Try Try Again

**Cross-Posted from my blog on myfitnesspal.com**

It’s almost 2 years since my gastric bypass.  I started at 440, now down to 285.

My lowest weight was between 263 and 265,  but it’s been slowly climbing.

I have another food plan from my Nutritionist (an MD), and more advice.  I *must* record foods eaten, and times, etc, to give him a better idea of what’s going on.

Last night, was very frustrated, very depressed.  Ended up seriously bingeing and went to bed early.

SO today, I’m starting over again.  Need to stay below 1250 calories (Doc wants it below 1000cal per day, but I have a large frame for a female, and I feel sick if I go too low).  Need to get at least 100 grams of protein per day and keep fat grams under 30, if I can.

The biggest issue is cutting way, way, wayyyyyy down on carbs.  I have done it in the past, I know it’s a successful strategy for me.  I just have to be very careful about carb creep, a lot of things had just enough carb in them to trigger a full craving.

I also ordered a variety pack of chewable vitamins made especially for post weight loss surgery peoples.  I had been using a liquid multivitamin, and even though it DID work well and I was able to digest it fully, the taste and texture eventually made me sick.  Yark sick.

I need to lose about 85 pounds.  For my height (5’11″) and large frame, if I weighed just under 200 pounds, I’d be fine.  I will not be able to get any sort of plastic surgery, so a lot of my weight will be hanging, deflated skin.  Anything under 200 pounds would be a miracle for me.

So yeah, the plan for right now is to record what & when I eat and my exercise times.  I have a recumbent bike here at home, and I really enjoy using it.  I can’t do any impact exercise (bad joints from being so big) and walking around the neighborhood could be dangerous, so I’m gonna stick with the bike.

I’ve been playing with an idea I saw on some random weight loss surgery forum: a poster with joint problems had to visit a physical therapist to improve her range of motion, etc.  The therapist recommended, of all things, learning a few country line dancing moves/routines, find some music she liked, and shuffle around.  Doesn’t have to be quick, just get up and move to *something* fun.  Can do in the privacy of your own home.

I know I’d look like a HUGE DORK, but hey, it might be fun.

No country music though, can’t stand it.

No more regrets

*facepalm* I hit enter accidentally just now and published a blank post

Anyway, have decided to make a list of the “important” things and try to do them each day.  I know, most people do this automatically; I do feel kinda stupid having to make a *list*.

But here it is:

• Write every day (or do something that promotes writing, like world-building or plot development)
• Exercise every day!
• Get all protein/vitamins/supplements/meds daily
• Do a serious chunk of housework
• Set aside time for goofing off on the Internet & World of Warcraft (scheduled play time, it’s important to me)
• Figure how how much & when to incorporate that Shiva Nata stuff

I usually feel guilty when I don’t do these kinds of things.  They act as weapons that I tend to beat myself up with.  Maybe I can turn them into good things?

You’re a stupid moron, useless waste of skin! Yarrgblargyarg…..

No! I wrote 3 pages today, cleaned the bathroom, and got most of my vitamins in! I even got Manilla the Rogue Dwarf to level 43! I am inherently USEFUL and my skin is right where it should be.

I wrote out 2 other posts detailing the thought processes that got me to this point, but they were really rambly and babbly and better left unpublished.  Still not *that* thrilled with this post either, but it’s wayyyy better so far.

Still learning thatShivaNatastuff (feels like it should be one long word like that).  I believe I’ve got the base positions memorized, have done a few “drills”, but for the most part, I’m kinda stuck. Now what?

One last thing I think I need to do, is either return to my paper journals, where I can babble as much as I want.  Or allow myself to do babbly posts here and keep them unpublished.  Or maybe add them to my second blog — it was created for anonymous ranting and tantrums and stuff.  Dude, I needed a spot for babbly posts and I already *HAD* one? Feels like Dorothy clicking her heels *facepalm*.

Gotta wonder what other problems I could solve like that …

Questioning my Sanity

Approx. 10 days ago, watching what I was eating, counting protein and liquid intake: gained until I maxxed out at 280 again.  Got scared, then got depressed, and basically gave up.  Started eating *whatever* I wanted, whenever I wanted.  Only thing I watched was the liquid intake, don’t wanna shrivel, ya know?

Today I weighed in at 263.

So yeah, I am questioning my sanity. Seriously.  Eating *junk* and full fat and carbs, and I lost again.  Ma brain, she be hurtin’.

My only plan now is to simply eat what appeals, stop when I get full, pay attention to liquids.  Maybe record all food & exercise, just to find patterns.   I still cannot accept that me eating without restraint will make me lose weight. It’s.just.not.rational.

Although I am reminded of something my surgeon said after the RNY: he gave me a “drastic bypass”.  I had thought he meant a small pouch, but later realized no, he meant he bypassed a LOT of the intestine and my absorption level is really, really low.  Makes me wonder exactly how much of what I eat really gets absorbed.  Even at 1500 calories per day, am I still in starvation mode?!

It’s so irrational to me, but hard to argue with results.  I dunno, just feel like there’s an answer here and I’m consistently missing it.

:\ *shrug*

I don’t suffer from insomnia …

I enjoy every minute of it! XD

Ok, maybe not.  If I don’t take the Amitriptyline and OTC sleeping pills, I end up staying awake for days at a time. Add that to the non-24 sleep disorder, and you end up deranged from sleep deprivation.  Fun hallucinations! Paranoia! Yay!

Sleep stuff is just fascinating to me in general, and I love reading others’ advice on insomnia.

Here’s one I really liked:

The first thing I do is hide the clock or at least turn it so I can’t see it.  Seeing the time makes me more anxious about still being awake.  Then I lie in my bed (all sources of light out) and write a novel in my head.  I have one that I always go back to and imagine the story, dialogue etc for the next chapter.  It’s certainly never going to be a best-seller as it usually puts me to sleep!   

I *love* this idea, but I also worry that I’d be compelled to write some of the ideas down and get too excited to sleep.  I have a lot of trouble with my mind not being able to turn off when I lie down, so maybe it’s not the best idea for me, but it sounds like a lot of fun.

Dammit, I miss writing.

Hearing Voices

***Update***

Right after I wrote this all out, I felt better.  Seriously, calmer and just about ready to try again tomorrow.  I might be back up to 280, but that’s WAY WAY WAYYYYYYYYY better than 440.

I do feel stupid for worrying so much, and I almost deleted this post, but then I thought “Can’t hurt to leave it up.” *shrug*

So no need to call a hotline or whatever, I’m fine, just feeling a little silly for getting worked up.

Here’s the post anyway …

Major battle inside my head.

I’m gaining weight, even with supposedly watching what I eat and exercising more.  I don’t record every bit of exercise or food, but I see patterns.  And there’s a Voice in my head shrieking to just give up, eat whatever-the-hell-I-wanna “because you weren’t gonna do it right anyway, this was inevitable, you big fat cow.

Add that to feeling overly emotional lately (weepy, even!) and everything is taking on some greenish tinge of desperation.  (It’s not a PMS thing, I don’t have the equipment anymore.)

Another #wls plan …

Trying a new method for nutrition post-weight-loss-surgery.

Going to minimize carbs like bread, pasta, rice, sugar.  Mandatory daily exercise.  And I can eat just about anything I want, as long as my net-caloric intake is under 1000 calories.

So as long as food intake – exercise output < 1000, I’m good.  On one hand, it feels stupid and gimmicky.  But on the other hand, it’s almost instant accountability — instant consequences.

“Sure, you can have extra cheese, but is it worth the 10 minutes of heavy pedaling to burn it back off?”

As long as I don’t let the pendulum swing too far in the opposite direction, I’ll be fine.  Frankly, I’m not too worried about over-exercising or not eating enough.  I didn’t get to 440 pounds by starving or moving around too much, ya know?

This is not necessarily going to be permanent, but it makes sense to me now.  Dr. Nutrition initially wanted me to eat less than 1000 calories per day, but from past experience, I knew that would put me into starvation mode.  Bad news.  My guts just don’t absorb enough.  This little idea is the next best thing.

Just now, I did 3.45 miles on my exercise bike (exerbike!) in 20 minutes.  I turned the tension up to setting #6 out of 8, and my legs are rubbery.  But I’m glad I did it, even broke a sweat!

This whole food/exercise decision is just one more step in my life-reorganization.  I’m tired of getting to the end of each day and regretting NOT doing certain things.  I made a list of things I need to do and things I want to do: like writing more, cleaning more, eating better, exercising more, playing WoW, etc.  Not all of it is FunStuff™ but not all is drudgery, either.  I’d like to be able to rest my head at night, satisfied that I was productive that day, that I didn’t waste too much time just sitting.  I miss writing, I miss playing computer games, and I really miss having a cleaner house.

The good news: it’s all up to me.  The bad news: it’s all up to me.   No fair!!

 

Quick results from appointment with Dr. Nutritionist

Height: 5’11″, large frame

Age: 37

Start Weight: 440lbs

Day of surgery: 426

Current weight: 271lbs

Goal weight was 180. And it’s not gonna happen.

Dr. Nutritionist (explained below if anyone cares) has basically said that for my height, body structure, and metabolism, I’m done losing weight.

On one hand, it IS nice to have this info, so I can stop crucifying myself for not losing another pound.  I can stop weighing in every day.  I am officially in Maintenance Mode.

My job today and every day hereafter is to eat healthy & get some kind of fun exercise every day, because it’s The Healthy Thing To Do.

I asked about programs like Weight Watchers or South Beach Diet.  He says don’t bother, that by the time I adjust their points systems to take my RNY into account, it would be easier to simply count calories.

I asked about adding aerobics or other ways to maybe speed up that metabolism.  Cute mini trampoline? Bad idea, he says.  Too rough on my joints.  Jogging? Really bad idea, same reason.  When I was 440lbs, I had a prescription for a wheelchair, was in constant severe pain.  I may not have that pain anymore, but my knees/hips/spine are all still damaged and the last thing I need is ligament damage or even a broken bone.

His advice for more kinds of exercise: walking at the mall and get an elliptical machine with high tension.  Over the next 5 or 10 or 15 years, I could drop some weight and tone up, but really, I’m pretty much done.

Have to admit, I go back and forth between feeling proud of how far I have come, to still being disgusted with myself … there are people having weight loss surgery today BECAUSE they weigh what I weigh.  I am somebody’s BEFORE picture, no, I am somebody’s current nightmare.  Someone, somewhere is in tears of joy because they qualify for surgery because they weight the same thing I do; someone, somewhere is in tears because they’ve been turned down and they don’t know how the hell they can live this way any longer.

No matter how much I’ve lost, I will always look like a pre-op.

So yeah, I’m torn between the two extremes.

So for now, my 20month post-op program is this: Avoid rice, bread, crackers, potatoes, & sugar; exercise daily w/ 30+ minutes of sweating; get all my vitamins and liquids and 80 – 100g of protein.  And try to be good to myself.

That last one is the hardest one of all.

*********** ********** **********

Dr. Nutritionist Backstory: There are 2 major hospital systems in my city (and one minor hospital that just needs to be shut down).  Both big hospitals had official Weight Loss Surgery departments.  At the time of my surgery, only one had the Centre of Excellence rating, and that’s the only kind my insurance would accept.  So I had surgery at BH, even though SHH was the better hospital.

I had no complications from the surgery itself, no infections, and everything healed beautifully.  The hospital stay itself was a huge mess, and I’ll never go back there if I have a choice.  The post-surgery follow-ups were always strained: I was never happy I had the surgery, but they expected happiness & joy!!  But hey, it was paid for, and I was alive *shrug*.  Their nutritionist was not bariatric-specific; she worked for the hospital itself and she was simply assigned to that department.  She was extremely nice, but her advice just never worked for me.

When BH’s bariatric department got a new nutritionist even less informed that the first one, I finally went for a second opinion.

The other major hospital, SHH, had by this time also become a Centre of Excellence.  They had a doctor of nutrition who specialized not only in bariatric nutrition but also gastric bypassed patients.  This is all he does.  So when he recommended I drop The Big Carbs (pasta, bread, crackers, sugar, and rice), I did.  And it felt pretty damned good.

Something to think about

I read a lot of forums, a lllllot of forums, rarely posting because of my shyness/social phobias.

Just now on my favorite forum, there was a thread discussing “red flags”. One poster was getting “bad vibes” off a person at work, and she wanted to know how to politely avoid the dude.  He hadn’t done anything specifically bad, she just had a horrible feeling around him.

Many responders told her to trust those instincts, avoid being alone with him, etc. That her subconscious is probably picking up some nonverbal things that her conscious mind can’t quite articulate yet, even to herself.

One specific poster said it might not even be that the guy is “bad”, but that the interaction was off.  She gave an example: a coworker constantly gave off weird vibes and alienated nearly everyone in the office.  He never did anything wrong, they just didn’t like him.  Turns out, he was very anxious in social situations, because people treated him weird.  So he went overboard in trying to be fun, jovial, engaging, trying to compensate for his anxiety, trying to make people like him.

But instead, everyone “saw” his performance as fake and insincere, which made everyone dislike him even more.  The more he tried, the more he pushed people away.

I almost burst into tears reading that, because I can identify with that guy so much.  Social interaction is so hard for me, hard to read people correctly, hard to respond correctly.  I can sense their discomfort, but no matter what I do, I also end up alienating people.  When all I want to do is connect in some small way.

Funny how some small post on an Internet forums can resonate …

Where do I go from here?

I’m worried this post is gonna sound whiny.  I don’t feel whiny, just a wee bit lost.

Finding a food plan/diet/strategy has been one HUGE frustration.  My weight seems to hover right between 270 and 275. I lose 3 pounds, gain 4, lose 5, gain 2, lose 2, etc etc.  And it doesn’t seem to matter what I eat or how much.

Example: Over the weekend I ate responsibly, low carb & high protein. Gained 2 pounds. Last night I had a little ice cream, then lost 3 pounds.  It’s counterintuitive and maddening.  No consistency what-so-EVER.  And one of the hallmarks of life after gastric bypass seems to be major inconsistency, and it’s pissing me off.

Hell, I don’t mind following a food plan, I can handle rules and limitations.  Finding the right plan is the hard part — too much is obviously bad, but too little activates starvation mode, and blah blah blah.

I’m tired of thinking about nutrition all the damn time, tired of food and food issues and food planning and food “experts”.  I had gastric bypass to finally have a decent quality of life, maybe get out of the house, get a job, find a friend, write full-time, be free of pain.  But now with everything focused on food, not only do I not have a decent quality of life, I think my mental glitches have gotten worse.

My nutrition doctor says the surgery got me to this point, and I have to get myself down to my goal weight. Hey, cool, how do I do that?

He says just keep doing what I’ve been doing.

But it’s not working.

Just keep doing it and see me again in a month.

Brain … hurts …

I’d thought about programs like Weight Watchers or South Beach, but cost is an issue.  And I’d really be pissed to shell out that kind of money only to be in the same place: weight-stalled, frustrated, and broke!

So for now, I’m not restricting carbs anymore, not denying myself anything. As long as I get my vitamins and protein and stay active with my exerbike, I’m not going to count calories and obsess anymore.  I do worry that I’m heading back toward 400 pounds, but seriously, I don’t know what else to do.

Making an instruction manual … for my pouch!

My pouch didn’t come with an instruction manual.  If I wanted a “Troubleshooting” section to refer to when things got weird, I was gonna have to make one.  Got the idea from a Lady and her Duck, who writes a “Book of Me’, a reference for her own life, for herself.

Having 4 meals and 1 snack per day, 300 calories each, is really working.  It’s too easy to NOT measure, to NOT count the numbers.  But it’s also way too easy to let myself focus on food/eating/meal planning every waking moment.  It’s just not good for my psyche to keep obsessing about food one way or the other.

Plan for today: make a list of food portions that can get me to my 300 calories limit.  Maybe even arrange in columns, so I just pick from the list.

Hehehe, I can have one from column A, one from column B, etc etc.  Talk about obsessing over food, damn! (I’m laughing, this is exactly the ridiculousness I want to avoid.  I just wanna know little easy ways to fill in a meal and make it healthy.  Add more raw veggies, I guess.

I also plan to play more World of Warcraft today.  I did something a little different and I’m having fun with it again. Yay.

Got an appointment with Dr. Nutritionist this afternoon.  My weight is playing games again, dropping 10 lbs, then up 2, down 1.5, up 2, down 3, until I’m almost back where I started.  But I did have bloodwork done at the Other Hospital, so I’ll sign the release for Dr. Nutrition to get those results as well.  I’m not going back to my surgeon’s nutritionist.  Her advice, while it had a few good ideas, was mostly unhealthy.  I’d be in starvation mode again, which is my main issue right now anyway.  No, thanks.

So yeah, chapter one in my own manual: eating first thing in the morning.  Usually, I have no appetite first thing.  After a few hours. I’d make a double strength protein drink, sip it over the course of 4 to 6 hours, then eat dinner around 5pm.  Snack after that until bedtime.  My body was understandably confused, assumed that when there was no food coming down until evening, that there was no food *available* during that time, and body decided to hold on to every single calorie.

And I get that.  Eating first thing makes sense biophysically, and really, if I heard someone was doing the same thing I was? I’d give the same advice.  Eat something, moron!!  (Well, I wouldn’t call *them* a moron, but myself, oh yeah, doofus du jour.)

I tried several different products in the mornings, but have finally found a good combination.

Chapter one of my pouch manual would be eating 4 small meals and a snack over the course of the day, each one = 300 calories, no more, no less.

Chapter 2, breakfast: one of those Atkins Daybreak baked squares.  They make oatmeal-cinnamon and blueberry-almond flavors.  One bar and a banana is PERFECT.  Right at 250 calories, and my pouch feels satisfied without pain.  I cannot stress enough how well this works for me.

In an hour or so, I’ll make some coffee, might add some unflavored protein powder to bump my numbers, might not, either way is fine.

Now I’m gonna go play WoW.  Might even work on that new character info page on the blog, need to update and fix a few issues .

Oooh, and sign up for an online penpal thingy.  I get so lonely sometimes, it scares me.  Would be nice to have someone to write to .