Happy Trails

The Livermore Walk From Obesity was Oct. 6 at LifeStyleRx in Livermore. The walk was a fundraiser for the American Society of Bariatric Surgery Foundation and Obesity Action Coalition. The ASBS Foundation raises money for the study and treatment of morbid obesity. OAC is an activism group dedicated to fighting discrimination against the obese and encouraging insurance companies to cover medical treatments for the disease.

I won't deny that I was a bit disappointed by the walk's turnout. I had lofty goals when I signed on as a team leader for the walk. I thought I could amass a Tracy team of at least 20 people who would raise $5,000. After all, I know how much this town raises in the American Cancer Society's annual Relay For Life. So I knew it could be done. But it just didn't happen for us.

Instead of 20 people, my team -- One Step at a Time -- had four members who raised less than $1,000. But as walk organizer Julie Rooney of LifeStyleRx said, "every little bit counts." And other walkers raised similar amounts of money, which added up to a decent sum of money for the charities involved.

Personally, I want to thank my generous sponsors: Dagny of Sassy Ladies of WLS; Kenny Luiz (my uncle); Lorraine Cardoza (my aunt); and Ben van der Meer (former colleague). Their support has meant more to me than words could ever articulate.

Those who didn't participate missed out on a fun day and a leisurely three-mile stroll down the Arroyo Mocho Trail. Walkers enjoyed a goodie bag and free breakfast, courtesy of ValleyCare Health Systems, and AchievOne protein lattes (a personal fave).

More than one person questioned why there wasn't more participation. Each of us talked about how we had difficulty getting people to join our team and the challenge of fundraising. The conversation reminded me of a friend of mine, Heather Maes. Heather is a 30-year-old single mom battling colon cancer. She's documented her fight on MySpace, in a blog she calls My Cancer Chronicles. The Tracy Press occasionally prints entries from her blog, which is how we first met.

Heather is a calendar model. Well, to be precise, she's actually Miss December on this year's Colondar. The Colondar is a fundraiser for the Colon Club, which is an organization that raises awareness of colon cancer among those younger than the stereotypical over-50 crowd. In September, Heather blogged about online encounters with people who did not agree with Colondar concept. Some called it disgusting; others lamented what they considered preferential treatment of cancer patients. One person even said that the limelight on cancer made others suffering from chronic illness feel "left out of the fun." I'm sure Heather can tell you all about the fun she's having as she undergoes her second round of aggressive chemotherapy.

But I digress. My reason for mentioning Heather and her Colondar (BTW: they are on sale for $15; you should buy one) is that I found myself walking three miles on an early October morning wondering why thousands of people get so passionate each year about fundraisers benefiting cancer societies, Special Olympics, and even the American Heart Association, but it was like pulling teeth to drum up any interest in a Walk From Obesity. I don't want to sound like the ignorant idiots who told Heather and other cancer patients that they didn't deserve to raise money for their causes. At the same time, I'm curious at why obesity doesn't get the same attention as other diseases.

Cancer, special needs and heart disease are relatively random afflictions caused by a combination of family history, lifestyle and luck -- or more correctly, a lack thereof. Obesity, on the other hand, affects a majority of our society. About 60 percent of our nation suffers from obesity (BMI of 35 or more); morbid obesity (BMI of 40 or more) affects about 35 percent of all Americans. Obesity is preventable, treatable and deadly. We all know how the disease comes about; and assuming you subscribe to the "calories in vs. calories out" theory of nutrition, we all know how to overcome it.

So why is it so hard to get support for a Walk From Obesity? I think because obesity is preventable and curable, people don't view it as a disease. And that includes those who suffer from it. If I had a nickel for every time I heard an obese or morbidly obese person say, "I know what I need to do; I just have to do it," I'd be a very rich woman. If the obese don't realize they are diseased, why should anyone else?

When I participate in Relay For Life each year, I am surrounded by those who are fighting cancer, have beaten cancer, have loved ones who fit into the previous categories or have been touched by cancer in other ways. At the Livermore Walk From Obesity, I was surrounded by bariatric medical professionals, post-ops and their loved ones. I even tried to drum up interest among my non-op friends, regardless of size. To me, this walk was about silencing a killer (just like any other fundraiser walk); nothing else.

But I realized that it's impossible to silence a killer when its victims refuse to come forward and defend themselves. I haven't given up, though. I hope the Dr. Mary Estakhri, the bariatric surgeon who has sponsored the Livermore Walk From Obesity for the past two years, will continue to support this event; and I also hope that, in time, the walk will gain steam as more and more people realize the how tight of a grip obesity has on this nation.

From the "duh" files...

SAN DIEGO -- Though I appreciate the time and effort taken in researching obesity and bariatric procedures and outcomes, some studies make me shake my head in wonder.

For instance, comparing the success rate of bariatric surgery to commercial weight loss programs seems ridiculous. After all, does anybody really think counting POINTS! can hold a candle to rerouting one's digestive tract to reduce capacity and nutrient absorption? That doesn't even seem logical to me, much less a wise use of funding.

Here are two of what I'd call "duh" studies that were presented at the convention this week:

* Bariatric surgery makes people more sensitive to alcohol -- I don't think any of us with gastric bypass needed Stanford researchers to tell us that our rerouted intestinal tract makes us cheap dates when it comes to running a bar tab.
Dr. John Morton, assistant professor of surgery and senior author of the study, was quoted in today's Science Daily as saying, "I've heard the anecdotes of a patient who will drink one glass of wine and get a DUI, but I wanted to know if there is really a difference before and after the surgery."
Dr. Morton later says in the article that most patients aren't aware of this and that Oprah has done the field a favor by pointing it out on her show about the dangers of cross-addiction. I don't know about the rest of the post-ops in the world, but I discovered that fact the first time I tried wine after surgery. I didn't need Oprah or a study to enlighten me. Furthermore, I had been warned by other post-ops about the phenomena long before I ever had surgery, so I don't think it's as big of a mystery as Dr. Morton professes.

* Binge eating and a sweet tooth lead to gastric-band failures -- Just to make sure we're all on the same page here, a team of Swiss researchers reported that those post-ops who binged on food or indulged in sweets experienced a higher incidence of band failure than those who did not. The conclusion? The best candidates for banding are highly motivated patients who don't binge or eat sweets. Wouldn't you say the same thing for any type of bariatric procedure?

Candelas San Diego

SAN DIEGO -- Words cannot describe the dinner I experienced this evening. We visited Candelas on Third Avenue. And I say visited, because it was so much more than just a place to eat; it was an all-encompassing environment with an amazing atmosphere, above-par staff and cuisine that was out of this world.

Our party decided on a collection of appetizers and one entree to share, because making a decision was so difficult. We all giggled a bit when our server, Tony, went over his recommendations on the menu. He said everything was "amazing" but suggested the duck, poblano soup and the avocado salad. We thought he was just angling for a good tip -- until we were presented with the incredible dishes we ordered.

The Carpaccio Franco ($12) had fan of paper-thin raw ahi drizzled with a lemon-cilantro mustard sauce served around a salad of marinated bell peppers, baby greens and tequila-marinated pear. The ahi was so tender that it melted on my tongue, but I would have liked a little more of the sauce to enhance its flavor.

Taking Tony's suggestions to heart, we ordered the Estructura de Aguacate ($11.50), which was a stacked salad of avocado, scallops, crap, shrimp, parsely and mild jalapeno with a light drizzle of mango-basil vinaigrette. The presentation was awe-inspiring. The salad was molded into a cylinder in the center of the plate with ribbons of dressing poured around the edges. It had a delicate flavor, with each ingredient complementing one another instead of competing for attention.

The Crema Fabiola ($14.50) is a stellar puree of poblano chile and cream with a half of a lobster tail poised in the center. The color contrast between the pink and white lobster and the sage-green soup was eye-catching but nothing prepared me for the taste of the soup. It was an explosion of flavor that led a few of us to consider licking the bowl when we were finished.

The only entree we ordered, the Pechuga de Pato Lucrecia ($25.50) was another sight to behold. The duck breast was cooked in its own juices until medium rare and then fanned around vegetables and mashed potato with a light passionfruit sauce. The duck barely required a knife to cut and its buttery texture dissolved easily on the tongue. Our only regret was that our pouches forced us to leave one succulent piece on the plate along with the potato. Even Tony remarked it was a crime.

We had planned to pass on dessert until Tony mentioned crepes covered in a goats milk caramel that sounded heavenly. The presentation was simple, two crepes swimming in thick, rich caramel with pecans sprinkled over the top. We each took only one bite, knowing that a second would leave us sick all night. But that one bite was all that was needed for an instant trip to nirvana. It was the type of dessert that makes you not want to put anything else in your mouth so you can savor the flavor as long as humanly possible and then burst into tears once it diminishes.

I could not even imagine a better way to end the most hectic day of the convention.

A whirlwind of a day

SAN DIEGO -- Thursday was such a crazy day that it took me until Friday to realize that I didn't publish this post. I'm back-dating it so it's chronological:

I sat in today on an interesting session for primary clinicians. The opening speaker was Dr. Sasha Stiles of Kaiser South San Francisco, where I had my bariatric surgery two years ago. Dr. Stiles is the program's medical director, creating Kaiser's Northern California program with Dr. Prithvi Legha (my surgeon). During my time with Kaiser, I grew to know Dr. Stiles more than Dr. Legha because she is the one who handled my pre-operative screenings and post-operative follow-up. I was very sad when my employer switched from Kaiser coverage, because she is such an amazing doctor. At least I'm still able to be in Dr. Legha's capable hands.

Dr. Stiles provided a brief introduction to the Primary Clinicians Tract that was an overview of the advancements made in the treatment of obesity. For a rail-thin woman, she knows a lot about obesity. She sees 6,000 patients a year through Kaiser's bariatric program, and the South San Francisco facility treats about 200 patients a month.

She didn't report anything that was new or earth-shattering but did pose some interesting questions for the audience to ponder. Her over-arching theme regarding the success of bariatric surgery was that it provides hope for the morbidly obese. Hope, she said, is what motivates patients to make the lifestyle changes required for long-term success.

She called the physicians collectively on the carpet for not doing a good enough job in following up with their patients to ensure long-term success. Studies show that dieting is stressful and that even the most successful weight loss programs have followers who fall off the wagon and start over. Dr. Stiles said anticipating this aspect of human nature can make bariatric programs more successfull, too. After all, if you anticipate that after two years, post-ops will stop attending after-care programs and possibly begin to gain back weight, doctors could then build services into their programs to bring those patients back to the fold in a supportive manner.

Makes sense to me. What do the rest of you think?

Food, fabulous food

SAN DIEGO -- It occurred to me last night after signing off that I've yet to post about food. One of the reasons I promote Susan Maria Leach's book, "Before and After: Living and Eating Well After Weight Loss Surgery," (revised edition goes on sale in two weeks) is because it proves that enjoying great food does not end when you go under the knife.

A lot of non- and pre-ops I meet fear gastric-bypass surgery means a life without taste, texture and gastronomical pleasure, but nothing could be further from the truth. If anything, most of us become food snobs after weight loss surgery. I ate fast food at least twice a week as a pre-op. Now, I could hardly be paid to eat at McDonalds or Carl's Jr. -- the food doesn't even taste good enough to be pouch-worthy. I can find something to eat just about anywhere, but I'd rather not waste valuable space in my gastric pouch on mediocre food.

So, what does the American Society of Bariatric Surgery have served at its annual conference? Last year, I made the mistake of thinking that because it was an event about bariatrics, the catering would reflect the needs of bariatric patients. Wrong. What I forgot in my naivete is that the conference is geared toward bariatric health care providers -- not patients -- so the food did not match what my pouch could tolerate. If it hadn't been for the BariatricEating.com booth last year, I would have surgery fainted for lack of protein. That's part of the reason I agreed to help Susan at her booth this year -- I owe her a debt of gratitude for saving my pouch last year.

So far this year, I've been pleasantly surprised. Yesterday's breakfast was the obligatory continental convention fare: pastries, muffins, bagels, fruit, juice and coffee. The BE.com gang picked up coffees and went to the booth to make protein lattes and cappuchinos. I enjoyed a delicious latte made up of Nectar Cappuccino, Matrix Chocolate, Micellar Milk and hot water (12 oz offers about 25 grams of protein). For my mid-morning snack, I sipped coffee mixed with vanilla Micellar Milk and a shot of Davinci sugar-free Englis Toffee syrup and Cinnamon Bliss (a sugar-free caramel replacement that tastes just like a spicy cinnamon roll). OK, I'll be honest: I had two of those for about 20 grams of protein combined.

Lunch, however, offered something for everyone. The buffet featured a selection of salads and build your own sandwiches. I enjoyed a small green salad with tomato-basil vinaigrette and swiss cheese rolled up with deli ham and grainy mustard -- fast, filling and delicious. I was wise and steered clear of the decadent desserts.

Back at the booth, we were serving Revial soy chips (I'll have to review those at a later time), parmesan cheese crisps, AchievOne, Nectar Twisted Cherry mixed with Cherry-Pomegranate Crystal Light, ThinkThin bars and New Whey protein bullets in addition to the Micellar Milk lattes. Again, my body has never been so happy. My blood sugar only dipped once all day.

For dinner, we attended the conference's welcome reception. Again, I didn't know what to expect. Imagine my delight when I spied appetizer tables overflowing with oysters on the half shell, succulent shrimp, snow crab claws, cheese trays, canapes and beef and turkey carving stations. I didn't even glance in the direction of the pasta and dessert areas, though I did spy a few people enjoying chocolate-covered strawberries and baklava. But personally, those are treats in which I could never eat just one. Instead, I helped myself to oysters with Tobasco and fresh lemon, shrimp and crab sans cocktail sauce, green olive tapenade eaten with a spoon, Jarlsberg cubes, and melon-wrapped proscuitto and brie with a dab of cream cheese and mandarin orange (it was easy to set aside the little squares of toast atop which the melon and brie canapes were served).

Heavenly food aside, the best part of the cocktail party was that you couldn't easily tell the post-ops from the non-ops. We were mostly all enjoying the same delicious cuisine combined with excellent conversation. And like I told a couple of very handsome Australian surgeons yesterday, that -- to me -- is what the gift of surgical weight loss is all about: looking, acting and living a normal life. I could have kissed just about every doctor there for that blessing.

New key studies on morbid obesity and bariatric surgery

SAN DIEGO -- The following studies will be released Wednesday at the American Society of Bariatric Surgery annual meeting in San Diego:

The Impact of Bariatric Surgery on Health Care Costs
Date/Time: 8:45 a.m. Wednesday
Lead Author: Anita P. Courcoulas, MD, University of Pittsburgh Medical Center
Key finding: Bariatric surgery reduces health care costs over time, especially those related to medication usage.

Bariatric Surgery in Adolescents: Analysis of 309 Cases
Date/Time: 9 a.m. Wednesday
Lead Author: Esteban Varela, MD, MPH, VA North Texas Health Care System and University of Texas Southwestern
Key finding: Bariatric surgery outcomes in adolescents appear to be as safe as for adults.

Preoperative Weight Gain Does Not Predict Failure of Weight Loss or Co-morbidity Resolution of Gastric Bypass for Morbid Obesity
Date/Time: 10:30 a.m. Wednesday
Lead Author: Michael C. Harnisch, MD, Duke University
Key finding: Gastric bypass surgery can be performed safely with improvements in co-morbidity and extended weight loss regardless of preoperative weight gain or loss.

Presurgery Psychiatric Disorders are Associated with Smaller Reductions in BMI at 6 Months After Gastric Bypass
Date/Time: 10:45 a.m. Wednesday
Lead Author: Melissa A. Kalarchian, Ph.D., Assistant Professor of Psychiatry and Psychology, Western Psychiatric institute and Clinic University of Pittsburgh Medical Center
Key finding: Preliminary analyses suggest pre-surgery psychiatric disorders are related to poorer weight outcome at six months after gastric bypass. Results suggest that intervention to improve psychosocial functioning, especially anxiety and depression, may improve surgery outcomes.

Laparoscopic Adjustable Gastric Banding in Patients >65 Years of Age
Date/Time: 2 p.m. Wednesday
Lead Author: David A. Provost, MD, University of Texas Southwestern Medical Center, UT Southwestern Medical Center
Key finding: Laparoscopic gastric banding provides a safe and effective weight loss option in patients 65 years and older

Dinner at Henry's

SAN DIEGO -- We ate dinner tonight at Henry's, an Irish Pub near the intersection of Market and Fifth. Though Henry's definitely has a pub atmosphere, the food choices were superb. No bangers and mash on the menu at this place.

Eating among post-ops is such a refreshing change from what I'm used to. Five of us are post-ops -- from two to six years out from surgery -- and discussing what to have for dinner is a fun experience in itself. No mention of pizza or fried foods.

The biggest decision we had was whether to order our own entrees or share. We all decided that we hadn't eaten enough during the day so we opted not to share. Us post-ops were copy cats; we each ordered the salmon with dill cream sauce and a double portion of veggies instead of mashed potatoes. Being the "youngest" post-op in terms of when I had my surgery, I ate the smallest amount but I held my own with the veterans.

What I loved most was watching each of them following the rules even at their stage: No drinking with meals, protein first, eating slowly and chewing each bite thoroughly. We had incredible conversation on topics ranging from WLS issues to work topics to just life in general. It was like a night out with my best girlfriends, except that these girlfriends eat the same way as me.

Gringas like to party

SAN DIEGO -- Popping in for a second after helping to set up the BE.com booth at the ASBS convention center. I've learned many skills in my short time here. For instance, there is a lot of skill behind the building of a trade show booth, particularly when the shipping company crushes most of your boxes and leaves you to make do with damaged products. You'd never guess we had any trouble by looking at it, though.

Susan Maria Leach's new edition of "Before and After: Living and Eating Well after Weight Loss Surgery" hits bookstore shelves at the end of the month. The new version of the "pink book," as its known by many fans, is now a teal blue paperback that features updated information on the various types of surgeries, meal plans and even more recipes than its predecessor. Presale orders are now being taken at BE.com.

The best part of hanging out with the BE.com crew is that I never go hungry. We were all famished at light-headed while working on the booth, but that wasn't a problem because we had plenty of Revival soy chips, Power Crunch and Oh Yeah! bars and Protein DeLite Protein on the Go (chocolate coconut is soooo tasty!). My blood sugar hasn't been as level as it is today in weeks -- and I've been traveling -- not too bad, if you ask me.

Look out, San Diego

I'm leaving tomorrow morning for the American Society of Bariatric Surgery annual conference in San Diego. My goal is to blog daily from the event but if this year is anything like last year, I'll be lucky to eek out a posting or two each day. The conference is jam-packed with educational sessions, events and an overwhelming trade show.

ASBS conference

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

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

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

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

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

2007 Walk From Obesity

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

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

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

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

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

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

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

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

Paying it Forward

My health scare in January has led me to reevaluate a lot of things in my life. I took advantage of the month I was off work to examine my priorities and determine whether they were in line with my values. Since then, I've made the appropriate changes. Some decisions were easier than others.

For instance, I realized that not only do I love my job and people for whom I work, but working at the Tracy Press also fulfills me. Truly, I'm a lucky person. Few people are lucky enough to love what they do. I need to appreciate being among the few in this case.

Loving my job was an easy realization to come to. The more difficult ones have to do with what I want outside of professional circles. There needs to be more to me than just a journalist. After all, having interests outside of our careers is what makes us well-rounded as humans. It gives us context and passion -- all things that are very important.

One thing I know for sure is that I want to take a more active role in advocacy for the obese. More than 60 percent of U.S. residents suffer from the disease of obesity, which means every man, woman and child in this country is touched by the disease. Yet even today, it remains one of the few areas where discrimination is prevalent and accepted. And that has to stop.

Having lost almost 200 pounds, much of which I had carried on my 5-foot, 3-inch frame since childhood, I have two choices: I can let my "normal" exterior fool me and those I meet by pretending I never had a weight problem, or I can use the experience and my newfound energy and mobility to help others. I've chosen the latter.

Childhood obesity has reached epidemic proportions, and it's time more people speak out against it as well. The Tracy Hospital Foundation has embarked on an education campaign that includes billboards around town. They help, but more has to be done. It's not fair or realistic to leave the fight up to medical professionals, schools and legislators. As someone who suffered through childhood obesity, I think I have a lot to bring to this particular fight -- and I intend to make my voice heard.

The first step I plan to take in my personal fight against obesity will be participation in the American Society of Bariatric Surgeons' Walk From Obesity. The nationwide event raises money to fund obesity research and advocacy efforts. Walks will be scheduled all over the country in September and October. Specific dates and locations will be announced in May. Keep reading here for more details.

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.