Presented by Dr. Monica Ganz, director of events and support groups for OH
Losing weight after the weight loss stops
When you first have surgery, your pouch is about the size of your thumb – mainly because of swelling and irritation from the procedure. The pouch takes a year to 18 months to heal, and healing allows increased food intake.
Another cause of post-op weight gain is that some people start to be less diligent with exercise after a year. It’s typical to consume more a year after surgery. You have more foods available to you, because you’ve spent the first year experimenting with new foods and now know what you can and can’t tolerate. Some people think they are hungrier, which is unlikely if there is decreased activity. Also, many post-ops never experienced true hunger before surgery because they were eating all the time. Monica says they were never truly hungry yet never truly satisfied either. Eating more nutrient-dense foods also leads to eating more calories.
Statistically, 50% of WLS patients will gain back more than 50% of the excess weight lost by five years. Twenty percent will gain back 20% of their weight loss immediately upon reaching their goal weight.
Calories in minus calories out equal a change in weight: When you take in the same number of calories you expend, your weight stays the same; when you eat more calories than you expend, you gain weight; and if you eat fewer calories than you expend, you lose weight.
Inadequate Weight Loss
Calorie intake too high/hunger: Are you planning your meals and spacing them apart appropriately? Are you making good food choices? The surgery doesn’t fail the patient; the patient fails the surgery.
Metabolism too low/hypoglycemia: Are you eating frequently enough? Are you making sure you eat protein-rich foods? You should have six planned eating events per day. That includes meals and protein supplements. Micronutrient deficiencies can also affect metabolism. Skin can be very sensitive to tape two years after surgery because of micronutrient deficiencies.
Why do we stop losing?
Again, it’s about calories in vs. calories out. Each of us has set weight that our body prefers. Not everyone is meant to be a size 4 after surgery. It can be done, but some post-ops find that the sacrifices required to keep body weight that low isn’t worth it in the long run.Eliminate excess or empty calories. Look for ways to cut out unnecessary fat and calories without compromising your nutrition. That means, cut out simple carbohydrates not protein. Don’t go crazy counting calories; realize that you need to improve your lifestyle, you are not on a diet. Pay attention to the glycemic index and pick foods that score lower.
All calories are NOT created equal
Energy density, water content, fiber content, absorption, processing and storage all contribute to the effects of calories on the body.Fruits and veggies are high in fiber and water and low in calories. Crackers, cheese and fatty meats contain a lot of calories relative to how heavy they are.
Foods that have a high water and/or fiber content add bulk to your meals, so you’ll feel satisfied without eating more calories. For example, a quarter-cup of raisins has the same calories as 1.75 cups of grapes, but the grapes will be more filling. 100 calories: 23 M&Ms, quarter-cup of raisins, 5 oz. Jell-O or 2.25 cups of strawberries. Obviously, the strawberries are the best option as a filling food. McDonalds large fries is 540 calories, which is equal to 22 cups of raw broccoli, 135 baby carrots, 17.5 oz. chicken breast or 4.5 whole sweet potatoes.
Soft carbohydrate syndrome
Soft carbs are the arch enemy of WLS patients and are the cause of weight gain or plateau in the majority of patients. If you can crush it, and it crumbles, stay away from it. That’s a sure sign of simple carbohydrates, which travel through the pouch easily and offer very little nutritional value or satisfaction.
Saturday, August 12, 2006
Vendor fair
There are about a handful of vendors at today's session, peddling everything from fitness videos and equipment to nutritional supplements and vitamins.
I'll be spending a few minutes with the vendors -- many of whom are leading workshops this weekend -- today and tomorrow to get a little more information on the products they represent and what has led them to make a career out of serving the obese and morbidly obese population.
Bariatric Advantage
Seth Felix is the Bariatric Advantage sales rep attending this weekend’s event. The son of a bariatric surgeon, Seth says he grew up with knowledge and interest in both bariatrics and obesity-related issues. He’s been with Bariatric Advantage for a little less than a year, but is an avid proponent of the products and confesses to snacking on some of the food items at work.
I used Bariatric Advantage vitamins – all of which are chewable – from three months before surgery to about a year afterward. I only switched brands because I was tired of the flavors. I’m happy to see the company debuting new flavors of vitamins and branching out beyond just vitamin and mineral supplements.
Seth told me the company will introduce two new flavors of its already-popular 400mg calcium supplement lozenge. BA already has mint, cinnamon – the top seller – and chocolate. Within the next two months, lemon and sour cherry will also be for sale. Seth excitedly tells me that they taste like Sweet Tarts and will offer a nice change for those who are tired of the original flavors.
BA’s No. 1 selling product, according to Seth, is the orange-flavored multivitamin for gastric-bypass patients. Like me, this is the BA product most bariatric patients start with, because all surgeons recommend a good multivitamin.
Bariatric Advantage also offers a multivitamin for LapBand patients that is called VitaBand. Because Bandsters don’t have to worry about malabsorption, their vitamin and mineral needs are different than bypass patients. Seth says the main difference is that VitaBand has iron included, and it’s the only BA vitamin that comes in watermelon flavor.“
We’re starting to get a lot of complaints from people who want our other multivitamin to be offered in watermelon as well,” he said.
Seth also spent a little time telling me about the company’s new products, such as their food supplements. BA is now offering food items for early post-ops, such as protein supplements and cereal. Packaged for easy travel, the products come in smaller, bariatric-friendly portions. He says the chocolate cereal reminds him of Cocoa Crispies. The cereal comes in chocolate, vanilla and banana – which can be exciting for post-ops sick of just chocolate and vanilla.
Another new product is the Promend AGB, which Seth says can work for bariatric patients but is actually geared toward post-ops who have cosmetic surgery. It’s a drink powder that provides 10g of protein and various herbal supplements to promote healing after cosmetic surgery.“And it tastes just like lemonade,” he said.
Excel Weight Loss Solutions
Karen Donaldson of Pocatello, Idaho, has been in the fitness industry for more than 20 years. As the founder of Excel Weight Loss Solutions, she works with people on nutrition, exercise and weight management.Karen started in the fitness industry focused on the disabled and those of limited mobility, which led to her eventual exposure to the obese and morbidly obese population.
“I’ve never been interested in working with jocks,” Karen said. “Those people will work out no matter what. I’d rather serve the rest of the population. It’s about real life.”
Dr. Monica Ganz, director of events and support groups for ObesityHelp, is a strong supporter of Karen and her program. Monica invited Karen to attend an OH event about 2.5 years ago because she was impressed by the workout video she produced.
“The nice thing about it is that anybody can do it – regardless of their fitness level,” Monica said. “And the videos feature normal-size and overweight models, which is important to me.
That fact has not been lost on Karen.
“Nobody is motivated by seeing somebody prance around in a thong leotard,” Karen said. “But if you look at someone who looks normal or is close to your size, then you believe you can do it; and you’re much more motivated.”
The other reason Monica is a big fan of Karen’s is that her exercise programs use resistance bands and exercise balls.
“This is something that everyone can do,” Monica said. “When I had surgery, it never occurred to me that I could exercise while sitting down. At that time, I couldn’t even walk.”
Also, as someone who travels more than 100 days each year, Monica favors the portability of the resistance bands. They don’t take up much space in the suitcase and are easy to do in hotel rooms.
“This keeps me on track,” she said. “I would never use the hotel gym, but I can use these in the privacy of my own room on my own time.”
Karen, who is presenting workshops this weekend on insulin resistance and strength training and on using exercise balls, also has her own line of aromatherapy products.Monica favors the aromatherapy locket with a piece of felt anointed with Appetite Balance, which helps curb cravings.
I'll be spending a few minutes with the vendors -- many of whom are leading workshops this weekend -- today and tomorrow to get a little more information on the products they represent and what has led them to make a career out of serving the obese and morbidly obese population.
Bariatric Advantage
Seth Felix is the Bariatric Advantage sales rep attending this weekend’s event. The son of a bariatric surgeon, Seth says he grew up with knowledge and interest in both bariatrics and obesity-related issues. He’s been with Bariatric Advantage for a little less than a year, but is an avid proponent of the products and confesses to snacking on some of the food items at work.
I used Bariatric Advantage vitamins – all of which are chewable – from three months before surgery to about a year afterward. I only switched brands because I was tired of the flavors. I’m happy to see the company debuting new flavors of vitamins and branching out beyond just vitamin and mineral supplements.
Seth told me the company will introduce two new flavors of its already-popular 400mg calcium supplement lozenge. BA already has mint, cinnamon – the top seller – and chocolate. Within the next two months, lemon and sour cherry will also be for sale. Seth excitedly tells me that they taste like Sweet Tarts and will offer a nice change for those who are tired of the original flavors.
BA’s No. 1 selling product, according to Seth, is the orange-flavored multivitamin for gastric-bypass patients. Like me, this is the BA product most bariatric patients start with, because all surgeons recommend a good multivitamin.
Bariatric Advantage also offers a multivitamin for LapBand patients that is called VitaBand. Because Bandsters don’t have to worry about malabsorption, their vitamin and mineral needs are different than bypass patients. Seth says the main difference is that VitaBand has iron included, and it’s the only BA vitamin that comes in watermelon flavor.“
We’re starting to get a lot of complaints from people who want our other multivitamin to be offered in watermelon as well,” he said.
Seth also spent a little time telling me about the company’s new products, such as their food supplements. BA is now offering food items for early post-ops, such as protein supplements and cereal. Packaged for easy travel, the products come in smaller, bariatric-friendly portions. He says the chocolate cereal reminds him of Cocoa Crispies. The cereal comes in chocolate, vanilla and banana – which can be exciting for post-ops sick of just chocolate and vanilla.
Another new product is the Promend AGB, which Seth says can work for bariatric patients but is actually geared toward post-ops who have cosmetic surgery. It’s a drink powder that provides 10g of protein and various herbal supplements to promote healing after cosmetic surgery.“And it tastes just like lemonade,” he said.
Excel Weight Loss Solutions
Karen Donaldson of Pocatello, Idaho, has been in the fitness industry for more than 20 years. As the founder of Excel Weight Loss Solutions, she works with people on nutrition, exercise and weight management.Karen started in the fitness industry focused on the disabled and those of limited mobility, which led to her eventual exposure to the obese and morbidly obese population.
“I’ve never been interested in working with jocks,” Karen said. “Those people will work out no matter what. I’d rather serve the rest of the population. It’s about real life.”
Dr. Monica Ganz, director of events and support groups for ObesityHelp, is a strong supporter of Karen and her program. Monica invited Karen to attend an OH event about 2.5 years ago because she was impressed by the workout video she produced.
“The nice thing about it is that anybody can do it – regardless of their fitness level,” Monica said. “And the videos feature normal-size and overweight models, which is important to me.
That fact has not been lost on Karen.
“Nobody is motivated by seeing somebody prance around in a thong leotard,” Karen said. “But if you look at someone who looks normal or is close to your size, then you believe you can do it; and you’re much more motivated.”
The other reason Monica is a big fan of Karen’s is that her exercise programs use resistance bands and exercise balls.
“This is something that everyone can do,” Monica said. “When I had surgery, it never occurred to me that I could exercise while sitting down. At that time, I couldn’t even walk.”
Also, as someone who travels more than 100 days each year, Monica favors the portability of the resistance bands. They don’t take up much space in the suitcase and are easy to do in hotel rooms.
“This keeps me on track,” she said. “I would never use the hotel gym, but I can use these in the privacy of my own room on my own time.”
Karen, who is presenting workshops this weekend on insulin resistance and strength training and on using exercise balls, also has her own line of aromatherapy products.Monica favors the aromatherapy locket with a piece of felt anointed with Appetite Balance, which helps curb cravings.
OH Visalia Conference -- Day 2
I have a few minutes between getting ready and eating breakfast to jot down a few thoughts before heading out to today's session.
I learned something interesting about ObesityHelp during dinner last night. OH does not pay its speakers a dime, which explains why its conferences are so affordable. After all, how many 2.5-day conferences have you attended that only cost about $100? Dr. Monica Ganz, the organization's director of events and support groups, says it's important to her that every penny from events goes toward making the events rewarding for attendees -- not to line the pockets of speakers.
That also explains why some sessions can be a crap shoot. When I was at the Fairfield conference in June, I overheard some attendees complain that certain speakers delivered nothing more than an infomercial for their services or products. I would say that's a gross exaggeration, but I did notice bits of self-promotion here and there during sessions. Knowing that the speakers were not paid in any way explains that, however. You can't expect them to travel to a conference unpaid without hope of some sort of remuneration or exposure to their target market.
As I'm blogging from the sessions today, I'll try my best to make it clear who offers products or services for sale so readers can make the most informed decisions regarding whether to believe the opinions of the speakers.
Oh, and keep reading throughout the weekend for my review of the numerous samples given out throughout the conference. For example, attendees last night received full-size samples of AchievOne coffee-flavored protein drinks, Power Crunch protein bars, and various other bariatric-friendly snacks.
I learned something interesting about ObesityHelp during dinner last night. OH does not pay its speakers a dime, which explains why its conferences are so affordable. After all, how many 2.5-day conferences have you attended that only cost about $100? Dr. Monica Ganz, the organization's director of events and support groups, says it's important to her that every penny from events goes toward making the events rewarding for attendees -- not to line the pockets of speakers.
That also explains why some sessions can be a crap shoot. When I was at the Fairfield conference in June, I overheard some attendees complain that certain speakers delivered nothing more than an infomercial for their services or products. I would say that's a gross exaggeration, but I did notice bits of self-promotion here and there during sessions. Knowing that the speakers were not paid in any way explains that, however. You can't expect them to travel to a conference unpaid without hope of some sort of remuneration or exposure to their target market.
As I'm blogging from the sessions today, I'll try my best to make it clear who offers products or services for sale so readers can make the most informed decisions regarding whether to believe the opinions of the speakers.
Oh, and keep reading throughout the weekend for my review of the numerous samples given out throughout the conference. For example, attendees last night received full-size samples of AchievOne coffee-flavored protein drinks, Power Crunch protein bars, and various other bariatric-friendly snacks.
Friday, August 11, 2006
Changing places
Because of hacking issues associated with Movable Type (the program used for this blog), the Tracy Press will stop hosting blogs. Instead, the Press will link to external blogs.
The good news is that anyone within the Tracy Press circulation area may now ask to have their blog linked from our Web site (E-mail tluiz@tracypress.com to make such a request).
The bad news is that my blog address will change this week. As far as I know, the plan is to keep all previously posted entries up as read-only files until I'm able to move all postings over to the new site. However, I'm not sure how long it'll take me to complete my transition. In the interest of serving readers best, I'll start uploading my oldest entries to the new site first. I won't publish new material until the transition is complete.
Click here to view and bookmark my new blog site. I'm hope that using Blogger will make this column more user-friendly to visitors. Please let me know what you think.
The good news is that anyone within the Tracy Press circulation area may now ask to have their blog linked from our Web site (E-mail tluiz@tracypress.com to make such a request).
The bad news is that my blog address will change this week. As far as I know, the plan is to keep all previously posted entries up as read-only files until I'm able to move all postings over to the new site. However, I'm not sure how long it'll take me to complete my transition. In the interest of serving readers best, I'll start uploading my oldest entries to the new site first. I won't publish new material until the transition is complete.
Click here to view and bookmark my new blog site. I'm hope that using Blogger will make this column more user-friendly to visitors. Please let me know what you think.
Movie Night -- "Super Size Me"
Tonight's session ends with a screening of "Super Size Me," the now famous documentary by Morgan Spurlock. Spurlock spent 30 days eating nothing but McDonalds food. During that time, he gained about 30 pounds and suffered serious health problems.
This is the third time I've seen the movie. The first time was a year before my gastric-bypass surgery, and it was then that I swore off McDonalds. I had it at home to watch the day I was released from the hospital. It helped strengthen my resolve as my mother and husband sat on either side of me eating Jack in the Box for dinner.
It's a film I highly recommend watching, if for no other reason than to understand why this country has more than 60% of its population who are considered obese.
This is the third time I've seen the movie. The first time was a year before my gastric-bypass surgery, and it was then that I swore off McDonalds. I had it at home to watch the day I was released from the hospital. It helped strengthen my resolve as my mother and husband sat on either side of me eating Jack in the Box for dinner.
It's a film I highly recommend watching, if for no other reason than to understand why this country has more than 60% of its population who are considered obese.
Importance of Vitamins and Minerals after Gastric Bypass Surgery
Led by Dr. Monica Ganz
People who’ve had malabsorptive procedures (Roux En Y and duodenal switch) are in danger of vitamin and mineral deficiencies because certain vitamins and minerals cannot be absorbed by the new digestive tract through ingestion.
Vitamins are essential for the release of energy from carbohydrates, fats and proteins. B-12, for example, is a vitamin that can’t be replenished once a person has become truly deficient in it.
Minerals don’t furnish energy but are vital in many other physiologic functions. The body stores and reuses minerals so deficiencies aren’t easily detected.
Many post-ops become deficient in iron and calcium.
Iron
Iron deficiency occurs because the pouch empties too quickly for iron to be absorbed and because RNY and DDS patients have their duodenum – where 50% of iron absorption takes place – bypassed. Symptoms of iron deficiency include fatigue, feeling cold, pica (compulsive eating of non-food items), tongue fissuring and pagophagia (compulsive eating of ice).
Supplements should be in the form of 18mg of ferrous fumerate or amino-iron, which is most absorbable. Taking iron with vitamin C (such as diluted orange juice or even a chewable vitamin C) to help its absorption. Food sources of iron include liver, oysters, shellfish, organ meats, lean meats, poultry and fish (best meat sources), dried beans and vegetables (best plant sources), egg yolk, dried fruits, dark molasses, whole grains and enriched breads and cereals.
Calcium
Calcium deficiency occurs because post-ops can’t eat enough of calcium-rich foods, and the mineral is absorbed in the duodenum. Symptoms of calcium deficiency include fragile bones and hypertension.Supplements should include 1200mg of calcium citrate (plus vitamin D) per day, four servings of dairy products per day. For each missed serving of dairy products, supplement with an additional 500mg of calcium citrate. This is why many post-ops are encouraged to take up to 2400mg per day.Another problem is that calcium deficiency is hard to detect because the body will leach the necessary calcium from the bones. Dexa bone-density tests are the best way to find out whether a post-op’s body is leaching calcium from the bones. Some people also notice teeth problems, such as a loss of enamel.
Vitamins most commonly found deficient in post-ops are vitamin B1 (Thiamin), vitamin B-12 and folic acid.
Thiamin
Thiamin is necessary for the breakdown of glucose for energy, nerve function, good digestion, normal appetite and good mental outlook. Deficiency is rare in the U.S., except in alcoholics. Symptoms include beri beri, fatigue, poor appetite, constipation, depression, etc. Supplementation is as easy as taking a chewable multivitamin (Bariatric Advantage, Optisource, etc.).
Vitamin B-12
Vitamin B-12 aids in the formation of mature red blood cells, synthesis of DNA, stimulates appetite, promotes growth and releases energy. Food sources include liver, kidney, dairy products, fish, clams, oysters, salmon and sardines.Gastric bypass post-ops MUST supplement with B-12 because the pouch doesn’t supply the intrinsic factor required for absorption. Signs of deficiency include pernicious anemia, tiredness and neurological disorders.Supplements can be by mouth, injection or nasal spray. Monthly injections are the safest best.
Folic acid
Folic acid is necessary for formation of red blood cells. Deficiency happens because of poor dietary intake, low iron and alcoholism. Symptoms of deficiency include rapid heartbeat, fatigue, anorexia, pale skin, paranoia, or sore, inflamed tongue. Food sources include soy, leafy greens, organ meats, mushrooms, oatmeal, red beans and wheat. Supplementation is usually as easy as taking a good multivitamin.
People who’ve had malabsorptive procedures (Roux En Y and duodenal switch) are in danger of vitamin and mineral deficiencies because certain vitamins and minerals cannot be absorbed by the new digestive tract through ingestion.
Vitamins are essential for the release of energy from carbohydrates, fats and proteins. B-12, for example, is a vitamin that can’t be replenished once a person has become truly deficient in it.
Minerals don’t furnish energy but are vital in many other physiologic functions. The body stores and reuses minerals so deficiencies aren’t easily detected.
Many post-ops become deficient in iron and calcium.
Iron
Iron deficiency occurs because the pouch empties too quickly for iron to be absorbed and because RNY and DDS patients have their duodenum – where 50% of iron absorption takes place – bypassed. Symptoms of iron deficiency include fatigue, feeling cold, pica (compulsive eating of non-food items), tongue fissuring and pagophagia (compulsive eating of ice).
Supplements should be in the form of 18mg of ferrous fumerate or amino-iron, which is most absorbable. Taking iron with vitamin C (such as diluted orange juice or even a chewable vitamin C) to help its absorption. Food sources of iron include liver, oysters, shellfish, organ meats, lean meats, poultry and fish (best meat sources), dried beans and vegetables (best plant sources), egg yolk, dried fruits, dark molasses, whole grains and enriched breads and cereals.
Calcium
Calcium deficiency occurs because post-ops can’t eat enough of calcium-rich foods, and the mineral is absorbed in the duodenum. Symptoms of calcium deficiency include fragile bones and hypertension.Supplements should include 1200mg of calcium citrate (plus vitamin D) per day, four servings of dairy products per day. For each missed serving of dairy products, supplement with an additional 500mg of calcium citrate. This is why many post-ops are encouraged to take up to 2400mg per day.Another problem is that calcium deficiency is hard to detect because the body will leach the necessary calcium from the bones. Dexa bone-density tests are the best way to find out whether a post-op’s body is leaching calcium from the bones. Some people also notice teeth problems, such as a loss of enamel.
Vitamins most commonly found deficient in post-ops are vitamin B1 (Thiamin), vitamin B-12 and folic acid.
Thiamin
Thiamin is necessary for the breakdown of glucose for energy, nerve function, good digestion, normal appetite and good mental outlook. Deficiency is rare in the U.S., except in alcoholics. Symptoms include beri beri, fatigue, poor appetite, constipation, depression, etc. Supplementation is as easy as taking a chewable multivitamin (Bariatric Advantage, Optisource, etc.).
Vitamin B-12
Vitamin B-12 aids in the formation of mature red blood cells, synthesis of DNA, stimulates appetite, promotes growth and releases energy. Food sources include liver, kidney, dairy products, fish, clams, oysters, salmon and sardines.Gastric bypass post-ops MUST supplement with B-12 because the pouch doesn’t supply the intrinsic factor required for absorption. Signs of deficiency include pernicious anemia, tiredness and neurological disorders.Supplements can be by mouth, injection or nasal spray. Monthly injections are the safest best.
Folic acid
Folic acid is necessary for formation of red blood cells. Deficiency happens because of poor dietary intake, low iron and alcoholism. Symptoms of deficiency include rapid heartbeat, fatigue, anorexia, pale skin, paranoia, or sore, inflamed tongue. Food sources include soy, leafy greens, organ meats, mushrooms, oatmeal, red beans and wheat. Supplementation is usually as easy as taking a good multivitamin.
Dining among peers
We just got back from dinner. There are about 10 people at tonight’s session, which makes for a close, intimate experience. I’ve gotten the chance to truly get to know each woman here. Two women have come from out of state for the conference – one from as far as Minnesota. The rest are from up and down the state.Our introductory session was just that, an introduction to the weekend’s activities. We’ve had numerous opportunities to ask whatever we want and get in-depth answers from Dr. Monica Ganz, director of events and support groups for ObesityHelp.The best thing, though, for me has been the experience of eating with other bariatric post-ops. In my daily life, I tend to eat with non-ops and can forget myself when eating. Sitting around a dinner table with post-ops was amazing, because we had a lot of similar habits. Many of us ordered soup for dinner. There were lots of offers to share food. And everyone ate at a similar speed. I didn’t have to worry about being the slow poke who held everyone up or having anybody comment on how much I ate (or didn’t, for that matter).
In Central CA for OH Conference
I've arrived safe and sound for the ObesityHelp Regional Conference in Visalia.
The conference begins today and lasts through Sunday. According to the OH Web site, 70 tickets are still available for the weekend. Visalia is only about 2.5 hours from Tracy if you take I-5 down and cut through Los Banos. However, there is some construction along Highway 152 in Los Banos. If you decide to drive that way, pack plenty of patience.
I'm staying in Tulare, at the Charter Inn & Suites. About 15 minutes from the Presidian Hotel where the conference is held, the hotel I'm at offers me a nice break from all the excitement that is often found at convention sites. And I happen to really like the staff here.
Today's session begins at 3 p.m. with registration and a vendor fair until 4 p.m.
Dr. Monica Ganz will host a Q&A session from 3:30 to 5 p.m. Monica is a social psychologist who had gastric-bypass surgery in 2002. She has since lost more than 320 pounds and now works for ObesityHelp. Monica is someone whom I greatly admire. Her warmth and compassion are effusive in her discussions, yet she never sugar coats the situation either. Her honesty is appreciated and accepted because it's always tempered with the compassion that comes from someone who has been morbidly obese and changed her life.
Dinner is from 5 to 7 p.m., during which time I'll try to find some place yummy to eat and also take some time to update my blog.
After dinner, the evening sessions will begin and last until 9 p.m.
Check back later today for more updates.
The conference begins today and lasts through Sunday. According to the OH Web site, 70 tickets are still available for the weekend. Visalia is only about 2.5 hours from Tracy if you take I-5 down and cut through Los Banos. However, there is some construction along Highway 152 in Los Banos. If you decide to drive that way, pack plenty of patience.
I'm staying in Tulare, at the Charter Inn & Suites. About 15 minutes from the Presidian Hotel where the conference is held, the hotel I'm at offers me a nice break from all the excitement that is often found at convention sites. And I happen to really like the staff here.
Today's session begins at 3 p.m. with registration and a vendor fair until 4 p.m.
Dr. Monica Ganz will host a Q&A session from 3:30 to 5 p.m. Monica is a social psychologist who had gastric-bypass surgery in 2002. She has since lost more than 320 pounds and now works for ObesityHelp. Monica is someone whom I greatly admire. Her warmth and compassion are effusive in her discussions, yet she never sugar coats the situation either. Her honesty is appreciated and accepted because it's always tempered with the compassion that comes from someone who has been morbidly obese and changed her life.
Dinner is from 5 to 7 p.m., during which time I'll try to find some place yummy to eat and also take some time to update my blog.
After dinner, the evening sessions will begin and last until 9 p.m.
Check back later today for more updates.
Thursday, August 03, 2006
Perks of the flu
There's a line in "The Devil Wears Prada" where a characters says, "I'm just a stomach flu away from my goal weight." In my former life as a morbidly obese person, I would never have understood how true that could be.
But as a "normal-size" person, I smirk at the truth of such a comment. I'm just getting over my first nasty illness since having gastric-bypass surgery almost 18 months ago. After taking a week off work and spending almost two weeks subsisting just on liquids, I'm finally on the road to recovery from what had to be the most aggressive stomach virus known to man -- or at least to me.
The week before I came down with this bug, I weighed myself at home and found I was holding steady at 158 pounds as I had for the last few months. When I went to the doctor for my stomach ailment, I weighed 158 on his office scale. I thought that was odd. After all, doctor's office scales tend to weigh on the heavy side because they get jostled so much. But I figured the scale must have been recently calibrated. But after five days of struggling to get in 300 calories a day, I noticed my clothes were getting baggy. I hopped on the scale one morning and was surprised to see it register at 150. I didn't think much of it, figuring I'd put at least some of the weight back on when I started eating solid food again.
But here I am, a week into eating solids, and not only have I not put the weight back on, but I've managed to drop another couple of pounds. And believe me, at this size, 12 pounds is really noticeable. My size 10 pants are loose, and I've gotten tons of recent remarks about looking thinner. And to think, I have the stomach flu to thank for it all.
But as a "normal-size" person, I smirk at the truth of such a comment. I'm just getting over my first nasty illness since having gastric-bypass surgery almost 18 months ago. After taking a week off work and spending almost two weeks subsisting just on liquids, I'm finally on the road to recovery from what had to be the most aggressive stomach virus known to man -- or at least to me.
The week before I came down with this bug, I weighed myself at home and found I was holding steady at 158 pounds as I had for the last few months. When I went to the doctor for my stomach ailment, I weighed 158 on his office scale. I thought that was odd. After all, doctor's office scales tend to weigh on the heavy side because they get jostled so much. But I figured the scale must have been recently calibrated. But after five days of struggling to get in 300 calories a day, I noticed my clothes were getting baggy. I hopped on the scale one morning and was surprised to see it register at 150. I didn't think much of it, figuring I'd put at least some of the weight back on when I started eating solid food again.
But here I am, a week into eating solids, and not only have I not put the weight back on, but I've managed to drop another couple of pounds. And believe me, at this size, 12 pounds is really noticeable. My size 10 pants are loose, and I've gotten tons of recent remarks about looking thinner. And to think, I have the stomach flu to thank for it all.
Tuesday, August 01, 2006
OH Conference in Visalia, CA
Obesity Help will have its last Northern Californai regional conference from Aug. 11 through 13 in Visalia.
I'm looking forward to attending and blogging from the event as I did at the Fairfield conference in June. The Visalia event promises to be even bigger and better. Tickets are still available and can be purchased by clicking the above link.
I hope to see you there.
I'm looking forward to attending and blogging from the event as I did at the Fairfield conference in June. The Visalia event promises to be even bigger and better. Tickets are still available and can be purchased by clicking the above link.
I hope to see you there.
Saturday, July 01, 2006
Risks of dying from obesity higher than that of bariatric surgery
Researchers from the Hospital of Saint Raphael in New Haven, Conn., report that the risk of dying from morbid obesity is 50 to 85 percent higher than the risk of dying from bariatric surgery.Scientists announced the study findings at the 23rd Annual Meeting of the American Society for Bariatric Surgery in San Francisco this past week.
“Morbid obesity is a killer disease that requires intervention,” said Dr. Randolph B. Reinhold, lead author and chairman of Saint Raphael’s surgery department, in a prepared statement. “This study puts into perspective that for some people, the risk of not having surgery is higher than having surgery.”
According to a press release from the society, the study evaluated 1,185 morbidly obese patients from 1997 to 2004. Of those people, 908 had bariatric surgery and 112 did not. The remainder were not available for the study. Over the course of the study, 2.9 percent of the surgery recipients died compared to 14.3 of those who did not have surgery.
“Bariatric surgery has been proven to be effective in achieving sustainable weight loss in people with morbid obesity and reducing or eliminating obesity-related diseases,” Reinhold said.
“Morbid obesity is a killer disease that requires intervention,” said Dr. Randolph B. Reinhold, lead author and chairman of Saint Raphael’s surgery department, in a prepared statement. “This study puts into perspective that for some people, the risk of not having surgery is higher than having surgery.”
According to a press release from the society, the study evaluated 1,185 morbidly obese patients from 1997 to 2004. Of those people, 908 had bariatric surgery and 112 did not. The remainder were not available for the study. Over the course of the study, 2.9 percent of the surgery recipients died compared to 14.3 of those who did not have surgery.
“Bariatric surgery has been proven to be effective in achieving sustainable weight loss in people with morbid obesity and reducing or eliminating obesity-related diseases,” Reinhold said.
Friday, June 30, 2006
Peach Cobbler Recipe
I believe I have perfected my cobbler recipe. Beau says it's a keeper...we'll see what his parents say when I serve it for dessert tomorrow. I would rather use Nature's Sweet instead of Splenda, but since I didn't have any, this is what I went with:
Tonya' s version of Grandma's Peach Cobbler
1/4 cup butter (1/2 stick)
1/2 cup almond flour
1/2 cup flour
1-1/2 teaspoons baking powder
1/2 teaspoon salt
1 cup Splenda
3/4 cup milk
3 cups peeled and sliced fresh peaches, with their juices
Preheat oven to 350°F.
Put the butter in a 9x13-inch Pyrex baking dish and put the dish in the preheating oven. While the butter is melting, mix up the batter by combining the flour, baking powder, salt, sugar and milk.
When the butter is completely melted, remove the pan and pour the batter into the melted butter. Then, carefully spoon the peaches and juice evenly over the batter. Return dish to the oven and bake for 45 minutes to an hour.
Tonya' s version of Grandma's Peach Cobbler
1/4 cup butter (1/2 stick)
1/2 cup almond flour
1/2 cup flour
1-1/2 teaspoons baking powder
1/2 teaspoon salt
1 cup Splenda
3/4 cup milk
3 cups peeled and sliced fresh peaches, with their juices
Preheat oven to 350°F.
Put the butter in a 9x13-inch Pyrex baking dish and put the dish in the preheating oven. While the butter is melting, mix up the batter by combining the flour, baking powder, salt, sugar and milk.
When the butter is completely melted, remove the pan and pour the batter into the melted butter. Then, carefully spoon the peaches and juice evenly over the batter. Return dish to the oven and bake for 45 minutes to an hour.
Thursday, June 29, 2006
Settling in
Just got in from the American Society of Bariatric Surgeons' Annual Convention in San Francisco.
"Information Overload" are the two best words to describe how I feel right now, but I learned some amazing information. I learned about new procedures in the field of bariatrics, saw various vitamin and protein supplements.
I saw Carnie Wilson! She's absolutely beautiful. Celebrity Fit Club must have been a success for her, because she's now at her goal weight.
I'll report more over the next several days.
"Information Overload" are the two best words to describe how I feel right now, but I learned some amazing information. I learned about new procedures in the field of bariatrics, saw various vitamin and protein supplements.
I saw Carnie Wilson! She's absolutely beautiful. Celebrity Fit Club must have been a success for her, because she's now at her goal weight.
I'll report more over the next several days.
Tuesday, June 27, 2006
Study suggests 10 new obesity causes
A study found obesity may not just be about eating and lifestyle.
Check out this article:http://www.cbsnews.com/stories/2006/06/27/health/webmd/main1757772.shtml
Check out this article:http://www.cbsnews.com/stories/2006/06/27/health/webmd/main1757772.shtml
Monday, June 26, 2006
Samples-o-rama
I've been busy trying all of the yummy samples I picked up at Saturday's OH seminar.
Some quick notes:
Body Choice Premium High Protein Pudding
I was not impressed by this protein pudding. First, I don't consider 14 grams of protein to be that high. I tried the chocolate flavor, and it was gelatinous and a bit grainy. There was a distinct protein aftertaste, and I didn't like the feeling on my tongue after eating it. Personally, I much prefer Snack & Slim pudding, which provides a creamy 20 grams of protein in a 5 oz. serving and has no icky aftertaste.
Bariatric Advantage Vitamins
BA has reformulated its vitamins, which means fewer are necessary each day. The taste of the chewables is just as good as before, except the flavor of the iron has improved dramatically (I love the new passion fruit flavor).
Achiev One
As I've said before, my pouch can't handle the coffee in these 20-gram protein mocha-style drinks. But my husband thoroughly enjoyed the hazelnut version I brought back with me. He said it's even better than Starbucks Frappucinos.
Some quick notes:
Body Choice Premium High Protein Pudding
I was not impressed by this protein pudding. First, I don't consider 14 grams of protein to be that high. I tried the chocolate flavor, and it was gelatinous and a bit grainy. There was a distinct protein aftertaste, and I didn't like the feeling on my tongue after eating it. Personally, I much prefer Snack & Slim pudding, which provides a creamy 20 grams of protein in a 5 oz. serving and has no icky aftertaste.
Bariatric Advantage Vitamins
BA has reformulated its vitamins, which means fewer are necessary each day. The taste of the chewables is just as good as before, except the flavor of the iron has improved dramatically (I love the new passion fruit flavor).
Achiev One
As I've said before, my pouch can't handle the coffee in these 20-gram protein mocha-style drinks. But my husband thoroughly enjoyed the hazelnut version I brought back with me. He said it's even better than Starbucks Frappucinos.
Sunday, June 25, 2006
ASBS Annual Convention
The American Society of Bariatric Surgeons is gathering in San Francisco this week for its national convention. The convention includes lots of classes for surgeons to learn new surgical techniques as well as other things related to bariatrics. But the highlight of the event is the exhibitors trade show that is from Wednesday through Friday. Day passes for the trade show can be purchased by the general public for $100. I can't wait to check it out myself. I'll be there Thursday.
Saturday, June 24, 2006
Live from Fairfield...
I attended today's ObesityHelp Regional Seminar in Fairfield. I can't even begin to describe how impressed I was by the all-day event. This seminar was small with a handful of vendors manning booths with lots of samples and a series of lectures delivered in the same room. There were about 200 people in attendance, some from as far away as Utah.
I apologize ahead of time for any typos; I blogged directly from the event and pushed each segment live without running spell check. If you find fewer than 10 typos, I think I did pretty well.
For those of you pressed for time or just not interested in wading through the details, let me sum up some of my favorite parts of the day:
Speakers
For the most part, I enjoyed all of the speakers. However, I was surprised by new information a few of them provided. I learned about a new bariatric procedure called vertical sleeve gastrectomy. A less invasive version of bariatric surgery, the vertical sleeve gastrectomy can be done more safely on high-risk patients and features a faster recovery time (see notes on Dr. Cirangle for more information). Another surprise was learning that peanut butter isn't considered a high-protein food. This is terrible news for the woman who often licks peanut butter from a spoon in the name of lunch. Not only is the fat content in peanut butter so high that it outweighs the protein benefit, but the protein in peanut butter isn't easily absorbed. There goes my favorite convenience food. The final, most profound, news I heard was that a runny nose, sneezing and hiccups after a meal are signs of overeating.
Lunch
The beauty of attending a bariatric seminar is that there is no anxiety when lunch time comes. I wasn’t worried that the menu wouldn’t be pouch-worthy. And boy, was I not disappointed.The only plates at the buffet were salad plates, which is important for me. I tend to be a member of the clean-your-plate club, and large-size dinner plates entice me to overeat. Salad plates ensure proper portion control. Lunch was a variety of salads: a curried chicken salad, tuna salad, a selection of cheeses, fruit and a mixed greens salad. Everything was tasty and perfect.
Interesting people
I talked to a few people who attended the seminar to get themselves back on track after regaining some of the weight they lost through surgery. One woman, four years after surgery, has put back on 45 pounds. Though she is still smaller than she was before surgery, she recognizes the fact that her previous size is just around the corner if she doesn’t gain control.
She says that her body tolerated junk food better than protein-rich foods, and she took to eating those more than good-quality foods. She stopped taking vitamins, stopped supplementing with protein, started drinking with her meals, etc.
She said one of her main mistakes was to start thinking of herself as “normal” and acting as if she was an average person. It’s taken her a long time to accept that she’s not normal and never will be. To get herself back on track, she’s started taking a doctor-prescribed appetite suppressant. She says it helps her use her tool the way it was created to be used.
“The big disappointment with weight loss surgery is that it doesn’t fix the daily struggle you fight each day.”
Another testament to it not being brain surgery.
Another interesting point that came up was how many of us blame so much of life’s challenges on being overweight and expect those challenges to disappear with weight loss. But that doesn’t happen. After surgery, your spouse may still belittle you, you’re still going to be insecure and you’re still going to face all of the same emotions you had before. The difference now is that you can’t eat to cope with those problems.
Vendor faire
The vendor faire, though small, offers some great information and features.
ObesityHelp.com has a sampling of products available at its online store. Everything from books to MedicAlert jewelry to hygiene helpers are showcased.Another booth offers a plethora of samples from Bariatric Advantage vitamins and Body Choice protein pudding (12g).
The Body by Katzen booth features numerous photo albums of work by Dr. J. Timothy Katzen, a Beverly Hills cosmetic surgeon who will also speak at today’s event. I even got the opportunity to see breast and buttock implants. The buttock implant is hard as a rock. Gives new meaning to the term “buns of steel.”
Dr. David Elliot of Healthy S.T.E.P.s Weight Loss Center, is a Santa Rosa bariatric surgeon who will also speak today. Dr. Elliot spent 20 years in the U.S. Army and was introduced to bariatrics while studying under another surgeon. He’s been performing gastric-bypass surgery on his own for the last six years.
Lauralyn Bellamy of Embody Success is a life coach who will also speak today. She’s a post-op who specializes in helping other post-ops adjust to life as thin people.
The most popular booth of the day is probably the one with Achiev One. Only available online, either through the company directly or through bariatric Web sites such as bariatriceating.com. Account Exec. Fernando Vasquez had samples of almost every flavor. He was missing my favorite – cappucino. Of course, I shouldn’t complain. After all, my pouch doesn’t even like decaf coffee, and the Achiev Ones do have a small amount of caffeine from the real coffee used as flavoring in them. The drinks are similar to store bought Starbucks Frappucinos, except that they offer 20 grams of protein in each 9.5-oz. bottle. I think they are yummy and have given numerous ones to post-ops I know with daily coffee habits. However, they are not for everyone. A woman behind me complains that they smell of beef jerky but don’t taste nearly as good.
Speakers
Lauralyn Bellamy – “The Key to Overcoming Self-Sabotage in Weight Loss and the Rest of Your Life
Lauralyn spent 51 years of her life on diets before having gastric-bypass surgery three years ago. According to her, “Sabotage is a misguided effort to protect yourself.” It may seem that there is nothing to protect oneself from, but the “reptilian brain” saves us from the unknown. Since many obese people cannot imagine themselves at a normal weight with a healthy, normal relationship with food, the brain considers that a danger zone and will sabotage efforts at weight loss.
Diets work for a short time, she says, because they distract us. Obsessing over food journals, counting calories or carbs or whatever, menu-planning, exercising, etc., keeps the brain from realizing what’s happening at first. Once the brain realizes what’s happened, it kicks in survival instincts and sabotages the weight loss.
Life coaching, Lauralyn’s specialty, is about making life-affirming changes. As she says, “This is not about using food as a reward, it’s about learning how to imagine the rest of your life.”
She goes on to say that it’s important to realize that your “sabotage voice loves you” and make it an ally in your efforts. The challenge is that nobody can dismantle his or her own defense mechanism, which is why therapists and life coaches are needed, she said. One example of a strong defense mechanism, she said, is forgetfulness. A third party can help to keep you conscious throughout the day and throughout your life. That's so important, she said, because surgery alone doesn't fix everything. It's not magic; it takes work.
Dr. J. Timothy Katzen – “Plastic Surgery After Weight Loss”
Dr. Katzen’s specialty has been post-weight loss plastic surgery for the past seven years. He’s certified by the American Board of Plastic Surgery and has offices in Beverly Hills, Santa Barbara and Hawaiian Gardens. Any surgeon can call him or herself a plastic surgeon, so it is very important to make sure surgeons are board certified.
Body contouring is the general term for the type of cosmetic surgery needed after drastic weight loss.
Why is it needed?
Weight loss leads to losing fat, shrinking muscles, buckling fascia (connective tissue). The skin attempts to recoil, but age, elasticity and overall health determines how well it can resume a normal shape.
Dr. Katzen explains what he calls the “Lamp Shade Analogy.” When a person gains weight, the body balloons out – body parts become spherical. When weight loss occurs, the body shrinks, leaving the appearance of a deflated balloon.Medically, reconstruction decreases and eliminates the occurrence of rashes, improves self-esteem, improves hygiene (a big issue when dealing with excessive folds of skin) and increases the ability to exercise.
Dr. Katzen suggests gastric-bypass patients consider cosmetic surgery once weight has stabilized, about 10 to 12 months after surgery and when you’re been at the same weight for about three months. Lap-Band patients, he said, should wait about 22 months after surgery.
He believes in doing reconstruction in a certain order: torso (abdomen and trunk), medial thighs, breasts and arms. Face work can be done at any time, he said. He recommends doing the torso first, because it’s the foundation of the body. He also does not believe in doing all of the needed reconstruction in one shot. He says it’s safer to do reconstruction in a series of procedures.
Another thing to remember, Dr. Katzen said, is that reconstructions are shape surgeries not weight surgeries. Patients should not expect to lose mass amounts of weight from cosmetic surgery, though having excess skin removed may give the appearance of major weight loss.
Cosmetic surgery is considered elective and is usually not covered by insurance companies. However, Dr. Katzen explains the necessity of documenting rashes, skin breakdown, back and neck pain and hernias, which help prove to some insurance companies that the reconstruction procedures are medically necessary.
Some terms to know
Panniculectomy: Removes apron of skin and the fat in it. No muscle tightening, no hernia correction. However, this surgery is the one most likely to be covered by insurance companies.
Abdominoplasty (tummy tuck): Removes skin and fat, tightens abdominal muscles, tightens fascia, allows for hernia repair. Incisions on women can vary from a high "french cut" to a low "hip-hugger" cut or anywhere in between. For men, the incision usually follows the underwear line.
Circumferential Body Lift: A continuation of the abdominoplasty incision that goes right around to the back. The procedure not only tightens the tummy but allows for lifting of the outer thighs, removing saddle bags, removing love handles and lifting buttocks. The incision is low in front, trails up over the hip and goes back down in the rear to help the scar be covered by insurance.
Buttock implants: Dr. Katzen says he’s a firm believer in implants to create a rounder back side. He doesn’t believe other procedures last. Saddle bag removal: Sometimes, body lifts don’t fully remove saddle bags and extra work is needed.
Thigh lift: Varying procedures that tighten and remove excess fat and skin from the legs. According to Dr. Katzen, Blue Cross of California no longer covers thigh procedures under any circumstances. He predicts this to be a trend with insurance companies. If you need a thigh lift, now is the time to try for one through your insurance company.
Breast surgeries: Includes augmentation, lift or a combo of both. Incisions can be in the shape of an anchor, T or lollipop. For women, augmentation is often needed. For men, the procedure is more about flattening the region and tightening the skin.
Arms: Minor problems an be treated with liposuction, medium problems can be treated with a lift that has a crescent-shape scar hidden in the armpit, severe problems require an incision from armpit to elbow.Dr. Katzen suggests people who want cosmetic surgery to quit smoking, exercise regularly and take vitamins as soon as possible before surgery.
Dr. David Elliot – “Protect Your Pouch: Maximizing Your ‘Window’ of Opportunity”
Dr. Elliot, a Santa Rosa bariatric surgeon, starts his session with an anatomy lesson of how Roux-En-Y gastric-bypass works. A one-ounce pouch (about the size of a golf ball) is created at the top of the football-sized stomach. The opening that connects the pouch to the intestine is about the size of a dime.
To protect the brand-new pouch, Dr. Elliot recommends the following the first month after surgery:
Slow progression of diet (food intolerances are common)
Hydration, between meals – not during
At mealtime, protein comes first!
Re-learning to eat (use a small plate, eat slowly)
The stoma (openings to and from the pouch) is swollen the first month, which means that dry foods will get stuck (inducing vomiting or gagging). Also, the divided stomach is hyper-sensitive to many foods, such as caffeine and dairy, among other things. He recommends protein supplements for the first three months in an effort to achieve 60 grams a day (my doctor recommends 80).
Common causes of vomiting:
Stomal stenosis or stricture – stoma closes, causing food and water to come up. Fixed by dilation
Eating too fast – most common reason; patient should spend 30 minutes eating
Excess mucus
Stomal ulcers
Bezoars – collections of undigested foodstuffs (think hairball) that have to be removed with an endoscope
One of Dr. Elliot’s key points is that surgery doesn’t equate to absolute success no matter what. Patients must exercise regularly, eat three meals a day (no snacking) that incorporate nutrient-rich foods to ensure their own long-term success.
Protein is the most important nutrient for the gastric-bypass patient. One point that surprised me, though, is that peanut butter is not considered a high-protein food. He said that the protein is too low in comparison to overall calories and fat. Fish and eggs, however, are excellent protein sources that are often well-tolerated by newer post-ops. For vegetarians, tofu, beans and legumes are good choices.
Hunger tends to return about six months after surgery. The pouch capacity increases (3/4 of a cup), the stoma size increases (pouch empties in two hours instead of four), and weight loss slows dramatically. For people who want to continue losing weight after six months, Dr. Elliot recommends avoiding carbs (they cause cravings and cramping that might be confused as hunger), not snacking (remove temptation from home and work), don’t drink with meals and “water loading.” Water loading is drinking a half-glass of water right before meals to dilute the ghrelin (hunger hormone) in the pouch. This helps some patients be satisfied longer and with less food.
One important thing to protect your pouch from is ulceration. Factors that can lead to ulcers include:
Alcohol
Smoking
Nonsteroidal medicine (ibuprofen, naprosyn, aspirin)
Dr. Elliot recommends giving up alcohol for life because of the danger of ulceration, as well as the high number of calories. On special occasions, he recommends drinking no more than a half glass of wine after a full meal because post-ops are “cheap drunks” because of how fast alcohol is absorbed by the new digestive tract.
Some patients who think they are in menopause find that their menstrual cycles starts back after gastric bypass. This had to do with hormonal imbalances brought about by obesity. For those who want to conceive, he recommends waiting at least one year before getting pregnant.
Most common reasons for regaining weight:· Lack of exercise· Snacking or grazing· Stretching of pouch because of overeating
Long story short, Dr. Elliot says that falling back into old habits is the main reason that people regain the weight they lost during the honeymoon period. Taking advantage of the honeymoon period to learn and create new lifestyle habits is the key to making sure surgery is a successful tool to overcome obesity.
Dr. Paul Cirangle – Will discuss long-term issues that WLS patients need to be aware of forever and the insurance situation in California
Dr. Cirangle’s first topic of discussion was nutritional deficiencies after surgical weight loss.
Malabsorptive procedures (gastric bypass) lead to more long-term nutritional deficiencies than restrictive procedures (Lap-Band). There are varying degrees of malabsoptoion depending on bypass procedure. Duodenal Switch has the highest incidence of deficiencies. RNY is middle of the road.
Malabsorption is why vitamins are such a necessity for bypass patients. Part of the procedure that is gastric bypass actually bypasses the parts of the intestine that absorb vitamins. Dr. Cirangle cites research that shows that patients who didn’t take vitamins regularly in the first two years after surgery not only became deficient later on but also were less likely to be able to correct the deficiency once it occurred. He says the best vitamins are the ones that you’ll take forever.
“If you don’t like the taste, you won’t take it and that makes it a bad vitamin,” he said.
Other reasons patients develop deficiencies is because they had them before surgery and because of the drastically reduced nutrient intake. A scary point Dr. Cirangle made is that gastric-bypass surgery is a procedure that by its nature causes ulcers. He recommends post-ops take some form of acid-reducer daily for the rest of their lives.
Anemia is common and can be caused by anastomotic bleeding (very rare), marginal ulcers, B-12 deficiency and iron deficiency. A third of post-ops will develop it within two years. Supplementing with folate not only helps prevent anemia but also protects your heart, he said.
“Very occasionally, anemia becomes so profound that we have to reverse the procedure,” he said. “That occurs most commonly with the Duodenal Switch.”
Other possible complications that require reversal are protein deficiency and kidney stones. The good news is that he says anemia is 95 percent correctable with supplementation.
The normal human digestive system is so efficient at absorbing calcium that 90 percent of what most people eat is excreted through feces. But for gastric-bypass patients, calcium absorption is difficult because the part of the intestine that absorbs it is bypassed. Dr. Cirangle recommends taking 500 mg at a time (3x a day) with a protein source to improve absorption. He also said that he doesn’t believe that calcium citrate is the only way to go for gastric-bypass patients to absorb calcium.
“To me, the best calcium is the one you like,” he said. “If you like Viactiv, which is calcium carbonate, that’s fine by me.”
Dr. Cirangle mentioned a new procedure on the horizon called a vertical sleeve gastrectomy. It’s a restrictive procedure – no malabsorption – that uses no incisions and is safest for high-risk patients. His practice has done 500 of the procedures, and he said that for those who self-pay, it’s the most affordable option. The other perk is that it’s the safest option for high-risk patients.
Dr. Monica Ganz – “Learning to Think Thin”
Dr. Ganz, who has lost 320 pounds with the help of gastric-bypass surgery, understands the need for the formerly obese to figure out how to think thin. Thinking like a thin person is the key to long-term success, she says. She’s a high-energy speaker who jumps from topic to topic with rapid-fire speed.The first thing Dr. Ganz recommends is to get rid of too-large clothes. The advantage to doing that is that it’s a commitment to “never go back” to your previous size.
Old habits die hard, she says. Every single day is a battle with food demons, but it gets easier with time. The problem with time is that it’s also easier to lapse into old behaviors. Taking pictures each month is a necessary practice. Many post-ops develop body dysmorphic disorder, which means the brain perceives the body to look bigger than it really is. She says it takes the brain a lot longer to catch up with your appearance than it does to lose the weight. According to Dr. Ganz, it can take up to five years for the mind to adjust. Taking measurements regularly is another tool to help combat body dysmorphia.
Be wary of your relationship with the scale
The key to making this a success is it’s a lifestyle. People who use the scale to determine what they will eat that day (treats if they lost weight; depravation if they gained weight) are still on diets, and diets are proven not to work. A scale is only to be used as a tool to guide you; you can’t depend on it as a measure of your self worth.
Getting back to basics
It takes 21 days to form a new habit, but most people give up at 18 days. Get a food scale and measure your portions.· Read labels· Hydration – if you have trouble keeping it down, try Propel, or something similar· Chew your food down to baby-food consistency· Undigested carbohydrates or protein cause gas· Eat slowly – use a timer· Use smaller size items (mini pans, salad plates, baby spoons, etc.)· Sip water all day long until you get 64 ounces to 74 ounces a day· Stay away from fast food (too much of a trigger)
Dr. Ganz recommends eating about 100 grams of protein each day to account for malabsorption. Not all foods have protein that is easily absorbed. For example, she said that eggs have protein that is 99 percent available, where as peanuts are only 49 percent available. On top of that, gastric bypass patients have 25 percent of their nutrients bypassed, meaning they absorb even less. A good rule of thumb to determine whether you need more protein is if you’re tired or have noticed your weigh loss has stalled.
Some aids to help you on your journey· Lactaid or Lactaid milk· Molly McButter to replace butter· Beano to combat gas
After weight loss, many people don’t know how to dress for their new size and shape. Take advantage of personal shopping services at department stores, even if you don’t buy anything. Have your makeup professionally done; go to a salon and have a makeover. Look your best and you will feel your best.
I apologize ahead of time for any typos; I blogged directly from the event and pushed each segment live without running spell check. If you find fewer than 10 typos, I think I did pretty well.
For those of you pressed for time or just not interested in wading through the details, let me sum up some of my favorite parts of the day:
Speakers
For the most part, I enjoyed all of the speakers. However, I was surprised by new information a few of them provided. I learned about a new bariatric procedure called vertical sleeve gastrectomy. A less invasive version of bariatric surgery, the vertical sleeve gastrectomy can be done more safely on high-risk patients and features a faster recovery time (see notes on Dr. Cirangle for more information). Another surprise was learning that peanut butter isn't considered a high-protein food. This is terrible news for the woman who often licks peanut butter from a spoon in the name of lunch. Not only is the fat content in peanut butter so high that it outweighs the protein benefit, but the protein in peanut butter isn't easily absorbed. There goes my favorite convenience food. The final, most profound, news I heard was that a runny nose, sneezing and hiccups after a meal are signs of overeating.
Lunch
The beauty of attending a bariatric seminar is that there is no anxiety when lunch time comes. I wasn’t worried that the menu wouldn’t be pouch-worthy. And boy, was I not disappointed.The only plates at the buffet were salad plates, which is important for me. I tend to be a member of the clean-your-plate club, and large-size dinner plates entice me to overeat. Salad plates ensure proper portion control. Lunch was a variety of salads: a curried chicken salad, tuna salad, a selection of cheeses, fruit and a mixed greens salad. Everything was tasty and perfect.
Interesting people
I talked to a few people who attended the seminar to get themselves back on track after regaining some of the weight they lost through surgery. One woman, four years after surgery, has put back on 45 pounds. Though she is still smaller than she was before surgery, she recognizes the fact that her previous size is just around the corner if she doesn’t gain control.
She says that her body tolerated junk food better than protein-rich foods, and she took to eating those more than good-quality foods. She stopped taking vitamins, stopped supplementing with protein, started drinking with her meals, etc.
She said one of her main mistakes was to start thinking of herself as “normal” and acting as if she was an average person. It’s taken her a long time to accept that she’s not normal and never will be. To get herself back on track, she’s started taking a doctor-prescribed appetite suppressant. She says it helps her use her tool the way it was created to be used.
“The big disappointment with weight loss surgery is that it doesn’t fix the daily struggle you fight each day.”
Another testament to it not being brain surgery.
Another interesting point that came up was how many of us blame so much of life’s challenges on being overweight and expect those challenges to disappear with weight loss. But that doesn’t happen. After surgery, your spouse may still belittle you, you’re still going to be insecure and you’re still going to face all of the same emotions you had before. The difference now is that you can’t eat to cope with those problems.
Vendor faire
The vendor faire, though small, offers some great information and features.
ObesityHelp.com has a sampling of products available at its online store. Everything from books to MedicAlert jewelry to hygiene helpers are showcased.Another booth offers a plethora of samples from Bariatric Advantage vitamins and Body Choice protein pudding (12g).
The Body by Katzen booth features numerous photo albums of work by Dr. J. Timothy Katzen, a Beverly Hills cosmetic surgeon who will also speak at today’s event. I even got the opportunity to see breast and buttock implants. The buttock implant is hard as a rock. Gives new meaning to the term “buns of steel.”
Dr. David Elliot of Healthy S.T.E.P.s Weight Loss Center, is a Santa Rosa bariatric surgeon who will also speak today. Dr. Elliot spent 20 years in the U.S. Army and was introduced to bariatrics while studying under another surgeon. He’s been performing gastric-bypass surgery on his own for the last six years.
Lauralyn Bellamy of Embody Success is a life coach who will also speak today. She’s a post-op who specializes in helping other post-ops adjust to life as thin people.
The most popular booth of the day is probably the one with Achiev One. Only available online, either through the company directly or through bariatric Web sites such as bariatriceating.com. Account Exec. Fernando Vasquez had samples of almost every flavor. He was missing my favorite – cappucino. Of course, I shouldn’t complain. After all, my pouch doesn’t even like decaf coffee, and the Achiev Ones do have a small amount of caffeine from the real coffee used as flavoring in them. The drinks are similar to store bought Starbucks Frappucinos, except that they offer 20 grams of protein in each 9.5-oz. bottle. I think they are yummy and have given numerous ones to post-ops I know with daily coffee habits. However, they are not for everyone. A woman behind me complains that they smell of beef jerky but don’t taste nearly as good.
Speakers
Lauralyn Bellamy – “The Key to Overcoming Self-Sabotage in Weight Loss and the Rest of Your Life
Lauralyn spent 51 years of her life on diets before having gastric-bypass surgery three years ago. According to her, “Sabotage is a misguided effort to protect yourself.” It may seem that there is nothing to protect oneself from, but the “reptilian brain” saves us from the unknown. Since many obese people cannot imagine themselves at a normal weight with a healthy, normal relationship with food, the brain considers that a danger zone and will sabotage efforts at weight loss.
Diets work for a short time, she says, because they distract us. Obsessing over food journals, counting calories or carbs or whatever, menu-planning, exercising, etc., keeps the brain from realizing what’s happening at first. Once the brain realizes what’s happened, it kicks in survival instincts and sabotages the weight loss.
Life coaching, Lauralyn’s specialty, is about making life-affirming changes. As she says, “This is not about using food as a reward, it’s about learning how to imagine the rest of your life.”
She goes on to say that it’s important to realize that your “sabotage voice loves you” and make it an ally in your efforts. The challenge is that nobody can dismantle his or her own defense mechanism, which is why therapists and life coaches are needed, she said. One example of a strong defense mechanism, she said, is forgetfulness. A third party can help to keep you conscious throughout the day and throughout your life. That's so important, she said, because surgery alone doesn't fix everything. It's not magic; it takes work.
Dr. J. Timothy Katzen – “Plastic Surgery After Weight Loss”
Dr. Katzen’s specialty has been post-weight loss plastic surgery for the past seven years. He’s certified by the American Board of Plastic Surgery and has offices in Beverly Hills, Santa Barbara and Hawaiian Gardens. Any surgeon can call him or herself a plastic surgeon, so it is very important to make sure surgeons are board certified.
Body contouring is the general term for the type of cosmetic surgery needed after drastic weight loss.
Why is it needed?
Weight loss leads to losing fat, shrinking muscles, buckling fascia (connective tissue). The skin attempts to recoil, but age, elasticity and overall health determines how well it can resume a normal shape.
Dr. Katzen explains what he calls the “Lamp Shade Analogy.” When a person gains weight, the body balloons out – body parts become spherical. When weight loss occurs, the body shrinks, leaving the appearance of a deflated balloon.Medically, reconstruction decreases and eliminates the occurrence of rashes, improves self-esteem, improves hygiene (a big issue when dealing with excessive folds of skin) and increases the ability to exercise.
Dr. Katzen suggests gastric-bypass patients consider cosmetic surgery once weight has stabilized, about 10 to 12 months after surgery and when you’re been at the same weight for about three months. Lap-Band patients, he said, should wait about 22 months after surgery.
He believes in doing reconstruction in a certain order: torso (abdomen and trunk), medial thighs, breasts and arms. Face work can be done at any time, he said. He recommends doing the torso first, because it’s the foundation of the body. He also does not believe in doing all of the needed reconstruction in one shot. He says it’s safer to do reconstruction in a series of procedures.
Another thing to remember, Dr. Katzen said, is that reconstructions are shape surgeries not weight surgeries. Patients should not expect to lose mass amounts of weight from cosmetic surgery, though having excess skin removed may give the appearance of major weight loss.
Cosmetic surgery is considered elective and is usually not covered by insurance companies. However, Dr. Katzen explains the necessity of documenting rashes, skin breakdown, back and neck pain and hernias, which help prove to some insurance companies that the reconstruction procedures are medically necessary.
Some terms to know
Panniculectomy: Removes apron of skin and the fat in it. No muscle tightening, no hernia correction. However, this surgery is the one most likely to be covered by insurance companies.
Abdominoplasty (tummy tuck): Removes skin and fat, tightens abdominal muscles, tightens fascia, allows for hernia repair. Incisions on women can vary from a high "french cut" to a low "hip-hugger" cut or anywhere in between. For men, the incision usually follows the underwear line.
Circumferential Body Lift: A continuation of the abdominoplasty incision that goes right around to the back. The procedure not only tightens the tummy but allows for lifting of the outer thighs, removing saddle bags, removing love handles and lifting buttocks. The incision is low in front, trails up over the hip and goes back down in the rear to help the scar be covered by insurance.
Buttock implants: Dr. Katzen says he’s a firm believer in implants to create a rounder back side. He doesn’t believe other procedures last. Saddle bag removal: Sometimes, body lifts don’t fully remove saddle bags and extra work is needed.
Thigh lift: Varying procedures that tighten and remove excess fat and skin from the legs. According to Dr. Katzen, Blue Cross of California no longer covers thigh procedures under any circumstances. He predicts this to be a trend with insurance companies. If you need a thigh lift, now is the time to try for one through your insurance company.
Breast surgeries: Includes augmentation, lift or a combo of both. Incisions can be in the shape of an anchor, T or lollipop. For women, augmentation is often needed. For men, the procedure is more about flattening the region and tightening the skin.
Arms: Minor problems an be treated with liposuction, medium problems can be treated with a lift that has a crescent-shape scar hidden in the armpit, severe problems require an incision from armpit to elbow.Dr. Katzen suggests people who want cosmetic surgery to quit smoking, exercise regularly and take vitamins as soon as possible before surgery.
Dr. David Elliot – “Protect Your Pouch: Maximizing Your ‘Window’ of Opportunity”
Dr. Elliot, a Santa Rosa bariatric surgeon, starts his session with an anatomy lesson of how Roux-En-Y gastric-bypass works. A one-ounce pouch (about the size of a golf ball) is created at the top of the football-sized stomach. The opening that connects the pouch to the intestine is about the size of a dime.
To protect the brand-new pouch, Dr. Elliot recommends the following the first month after surgery:
Slow progression of diet (food intolerances are common)
Hydration, between meals – not during
At mealtime, protein comes first!
Re-learning to eat (use a small plate, eat slowly)
The stoma (openings to and from the pouch) is swollen the first month, which means that dry foods will get stuck (inducing vomiting or gagging). Also, the divided stomach is hyper-sensitive to many foods, such as caffeine and dairy, among other things. He recommends protein supplements for the first three months in an effort to achieve 60 grams a day (my doctor recommends 80).
Common causes of vomiting:
Stomal stenosis or stricture – stoma closes, causing food and water to come up. Fixed by dilation
Eating too fast – most common reason; patient should spend 30 minutes eating
Excess mucus
Stomal ulcers
Bezoars – collections of undigested foodstuffs (think hairball) that have to be removed with an endoscope
One of Dr. Elliot’s key points is that surgery doesn’t equate to absolute success no matter what. Patients must exercise regularly, eat three meals a day (no snacking) that incorporate nutrient-rich foods to ensure their own long-term success.
Protein is the most important nutrient for the gastric-bypass patient. One point that surprised me, though, is that peanut butter is not considered a high-protein food. He said that the protein is too low in comparison to overall calories and fat. Fish and eggs, however, are excellent protein sources that are often well-tolerated by newer post-ops. For vegetarians, tofu, beans and legumes are good choices.
Hunger tends to return about six months after surgery. The pouch capacity increases (3/4 of a cup), the stoma size increases (pouch empties in two hours instead of four), and weight loss slows dramatically. For people who want to continue losing weight after six months, Dr. Elliot recommends avoiding carbs (they cause cravings and cramping that might be confused as hunger), not snacking (remove temptation from home and work), don’t drink with meals and “water loading.” Water loading is drinking a half-glass of water right before meals to dilute the ghrelin (hunger hormone) in the pouch. This helps some patients be satisfied longer and with less food.
One important thing to protect your pouch from is ulceration. Factors that can lead to ulcers include:
Alcohol
Smoking
Nonsteroidal medicine (ibuprofen, naprosyn, aspirin)
Dr. Elliot recommends giving up alcohol for life because of the danger of ulceration, as well as the high number of calories. On special occasions, he recommends drinking no more than a half glass of wine after a full meal because post-ops are “cheap drunks” because of how fast alcohol is absorbed by the new digestive tract.
Some patients who think they are in menopause find that their menstrual cycles starts back after gastric bypass. This had to do with hormonal imbalances brought about by obesity. For those who want to conceive, he recommends waiting at least one year before getting pregnant.
Most common reasons for regaining weight:· Lack of exercise· Snacking or grazing· Stretching of pouch because of overeating
Long story short, Dr. Elliot says that falling back into old habits is the main reason that people regain the weight they lost during the honeymoon period. Taking advantage of the honeymoon period to learn and create new lifestyle habits is the key to making sure surgery is a successful tool to overcome obesity.
Dr. Paul Cirangle – Will discuss long-term issues that WLS patients need to be aware of forever and the insurance situation in California
Dr. Cirangle’s first topic of discussion was nutritional deficiencies after surgical weight loss.
Malabsorptive procedures (gastric bypass) lead to more long-term nutritional deficiencies than restrictive procedures (Lap-Band). There are varying degrees of malabsoptoion depending on bypass procedure. Duodenal Switch has the highest incidence of deficiencies. RNY is middle of the road.
Malabsorption is why vitamins are such a necessity for bypass patients. Part of the procedure that is gastric bypass actually bypasses the parts of the intestine that absorb vitamins. Dr. Cirangle cites research that shows that patients who didn’t take vitamins regularly in the first two years after surgery not only became deficient later on but also were less likely to be able to correct the deficiency once it occurred. He says the best vitamins are the ones that you’ll take forever.
“If you don’t like the taste, you won’t take it and that makes it a bad vitamin,” he said.
Other reasons patients develop deficiencies is because they had them before surgery and because of the drastically reduced nutrient intake. A scary point Dr. Cirangle made is that gastric-bypass surgery is a procedure that by its nature causes ulcers. He recommends post-ops take some form of acid-reducer daily for the rest of their lives.
Anemia is common and can be caused by anastomotic bleeding (very rare), marginal ulcers, B-12 deficiency and iron deficiency. A third of post-ops will develop it within two years. Supplementing with folate not only helps prevent anemia but also protects your heart, he said.
“Very occasionally, anemia becomes so profound that we have to reverse the procedure,” he said. “That occurs most commonly with the Duodenal Switch.”
Other possible complications that require reversal are protein deficiency and kidney stones. The good news is that he says anemia is 95 percent correctable with supplementation.
The normal human digestive system is so efficient at absorbing calcium that 90 percent of what most people eat is excreted through feces. But for gastric-bypass patients, calcium absorption is difficult because the part of the intestine that absorbs it is bypassed. Dr. Cirangle recommends taking 500 mg at a time (3x a day) with a protein source to improve absorption. He also said that he doesn’t believe that calcium citrate is the only way to go for gastric-bypass patients to absorb calcium.
“To me, the best calcium is the one you like,” he said. “If you like Viactiv, which is calcium carbonate, that’s fine by me.”
Dr. Cirangle mentioned a new procedure on the horizon called a vertical sleeve gastrectomy. It’s a restrictive procedure – no malabsorption – that uses no incisions and is safest for high-risk patients. His practice has done 500 of the procedures, and he said that for those who self-pay, it’s the most affordable option. The other perk is that it’s the safest option for high-risk patients.
Dr. Monica Ganz – “Learning to Think Thin”
Dr. Ganz, who has lost 320 pounds with the help of gastric-bypass surgery, understands the need for the formerly obese to figure out how to think thin. Thinking like a thin person is the key to long-term success, she says. She’s a high-energy speaker who jumps from topic to topic with rapid-fire speed.The first thing Dr. Ganz recommends is to get rid of too-large clothes. The advantage to doing that is that it’s a commitment to “never go back” to your previous size.
Old habits die hard, she says. Every single day is a battle with food demons, but it gets easier with time. The problem with time is that it’s also easier to lapse into old behaviors. Taking pictures each month is a necessary practice. Many post-ops develop body dysmorphic disorder, which means the brain perceives the body to look bigger than it really is. She says it takes the brain a lot longer to catch up with your appearance than it does to lose the weight. According to Dr. Ganz, it can take up to five years for the mind to adjust. Taking measurements regularly is another tool to help combat body dysmorphia.
Be wary of your relationship with the scale
The key to making this a success is it’s a lifestyle. People who use the scale to determine what they will eat that day (treats if they lost weight; depravation if they gained weight) are still on diets, and diets are proven not to work. A scale is only to be used as a tool to guide you; you can’t depend on it as a measure of your self worth.
Getting back to basics
It takes 21 days to form a new habit, but most people give up at 18 days. Get a food scale and measure your portions.· Read labels· Hydration – if you have trouble keeping it down, try Propel, or something similar· Chew your food down to baby-food consistency· Undigested carbohydrates or protein cause gas· Eat slowly – use a timer· Use smaller size items (mini pans, salad plates, baby spoons, etc.)· Sip water all day long until you get 64 ounces to 74 ounces a day· Stay away from fast food (too much of a trigger)
Dr. Ganz recommends eating about 100 grams of protein each day to account for malabsorption. Not all foods have protein that is easily absorbed. For example, she said that eggs have protein that is 99 percent available, where as peanuts are only 49 percent available. On top of that, gastric bypass patients have 25 percent of their nutrients bypassed, meaning they absorb even less. A good rule of thumb to determine whether you need more protein is if you’re tired or have noticed your weigh loss has stalled.
Some aids to help you on your journey· Lactaid or Lactaid milk· Molly McButter to replace butter· Beano to combat gas
After weight loss, many people don’t know how to dress for their new size and shape. Take advantage of personal shopping services at department stores, even if you don’t buy anything. Have your makeup professionally done; go to a salon and have a makeover. Look your best and you will feel your best.
Friday, June 23, 2006
Cooking with almond flour
I've spent a ton of time in the kitchen this week, trying to come up with summertime favorites that are bariatric friendly.
I'm working to perfect a cobbler recipe. My first attempt this week (with white and yellow peaches from the local farmers market) was tasty but too watery. It seems the butter in the recipe wasn't fully absorbed. This taught me an important lesson about the principles of using almond flour to cut down the carb content of foods.
According to Susan Maria Leach, author of "Before and After", which provides a hefty number of bariatric-friendly recipes that Leach modified herself, I made a few common beginners' errors.
When using almond flour, she recommends cutting the fat in a recipe in half because almonds provide a decent amount. Another thing she does is cut the liquid by a quarter, because almond flour doesn't absorb liquid the same way as all-purpose flour. She also recommends using Nature's Sweet, which is available for sale on her Web site, as a sweetener. A high-quality form of maltitol (a sugar alcohol), it behaves the same way as sugar when cooked. This is different from Splenda, which doesn't offer the same volume as sugar.
This information will come in handy next week when I try again after the farmers market. If it works, I'll post the recipe, too. If not, I'll try again the next week.
I'm working to perfect a cobbler recipe. My first attempt this week (with white and yellow peaches from the local farmers market) was tasty but too watery. It seems the butter in the recipe wasn't fully absorbed. This taught me an important lesson about the principles of using almond flour to cut down the carb content of foods.
According to Susan Maria Leach, author of "Before and After", which provides a hefty number of bariatric-friendly recipes that Leach modified herself, I made a few common beginners' errors.
When using almond flour, she recommends cutting the fat in a recipe in half because almonds provide a decent amount. Another thing she does is cut the liquid by a quarter, because almond flour doesn't absorb liquid the same way as all-purpose flour. She also recommends using Nature's Sweet, which is available for sale on her Web site, as a sweetener. A high-quality form of maltitol (a sugar alcohol), it behaves the same way as sugar when cooked. This is different from Splenda, which doesn't offer the same volume as sugar.
This information will come in handy next week when I try again after the farmers market. If it works, I'll post the recipe, too. If not, I'll try again the next week.
Thursday, June 22, 2006
Recipes wanted
I'm looking for bariatric-friendly summertime recipes. Anything low-carb and high in protein is good. But even if you only have a regular recipe, post it anyway. Maybe we can figure out a way to make it friendly for WLS patients.
I'll start by posting my chicken salad recipe. I make it in single-serving batches, because my husband isn't a fan of chicken so the measurements are approximate for me.
3 oz. cubed chicken breast
1 tablespoon minced celery
1 teaspoon minced red onion
1 teaspoon dill
Marie's peppercorn ranch dressing
Craisins to taste (or other fruit -- apples and grapes are great)
Sprinkle of chopped nuts (pecans and pine nuts are my fave)
Mix first four ingredients in a bowl, add enough dressing to moisten chicken. Salad can be put in the fridge at this point for later. Right before serving, add Craisins and nuts. If you add them too early, the Craisins will bleed color on the chicken and the nuts will lose their crispenss. If necessary, you can add more dressing to keep the mixture moist.
Serve it on a pile of baby greens or atop a Ry-Krisp cracker. YUM!
I'll start by posting my chicken salad recipe. I make it in single-serving batches, because my husband isn't a fan of chicken so the measurements are approximate for me.
3 oz. cubed chicken breast
1 tablespoon minced celery
1 teaspoon minced red onion
1 teaspoon dill
Marie's peppercorn ranch dressing
Craisins to taste (or other fruit -- apples and grapes are great)
Sprinkle of chopped nuts (pecans and pine nuts are my fave)
Mix first four ingredients in a bowl, add enough dressing to moisten chicken. Salad can be put in the fridge at this point for later. Right before serving, add Craisins and nuts. If you add them too early, the Craisins will bleed color on the chicken and the nuts will lose their crispenss. If necessary, you can add more dressing to keep the mixture moist.
Serve it on a pile of baby greens or atop a Ry-Krisp cracker. YUM!
Wednesday, June 21, 2006
Liquid calories count
I was talking with a friend today about my recent trip to Tahoe. I was telling her all about the fun I had and the yummy rum runners I discovered there. As I was telling her the ingredients of a rum runner, she commented that they seemed high in calories. I shrugged and said that I knew they were high in sugar, but that the calories were probably lower than she thought.
I looked up the calorie values online and was shocked to see that a basic rum runner is about 200 calories. That's a quarter of what I consume from food in a typical day! That got me to wondering how many calories I drank during my trip. After some simple math, the number 1,600 glared at me from my cell phone calculator. I consumed 1,600 calories in beverages over the course of three days! That's about two full days of food for me.
I'm not one to cry over spilt milk and I'm not losing sleep over this, but it does stop me in my tracks. I'll take more care in choosing my beverages in the future.
I looked up the calorie values online and was shocked to see that a basic rum runner is about 200 calories. That's a quarter of what I consume from food in a typical day! That got me to wondering how many calories I drank during my trip. After some simple math, the number 1,600 glared at me from my cell phone calculator. I consumed 1,600 calories in beverages over the course of three days! That's about two full days of food for me.
I'm not one to cry over spilt milk and I'm not losing sleep over this, but it does stop me in my tracks. I'll take more care in choosing my beverages in the future.
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