5 months out, 50 pounds down

I can't believe it's already been over 5 months since my surgery. Honestly, most days I can't even tell that I had surgery because I am so adjusted to the new normal. I don't feel the restriction of my new smaller stomach much either, perhaps because it has stretched out some already but also because I naturally serve myself smaller portions now.  In the grand scheme of things, it really is the portion size that is the most significant difference than before surgery.  I still allow myself treats sometimes just like before and mostly that feels right, though I have to fight off the temptation of junky treats (yes, twizzlers, I am talking about you!) and save the calories for the really worthwhile stuff (fresh avocado, high quality dark chocolate.)

I am still losing weight but much more slowly now. It frustrates me but it makes sense intellectually. I would like to lose another 30 pounds, which at this rate will probably take me 6 more months, at least. I never could have lost anywhere close to 51 pounds on my own and so I am hopefully that if I follow the "rules" my surgeon gave me I will get to my goal eventually.  I have a 6-month check up with the surgeon in a couple of weeks and I will get the results of extensive blood work they did recently- I am hoping that will be very affirming and show that I have already improved my health.

Back after a Break

I took an extended break from blogging- to my perfectly honest, it was bumming me out that no one ever comments on my blog.  Silly, I know...  But my weight loss has started to slow down and I thought starting to blog again might be a good way to articulate what's working and where I need to improve to stay on track.

First the good news, I have lost 37 pounds total and I feel great physically.  I'm wearing smaller clothes and I feel much better about my appearance overall.  I am doing a pretty good job of meeting my protein goal (60-80 grams per day) on a consistent basis.  I am staying away from all carbonation, most caffeine and all alcohol.  I am wearing my fitbit one every day and trying to increase my daily activity (steps, stair climbing).  I am paying close attention to the feeling of restriction when I eat and stopping when I feel it so I don't stretch out my sleeve.

But I am not quite following all of the rules.  The biggest one is the "no grazing" rule.  My surgeon and nutritionist said I should be eating 5-6 small meals or snacks per day maximum.  Because I eat small quantities, I only stay full for about 45 minutes or so.  It takes lots of willpower (never my strong suit...) not to snack every hour all day long and I haven't been staying on track.  I decided this morning to try setting the timer on my phone for 2 hours whenever I finish eating so I don't eat again until the timer goes off.  This should help me distinguish between true hunger, thirst and boredom or feeling down.

I am supposed to be drinking 64+ ounces of sugar-free liquids a day and I am not getting nearly enough.  I forget or I pour myself a drink but don't actually drink it or I don't have something to drink available when I notice I am thirsty.  I really need to work on this one, both because dehydration could be unhealthy and because the liquids should help me feel full between meals and snacks.

I am supposed to eat protein first, then fruits and vegetables, and starches only if I have room.  This is a hard one for me because eating one food at a time doesn't feel normal and I still have cravings for sweets.  I seem to be able to tolerate eating basically anything, which is a mixed blessing!

I am also not doing much cardio exercise or weight training.  What I love about the fitbit is that it motivates me to meet my daily goals without making me feel guilty.  Because I associate exercise with punishment, the fitbit helps me think in terms of "activity" rather than "exercise."  Increasing my activity and adding light weight training would be good for my weight loss and my overall health (and mood) but I haven't yet found a groove.

Now that I've written this all out, I see I have a lot to still work on.   Onward and upward.

One Month Check-Up

Saw my surgeon and my nutritionist yesterday for my one month check-up.  Nutritionist wasn't thrilled to hear that I am eating every 2 hours and wants me to limit it to every 3 hours and drink lots of water in between.  She claims I won't get as hungry when I am eating "heartier" foods, which I hope is true.  I am now on the soft foods phase so I can eat most things except for raw fruits, raw veggies, nuts and seeds.  However, just because I can technically eat something doesn't mean that either my sleeve will tolerate well or that it's good for me.  Surgeon wants me to shoot for 80 grams of protein a day, which is a lot!!!  Since I don't eat meat or poultry and they want me to reduce my dependency on protein shakes (no argument there!), I am going to be eating a lot of dairy products, soy, eggs and tuna!  He told me that he is proud of me and pleased with my progress and that makes me happy. 

Four weeks since surgery

Yesterday was my 4 week anniversary! I am feeling much more normal than I did during the first few weeks. I still tire easily but that's not a big surprise given how little I am eating, how much stress I am under, and how hot it is outside. I am totally sick of my puréed diet but am allowed to advance to the next stage- soft foods- on Thursday. I have started a bit early by experimenting with some finely chopped egg salad and smoked salmon salad (two separate things.) so far so good.  The only things forbidden on the next stage are raw fruits and veggies and nuts and seeds but many people find there are other things they just can't tolerate yet. (Still no caffeine, added sugar, carbonation or alcohol as well.) The rule is to always eat protein first, then veggies, and only fruit or starch if you still have room.  This helps the healing process and helps the body choose to lose fat rather than muscle mass. Since I don't eat meat or poultry or shellfish, I will be eating a lot of fish, eggs, and dairy products.  Beans are hard to digest at this stage but very well-cooked beans in small amounts may be ok. My hope is that I can get enough protein from my meals and snacks to go down to one protein shake a day, which would be great because I am super sick of them. As of today I have lost 25 pounds, which feels awesome!

Working and Sleevin'

I went back to work this week. The first few days were pretty rough but I think I learned from them and am hoping I am in a better groove now. Here are my initial tips for going back to work post-op:

You have to figure out ways to make it super easy to get in your liquids and your protein! I bought a mini-fridge for my office because I hate interrupting my work when I am focused on something in order to go to the communal kitchen. If my drinks and snacks are right in my office, it doesn't feel like an interruption to grab something.

Pay attention to what time it is when you eat. During my two weeks off, I didn't worry much about the clock but now I need to make a mental note of what time it is and when I should switch to my next stage.  I haven't set a fixed routine but find that eating every three hours helps me keep my energy up.  For example, today I had a protein shake at 9am, Greek yogurt at noon, and another protein shake around 3pm. I got in my liquids in between by having a glass of water around 7:30am, decaf iced tea around 10 and a vitamin water zero at 4pm. I forgot to drink between 1-3 but at least that wasn't too long of a stretch. I ate baby food  for dinner around 6:30pm (a surprising tasty purée of beans and veggies variety brought to me by a co-worker. Especially good once I added some salt and pepper!) I had a low-sugar yogurt Popsicle for dessert around 7:30 and now I am drinking some crystal light.

Wear comfortable clothes. Sitting in one position for a long period of time is a bit hard on my incisions and it helps to be wearing loose clothing.

Warn co-workers than your new baby stomach makes loud noises after eating so you won't be as embarrassed when it happens.

Back to Work and Purée Experimentation Phase

Tomorrow will be two weeks since my surgery and my first day back at work full-time.  I feel ready- my pain is almost gone at this point, I am sleeping well at night, and as long as I get enough protein and liquids are don't go too long without eating my energy is not bad. I still have some activity restrictions- lifting greater than 10 pounds, swimming, heavy exercise, but otherwise I am free to go about my day normally except for the special diet.  The diet is ok- I graduated from the liquid diet to the purée stage, which will last for 3 weeks. Basically everything I eat has to be the consistency of stage 1 or 2 baby food, which means completely smooth and quite runny.  I also need to get in a minimum of 60 grams of protein per day, which is quite a challenge with the very small stomach capacity.  At this point, I usually have room for about 1/4 cup of food per meal.  For whatever reasons, certain foods are much easier to tolerate than others, which seems to have little rhyme or reason.  Here's what I have tried so far and how it worked out for me:
Cottage cheese mixed with stage 1 baby apples sprinkled with cinnamon- good
Runny mashed potatoes mixed with "chicken" broth flavored protein powder- so/so
Runny cream of wheat mixed with vanilla protein powder- good
Cottage cheese mixed with baby squash- couldn't get it down at all
Plain Greek yogurt mixed with baby apples- good
Runny mashed potatoes mixed with unflavored protein powder- good
Sugar free dark chocolate pudding mixed with plain Greek yogurt, creamy peanut butter, PB2, and milk- good
Low-fat ricotta mixed with tomato sauce, heated- good
Butternut squash soup mixed with unflavored protein powder- couldn't get it down

Not the world's most interesting diet but it works!

Ups and Downs

It's been eight days since my surgery and I am still recovering and not ready for much else.  I started driving yesterday and it was quite uncomfortable physically so I am going to stick close to home and only drive when necessary until my incisions are less sore.  I have 6 incisions and most of them feel ok most of the time but the one above my belly button really hurts, even when I am just sitting on the couch.  I don't think it's infected (the doctor gave me a handout on what to look out for and I don't have any of the signs of infection) but I am surprised that it hurts as much as it does.  I see my doctor tomorrow so they will check it and make sure everything's ok.  I also want to talk to the doc about pain management because I feel like they gave contradictory messages- take the heavy duty pain meds if you need it vs. try to wean yourself off the narcotics as soon as possible.  Um, which one is it?  I have stopped the narcotics except at bedtime but it the pain is definitely a bummer without them. Plain tylenol doesn't really help at all and I'm not allowed NSAIDs (advil, aleve, aspirin.)  In other news, as of this morning I have lost 8 pounds since my surgery.  I lost 10 before surgery so I am down 18 pounds total. Amazing!  I stay on a liquid diet for another 2 days and then I will be allowed to eat smooth purees- stage one or two baby food, soups, sugar-free yogurt, etc.

So how am I spending my time? Mostly watching lots of TV while slowly sipping on protein shakes and vitamin water zero.  My dvr is empty at this point so I've resorted to sitcom reruns: Roseanne, Will & Grace- currently watching a fun episode called The Unsinkable Mommy Adler, The People's Court (I want to be Judge Marilyn Milian in my next life),  and my newest guilty pleasure- Botched on E!, which is a reality show about a pair of plastic surgeons who fix patients' botched plastic surgeries by (you guessed it) more plastic surgeries.