Open mouth; insert foot

I attended tonight's meeting of the Tracy Express Network (a local chapter of the American Businesswomen's Association).

During the networking portion of the evening, I was chatting with an engaging woman from New York Life. We were talking about all the illnesses that seemed to be going around this spring, which both of our husbands caught with gusto. I told her that I get very worried when my husband is ill, because he's such a thin guy, adding that I don't have the same concern for myself. She chuckled a bit and looked me up and down. I realized then that this woman had no idea I have ever looked contrary to the way I do today. I let the subject drop and we parted ways to mingle further.

We caught up again a few moments later when another member, a woman I know rather well, greeted me by calling me "Skinny." She made a comment to the New York Life agent about how great I looked. Finally, I let the agent in on the secret.

"You have no way of knowing this, but I used to be almost 200 pounds heavier than I am today. That's why calling me 'skinny' is humorous."

She was obviously shocked and after congratulating me, said she never would have guessed. I told her that I realized she had no idea based on her reaction to my earlier comment about my husband.

"Truly," I told her, "I have to be careful. I often forget I'm no longer a big girl and will make comments that come off as insensitive or rude."

It's not that I'm a narcisist who thinks the world revolves around her. It's just that I've chronicled my weight-loss experience for so long and so many people approach me in public about it that I forget it's not common knowledge. And then there are times like tonight that jolt me back into reality. I assume that the further out I get from surgery, the more common it will become to meet people who assume I've always been thin. I'm not sure I'll ever get used to it. I want to say that it'll become old had after a while, but that's hard for me to picture. I guess time will tell.

Too skinny?

I met a woman over the weekend who said something I consider interesting. Her husband had gastric bypass a handful of years ago. She said he's since gained about 40 pounds or so. I nodded, letting her know that's a common occurrence for veteran post-ops. Her response gave me pause for a moment.
"I think most people get too skinny after WLS," she said. "Your body has to put on an extra 20 to 40 pounds just to look normal."
I said nothing.
Then she added, "Then again, maybe it's just that the rest of us are used to seeing our loved ones be so big that we have trouble adjusting to their new size."
Hmmm...that was profound.
I get told I'm too thin all the time now. My favorite is when people inform me that it's time for me to stop losing weight -- as if I'm blind to my own size. I always let people know that I could lose another 20 pounds and still be within a normal weight range for my height, but I'm also clear that I'm happy at my present size. Though anything is better than carrying 335 pounds on a 5-foot, 3-inch frame, 138 pounds seems to be my body's preferred weight.
I don't understand why people feel obligated to tell me their opinion of my size. I assume it's because in our society, it's considered appropriate to tell someone when they are too skinny in your eyes even though you'd get a dirty look or backhanded if you pointed out an obese friend should lose a few pounds. I'm guessing that woman I met over the weekend has a clearer view into the average person's psyche than I do. If what she says is true, it's a matter of comfort. We know obesity is unhealthy but we're not comfortable with those close to us changing their appearance too much.
I wonder if this phenomenon will change down the line. Maybe in three years, people will be so accustomed to my size that they don't think twice about it. Then again, maybe well-meaning acquaintances and relatives will continue adding their two cents.

Who am I?

My husband and I just got back from a wedding on his side of the family. Though I feel at home at my present size, there are still many in his family -- and even a few in mine -- who haven't seen me in a year or more.

The funny thing is that few people assume I've lost a drastic amount of weight. Instead, they just figure I'm a different wife than the one my husband had the last time they saw him. Even better are those who think my husband is having an affair and dared to take his mistress to a family function.

I suppose this would offend some women, but I find it amusing. So long as they think I look fabulous, I won't complain about who they assume I am.

WLS not right for everyone

Melting Mama has a thought-provoking post on her blog about surgical weight loss. Instead of trying to restate what she says -- truly, she articulates the point way better than I ever could -- I suggest you click over to her site and read her words for yourself.

FYI

I'm noshing on a creamy peanut butter Think Thin protein bar, and it tastes a bazillion times better than the sugar-free peanut butter meltaway I blogged about yesterday. And a half-bar adds 10 grams of protein to my day.

When chocolate goes bad

There was a time in my life when I could say with confidence that I had never met chocolate I didn't like. That time was from about five seconds after I was born until about an hour ago.

To be honest, chocolate hasn't impressed me as much as it used to since I had WLS. I still love it, but a protein shake or bar can curb a chocolate craving better than a cookie. But every now and then, I still get a hankering for rich, delicious chocolate candy. Today was one of those days.

I was strolling around the mall this evening with my husband when the urge to have chocolate overwhelmed me outside of the Sweet Factory. I went inside to peruse the sugar-free section. I walked out with a bag of chocolate-covered pretzels, almonds, raisins, peanut clusters and something called a peanut butter meltaway. All together, I had about an eighth of a pound of candy in my bag.

Upon getting home, I couldn't wait to try some. I had a yummy dinner of Asian-style chicken and veggies and decided an hour later to treat myself to some of that sugar-free chocolate deliciousness I had purchased at the mall.

I opened up the bag and took a whiff. Hmm...not the intoxicating aroma I had envisioned. Oh well. I shrugged my shoulders and dove in for one of those oh-so-dreamy sounding peanut butter meltaways. I took a bite, crinkled up my nose and promptly spit it out. It was bland and chalky and not worth the 10 calories I probably ingested during my brief taste.

Next I tried a pretzel. I was smarter this time, though, and just tried a tiny bit. The salty pretzel was stale and the cholate disapointing. It was waxy and again, lacking in flavor. It reminded me of a less-sweet version of Flicks, the "chocolate-flavored" candy wafers I abhorred as a child. Next I tried a peanut cluster. It was, by far, the best thing in the bag but that still didn't make it good.

Disappointed, I tossed the rest of the candy in the trash. Chocolate or not, the taste wasn't worth the effort it took to chew it. I never would have guessed that chocolate existed that was bad enough that I would throw it away, but I found it. Then again, maybe the chocolate wasn't that bad after all. Maybe chocolate just lost its hold over me. Or maybe, the change in my taste that makes fast food no longer palatable to me has crossed over into desserts. If it's not fabulous, it's just not worth my time.

Ghengis Khan

My husband and I tried out Ghengis Khan on Grant Line Road today (in the new shopping center by Costco). He loves Mongolian barbecue. Before I had surgery, we'd visit the Ghengis Khan in Stockton a few times a year. Since surgery, though, we've shied away from all buffets. It just doesn't make sense to shell out the money when I'm not going to eat much, nor does it seem smart to surround myself with the temptation of an all-you-can-eat event. But my husband really wanted to try it, and Ghengis Khan is affordable as far as buffet restaurants go.

The best thing about Ghengis Khan is its location. It's in a small strip mall along with Kinder's Meats, Kitchen Angel, a coupld of salons and a check-cashing store. It's remote location makes it the prime dinner spot on a weeknight. The manager said the place is packed on weekends but it's not a weekday destination yet.

If you're unfamiliar with Mongolian barbecue restaurants, they all work the same. You walk in, grab a bowl at the buffet that you stuff with thin slices of frozen raw meat (turkey, chicken, beef or pork), noodles, and a variety of vegetables and cooking sauces. At the end of a counter, you turn over your bowl to one of the cooks who dumps it out on a hot metal cooking surface. He uses two long sticks to move the food around the cooking surface until it's done. He puts your food into a clean bowl and then hands it back to you, piping hot.

While your food is cooking, a server is busy setting up your table. When you get to your table, there is soup, rice, an appetizer (fried wontons with sweet & sour sauce) and a sesame biscuit. You order your drinks and enjoy your food.

I had fun creating my bowl tonight. I added turkey, chicken, a heaping pile of spinach and cabbage, a little bit of corn, onions, mushrooms, broccoli, zucchini, cilantro, jalapenos and peanuts. I added one scoop of each sauce, three scoops of garlic sauce and a scoop of sesame oil.

My overflowing bowl cooked down into a scant bowlful, but it was so tasty that I didn't care I would leave most of it behind. After about 30 minutes of eating, I looked down to realize that I didn't even make a dent in the bowl. The server came by and asked if I wanted to box it up. That was shocking. Most all-you-can-eat places do not allow you to take food home with you. But the server said that anyone who only makes one trip gets to take home their leftovers.

That was exciting for me, because I now have at least two more yummy meals waiting for me in my fridge. And it's nice to know that there is a buffet in town I can visit without feeling like I'm the weirdo who doesn't make trip after trip.

I know many post-ops carry around a card that tells restaurateurs that they've had gastric-bypass surgery and asking that they be allowed to eat off the children's or seniors' menu. That's not something I've ever done because I don't find things on those menus to be that healthy. Besides that, I just don't think it's a restaurant's job to bend its rules for me because I decided to alter my body's biology. So, I would never ask for such things, but it's nice when a restaurant offers. And for that reason, I'll be back to Ghengis Khan.

Off Topic: Call Me Miss Green Thumb

I just have to share about my weekend endeavor. I planted a container garden on my patio. I'm now the proud owner of a tomato plant, Thai chile plant, basil, nasturtiums and marigolds. This could be as addictive as chocolate. I'm now eyeing a three-tiered plant stand to grow more herbs.

Can't wait till harvest time.

Things that make me go "hmm ..."

Took a quick trip to Kohl's today to check out the clearance ranks. I had fun trying stuff on, especially now that I'm a solid medium/size 8 almost everywhere. At JC Penney two weeks ago, I discovered that I fit 8 petites to a T.

I was excited today to see the awesome selection Kohl's had in its petite clearance section. Found a beautiful kimono-style blouse for $4 that I thought would be perfect for ASBS in San Diego. I took the medium into the dressing room, unzipped it and slipped it on. Looked great except for one teensy-weensy problem: I couldn't get it zipped up past my rib cage. Hmm ... OK, Plan B kicked in and I went in search of a large. I found one in a different color that I liked just the same as the first. Took that one in the dressing room, held my breath and tried it on. Again, no luck. No matter how much sucking in I did, I couldn't get the zipper past my ribs.

Before I had gastric bypass, this occurrence would have broken my heart. It would have ruined my day and I would have gone home mopey. But today, I just laughed. All I could think was, "Well, ribs are bones ... can't suck those in no matter what." My feelings weren't hurt; I didn't have any feeling of failure. I just figured that explained why such a cute blouse made it to the clearance rack in the first place.

And now, as I get ready for bed, I think of how far I've come in the last two years.

Product Review: Micellar Milk

Photo courtesy of BariatricEating.com

Nature's Best Micellar Milk is a relatively new addition to the ready-to-drink proteing supplement market. I had heard of it from other post-ops on the BariatricEating.com (which sells it) message board last year but hadn't gotten around to ordering any before getting sick in January.

While I was in the hospital, a member of my local support group, Tammy Coursey, smuggled a container of vanilla and chocolate into the hospital for me. She swears by it as helping her get in her required protein since having surgery last Thanksgiving. She enjoys the vanilla poured over ice, saying its thin milk-like texture is perfect for her pouch -- not too heavy like blended supplements can be.

Aside from being thin and easy to drink, Micellar Milk is also nutrient-rich. A 17-ounce container provides 40 grams of protein with 220 calories, 2 grams of fat and 4 grams of sugar.

My favorite flavor is vanilla, which reminds me of rice pudding in taste. My husband is in love with the newest flavor, strawberries & cream. He says it's just like Strawberry Quik. Micellar Milk also comes in chocolate.

Having the consistency of milk makes Micellar Milk a perfect protein-rich substitue for milk in many recipes. When I was recovering from my bowel obstruction and restricted to a full-liquid diet, I used it in lieu of milk to make Sans Sucre instant chocolate mousse. I also used it in vanilla custard (with a dash of sugar-free Torani syrup). It was a tasty way to make sure I met my protein needs without overtaxing my digestive system.

If you visit the BE.com message board's recipe thread, you'll find all sorts of recipes that incorporate what members affectionately call Mice Milk. One favorite is Mice Cream, a protein-rich version of ice cream.

Personally, I enjoy Mice Milk by itself or with a few variations. One of my favorite ways to serve it is to make ice cubes out of leftover coffee and pour either chocolate or vanilla Mice Milk over the cubes for a cool treat at the office. One weekends, I'll use vanilla Mice Milk as creamer in my coffee with a shot of Torani sugar-free Irish Cream syrup for an Irish Cream protein latte that puts Starbucks to shame.

Hit or Miss: Definitely a hit. I have two cases at home right now, but they are going fast.

Somerville supports kids

An entire town went on a diet for a year in an effort to help the children in the community adopt healthier habits, according to an Associated Press article.

Thanks to financial support from a couple of grants, educational programs emphasized the importance of increasing activity and making food choices that included more fruits and vegetables and less fat. School lunches featured more fruits and vegetables, and children were encouraged to eat as much of them as they desired. Restaurants even joined the effort by offering healthier options and smaller portions. At the end of the program, researchers say the town's children avoided gaining one pound of body weight, compared to children in neighboring communities -- making the program a success.

Read the article yourself and tell me what you think.

The difference that makes it

Katie Jay of the National Association of Weight Loss Surgery has just published an article by me on the free portion of her Web site.

The article is a basic retelling of my personal story, one that readers of this blog know all too well. However, I hope that having it published on the NAWLS site opens me up to a wider audience. Bookmark the site, because Katie has already asked me to write another article for NAWLS and to record an audio interview with her.

ASBS conference

The American Society of Bariatric Surgeons will hosts its annual meeting and conference next month in San Diego. The weeklong event will begin June 11 at the San Diego Convention Center.

ASBS is the only national governing body for bariatric surgeons. It's the group behind the Centers of Excellence distinction that surgical centers strive to achieve. The organization Web site offers a list of Centers of Excellence by state for patients to peruse.

The conference is a big deal. Not only does it allow medical professionals to congregate and network, it provides continuing education courses and panel discussions of interest to those who work with the obese. Surgeons and other bariatric health-care providers will learn the latest surgical techniques and discuss research data on topics such as how access to nutritional supplementation affects compliance in patients and whether preoperative weight loss makes a difference in surgical outcomes.

The conference also features an extensive trade show with vendors showcasing everything from super-size furniture that is comfortable for morbidly obese patients to compression garmets that hold in excess skin so post-ops can achieve a more normal appearance under clothes. There are also vitamin and supplement vendors galore, in addition to advocacy groups. Carnie Wilson was a featured guest at a vendor's booth last year. No word whether she'll attend again this year.

I attended one day of last year's trade show in San Francisco. This year, I'm fortunate enough to spend most of the week at the event. I'll be blogging on the various workshops and educational sessions I attend.

Point to ponder: Childhood obesity

I was thumbing through a copy of Bariatric Times at a friend's house earlier today when an article on childhood obesity caught my eye. The article itself wasn't that earth-shattering but there was a profound quote from a source that hit home with me.

Loosely paraphrased, it read, "The key to treating childhood obesity is to understand that the afflicted come from homes where overeating and inactivity are allowed or encouraged."

Interesting perspective. I read those words and find them logical and succint. A lot of efforts toward reducing childhood obesity focus on educating and motivating the children but don't seem to target changing the environment at home. I wonder how effective it is to teach little Johnny the importance of making wise food choices and exercise if he goes home each day to a harried household where dinner is from the nearest drive-through and served in front of the Nintendo Xbox.

Any thoughts?

Recipes wanted

Summer is almost upon us, and that has me thinking of warm-weather meal options. Anybody have any recipes to share that include seasonal produce or are quick and easy and don't heat up the kitchen? Andrea, care to share some of your vegan favorites? Anyone else?

Vegetarian heaven

The downtown farmers market started today, and there was a vendor selling Afghan food who has stolen my heart. I'm serious -- we are new best friends. First off, he fed me lunch by giving me half a dozen different samples. I walked away with a low-carb pumpkin bolani, lentil curry, eggplant pesto, hummus, sweet-and-sour carrot chutney and whole wheat pita bread.

If you haven't tried Afghan food, I highly recommend it. To me, it tastes "cleaner" than Indian food but still has the complexity of flavor and spiciness that I love. All the stuff I bought today either was made with olive oil or had no added fat. Most of the breads offerred are made with lentil flour. That means no gluten and
lower carbs. The spinach bolani was super-yummy, too.

For those who don't know, bolani is almost like a cheeseless quesadilla. It's a folded piece of flatbread filled with spices and veggies. This vendor had low-carb pumpkin, low-carb spinach, then a veggie and potato version.

If you're in town next weekend, check it out. The farmers market will be open from 9 a.m. to 1 p.m. every Saturday until November. The market is on 10th Street, between Central Avenue and B Street.

If you don't live near the Tracy area, check out the company's Web site by clicking here.

The highs and lows of blood sugar

Melting Mama posted an article to her blog this week about the relationship between gastric bypass and low blood sugar. The article was of particular interest to me, because I was diagnosed with hypoglycemia a few weeks ago. Since then, life has been a constant balancing act as I figure out the best way to keep my blood sugar level throughout the day.

Before the diagnosis, I thought I was losing my mind. I was lethargic, spacey, dizzy, easily confused and could not focus on the simplest tasks. It would take every bit of willpower I had to stay awake at work and on the drive home. As soon as I'd walk in the door, I head straight to bed and crash. Often, I'd sleep for the entire night only to spend an hour the next morning willing myself out of bed.

After a month of dealing with this, just about any diagnosis would have been welcome. But once I heard the news, then reality set in. Not only is this most likely a permanent condition that will require constant diligence, I had trouble wrapping my brain around my body's new dietary needs.

Here I had spent two years following the gospel of three meals a day (no snacks), few to no carbs, protein drinks vs. protein bars (drinks are lower in calories), and absolutely no sugar. I had finally gotten the rules down pat and didn't have to think about them anymore.

But hypoglycemia carrries its own set of rules: Eating every three to four hours keeps blood sugar most level; protein elevates blood sugar but fiber helps level and maintain it so complex cars are a good thing; protein bars are better than protein drinks because they don't cause a rapid change in blood sugar; and in low moments, sugar can be the difference between maintaining consciousness and passing out.

I had a brief moment of bitterness upon hearing my surgeon's bariatric coordinator rattle off this advice to me. I felt like the rug had been pulled from beneath me. Eating four to five times a day worried me. What if I gained all my weight back? Carbs a good thing? What if eating them led me to feel hungrier or caused me to binge? Eat sugar? Seriously? What planet was this and what did the pod people do to my doctor?

After getting off the phone, I did a little Web research and talked to other post-ops who also had hypoglycemia. I made myself a shopping list and other notes based on their advice. Though my doctor wanted me to eat three full meals a day and two protein-rich snacks, most post-ops I talked to said their blood sugar levels were best maintained by eating four or five equal-sized mini-meals each day. All the post-ops I spoke to said cheese and peanut butter were their best friends. Some kept glucose pills handy; others didn't. All recommended I keep a stash of yucky-tasting crackers that I could grab when at a low point but that wouldn't be tempting to me otherwise.

Next, experimentation came into play. Cheese was definitely my best friend, but peanut butter wasn't as helpful. I keep a jar of it at the office just in case I get desperate, but I'm more apt to select a protein bar instead. My body feels best if I eat at least three whole-food meals each day.

For me, bars are definitely better than drinks. My favorite bars are Think Thin cruncy peanut butter (available at Trader Joe's) and Oh Yeah! chocolate-mint wafers (available online and at the Vitamin Shoppe). A half-serving is all I need to keep my blood sugar level. Both Think Thin and Oh Yeah! chew down very well so as not to overfill my pouch, but the Oh Yeah! bars are more convenient because they come with two wafers in each pack -- instant portion control.

Liquid protein is a toss-up for me. AchievOne sends my blood sugar soaring through the roof and then crashing down, but I can mitigate that if I eat an ounce of cheese after finishing my drink. Nectar-brand drinks don't cause any wackiness at all.

Carbs are a necessity for me, but I'm still learning how to effectively use them. My typical breakfast is high-fiber cereal mixed with flax seeds and Fage 0% Greek-style yogurt. Cheese and crackers is not as helpful and ends up being more of a trigger food. Salads are a good way to incorporate complex carbohydrates with my protein. I eat salad almost every day now.

As I said before, it's a balancing act. It's a challenge but it's not impossible. and if anything, at least it prevents me from getting bored.

Pre-op anxiety

I met with a pre-op today who is experiencing some last-minute anxiety over having surgery. A lot of what she confided in me today reminds me of my night-before-surgery meltdown in the Travelodge next to Kaiser SSF.

She's overwhelmed by her fears, and almost all of them are normal. She said she's overcome by what I call "last supper syndrome," which is the compulsion to make every meal your last as if you'll never eat again. I assured her that everyone goes through that. I spent six months before surgery saying goodbye to food that I thought I would never eat again. It took four times to truly bid farewell to the chocolate mousse cake at Fabio's, but I managed. The funny thing is, as I told this woman today, that many of the things I thought I couldn't live without are things that don't even tempt me now. My taste for them no longer exists.

She also fears failure. After all, she's failed at every diet she's tried before. Granted, this isn't a diet, but when you're a pre-op, surgery seems like a golden egg -- too good to be true. We all going into surgery worrying that we'll be the one person the surgery doesn't work for. But once we have surgery, we realize we have the power to make it a success. The patient fails the surgery; the surgery does not fail the patient.

I think the scariest thing of all when heading into surgery is the knowledge that your entire life is about to change but the inability to know exactly in what way. We can interview post-op after post-op, but everyone's mileage varies. We never know how we will react to surgery until we go under the knives ourselves.

Anybody out there care to share their fears in regard to weight loss -- surgical or otherwise?

Effects of preoperative exercise on complications and recovery

The December 2006 issue of Beyond Change, a newsletter focusing on obesity and obesity surgery, features an article proving what I've been touting for the last two years: Exercising before surgery vastly improves recovery time and decreases surgical complications.

If you want to read the article, click on the above link or here.

Before I had gastric-bypass surgery, I had heard rumors about the benefits of exercise when it came to recovery. I paid close attention to post-ops experiences and noticed that those who had a regular exercise program before surgery had fewer complaints about their surgical experience.

WLS was my first major surgery, and I was terrified about having my planned lap procedure being converted to open or suffering from wound infections. A doctor at the time told me that one thing obese people could do to prevent such occurrences is to increase bloodflow to the abdomen. Her opinion was that the more blood that flowed to the area, the faster wounds would heal. She also thought strong abdominal muscles healed from the trauma of surgery faster than undeveloped ones.

I had been exercising regularly for months before having WLS, but four weeks before my surgery date, I kicked things into high gear by hiring a personal trainer. We focused on building up my muscle mass (to mitigate the amount I would lose while recovering) and toning my core. At my first session, I did 25 crunches on a stability ball. By the time the month was up, I was doing 300 crunches a day on the floor -- and I weighed 310 pounds.

Surgery was a breeze for me. I'm not saying it was painless, but it wasn't as painful as I expected. I was walking laps in the ICU so well that I pushed for transfer because watching me made the other bariatric post-ops feel bad. I had no trouble adjusting myself in bed. And once I figured out how to negotiate the IV lines, I stopped needing assistance to get out of bed.

A week after my release, I was back in the gym. I wasn't insane. I started doing five minutes on the treadmill (the gym was across the street from my apartment) and worked my way up slowly to 30 minutes in two weeks.

A lot of post-ops I've met try to say my age is what made my recovery so easy. That's hogwash. One of my best post-op friends had a similar experience and she's 50. But she also hired a personal trainer before surgery, and she credits that investment for her easy recovery just as I do.

Fun post

Check out the Crazy Salad Cravings post. I've added a few different salad ideas to it in the comments section. Look it over and then add your own.

2007 Walk From Obesity

Mark your calendars: The 2007 Livermore Walk From Obesity will be from 9 a.m. to 11 a.m. Saturday, Oct. 6.

Money raised from the three-mile walk will benefit the ASBS Foundation and the Obesity Action Coalition. The ASBS Foundation is the nonprofit arm of the American Society of Bariatric Surgeons, and it has done a lot in the way of advocacy on behalf of the morbidly obese. According to the foundation, it "is serious about improving the lives of the morbidly obese by focusing on ... Increased funding of research specifically in morbid obesity (and) increased public and professional education."

OAC is an advocacy group that fights on behalf of anyone who is obese or touched by obesity. The nonprofit's goals are as follows:

* Educate patients, family members and the general public on obesity and its effects on the healthcare community.
* Help patients gain access to medical treatment for obesity.
* Work to ensure that those obesity treatments are safe and effective.
* Strive to eliminate the negative stigma associated with obesity.
* Elevate and empower obese individuals to take action that makes a difference in their lives and the lives of others.

The walk is not exclusively for thin people or for obese people. It's not for bariatric patients or those on weight-loss programs. It's open to everyone who has a desire to help put an end to this debilitating disease. As one item I read said, "We walk on behalf of those who cannot because obesity has robbed them of their mobility or their lives."

As I've blogged about before, fighting the disease of obesity and advocating for those afflicted with it is very important to me. I don't think there is another cause that I can say incites such passion in me. And I am thankful that gastric-bypass surgery has given me the ability to fight this fight for those who cannot.

I am volunteering to help organize the event in addition to organizing a local team. If you are interested in participating in the team, want to organize one of your own, or want to volunteer to help plan it, let me know and I will get you the details. I don't have the details on fundraising requirements, but I believe each walker is expected to raise at least $100.

If you are outside of the East Bay Area, there may be a walk scheduled for your area. Visit the walk's site for further information. It's not yet updated with dates for all the walks, but that should happen by next week.

Vitamin Shoppe

I was shopping in Modesto on Saturday when I discovered a Vitamin Shoppe store on Pelandale in the same shopping center as Cost Plus World Market. I had heard from other bariatric patients that Vitamin Shoppe had a great selection of bariatric-friendly products and knowledgeable staff.

I had a little time to kill so I ducked in. It proved to be everything I heard of and more. When I walked into the spacious store, the selection of supplements was almost overwhelming. I was glancing over the events calendar, which features product tastings and events hosted with local gyms when the manager greeted me. I told her I was a gastric-bypass patient and that I was just looking to compare the store's prices with my favorite supplier. She handed me a flier the store has for bariatric patients that lists all the WLS-friendly products they have and a $5 off coupon.

Not only did the store have many of my favorites -- such as Micellar Milk, Zero-Carb Isopure and PowerCrunch bars -- but it also carried some of the products I've been wanting to try but haven't got around to ordering -- such as Oh Yeah! protein wafers and PowerCrunch's new cinnamon bun flavored bars. And to top it off, the store's products were priced about a $1 less than my favorite online supplier, and there's no shipping to worry about if you have a store nearby.

They didn't have all of my favorites, though. The manager said AchievOne RTDs aren't even offered as an option from her supplier. Revival soy chips and Snack & Slim pudding were also MIA. However, the store sells a sugar-free instant protein pudding that the manager mixed up for me to try. I was impressed; it was chocolately and tasty.

While looking over the various supplements, I found out one of the clerks had gastric bypass three years ago. She told me this was her first job since having surgery. She looked great, and she told me she feels great, too. We discussed our experiences with surgery while I looked over digestive supplements. The store carries a wide variety of vegan and vegetarian probiotics and digestive enzymes.

Probiotics can come in handy for people who've taken lots of antibiotics, because they replace the good bacteria in the digestive tract. Digestive enzymes work to break down undigested food in the intestinal tract. This is an important aid for WLS patients. Our new anatomical design means our food doesn't benefit from the chemical and mechanical digestion that typically takes place in the stomach. That's why we have to chew our food to baby-food consistency and stick with foods that chew down easily. Food that isn't chewed well enough can get stuck or irritate the intestines. Depending on the brand selected, digestive enzymes break down protein, fat, fiber and dairy and other foods.

Before I realized it, I had spent two hours at the Vitamin Shoppe and was late for my shopping date. I left in a rush, but I promise to be back.

Number of children hospitalized for Type 2 diabetes soars

My friend just sent me this link from Yahoo News that reports a 200% rise in the number of children hospitalized with complications from Type 2 diabetes.

Experts quoted in the article link the increase to the epidemic of childhood obesity, which seems to get worse each day. But a couple of people question the validity of the study's findings. One doc questioned whether the children were properly diagnosed. Another points out that the distinction between Type 1 diabetes and Type 2 diabetes has only been around since 1997, meaning the "soaring" numbers could just be from increased recognition rather than increased incidence.

Check out the link and tell your thoughts.

Shopping surprise

I've noticed over the last few weeks that my clothes don't fit like they used to. My shirts slide off my shoulders; my pants sag around my hips.

I decided today that I needed to remedy that problem with a jaunt to the mall. With my best friend in tow, I headed to JC Penney in Modesto. The store was having a fabulous sale, and we had coupons, too. Besides needing clothes that fit, I also needed career wear for a conference I'll be attending next month. I knew that meant this would be a heavy-duty shopping trip.

Upon entering the store, we headed to the career wear section and picked our way through the various separates. My best friend has an impeccable sense of style so I let her take control of picking stuff. We both had armfuls of clothes in sizes 8 and 10 when we entered the fitting room. Imagine my surprise when I found that every single size 8 was too big! I looked like I was wearing my big sister's clothes.

After looking at how some of the jackets fit me, my best friend suggested we head to the petite section. I protested, telling her all the reasons I've never been able to wear petites: crotch isn't long enough in pants; bust never fits in shirts. But it was obvious I couldn't wear anything we had already selected, and neither of us thought an average size 6 would fit.

First problem we found is that the selection in petites is lacking. The second problem I had is that the clothes looked outrageously small to me -- like they should be for children. We managed to find two suits, a skirt, a pair of those new long shorts that are trendy right now and a few blouses to try on. We grabbed 8s and 6s of everything we could, just in case. We now knew that 10s were out, no matter what.

In the fitting room, I held my breath as I tried on the first pair of slacks.

"Look, look!," my best friend exclaimed as I zipped them up. "They fit you!"

I surveyed my reflection in the mirror. They sure did, and they made my hips look so slim that I wasn't sure I knew the woman staring back at me. It turns out that everything fit, though we later decided the white-and-gray pinstripe suit was not practical enough to warrant its $100 price tag.

I walked out of JC Penney with a black suit, two blouses, long black shorts and a gray skirt for under $100 -- all in a petite size 8. Not a bad deal, if you ask me.

Blog Potato

Inside Out has been added to the Blog Potato blogroll. What's a Blog Potato? Just as couch potatoes sit on the couch all day; blog potatoes are people who blog all the time. Blog Potato has the ambitious goal of compiling the longest blogroll on the Internet. If you have a blog, visit the site and get yourself added.

Melting Mama

I've become hooked this week on reading other blogs related to surgical weight loss. There's an abundance of them out there, and each has its own merits. Take Melting Mama, for example.

The site's owner, Beth, is a Bostonian about my age who once topped the scales at more than 300 pounds. What I love most about her blog is its snarky tone. She's had a slew of complications since WLS, and she doesn't shy away from them. I appreciate that about her, because as I've said, this journey isn't all peaches and roses -- and I think more people need to be aware of the risks associated with it.

So, take a sec and check out Melting Mama, and then click back here and tell me what you think.

Chance meeting leads to friendship

I recently had the opportunity to meet Katie Jay, the director of the National Association for Weight Loss Surgery. Jay is a dynamic woman who self-published her memoir, "Dying to Change: My Really Heavy Life Story."

She refers to herself as an obesity survivor, and to her credit, she's maintained a 190-pound weight loss since she had bariatric surgery three years ago. Jay travels as a speaker, workshop leader and life coach, making a career out of supporting others in their efforts to overcome obesity.

We crossed paths by chance. She had connected with a Tracy woman who is starting up a bariatric life coaching business here in town. Jay was offering the woman some sage words of advice when the topic of Jay's recent bowel obstruction came up. The local woman briefly told Jay of my recent experience and decided that we had to meet, because our stories were similar.

After exchanging a few e-mails, Jay and I chatted on the phone for almost two hours. We talked about our histories, our bariatric journeys, our respective bowel obstructions (nothing like getting personal right out of the gate), and our goals. And I think it's safe to say we're well on our way to becoming friends, because we see eye-to-eye on so many levels.

Jay's Web site offers a wealth of information for those considering bariatric surgery. She offers numerous articles that discuss the various types of procedures available, common obstacles, insurance issues and the emotional challenges post-ops face. One article of hers that I particularly enjoyed is titled "My Body is a Wonderland." The article discusses Jay's journey toward self-acceptance through yoga. It's a profound and inspiring tale. Check it out, and come back here to post a comment on it. I'd love to hear your thoughts

The dark side of WLS

In the 18 months that I have been writing about my decision to have bariatric surgery and my subsequent journey toward a healthy weight, I've tried to paint a clear picture of my overall experience.

But there have been some topics I've steered clear from for fear that they are too unpleasant for general consumption. The fact is that bariatric surgery is not all peaches and roses. No two patients have the same experience, because every body reacts to the anatomical changes in a different way. Some post-ops feel as if they've never had surgery, because their experience is that unremarkable. Other post-ops experience side effects so embarassing they fear leaving the house. And it's those side effects that are the topic of today's post.

Gas
There are two types of gas that bariatric patients suffer from: pouch gas and intestinal gas. Pouch gas is the easiest to deal with. Any over-the-counter gas aid with simethicone will dispel pouch gas and ease the pressure and pain.

Intestinal gas is the most painful and problematic. No over-the-counter gas aids work well in the intestinal tract. However, Digestive Advantage markets an over-the-counter pill that prevents gas in the intestines. The once-daily pill must be taken daily to work, and takes a few days to become effective, but it drastically reduces the amount of intestinal gas one experiences.

The final issue with gas is that a few patients -- particularly those who have duodenal switch -- experience flatulence with such a pungent odor that it alienates them from the world outside. They don't want to be alone with themselves, much less with anyone else. This problem can be particularly traumatizing in some patients who find their world even smaller after weight-loss surgery than it was when they were morbidly obese. For these post-ops, Devrom can be a godsend. Devrom is an internal deodorant that works to neutralize the odor in gas and excrement. It's not pretty to talk about, but it's a tool that provides post-ops in this uncomfortable situation with some measure of freedom.

Constipation
Constipation is a common problem after bariatric surgery. Decreased consumption of food and fluids, combined with protein supplements, make for a situation where things don't move. Constipation may seem like no big deal, but if it goes on too long, it can lead to hemmorhoids, fistulas and obstructed bowels -- all of which are painful and can be dangerous. The best way to prevent constipation after gastric-bypass is to consume at least 64 ounces of water a day. Other post-ops advocate taking stool softeners and/or fiber supplements daily to add some bulk to the intestines and to encourage everything to keep moving. Those are great preventive measures, but what does one do if constipation is already a problem? Milk of Magnesia and Smooth Move tea are excellent solutions. They are non-stimulant laxatives that help solve the problem of constipation in relatively short order.

Diarrhea
Though more rare than constipation, diarrhea can also be a side effect of bariatric surgery. Aside from the social discomfort of dealing with diarrhea, constant loose bowels can also cause dehydration. Depending on how long it's been since the patient had gastric-bypass, there are a few solutions. Eating bananas can firm up bowel movements. For patients at least one year out, high-fiber cereals can add much needed bulk. Another option is to use fiber supplements. Fiber supplementation is a good solution, but it takes time to kick in.

What's left to do

Yesterday, I posted a list of my accomplishments since having gastric-bypass surgery two years ago. The list is full of activities and "a-ha" moments of which I never previously thought were possible. But there are still things I want to do that I've yet to accomplish.

And here is a list of those things:

* Set foot on a boat -- I'm not promising to stay on the boat, but I'm willing to walk on it.

* Take a cruise -- Ships are different than boats. They are big enough so I can pretend I'm not surrounded by water. My hope is to take a short cruise in 2008.

* Go rock climbing -- I have wanted to try rock climbing since I was in college, but I've never had the courage.

* Ride on a motorcycle -- Sigh...if I could arrange it so Jesse James was the driver, it would be even better.

* Learn to swim -- I'm not a fan of water. Therefore, swimming has never really appealed to me, but I think it's something I should learn.

* Publish a book -- I'd like to find a publishing house willing to pay me to write a bariatric-related book.

* Be a guest on Oprah -- I think I have an inspiring story to tell. Sure, Oprah is a stretch. But hey, isn't that what goal-setting is all about?