Web MD has an article today, stating that low-carb diets may impair brain function. Read it here.
The article is as interesting as the study, which only followed participants for three weeks. Participants were tested on short- and long-term memory and attention three times during the study. I'm not sure you can come to any firm conclusions on anything after only three weeks, but these scientists have tried.
To me, the study's results are in line with what I know of how carbohydrates affect the human body. Read the fine print on any program recommending low-carb living, and you will see that advocates believe it takes 10 to 14 days to wean the body from reliance on simple carbohydrates. Withdrawal symptoms include irritability, sluggishness, lethargy and difficulty concentrating. Once the body has recovered from its withdrawal, usually people find themselves more alert, energetic and able to multi-task.
So if participants in this study only limited their carb intake for a week, it would stand to reason that they'd be in the midst of withdrawal symptoms when researchers tested their brain function. A week later, after resuming carbohydrate consumption, those symptoms would be gone.
Monday, December 15, 2008
Monday, September 08, 2008
AP: Liver Disease Plagues Overweight Kids
This story from the Associated Press is sobering. Docs are finding the need for children to have liver transplants is increasing, thanks to obesity. As a fat kid, I knew the mantra of the time that I would grow out of it, that I was just big-boned or my personal favorite, that I may be big but at least I was healthy, was a gigantic load of crap.
Too bad it's taken 20 years for medical professionals to put two and two together on that one.
Too bad it's taken 20 years for medical professionals to put two and two together on that one.
Friday, July 25, 2008
Kaiser Point West Says Goodbye to Gity
I will be in
Gity has been special to me from the moment I met her at my bariatric orientation in October 2004, when she asked the assembled group why there was so much guilt among the obese.
“Does anyone ever blame the cancer patient for their disease? Or the bypass patient for their heart problems? No. Why? Because we all understand that diseases are out of our control.”
Gity is the first person I recall seeing when I awoke from surgery. She wished me a happy birthday, since Feb. 24, 2005 was the first day of the rest of my life. And she was right, it was a happy birthday – and my life has never been the same.
I will miss her, though I know we’ll keep in touch. I just wonder if Kaiser has any idea at what they are losing.
Friday, July 18, 2008
Tales From the Dark Side, Part II
In following up to yesterday’s post, I want to address my answer to the question, “Given the chance, would you have RNY again?”
WLS blogger Melting Mama, has a nine-minute YouTube video that explains why she wouldn’t. If you haven’t already, please watch the video (at the top of yesterday’s entry) before reading this. It’s not that MM wouldn’t have WLS, it’s just that given the choice, she would have picked an alternate procedure.
MM’s WLS journey is similar to mine in that we both went under the knife when we were in our 20s, both were over 300 pounds at the time, both had RNY and both now suffer from anemia and hypoglycemia as a direct result of that surgical procedure.
Yet now, more than three years later – four for her – we have very different views on what path we’d take if we could go back in time.
Why?
Because of one very key difference: MM was a very healthy 20-something who just happened to tip the scales at more than 300 pounds. I, on the other hand, was slowly dying in a 27-year-old fortress of fat. That’s the difference that makes our post-op experiences worlds apart.
Here’s my laundry list of pre-op concerns:
At 27, I felt like I was 80. I worked so hard to pretend the above conditions weren’t a problem and that I was “healthy” despite my weight, that I was exhausted by the end of the day. I had been morbidly obese since childhood, and my body was ready to collapse under its own weight.
After a long talk with a compassionate, yet direct, medical provider, I realized that I was on the cusp; my obesity was just beginning to catch up with me. I could continue down the path I was on and face increasingly severe co-morbidities or I could do something drastic to lose weight in an attempt to drastically reverse my course.
I chose the latter, and I haven’t had a single regret since.
Even when writhing in pain from a life-threatening bowel obstruction, I said with confidence that I would do it all over again because one day of life in a normal-size body is sweeter to me than any number in my pre-operative form.
But let’s get two things clear:
In my opinion, MM is not a whiner. Every word she says is true. We just have a different perspective on our situations. MM is right on the money when she calls WLS a trade-off. You give up obesity in exchange for other concerns or issues. In her case, the juice isn't worth the squeeze. In mine, it is.
She may not have had a bowel obstruction, but her hypoglycemia and nutritional deficiencies are much more severe than mine; I don’t suffer seizures nor do I need round-the-clock glucose monitoring. I also think that I’ve gotten more diligent after-care than she has – even when that bowel obstruction went misdiagnosed for six freaking months.
And I will say one thing very plainly: Reactive hypoglycemia is a nightmare.
MM says it best with the succinct comment, “Yeah, I look good. But what does that matter if I’m dead?”
If I ever came close to regretting bariatric surgery, it was when I became hypoglycemic. It’s difficult to articulate what it’s like other than to say it feels like your body is your enemy. Between that and the anemia presenting themselves at the same time, I felt like I was at the brink of insanity. The emotional and physical toll of hypoglycemic episodes were debilitating for me until brought them under control with the help of a caring, knowledgeable doctor a few months ago.
This last year has really been tough. I won’t lie. But in my situation, morbid obesity was still tougher.
WLS blogger Melting Mama, has a nine-minute YouTube video that explains why she wouldn’t. If you haven’t already, please watch the video (at the top of yesterday’s entry) before reading this. It’s not that MM wouldn’t have WLS, it’s just that given the choice, she would have picked an alternate procedure.
MM’s WLS journey is similar to mine in that we both went under the knife when we were in our 20s, both were over 300 pounds at the time, both had RNY and both now suffer from anemia and hypoglycemia as a direct result of that surgical procedure.
Yet now, more than three years later – four for her – we have very different views on what path we’d take if we could go back in time.
Why?
Because of one very key difference: MM was a very healthy 20-something who just happened to tip the scales at more than 300 pounds. I, on the other hand, was slowly dying in a 27-year-old fortress of fat. That’s the difference that makes our post-op experiences worlds apart.
Here’s my laundry list of pre-op concerns:
- Chronic joint and back pain (I popped Darvocet and ibuprofen like candy);
- High blood pressure (filled my first prescription for the condition at 21);
- Debilitating migraines;
- Infertility;
- Chronic swelling;
- Difficulty breathing;
- Lack of mobility;
At 27, I felt like I was 80. I worked so hard to pretend the above conditions weren’t a problem and that I was “healthy” despite my weight, that I was exhausted by the end of the day. I had been morbidly obese since childhood, and my body was ready to collapse under its own weight.
After a long talk with a compassionate, yet direct, medical provider, I realized that I was on the cusp; my obesity was just beginning to catch up with me. I could continue down the path I was on and face increasingly severe co-morbidities or I could do something drastic to lose weight in an attempt to drastically reverse my course.
I chose the latter, and I haven’t had a single regret since.
Even when writhing in pain from a life-threatening bowel obstruction, I said with confidence that I would do it all over again because one day of life in a normal-size body is sweeter to me than any number in my pre-operative form.
But let’s get two things clear:
- I DO NOT feel that way, because I’m “thin.” Go back and read my early posts – from before I had surgery – and you will see that I was terrified of being thin. It was a foreign concept to me at the time, something I could not wrap my brain around.
- Surgery wasn't a cure-all for me. I still suffer from some of my pre-operative health concerns; they are just easier to manage at this size.
In my opinion, MM is not a whiner. Every word she says is true. We just have a different perspective on our situations. MM is right on the money when she calls WLS a trade-off. You give up obesity in exchange for other concerns or issues. In her case, the juice isn't worth the squeeze. In mine, it is.
She may not have had a bowel obstruction, but her hypoglycemia and nutritional deficiencies are much more severe than mine; I don’t suffer seizures nor do I need round-the-clock glucose monitoring. I also think that I’ve gotten more diligent after-care than she has – even when that bowel obstruction went misdiagnosed for six freaking months.
And I will say one thing very plainly: Reactive hypoglycemia is a nightmare.
MM says it best with the succinct comment, “Yeah, I look good. But what does that matter if I’m dead?”
If I ever came close to regretting bariatric surgery, it was when I became hypoglycemic. It’s difficult to articulate what it’s like other than to say it feels like your body is your enemy. Between that and the anemia presenting themselves at the same time, I felt like I was at the brink of insanity. The emotional and physical toll of hypoglycemic episodes were debilitating for me until brought them under control with the help of a caring, knowledgeable doctor a few months ago.
This last year has really been tough. I won’t lie. But in my situation, morbid obesity was still tougher.
Thursday, July 17, 2008
Tales From the Dark Side, Part I
This video, courtesy of WLS blogger Melting Mama, is a must-see for anyone considering bariatric surgery. The picture she paints is grim reality that more pre-ops need to be exposed to. It’s a nine-minute video but it’s worth the time.
It’s been almost 3½ years since I had gastric-bypass – roughly about six months after Melting Mama. Our stories are similar in many ways: we were both over 300 pounds before WLS, we both were under 30, we both had roux-en-Y procedures, and we both suffer from anemia and hypoglycemia as a result of our surgical procedures.
Despite those similarities, though, we have different perspectives on our surgeries. Melting Mama would not have RNY all over again; I would.
I don’t want to steal the video’s thunder but it addresses the biggest issue I have with the popularity of surgical weight loss: LACK OF EDUCATION.
I remember my WLS orientation like it was yesterday. After six months of waiting, I was finally at Kaiser SSF to get more information on bariatric surgery. Like Melting Mama, I wanted the LapBand; it was less-invasive than gastric bypass, had no malabsorption and led to more gradual weight loss. I was also talked out of it when the surgeon at orientation informed me it was not covered by Kaiser and then gave me his laundry list of reasons why it was a bad idea anyway.
Beside that, there was one thing that struck me as odd about orientation – my fellow pre-ops didn’t seem to have a clue about bariatric surgery or what they were getting themselves into.
At this point, I had spent months poring over articles and research about WLS. I had interviewed people who had various procedures at various times. I talked to people with life-threatening complications and ones whose post-op journey was smooth sailing. I was armed and dangerous with more knowledge than my own physician when I marched into his office and asked to be considered for Kaiser’s program.
My cohorts at orientation, however, seemed to know little more than RNY made Al Roker and Carnie Wilson lose lots of weight and that they looked thin and beautiful. I remember one man who was downright outraged when he was told he’d have to limit his intake of sugar.
“But Al Roker says he can eat whatever he wants; he just eats less.”
It was hard not to roll my eyes.
I sat through three similar group classes before making a big decision: I would document my journey in writing and share it with the world.
Up to that point, I had intended to keep my surgery private. Like many of my friends, I was merely going to have “abdominal surgery” and let people think I was having my gall bladder removed or whatever. I didn’t want to make myself a spectacle. I didn’t want to open myself up to negative comments. I wasn’t even going to tell my family.
But the reactions and comments of the pre-ops I encountered in my journey showed me there was a dearth of reliable information on the subject of WLS that was easy to access. It also showed me that when it comes to losing weight, few people read the fine print. They are so intoxicated by the idea of being thin, they don’t pay any attention to the price they may have to pay. In short, they hear what they want.
So, my mission was simple: I would write a column dedicated to the subject with the goal of educating those who wanted or needed bariatric surgery and the general public. I wanted people to understand the seriousness of the decision, the dangers of the surgery and the fact that it requires a complete change in attitude and habits. I figured that since I had already done all the research, I could make it easier on others who followed in my footsteps to be as educated as I was when it came time to go under the knife.
Sadly, I overestimated my peers. Since I started this journey in 2004, I have only come across a handful of pre-ops truly willing to weigh the pros and cons of surgery. Even more sad are the number of post-ops who actually go on to make the changes necessary for success.
Wednesday, July 16, 2008
The Human Pin Cushion Speaks Again
My latest set of lab results just came in, and the news is mostly good.
After three rounds of iron therapy with Repliva, my hemoglobin has risen to 10.2 -- a small increase, but we're taking it as a good sign and continuing my current dosage of 150mg.
My B-12 levels are on the low side of normal at 232 with normal being considered any amount over 200. Doc isn't worried yet.
Parathyroid hormone (PTH) is elevated to 87 instead of being below 65, which -- combined with normal calcium levels -- indicates hyperparathyroidism. Don't you just love big words? Long story short, I'm not absorbing the calcium I'm taking in. I'm switching to UpCal D, which is a powdered form of calcium that mixes easily in liquid. I have a few friends who credit it with rapidly decreasing their PTH levels. I found it online for about $20 for a 16-oz canister. If you know of a cheaper source, e-mail me.
With my body having a difficult time still recovering from last year's bowel obstruction, my doctor has recommended keeping close tabs on my labs this year. We'll retest iron, B-12 and PTH in two months to see if my modifications have improved matters at all.
After three rounds of iron therapy with Repliva, my hemoglobin has risen to 10.2 -- a small increase, but we're taking it as a good sign and continuing my current dosage of 150mg.
My B-12 levels are on the low side of normal at 232 with normal being considered any amount over 200. Doc isn't worried yet.
Parathyroid hormone (PTH) is elevated to 87 instead of being below 65, which -- combined with normal calcium levels -- indicates hyperparathyroidism. Don't you just love big words? Long story short, I'm not absorbing the calcium I'm taking in. I'm switching to UpCal D, which is a powdered form of calcium that mixes easily in liquid. I have a few friends who credit it with rapidly decreasing their PTH levels. I found it online for about $20 for a 16-oz canister. If you know of a cheaper source, e-mail me.
With my body having a difficult time still recovering from last year's bowel obstruction, my doctor has recommended keeping close tabs on my labs this year. We'll retest iron, B-12 and PTH in two months to see if my modifications have improved matters at all.
Tuesday, July 15, 2008
Maybe We're Doomed Before Birth
An LA Times article suggests we may be predisposed to obesity in utero, depending on our mothers' eating habits and health concerns during pregnancy.
What do you think?
What do you think?
Thursday, July 10, 2008
Time Flies
Hard to believe it's been so long since I've posted. I was thinking about it the other day. I'm always thinking of posting on here or reminding myself to remember to post something I think is profound or would be worthwhile to others with interest in obesity or weight loss. But then I get side-tracked and it slips my mind.
I think that's what happens to most of us.
I remember a couple of years ago -- shortly after my first post-op anniversary -- that a similar subject came up with a WLS friend of mine. I had recently returned from a conference and was relaying to her how many surgeons and bariatric coordinators complained that attendance at support groups and bariatric events drastically dwindled after the first post-op year. Docs were looking for answers as to how to retain their patients' interests.
The consensus at the time was that as pre-ops, patients will jump through any hoop necessary to get doctor and insurance approval. But once they go under the knife, they become less compliant. After all, it's not like anyone can take your surgery away after the fact, right?
My friend, however, posed another explanation. She had missed her support group's last three monthly meetings at the time. Her reason? "I'm too busy living life," she said.
Hmmm...
She went on to explain: "I worked too hard in having surgery and losing weight to live my entire life according to support group schedules. I am making the most out of my new life, and if that means I can't sit through two hours at a support meeting because I'm in Shasta or Disneyland or on a cruise with my husband, then so be it. I refuse to apologize for that."
Interesting...
At the time, I thought, "good for her." She was out living life. I didn't feel like I was sitting on the sidelines, but I did make a concerted effort to organize my playtime around support group meetings and events whenever possible. Then again, I was leading a WLS support group, writing on the subject of WLS regularly in print and online and dipping my toes into the waters of private consulting. I was eating, sleeping and breathing the world of surgical weight loss.
Then another year passed and I got knocked on my backside with a bowel obstruction. The months between my second and third WLS anniversaries trickled by at an unbearably slow pace as I struggled to regain my health and vitality. It wasn't until March of this year that I started to feel some resemblance to the upbeat ball of energy I had been in my first post-op year.
Since then, life has been too good to stand. And like my friend, I'm so busy living it that there doesn't seem to be much time left over to sit down and document it. All I can say is that it's an amazing adventure -- and given the choice, I'd do it all over again.
I think that's what happens to most of us.
I remember a couple of years ago -- shortly after my first post-op anniversary -- that a similar subject came up with a WLS friend of mine. I had recently returned from a conference and was relaying to her how many surgeons and bariatric coordinators complained that attendance at support groups and bariatric events drastically dwindled after the first post-op year. Docs were looking for answers as to how to retain their patients' interests.
The consensus at the time was that as pre-ops, patients will jump through any hoop necessary to get doctor and insurance approval. But once they go under the knife, they become less compliant. After all, it's not like anyone can take your surgery away after the fact, right?
My friend, however, posed another explanation. She had missed her support group's last three monthly meetings at the time. Her reason? "I'm too busy living life," she said.
Hmmm...
She went on to explain: "I worked too hard in having surgery and losing weight to live my entire life according to support group schedules. I am making the most out of my new life, and if that means I can't sit through two hours at a support meeting because I'm in Shasta or Disneyland or on a cruise with my husband, then so be it. I refuse to apologize for that."
Interesting...
At the time, I thought, "good for her." She was out living life. I didn't feel like I was sitting on the sidelines, but I did make a concerted effort to organize my playtime around support group meetings and events whenever possible. Then again, I was leading a WLS support group, writing on the subject of WLS regularly in print and online and dipping my toes into the waters of private consulting. I was eating, sleeping and breathing the world of surgical weight loss.
Then another year passed and I got knocked on my backside with a bowel obstruction. The months between my second and third WLS anniversaries trickled by at an unbearably slow pace as I struggled to regain my health and vitality. It wasn't until March of this year that I started to feel some resemblance to the upbeat ball of energy I had been in my first post-op year.
Since then, life has been too good to stand. And like my friend, I'm so busy living it that there doesn't seem to be much time left over to sit down and document it. All I can say is that it's an amazing adventure -- and given the choice, I'd do it all over again.
Friday, March 21, 2008
Pumping Iron
I'm just wrapping up week three of my Repliva regimen. A word of warning to anyone interested in the prescription iron supplement: The pills are HUGE! The Web site, I think, makes the pills appear to be the size of birth control pills when in reality, they are the size of prenatal vitamins.
I wish I could say I feel differently now than before I started Repliva, but I don't. It still takes me 30 to 45 minutes to get out of bed in the morning. I still feel as if I'm walking underwater as I go about my day. Every little thing feels like it requires great effort. To say I'm dragging is a bit of an understatement.
Regardless, I'm still confident the Repliva will work in time, and I have yet to miss a dose.
Thursday, February 28, 2008
Annual Lab Results: The Human Pin Cushion Speaks
It's that time of year again. You post-ops all know what time I'm referring to. The time when we head to the doctor a leave with a handy-dandy lab request form in hand that has more boxes marked on it than unmarked, leaving us to wonder whether it would have just been easier for the doctor to write a note saying, "Check for everything but ... "
My lab results weren't that great last year. Both my blood sugar and iron levels were low. But with my employer changing insurance providers and then me taking a new job that offered other types of insurance plans, I had a hard time keeping track of things.
I met my PCP last week and instantly liked him. Merced may have a shortage of physicians, but so far, I think the ones we do have are top notch. He ordered a full course of lab tests for me and referred me to a nutritionist to discuss my hypoglycemia.
At the lab, I struggled not fall asleep as the technician drew eight vials of blood. I made a bee-line from the lab to a food source when it was all said and done.
My results came in early this week. I wish I could say I was surprised by them, but they only served to confirm what I already knew: I'm a bit out of whack.
First the good news: My cholesterol is 167. My risk level for cholesterol-related heart disease is 0.67. Average risk is 2.34-4.13. My doc is very happy. The nutritionist says I can eat all the cheese I want. Must be why I like her so much ;-)
Now for the not-so-good news: I have mytocytic anemia, most commonly referred to as iron-deficiency anemia. Most common, most easy to treat. The main concern is that I've been supplementing daily yet my iron levels are half of what they were a year ago, and my organs are not getting the oxygen they need. This is why I'm so tired and why I can't sustain physical activity for very long.
Here are my results for perspective:
Ferritin -- 1 (normal is 10-154)
Total Iron -- 22 (normal is 40-175)
Hemoglobin --- 10 (normal is 12-15)
Thought my ferritin level is in the toilet, the nutritionist I saw today said she doesn't recommend infusion therapy unless total iron is 10 or less, or hemoglobin is 7 or less. It's her opinion (she's also a family practitioner) that I can afford to try a higher dose of oral therapy for six weeks to see if that improves my levels. If it doesn't, then she'll combine oral therapy with weekly injections. Transfusion will be her last course of action. We will continue to monitor my iron levels every six weeks until I get in the normal range.
I've been taking 20mg of chewable iron daily. She's prescribing a new type of iron supplement that's supposed to be really good for women in general, but has also shown great results in bariatric patients. It's called Repliva. It's set up like birth control pills, where you take one active pill a day for 21 days and then an inactive pill for 7 days. Apparently, the body absorbs iron better when it gets a little break in between supplement cycles. Repliva is said to be more bioavailable than other forms of iron, because it contains B12, Vitamin C and Succinic Acid, which all act as binders to improve absorption. So, in theory, my body will absorb all 150mg of my daily dose. It's available by prescription only, and there is a chance that my insurance company won't cover it. But if it's not covered, I will figure something out. I can't afford not to supplement my iron intake. I'm not the type of person to cut corners when it comes to my health.
I really like my nutritionist. She gave me a glucometer so I can test my blood sugar levels daily and also gave me a plan of action on how to better control my hypoglycemia. I feel like she really took her time explaining reactive hypoglycemia to me and giving me additional tools to manage it. For instance, she told me that reactive hypoglycemia is much more common in the morning, which explains why I have such issues after breakfast that can lead to me ping-ponging all day to achieve balance. The solution may be as easy as eating only protein for breakfast. Following the same logic, that would mean that if I do want to indulge in a carbohydrate, dinner is the best time to do so.
Aside from logging my meals and testing regularly to find patterns, my immediate goal is to figure out how much carbohydrate my body can handle at one time and then ensuring I get a steady dose of that level throughout the day. This should alleviate my problems with fluid retention and bloating. I'm starting with 100 grams of carbs a day, split equally (20g) through my five meals. She prepared me for the need to juggle as my glucose monitoring reveals a pattern. For example, she said I might find that I have to limit my morning meals to only 10 grams of carbs but can boost my afternoon and evening meals to 30 grams.
Long story short, she did a lot to make me feel that all is not lost. That my hypoglycemia can be managed. And though it will take patience and discipline, I feel like she's willing to partner with me in figuring out my specific needs.
My lab results weren't that great last year. Both my blood sugar and iron levels were low. But with my employer changing insurance providers and then me taking a new job that offered other types of insurance plans, I had a hard time keeping track of things.
I met my PCP last week and instantly liked him. Merced may have a shortage of physicians, but so far, I think the ones we do have are top notch. He ordered a full course of lab tests for me and referred me to a nutritionist to discuss my hypoglycemia.
At the lab, I struggled not fall asleep as the technician drew eight vials of blood. I made a bee-line from the lab to a food source when it was all said and done.
My results came in early this week. I wish I could say I was surprised by them, but they only served to confirm what I already knew: I'm a bit out of whack.
First the good news: My cholesterol is 167. My risk level for cholesterol-related heart disease is 0.67. Average risk is 2.34-4.13. My doc is very happy. The nutritionist says I can eat all the cheese I want. Must be why I like her so much ;-)
Now for the not-so-good news: I have mytocytic anemia, most commonly referred to as iron-deficiency anemia. Most common, most easy to treat. The main concern is that I've been supplementing daily yet my iron levels are half of what they were a year ago, and my organs are not getting the oxygen they need. This is why I'm so tired and why I can't sustain physical activity for very long.
Here are my results for perspective:
Ferritin -- 1 (normal is 10-154)
Total Iron -- 22 (normal is 40-175)
Hemoglobin --- 10 (normal is 12-15)
Thought my ferritin level is in the toilet, the nutritionist I saw today said she doesn't recommend infusion therapy unless total iron is 10 or less, or hemoglobin is 7 or less. It's her opinion (she's also a family practitioner) that I can afford to try a higher dose of oral therapy for six weeks to see if that improves my levels. If it doesn't, then she'll combine oral therapy with weekly injections. Transfusion will be her last course of action. We will continue to monitor my iron levels every six weeks until I get in the normal range.
I've been taking 20mg of chewable iron daily. She's prescribing a new type of iron supplement that's supposed to be really good for women in general, but has also shown great results in bariatric patients. It's called Repliva. It's set up like birth control pills, where you take one active pill a day for 21 days and then an inactive pill for 7 days. Apparently, the body absorbs iron better when it gets a little break in between supplement cycles. Repliva is said to be more bioavailable than other forms of iron, because it contains B12, Vitamin C and Succinic Acid, which all act as binders to improve absorption. So, in theory, my body will absorb all 150mg of my daily dose. It's available by prescription only, and there is a chance that my insurance company won't cover it. But if it's not covered, I will figure something out. I can't afford not to supplement my iron intake. I'm not the type of person to cut corners when it comes to my health.
I really like my nutritionist. She gave me a glucometer so I can test my blood sugar levels daily and also gave me a plan of action on how to better control my hypoglycemia. I feel like she really took her time explaining reactive hypoglycemia to me and giving me additional tools to manage it. For instance, she told me that reactive hypoglycemia is much more common in the morning, which explains why I have such issues after breakfast that can lead to me ping-ponging all day to achieve balance. The solution may be as easy as eating only protein for breakfast. Following the same logic, that would mean that if I do want to indulge in a carbohydrate, dinner is the best time to do so.
Aside from logging my meals and testing regularly to find patterns, my immediate goal is to figure out how much carbohydrate my body can handle at one time and then ensuring I get a steady dose of that level throughout the day. This should alleviate my problems with fluid retention and bloating. I'm starting with 100 grams of carbs a day, split equally (20g) through my five meals. She prepared me for the need to juggle as my glucose monitoring reveals a pattern. For example, she said I might find that I have to limit my morning meals to only 10 grams of carbs but can boost my afternoon and evening meals to 30 grams.
Long story short, she did a lot to make me feel that all is not lost. That my hypoglycemia can be managed. And though it will take patience and discipline, I feel like she's willing to partner with me in figuring out my specific needs.
Sunday, February 24, 2008
Happy Birthday to Me!
It's hard to believe, but it's been three years since I went under the knife and changed my innards and my life. Gastric-bypass surgery, and the subsequent weight loss it caused, has led to a whirlwind of changes. Sometimes, I feel like it was just yesterday that it all occurred, and other times, it feels like I've been in this new body forever.
I can now admit my top weight was closer to 350, even though my highest recorded was 335. I do remember registering 350 on the scale at Curves once, but denial is a beautiful thing and kept me sane at the time.
The last year has been an interesting one -- bowel obstruction, surgery, hypoglycemia, anemia, divorce, job change, location change. Come to think of it, not much hasn't changed. But when it comes to my re-birthday, as the Kaiser staff called it, or my surgi-versary, as other post-ops call it, I like to reflect on how bariatric surgery has changed me as a whole.
Year after year, I am amazed at how far I have come.
In February 2005, I was 27 years old but I felt 80. At 310 (Had to lose weight to meet Kaiser's requirements for surgery), I was bigger around than I was tall; I was tired all the time but suffered from insomnia. I had trouble breathing, though I wouldn't admit it to anyone. My knees constantly hurt; my feet would swell up to the point of distortion; just moving about my daily life was chore.
Today, I fluctuate between 140 and 15o. Fluid retention will boost me up to 160 from time to time, but I'm working on that. I weigh myself once a month or so, just to keep things in check. Like many gastric-bypass patients, I still fear waking up one day with all the weight piled back on me. Silly, yes, but it's a real fear. Rather than suffer from joint pain, I deal with my tailbone hurting from lack of cushion. I won't lie to you. It's a nice problem to have. I have been called skinny and scrawny, and I'm not the least bit insulted. I'm not as active as I would like to be, but I am more active than I ever thought possible.
My biggest internal struggle is fear of complete assimilation. Having moved away from Tracy, nobody I meet knows I used to be morbidly obese unless I tell them. It's nice to be judged on who I am now, rather than who I used to be or people's perception of bariatric surgery or massive weight loss. But I don't ever want to forget the old me. A lifetime of morbid obesity shaped my character. It gave me a different type of compassion for others, but it also made me strong. I always felt like I had to work extra hard compared to those around me to combat the stereotype that fat people are lazy or stupid. I was a high-achiever. I still am. And that's not necessarily a bad thing. More people should aspire to more than mediocrity.
I am not ashamed of my past, but I don't want it to define me in the eyes of others. Then again, I'm not sure I can make that choice. After all, we all get to choose how we define others, regardless of what they want.
Three years ago, I thought I was happy. And maybe I was. I had a good life and a healthy level of confidence in myself. I thought I had more blessings than I had a right to expect. But today, I'm so stinking happy I can barely stand myself. It's a different type of happiness. I'm content not complacent. I think there is a big difference between the two. Though I'm not dissatisfied with my life, I know it can only get better -- because every single day since having surgery Feb. 24, 2005, has been better than the one before it. And that, my friends, is what reaffirms that I made the right decision for me when I chose gastric-bypass.
Friday, February 15, 2008
Fast, not Furious
I'm in the midst of a 10-day liquid fast in honor of the Lenten season. Actually, my church is involved in a PUSH initiative, which stands for Pray Until Something Happens. The initiative is built around revolving fasts: For the first 10 days, everyone consumes liquids only and prays five full minutes a day; the next 10 days are a media fast, during which time, everyone abstains from TV, newspapers, movies, video games, texting, e-mail, Internet usage, etc., unless it glorifies God or is required for work; the following 10 days are devoted to random acts of kindness; and the final 10 days require everyone to devote 1 hour each day to prayer.
The fast excites me greatly, particularly this first set. I have needed to do a liquid-protein fast for quite some time. My digestive system has been wonky ever since my bowel obstruction last year, and it seems that I just can't get my body into any kind of symbiosis. There's a question of whether I've developed food allergies or sensitivities, or if something more acute is amiss. Though there is a laundry list of tests that can be run, one efficient way to figure out a problem is to go on an elimination diet.
This church-wide fast has given me the motivation I need to limit my diet to liquid protein supplements, and I have to be honest...I have felt better in the last week than I have in the last year. I'm not terribly hungry, I have oodles of energy, and my intestines seem to be a lot happier. I may extend the fast to four weeks before slowly reintroducing foods into my diet under doctor supervision to see if we can pinpoint exactly which foods my body can't/won't process.
Micellar Milk lattes are still among my favorite protein treats, but I have to say that Met-Rx's 51-gram RTD in cookies and cream makes a very yummy mocha-like drink. That kept me quite happy all day yesterday. Lean Body's RTDs in ice cream flavors are also tasty, but I don't think they taste anything like ice cream. Then again, it's been a long time since I've had ice cream. Maybe I've forgotten what it tastes like.
The fast excites me greatly, particularly this first set. I have needed to do a liquid-protein fast for quite some time. My digestive system has been wonky ever since my bowel obstruction last year, and it seems that I just can't get my body into any kind of symbiosis. There's a question of whether I've developed food allergies or sensitivities, or if something more acute is amiss. Though there is a laundry list of tests that can be run, one efficient way to figure out a problem is to go on an elimination diet.
This church-wide fast has given me the motivation I need to limit my diet to liquid protein supplements, and I have to be honest...I have felt better in the last week than I have in the last year. I'm not terribly hungry, I have oodles of energy, and my intestines seem to be a lot happier. I may extend the fast to four weeks before slowly reintroducing foods into my diet under doctor supervision to see if we can pinpoint exactly which foods my body can't/won't process.
Micellar Milk lattes are still among my favorite protein treats, but I have to say that Met-Rx's 51-gram RTD in cookies and cream makes a very yummy mocha-like drink. That kept me quite happy all day yesterday. Lean Body's RTDs in ice cream flavors are also tasty, but I don't think they taste anything like ice cream. Then again, it's been a long time since I've had ice cream. Maybe I've forgotten what it tastes like.
Sunday, January 27, 2008
What Price Vanity?
I was just finishing up the most amazing lunch yesterday at a restaurant in Fresno when I encountered a fun group of women sitting in the booth behind me. I had overheard one woman talking of sugar-free chocolate. I turned around to tell her of my favorite brand and we started talking about diabetes, hypoglycemia and eventually bariatric surgery. One woman in the group had gastric-bypass. She told me she had dropped 85 pounds, adding that she wasn't "very big" to begin with.
Knowing that there is some elitism in the bariatric community regarding pre-op size, I shrugged and said their was nothing wrong with being a lightweight. After all, better to take control of obesity before its long-term effects take control of you.
"Oh...I had it purely out of vanity," she said.
That stopped me dead in my tracks.
Since having weight-loss surgery almost three years ago, I've encountered a variety of pre- and post-ops with varying reasons for wanting/having surgery. Though every person has given the same party line about "health concerns," I know more than a few really didn't care about their health -- they just wanted to be thin.
It was those people who I originally wanted to help when I started writing this column (now blog) in 2004. I thought educating them on the risks associated with surgery would drive home the point that this is truly a drastic solution to what should be a very drastic health condition. There are days when I feel like I've accomplished that goal, and other days when I feel like I'm hitting myself in the head with a hammer to no avail. But one thing I can say is that nobody I've encountered over the years has had the either the self-awareness or the gumption of the woman I met in the restaurant.
I applauded her for her honesty. There are many who might not agree with her decision to have surgery for reasons of vanity, but I have to give her credit for being open and honest about her motivation. At the same time, there's a part of me that worries about the implications of such decisions. Having been morbidly obese most of my life, I would never wish that fate on anyone. But I would hate to see this surgery be used as "cosmetic surgery" for anyone wishing to drop 20 or 30 pounds without having to "work at it." That, to me, would be an abuse of this marvelous tool.
Is such thinking naive?
Knowing that there is some elitism in the bariatric community regarding pre-op size, I shrugged and said their was nothing wrong with being a lightweight. After all, better to take control of obesity before its long-term effects take control of you.
"Oh...I had it purely out of vanity," she said.
That stopped me dead in my tracks.
Since having weight-loss surgery almost three years ago, I've encountered a variety of pre- and post-ops with varying reasons for wanting/having surgery. Though every person has given the same party line about "health concerns," I know more than a few really didn't care about their health -- they just wanted to be thin.
It was those people who I originally wanted to help when I started writing this column (now blog) in 2004. I thought educating them on the risks associated with surgery would drive home the point that this is truly a drastic solution to what should be a very drastic health condition. There are days when I feel like I've accomplished that goal, and other days when I feel like I'm hitting myself in the head with a hammer to no avail. But one thing I can say is that nobody I've encountered over the years has had the either the self-awareness or the gumption of the woman I met in the restaurant.
I applauded her for her honesty. There are many who might not agree with her decision to have surgery for reasons of vanity, but I have to give her credit for being open and honest about her motivation. At the same time, there's a part of me that worries about the implications of such decisions. Having been morbidly obese most of my life, I would never wish that fate on anyone. But I would hate to see this surgery be used as "cosmetic surgery" for anyone wishing to drop 20 or 30 pounds without having to "work at it." That, to me, would be an abuse of this marvelous tool.
Is such thinking naive?
Monday, January 21, 2008
The Long Way Around
I've been making little changes since the first in an effort to increase my daily activity level beyond what I do at the gym.
My first order of business was to park farther away from my office. Though I still prefer not to park in the lot that's a half-mile downhill from my office, I don't spend 15 minutes anymore milling around and around looking for an empty spot near the building's entrance.
The next step was to stop using interoffice mail. The campus is not nearly big enough to warrant me dropping paperwork in the office and waiting three days for it to arrive at its destination. Such a decision is even sillier when it only takes about 20 minutes to walk from one end of the campus to the other.
Last week, I decided to stop using the elevator to my third-floor office. To be honest, the elevator is so slow that it's not much of a convenience feature anyway. I take the elevator because I favor high heels (at my height, you take all the extra help you can get), and my klutzy natures makes stairs not so easy to negotiate.
I would probably still be taking the elevator had I not realized last week that I'm not wearing high heels as often to the office. Why the change in fashion? Simple, because on Week 1, I started parking farther from the office. I realized a need to change my footwear by the second day of that habit. I still can't believe it took me two weeks to realize that switch also meant my excuse for using the elevator was null. Then again, I never said I was the brightest bulb in the drawer.
My first order of business was to park farther away from my office. Though I still prefer not to park in the lot that's a half-mile downhill from my office, I don't spend 15 minutes anymore milling around and around looking for an empty spot near the building's entrance.
The next step was to stop using interoffice mail. The campus is not nearly big enough to warrant me dropping paperwork in the office and waiting three days for it to arrive at its destination. Such a decision is even sillier when it only takes about 20 minutes to walk from one end of the campus to the other.
Last week, I decided to stop using the elevator to my third-floor office. To be honest, the elevator is so slow that it's not much of a convenience feature anyway. I take the elevator because I favor high heels (at my height, you take all the extra help you can get), and my klutzy natures makes stairs not so easy to negotiate.
I would probably still be taking the elevator had I not realized last week that I'm not wearing high heels as often to the office. Why the change in fashion? Simple, because on Week 1, I started parking farther from the office. I realized a need to change my footwear by the second day of that habit. I still can't believe it took me two weeks to realize that switch also meant my excuse for using the elevator was null. Then again, I never said I was the brightest bulb in the drawer.
Thursday, January 03, 2008
Industry Secrets
Bankrate.com has a great article on Secrets of the Weight Loss Industry. Definitely worth checking out for those who are looking for non-surgical options.
Wednesday, January 02, 2008
Day 2
It's the second day of the new year, and I'm just posting to see how everyone is doing with their resolutions. Has anyone already given up? Has anyone decided to postpone their resolutions? Have any of you woken up to realize that your resolution wasn't the right choice for you?
I've never been the typical resolution maker, so I don't have a history of failed ones to nag at me. I always resolve to make the new year better than the last. I know I will make mistakes, but I try my best to make different mistakes from year to year so I can at least say I'm experiencing growth.
So this year has been a little different since I've made specific pledges. So far, so good. I've really been enjoying water and tea for the last two days. Seems I was drinking more caloric beverages than I had realized, because water has tasted like a sweet treat. My weekend of cooking madness has ensured I have more than enough leftovers to keep me away from temptation, and I don't have to worry about having the time or energy for a healthy dinner each night. So all in all, I'd say I'm off to a good start.
How about you?
I've never been the typical resolution maker, so I don't have a history of failed ones to nag at me. I always resolve to make the new year better than the last. I know I will make mistakes, but I try my best to make different mistakes from year to year so I can at least say I'm experiencing growth.
So this year has been a little different since I've made specific pledges. So far, so good. I've really been enjoying water and tea for the last two days. Seems I was drinking more caloric beverages than I had realized, because water has tasted like a sweet treat. My weekend of cooking madness has ensured I have more than enough leftovers to keep me away from temptation, and I don't have to worry about having the time or energy for a healthy dinner each night. So all in all, I'd say I'm off to a good start.
How about you?
Tuesday, January 01, 2008
I (heart) food blogs and Web sites
I'm not sure what foodies did for new recipes before the advent of the Internet. I suppose they kibbutzed with friends for new ideas, pored over newspapers and magazines and bought up fundraiser cookbooks. All great methods. In fact, I will still buy up any fundraiser cookbook found at yard sales (the Tracy Fire Department Auxiliary's cookbook is a definite asset to any collection, as are any of the editions put out by the Hilmar Covenant Church or YLI). And I will always be a sucker for any newsstand magazine that advertises slow-cooker recipes (the slow cooker is a must have for any bariatric patient).
Since moving out on my own, I've been able to be more adventurous in my kitchen experiments. After all, I only have to worry about myself and my tastes. Trust me, I didn't get to weigh 335 pounds by being a picky eater. However, the Internet has really helped me broaden my cooking horizons.
For a while, I subscribed to a local food co-op. Getting produce boxes from food co-ops can be a little scary. You never know what your box might hold or what to do with it. That's where the Internet comes in. When I opened my box one week to find fennel, which I had only glanced at on the food network, I only needed to type in "fennel recipes" into Google before finding a pasta sauce recipe that not only used the fennel bulbs I had, but also leftover sweet potatoes from Thanksgiving. Instead of pasta, though, I served the sauce over spaghetti squash, another gift from the co-op box.
For my church potluck last night, I decided I couldn't just go with gobs of cookies and candy made from the bulging baking shelf of my pantry. I needed to have some "good food" to go along with it. I opted for a chicken stew from SimplyRecipes.com, which just might be the best food blog in existence. What I love most about SimplyRecipes.com is that the author resides in Sacramento, which means whatever is in easy and available for her is also in season and available to me. Realizing (thanks to the feedback of a few well-meaning friends) that the recipe I chose might be a little "out there" for church folk, I decided to also take a tried-and-true casserole in the form of Paula Deen's (of the Food Network's Paula's Home Cooking") shrimp and wild rice casserole. It was a favorite of my ex-husband's (though he always had me omit the bell pepper and onion), especially when I doubled the cheese.
The chicken stew, though, was my favorite. Chock-full of onions, tomatoes and super tender and moist chicken, it was every bariatric patient's dream. I would challenge any gastric-bypass patient who says he/she can't tolerate chicken to stick by his/her story after trying this dish. The chicken literally melts into the sauce, leaving a warm, hearty meal.
I should stop there, but I won't. I can't sign off without leaving you the recipes I'm speaking of.
Chicken Stew with Onions, Tomatoes and Dijon
(from SimplyRecipes.com)
I rarely ever make a recipe exactly how it's written. I put my own spin on just about everything. So, for this recipe, I used six chicken thighs and two bone-in chicken breasts. I also omitted the roasted garlic, though it sounds divine! The key, to me, is in the browning of the chicken. Get it good and crispy, because that adds complexity to the final product. (My favorite olive oil is Lost Dogs Farm of Tracy, Calif.) Though the recipe calls for it to be served with rice, I think it would be incredible over savory polenta, such as what Alton Brown recently made on an episode of "Good Eats" on the Food Network. For myself, I just mixed in some steamed zucchini.
Shrimp and Wild Rice Casserole
(from Paula's Home Cooking)
1 (8-ounce) package wild rice
1 pound medium shrimp, peeled and deveined
2 tablespoons butter
1/2 green bell pepper, seeded and chopped
1/2 onion, chopped
1 (10 3/4-ounce can) condensed cream of mushroom soup
2 cups grated sharp Cheddar
Salt and pepperCook the rice according to package directions minus 1/4 cup water. Drain and cool.
(from Quick Fix Meals with Robin Miller)
For this dish, I left out the pasta and used roasted spaghetti squash instead.
2 ounces uncooked penne pasta
1 tablespoon unsalted butter
2 teaspoons olive oil
1 fennel bulb, sliced crosswise into 1/4-inch thick slices
1 tablespoon chopped fresh rosemary leaves, or 1 teaspoon dried
1 tablespoon sugar
1 cup reduced-sodium chicken broth
1 cup milk (regular or lowfat)
2 tablespoons all-purpose flour
2 cups leftover roasted sweet potatoes, cut into 1-inch cubes
2 tablespoons grated Parmesan
2 tablespoons chopped fresh parsley leaves
1/2 teaspoon salt
1/4 teaspoon ground black pepperCook pasta according to package directions. Drain and set aside. Keep warm.
Since moving out on my own, I've been able to be more adventurous in my kitchen experiments. After all, I only have to worry about myself and my tastes. Trust me, I didn't get to weigh 335 pounds by being a picky eater. However, the Internet has really helped me broaden my cooking horizons.
For a while, I subscribed to a local food co-op. Getting produce boxes from food co-ops can be a little scary. You never know what your box might hold or what to do with it. That's where the Internet comes in. When I opened my box one week to find fennel, which I had only glanced at on the food network, I only needed to type in "fennel recipes" into Google before finding a pasta sauce recipe that not only used the fennel bulbs I had, but also leftover sweet potatoes from Thanksgiving. Instead of pasta, though, I served the sauce over spaghetti squash, another gift from the co-op box.
For my church potluck last night, I decided I couldn't just go with gobs of cookies and candy made from the bulging baking shelf of my pantry. I needed to have some "good food" to go along with it. I opted for a chicken stew from SimplyRecipes.com, which just might be the best food blog in existence. What I love most about SimplyRecipes.com is that the author resides in Sacramento, which means whatever is in easy and available for her is also in season and available to me. Realizing (thanks to the feedback of a few well-meaning friends) that the recipe I chose might be a little "out there" for church folk, I decided to also take a tried-and-true casserole in the form of Paula Deen's (of the Food Network's Paula's Home Cooking") shrimp and wild rice casserole. It was a favorite of my ex-husband's (though he always had me omit the bell pepper and onion), especially when I doubled the cheese.
The chicken stew, though, was my favorite. Chock-full of onions, tomatoes and super tender and moist chicken, it was every bariatric patient's dream. I would challenge any gastric-bypass patient who says he/she can't tolerate chicken to stick by his/her story after trying this dish. The chicken literally melts into the sauce, leaving a warm, hearty meal.
I should stop there, but I won't. I can't sign off without leaving you the recipes I'm speaking of.
Chicken Stew with Onions, Tomatoes and Dijon
(from SimplyRecipes.com)
I rarely ever make a recipe exactly how it's written. I put my own spin on just about everything. So, for this recipe, I used six chicken thighs and two bone-in chicken breasts. I also omitted the roasted garlic, though it sounds divine! The key, to me, is in the browning of the chicken. Get it good and crispy, because that adds complexity to the final product. (My favorite olive oil is Lost Dogs Farm of Tracy, Calif.) Though the recipe calls for it to be served with rice, I think it would be incredible over savory polenta, such as what Alton Brown recently made on an episode of "Good Eats" on the Food Network. For myself, I just mixed in some steamed zucchini.
1 whole head garlic
Olive oil
Salt and freshly ground pepper
One 3-4 pound whole chicken, cut into 8 serving pieces (2 breasts, wings, thighs, legs)
6 medium red onions (about 2 pounds)
One 28 to 32 ounce can good quality whole peeled tomatoes, drained
1 Tbsp fresh thyme or 1 1/2 teaspoons dried thyme
2 bay leaves
A pinch of chile powder
1/3 cup dry white wine
3 Tbsp old-fashioned whole seed Dijon mustard (or 1/4 cup regular Dijon mustard)
1 Preheat oven to 400°F.
2 Peel away the outer layers of the garlic bulb skin, leaving the skins of the individual cloves intact. Using a knife, cut off 1/4 to a 1/2 inch of the top of cloves, exposing the individual cloves of garlic. Place garlic head on a piece of aluminum foil. Drizzle olive oil over the garlic, and sprinkle with salt and pepper. Wrap the garlic head with the foil and place in the oven. Bake for 45 minutes or until the flesh of the cloves are light brown feel very soft when pressed with the tip of a knife. Set aside to cool. (See how to roast garlic.)
3 While the garlic is roasting, heat a tablespoon of olive oil in a large, heavy-bottomed pot (with lid) or Dutch oven, on medium high heat. Rinse the chicken pieces in cold water then pat dry with paper towels. Season liberally with salt and pepper.
Brown the chicken pieces, starting them skin-side down, cooking them a few minutes on each side, working in batches so that you don't crowd the pan.
4 While the chicken is browning, peel and quarter the onions. Remove chicken from pan when nicely golden with tongs or a slotted spoon and set aside on a plate. Discard any fat and oil beyond about 1 Tbsp left in the pan. Put the onions in the pot and cook them until softened, stirring frequently, about 5 minutes.
5 Add the tomatoes to the pot, the thyme, bay leaves, and ground chile powder. Put the chicken pieces on top of the tomatoes. Pour in the wine and bring to a simmer. Cover and cook on medium-low heat for 40 minutes, stirring from time to time so that the vegetables don't stick.
6 After the garlic has cooled enough to handle, squeeze out the roasted garlic from the cloves into a small bowl and crush with a fork. Sprinkle with salt and pepper to taste. Set aside to serve with the chicken stew.
7 When the chicken has cooked, add the mustard to the pot and stir to blend. Increase the heat to medium-high and cook uncovered for 10 more minutes, or until the sauce is thick enough to cling to the meat. Remove bay leaves. Salt and pepper to taste.
Serve stew over rice or pasta, with the garlic paste on the side.
Serves 4 to 6.
Recipe adapted from Chocolate and Zucchini: Daily Adventures in a Parisian Kitchen
(from Paula's Home Cooking)
1 (8-ounce) package wild rice
1 pound medium shrimp, peeled and deveined
2 tablespoons butter
1/2 green bell pepper, seeded and chopped
1/2 onion, chopped
1 (10 3/4-ounce can) condensed cream of mushroom soup
2 cups grated sharp Cheddar
Salt and pepperCook the rice according to package directions minus 1/4 cup water. Drain and cool.
Bring 2 cups water and 1/2 tablespoon salt to a boil in a medium saucepan and cook the shrimp for 1 minute. Drain immediately and set aside.
Heat the butter in saucepan and saute the pepper and onion until soft, about 5 minutes.
Preheat oven to 325 degrees F.
In a large bowl, combine the rice, soup, 1 1/2 cups of cheese, shrimp and vegetables. Add salt and pepper, to taste. Mix well. Spray a 9-inch square aluminum cake pan or an 11 by 7-inch glass casserole dish with vegetable spray. Place the mixture in the pan and top with remaining 1/2 cup cheese. Bake for 30 minutes, until bubbly.
Penne with Sweet Potatoes and Fennel(from Quick Fix Meals with Robin Miller)
For this dish, I left out the pasta and used roasted spaghetti squash instead.
2 ounces uncooked penne pasta
1 tablespoon unsalted butter
2 teaspoons olive oil
1 fennel bulb, sliced crosswise into 1/4-inch thick slices
1 tablespoon chopped fresh rosemary leaves, or 1 teaspoon dried
1 tablespoon sugar
1 cup reduced-sodium chicken broth
1 cup milk (regular or lowfat)
2 tablespoons all-purpose flour
2 cups leftover roasted sweet potatoes, cut into 1-inch cubes
2 tablespoons grated Parmesan
2 tablespoons chopped fresh parsley leaves
1/2 teaspoon salt
1/4 teaspoon ground black pepperCook pasta according to package directions. Drain and set aside. Keep warm.
Meanwhile, melt butter and olive oil together in a large skillet over medium heat. Add fennel, rosemary and sugar and cook 10 minutes, until fennel is tender and golden brown. Stir in the sweet potatoes.
Whisk together chicken broth, milk, and flour. Gradually add to skillet and simmer 3 minutes, until mixture thickens, stirring constantly. Add the pasta and stir to coat. Stir in Parmesan, parsley, salt, and pepper and cook until heated through, stirring constantly, about 3 minutes.
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