, since that’s the only thing that changes from one holiday to the next). The Butterfingers I could leave but I love gummy candy and there’s a dish of Sweet-Tart gummy bunnies that I keep sneaking one here and there as I go by.

Then today a box of cookies showed up, and then a box of danish after lunch that disappeared right before I went to take this picture (and as I write this someone is adding more candy to the dishes).

I have to pass this every time I go to my desk.

I then went on to start talking to my coworker about how sneaking labeling laws are in regards to lots of stuff but mostly GMO and Sugar. Did you know that if something has 2 grams of sugar or less they can say it’s sugar free even though it has sugar in it (I found this out at my 2nd class on Monday)? So depending on the amount of that product you eat you could end up with way more sugar than you expected. Plus it’s a beast that’s known by many names so unless you know what your looking for you could miss sugar being in something.

Here is a list of the different how hidden sugar and sweeteners can be listed on your labels:

  • White sugar
  • Brown sugar
  • Corn syrup
  • Corn syrup solids
  • High fructose corn syrup
  • Malt syrup
  • Maple syrup
  • Pancake syrup
  • Fructose sweetner
  • Liquid fructose
  • Honey
  • Molasses
  • Brown Rice Syrup
  • Cane Juice
  • Evaporated Cane Juice
  • Granulated sugar
  • Jaggary (unrefined cane sugar)
  • Palm sugar (made from sap of the Palmyra palm)
  • Anhydrous dextrose
  • Crystal dextrose
  • Sucrose (table sugar)
  • Refined Cane Sugar
  • Beet Sugar
  • Dextrose (crystalline glucose from starch)
  • Fructose (fruit sugar)
  • Maltose (malt)
  • Lactose  (milk sugar)
  • Fruit juice concentrait
  • Powdered Sugar
  • Gluclose
  • Invert sugar (simple syrup)
  • Galactose (dairy)
  • Tubinado sugar (sugar cane-brown)
  • Confectioner’s sugar (powdered)
  • Caramelized sugar
  • Caramel
  • Agave
  • Acesulfame Potassium
  • Aspartame
  • Cyclamate
  • Neotame
  • Saccharin (Splenda)

The list goes on and on, these are just the common ones. I also shared with her this video from Robin O’Brien’s TED Talk on GMO’s and food allergies.

The bill that allowed for GMO foods to be used was passed in 1992 which would have been when I was 6. Now pretty much all of my friends that have had babies have been born with some sort of food allergy, and I wholeheartedly believe it’s because all of the additives, artificial dyes and GMO ingredients that have been in our food for the majority of our lives. I could go on about GMO’s but I will save that for another day this post has fulfilled it’s mission which was to distract me from temptation island until it was time to go.

“One should eat to live, not live to eat” – Benjamin Franklin

Yesterday was class two of three before we can submit my paperwork to Cigna for approval (see this post for what the current requirements are for my insurance plan). The class was on grocery shopping and how to read labels in order to make smarter decisions post op. This is super important post op (especially for gastric bypass patients because of the malabsorption part of that procedure) since you physically wont be able to consume a normal volume of food.

The recommended program for nutrition post op for RNY/Gastric sleeve are as follows:

  • Eat 5-6 small meals per day
  • 60-80g of protein per day
  • 64 oz sugar-free and caffeine-free fluid per day
  • No drinking during meals and for 30 minutes before or after meals
  • Take a Multivitamin daily
  • Take 1500 mg Calcium Citrate (no more than 500-600 mg at a time)
  • Take Iron daily (separate from calcium)
  • Take B-12 daily
  • Limit calorie dense foods (sugar, fat)

Avoid

  • Carbonated beverages (soda, beer, fizzy water etc.)
  • Nicotine use/exposure
  • Alcohol consumption during the rapid weight loss period (12-18 months)
  • High fat and high sugar foods
  • Straws
  • Chewing Gum
  • Getting pregnant for at least 18 – 24 months.

The class starts by everyone introducing themselves, what procedure they are having, what class they are on, and any struggles they are having. Then our nutritionist had us “go shopping” by selecting from a wall of food (empty food packages). She then would create a days worth of meals composed of the things people selected to see where we would land for our daily goals. She did this different times once for sugar, fat, sodium, and protein. After she would create the plan that put us over the daily limits she went back and selected things that were smarter alternatives.

Most of this information was review for me however I thought the class was beneficial, and I did learn a handful of new things. I didn’t know that fruit doesn’t count toward your daily allowed grams of sugar which makes me feel a lot better about the days that I was over for sugar on My Fitness Pal because I ate fruit for multiple meals.

I was a little shocked to see how many people in this group didn’t know how to read nutritional labels. Obviously we are all there because we could use a little help with our food choices, I just don’t understand how you can have made attempts at weight loss without knowing how decipher this information. I was also blown away by how many people didn’t know much about any of the surgeries or which one they were considering. Granted we had some people who haven’t meet with surgeon yet, however by the time I decided to go in for the consultation I had already done days of research and pretty much had my mind made up about what I wanted. Now I know I am an over preparer for sure but one would think you would gather some basic details before considering going under the knife.
After my class I had a physical with my PCP, I recently switched to her and she is fabulous. She was also blown away by how stellar my labs were. The only things that she’s worried about is that my HDL level is still low, but she thinks that the surgery should help with that since weight loss will bring that number up.

Cholesterol 123 (140-200)

Triglycerides 113 (35-135)

HDL 29 (40-75)

LDL 72 (60-100)

Estimated Average Glucose 103 (68-126)

Hemoglobin 5.2% (4.o – 6.0)

Thyroid Stimulating Hormone .657 (0.465-4.680)