A reunion to remember

I had the pleasure of visiting yesterday with a former colleague and good friend who moved out of state a couple of years ago. This is the second time I've seen her since she moved away. The first was shortly after I had gastric-bypass surgery. In our discussions before she flew in, she worried repeatedly that she wouldn't recognize me. I brushed off her concerns, because she has kept updated on my progress through this blog, and as one of my close friends, I know she'd never not know me.

But that didn't change how emotional our meeting was yesterday, or how exciting it was to see her and her daughters. I nannied for her family when I first moved to Tracy. When I met her and her family, the girls were 8 and 6 and her son was 2. Now the girls are are a beautiful 12-year-old and 14-year-old. At 5 feet, 8 inches, they tower over me. Her 8-year-old son stayed home with his dad so I didn't get to see him.

The girls were more outwardly amazed by my transformation than their mother. That's understandable. I e-mail with their mom numerous times each week. She reads my blog. I haven't had much contact with the girls since they left. And just as I remember them perpetually as the children in the grade-school pictures of them I have framed on my desk at the office, I'm sure they always remember me as the larger-than-life babysitter who tipped the scales at more than 300 pounds.

I hugged the girls half a dozen times each, shocked by their transformation in young women almost as much as they were shocked by mine. The oldest kept throwing her arms around me and exclaiming about how small I was. The 12-year-old told me how good I looked but not before saying, "You always looked good. You just look good in a different way now." Both girls approved of my new red hair color; I suppose that makes me hip. We spent some time catching up before they ran off to an A's game with their grandparents (Tampa Bay defeated the A's, 4-1), and then their mother and I went out for dinner and conversation.

Dinner took us to Pasta Pelican in Alameda. My friend enjoyed a delicious combination of chicken and sun-dried tomatoes in a light cream sauce over linguini. I had the Pasta Pelicano -- a succulent grilled chicken breast topped with melted mozzarella, tomatoes and artichoke hearts that I had served over steamed zucchini, carrots, broccoli and mushrooms.

After dinner, we headed upstairs to the restaurant's bar for a drink and more conversation. We talked about everything under the sun -- our respective jobs, families, what's happened in Tracy since she moved away more than 2 years ago and where her family planned to move next. After closing down the bar, we headed off to Starbucks for iced tea (me) and coffee (her) before heading back to her mom's home at midnight.

It was a night well spent, one that reminds us of how we became fast friends to begin with back in 2000 when we shared a desk at the Tracy Press. But as is often the case with good friends, it was entirely too short of a visit. She flies back home this evening and goes back to her busy life, as I will with mine. But at least we have last night, and the memories of that to last us until our next meeting.

My thoughts on Shrek

I had hoped some readers would offer their opinions on whether Shrek is a bad influence in the anti-obesity movement before weighing in with my own, but it seems I will have to be the first.

I find it interesting that anti-obesity groups would rather spend time and energy nitpicking the government's choices instead of creating programs that promote their purported goals. Then again, maybe nitpicking the government is the only way they know to promote their own agenda.

The question at hand is whether the government erred in choosing Shrek as its "spokesman" to encourage children to be more active when the character is also involved in the endorsement of McDonalds Happy Meals and sugary breakfast cereals.

According to an Associated Press article released Thursday, the Campaign for a Commercial-Free Childhood says the upcoming Shrek sequel has too many promotional ties with unhealthy foods.

"There is an inherent conflict of interest between marketing junk food and promoting public health," Susan Linn, the group's director, wrote in a letter sent Wednesday to Health and Human Services Secretary Michael Leavitt.

"Surely Health and Human Services can find a better spokesperson for healthy living than a character who is a walking advertisement for McDonald's, sugary cereals, cookies and candy," Linn, an instructor in psychiatry at Harvard Medical School, was quoted as saying in the article.

I have to give Linn credit for her idealism. In a perfect world, there would be numerous healthy role models for children. But our world isn't perfect. And let's be realistic here: Kids listen to cartoon characters, whether adults like that fact or not. I remember first trying canned spinach as a kid to mimic Popeye, and my niece and nephew begging for cucumbers and tomatoes because of VeggieTales.

Based on that experience, I'd say the government is smart to use a cartoon character in its anti-obesity campaign. So what if Shrek also endorses Happy Meals and candy? If kids can remember that McDonald's has Shrek Happy Meals, then I'm sure they can also remember Shrek's recommendation that they exercise at least an hour a day.

Is Shrek a bad influence on kids?

Please share your thoughts on the following Associated Press story on MSNBC.com:

Associated Press
A children’s advocacy group wants the Department of Health and Human Services to oust Shrek, the animated ogre, from his role as spokesman for an anti-obesity drive.

The Campaign for a Commercial-Free Childhood says the soon-to-open “Shrek the Third” has too many promotional ties with unhealthy foods to justify using Shrek as a health advocate.

“There is an inherent conflict of interest between marketing junk food and promoting public health,” Susan Linn, the group’s director, wrote in a letter sent Wednesday to HHS Secretary Michael Leavitt.

“Surely Health and Human Services can find a better spokesperson for healthy living than a character who is a walking advertisement for McDonald’s, sugary cereals, cookies and candy,” said Linn, an instructor in psychiatry at Harvard Medical School.

HHS spokesman Bill Hall said the department had no intention of halting the public service ads, which were launched in February.

The ad campaign — which seeks to curtail childhood obesity — is a joint project of HHS, the Ad Council’s Coalition for Healthy Children and DreamWorks Animation SKG, creator of the three Shrek movies. It features ads in which Shrek, a stout and often clumsy ogre, and his fellow characters urge children to exercise at least an hour a day.

“Shrek is a very well known character in the target population of this campaign,” Hall said. “We have always promoted a balanced, healthy diet, which does not necessarily exclude the occasional treat.”

Linn’s organization — a nationwide coalition which monitors marketing aimed at children — said “Shrek the Third,” which opens May 18, has promotional deals with dozens of food products, including Mars Inc.’s Snickers and M&M’s candy; PepsiCo Inc.’s Sierra Mist drink; and Kellogg Co.’s Fruit Loops, Frosted Flakes, Pop-Tarts, Cheez-Its and Keebler cookies.

The film also has a tie-in with McDonald’s; there will be Shrek-themed promotions of Happy Meals and DreamWorks will create animation for some McDonald’s commercials.

“Why would young children follow Shrek’s advice about healthy living and ignore his entreaties to eat Happy Meals and Pop-Tarts?” Linn wrote. “If government agencies are serious about combating childhood obesity, they should stop cozying up to industry and start taking real steps to end the barrage of junk food marketing aimed at children.”

Penelope Royall, the HHS deputy assistant secretary for disease prevention and health promotion, stressed that the public services ads were using Shrek to promote exercise, not foods.

Mean people suck

Forgive my juvenility, but some days, I get so fired up that I just can't use my words. And on those days, even I -- a trained journalist and word smith -- resort to using profanity and childish words like "stupid," "sucks" and "lame." So consider yourself warned as you read below.

Bariatric surgery is a wonderful gift to the morbidly obese. Those of us who have spent most of our lives fighting against our own bodies and the disease of obesity are eternally grateful to have the tool of surgical weight loss at our disposal. However, some of us take it to the extreme. They say there is no stronger believer than a convert -- and many of you will find that's very true when talking to bariatric post-ops.

Many post-ops are so excited to see the numbers on the scale go down almost effortlessly (which happens to everyone during the honeymoon phase) that they want to shout their success from the rooftops. Good for them. As someone who was morbidly obese almost her entire life, I understand the feelings of elation that come with seeing the pounds melt away. But that does not give us the right to judge others.

Just because surgery was the right answer for me does not make it the right answer for everyone else in the world. I wouldn't even dare ask someone if he or she has considered surgery -- it's not my business. If someone who knows me is considering surgical weight loss, they know they can talk to me about it. But I would never bring it up. In fact, I have to admit that I do not walk around in my daily life, surveying whether others should have bariatric surgery at all. It's really not my business nor my concern. It's enough work for me to worry about myself.

Why am I all hot and bothered by this topic? I'm tired of seeing other bariatric patients act cruelly or cluelessly toward those who still battle with obesity. I know they haven't forgotten what it's like to be locked in a prison of their own making. They haven't forgotten the shame, the depression or the embarassment...we never do. So why on earth do they say some of the stupid things they do? My only answer is that they are blinded by their own success.

I still remember the man in the Orchard Restaurant on Highway 132 in Vernalis who took it upon himself to suggest I have gastric-bypass surgery when I weighed about 280. I still want to punch that man in the teeth. I don't care if his heart was in the right place; he really had no right to judge someone he didn't know and tell them that the solution to his weight problem was the solution to theirs.

I have an aunt who has lost about 150 pounds through strict changes to her lifestyle. She had some health issues that severely limited what foods she could eat. As she tells it, eating whatever she wanted was no longer a comfortable choice. So she changed her eating habits, and the weight fell off. It was no easy task, but she did it. And like anyone else who has dropped a significant amount of body weight, she deserves praise and rewards for her accomplishments. However, it seems a group of her colleagues who are bariatric patients disagree.

One woman in the group asked my aunt how she lost her weight without benefit of surgery. My aunt replied, "I count calories. Right now, I'm eating about 1,200 a day."

Instead of congratulating my aunt on her willpower (like I would do) or saying nothing, this woman chose to insult my aunt by saying, "Oh my God! I would feel like a fat pig if I ate 1,200 calories a day!"

As my aunt told this story, which I could tell hurt her feelings, all I could think of was "Well, of course you would. You had surgery to limit the capacity of your stomach. You can't compare yourself to non-ops." But instead, I just told my aunt that her coworker was a mean, jealous woman who should be ignored. Because there is just no point in using logic with some people.

So, to the post-ops reading this: Please don't be like those I've mentioned. Never forget what it was like to be obese and treat people how you would have wanted to be treated.

And to the non-ops: Don't be afraid to speak your mind. If someone mentions gastric-bypass surgery to you, tell them it's none of their business. Because guess what? It's not.

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.

Picture-perfect salad

As the weather warms up this week, I find myself craving salads. Yesterday's lunch consisted of diced chicken breast tossed with herb-garlic cheese and bacon-tomato ranch dressing over spinach greens with a garnish of pumpkin seeds and dried cranberries. It sounds weird, but I promise it was tasty.

The pumpkin seeds, however, reminded me of another salad that I tried about a month ago at an office potluck. This salad, called an Aztec Platter, features quinoa, corn and beans. Quinoa is a grain known for having been a staple food of the Aztecs. It's one of the few plant sources that is a complete protein, meaning it has all the amino acids essential for the human body.

Quinoa has a mild flavor and aroma, and cooks into a light, fluffy texture in only 15 minutes. And that makes this vegetarian salad the perfect light lunch or dinner that won't heat up the house in the warmer months.

Aztec Platter
(Serves 6)

Quinoa-corn salad
1 cup quinoa, well rinsed
1 cup thawed frozen corn kernels
Juice of 1 lemon
1 tablespoon olive oil
2 or 3 scallions, minced
Salt and freshly ground pepper, to taste

Bean salad
1 pound canned beans (pinto, pink or kidney), drained and rinsed
1 heaping cup finely diced ripe tomatoes
1 tablespoon apple cider vinegar or balsamic vinegar
¼ cup chopped fresh parsley, or to taste
Freshly ground pepper, to taste

Garnishes
Pumpkin seeds
Black olives
1 medium red bell pepper, cut into strips

1. Bring 2 cups of water to a boil in a heavy saucepan. Add the quinoa and simmer gently, covered, for 15 minutes. When the quinoa is done, remove it from the heat, fluff it with a fork, and transfer it to a mixing bowl. Combine the quinoa with the remaining ingredients for the quinoa-corn salad and toss well.

2. While the quinoa is cooking, combine all the ingredients for the bean salad in another bowl and toss together.

3. To assemble the Aztec Platter, transfer the quinoa-corn salad onto a large platter and spread evenly to within an inch or so of the edge. Pushing the salad outward from the center, make a well in the center of the platter about 5 inches in diameter. Mound the bean salad into the well and sprinkle it with a handful of pumpkin seeds. Note: You can also add feta cheese for a burst of flavor.

4. Using above photo as a guide, arrange olives and pepper strips around the edge of the platter.

Calories: 233
Total fat: 4g
Protein: 9g
Carbs: 40g
Cholesterol: 0g
Sodium: 9mg

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Is it hot in here or is it just my cooking?

Since having gastric-bypass surgery more than two years ago, I've noticed that my consumption and craving of processed foods have declined. I now favor buying lots of fresh ingredients and spending time in the kitchen, making meals from scratch.

Sundays are my favorite days for cooking. I find spending a few hours on Sundays saves me so much time in the kitchen each night after work, which makes cooking dinner not such a nightly chore. Also, cooking from scratch offers a satisfaction that chicken nuggets or fast food just can't compete with.

Right now, I'm enjoying the aroma of chicken cooking on the stove to make the base for chicken soup for tomorrow night's dinner. Talk about a feel-good childhood memory. And with Safeway selling Foster Farms whole chickens for 99 cents/pound through Tuesday, it's an affordable dinner as well. There is nothing as flavorful as homemade chicken stock, and it's so easy to do, too. Here's my recipe:

Chicken Stock
1 whole chicken (discard organs but retain neck and tail) or chicken parts
2 onions, peeled and halved
4 carrots, cut into three pieces each
4 stalks of celery (or cut the leafy portion from the top and the root from the bottom and use that, saving the nice stalks for a different use)
4 cloves of garlic, peeled and smashed
Salt and pepper, to taste
Water

Put the chicken or chicken pieces (and neck and tail) in a large stock pot. Add veggies, packing them tightly into the pot. Add enough water to cover chicken and veggies and bring to a boil. Boil two to four hours, until chicken falls apart. Add more water as needed throughout cooking process. Once chicken is done, turn off heat and allow to cool. Remove chicken to a bowl to cool fully and reserve for other uses (chicken made this way is so flavorful and moist). The neck and tail can either go to the dog or the trash -- your preference.

Strain broth into a large bowl, pressing down on solids to extract all liquid possible. Put broth in fridge to cool overnight. In the a.m., strain the solidified fat from the broth to leave yourself relatively fat-free chicken stock.

At this point, you can use the stock as a base for chicken soup or pour into ice cube tray to freeze for use later whenever chicken stock or broth is called for in recipes.

Chicken soup
6 cups chicken stock
1 med. onion, chopped
4 carrots, peeled and sliced
3 stalks celery, coarsely chopped
3 cloves garlic, peeled and minced or 1/2 tsp. garlic powder
2 cups chopped cooked chicken, or as much as you like

Add veggies to stock pot and cover with chicken stock. Bring to boil and cook until veggies are tender. Add chicken and cook until heated through. Ladle into bowls and serve.

Note: Add a 1/4 of rice or 1 cup of pasta with veggies for chicken-and-rice or chicken-noodle soup.

Looks can be deceiving

It's been a little more than two years since I had Roux-En-Y gastric-bypass surgery. Most days, I'm at home in my new, smaller body. I'm braver about scooting through tight spaces and I no longer look for armless chairs in public settings. But other days, something will happen that jolts me with the realization that my brain still hasn't caught up with the changes my body has undergone.

For instance, I was visiting some friends after work a few weeks ago when I was confronted by the reality of my size. I was helping my friend in the kitchen, and she offered to let me borrow a dress so I didn't wreck my work clothes. When I went to put her dress on, I held my breath for a moment in anticipation of it being tight. Instead, the knit dress hung off me like a burlap sack. She laughed; I was shocked. Looking at her, I could not see the difference in our sizes but there was no arguing with reality. I'm no dummy. I know what size I wear, but I've apparently lost perspective when it comes to judging the size of others in relation to me.

The disconnect between how one looks in reality compared to how they see themselves is called body dysmorphia. It's a condition that's commonly experienced by those with eating disorders (it's why anorexics rarely see themselves as thin). It's also common among those who've experienced rapid weight loss. The brain seems to have a hard job catching up with the drastic changes. I have heard that it can take some of us up to five years after gastric-bypass surgery before what we see in the mirror matches what the rest of the world sees when they look at us.

One of the best weapons agains body dysmorphia is photographic documentation. Pictures taken throughout the weight loss process help the brain make the leap from "before" to "after." This explains to me why I sometimes perceive myself as a size 14 or 16 instead of the 28 I used to be or the 10 I am now. I think I'm lucky, though. At least I'm getting closer to a realistic view of myself.

Foundation pledges $500M to battle obesity in kids

The Robert Wood Johnson Foundation announced early this month that it would commit at least $500 million over the next five years to tackle the problem of childhood obesity, reports ABC News.

The money will be used to fund grants for anyone with ideas on how to fight the nation's growing problem. The concept has prompted me to brainstorm my own solutions to the problem. It's easy to sit back and complain about the epidemic of childhood obesity, but solving it is a different story.

I'd love to hear your thoughts on the subject. If you have an idea, please share it. Maybe we can put our heads together and figure out something to put into practice here in Tracy to improve the health of our children.

Trading vices

A recent story from ABC News reminds me of an emerging side effect of bariatric surgery: cross addiction.

Cross addiction is when a person trades one addiction for another. Sometimes, cross-addiction is considered harmless. If you kick heroin, a two-pack-a-day cigarette habit pales in comparison.

The ABC News story focuses on one woman's shopping addiction, which put her in financial peril. Other addictions bariatric patients need to watch out for include sex, alcohol and drugs. Those addictions are troubling because they bring other health concerns along with them. Sex addiction can lead to sexually transmitted diseases, unwanted pregnancy and even issues with self-esteem and depression. Alcohol can irritate the gastric pouch, leading to ulceration and limited absorption of nutrients -- not to mention the risks of losing one's job or family. Drug addiction -- depending on the drug -- also can lead to a variety of health problems and concerns.

The most important thing surgical weight loss patients can do to avoid cross-addiction is to be wary of it. Knowing that it's a danger is the first step. Being self-aware is the next. If you feel that you might be slipping into a cross-addiction, seek out help. Find an addiction specialist in your area -- one that has familiarity with food addiction is best -- and work with him or her to develop healthy coping mechanisms.

Viva Las Vegas

My best friend, Amber, and I just returned from our first trip to Las Vegas in celebration of her 30th birthday. We didn't make it to very many casinos -- truly, you just can't do everything in the city that never sleeps -- but we visited the Palms, MGM Grand, Bellagio, Venetian, Caesars, Harrahs, New York New York and Stratosphere.

Some highlights from our trip:

The Bellagio -- High winds over the weekend canceled the fountain show when we were there, but the casino and hotel themselves are sights to behold. As Amber said, "The bathrooms are almost too nice to pee in!" The Bellagio Cafe, which has tables overlooking the breath-taking conservatory (garden and gazebo design changes four times a year with the seasons), had the best food I've ever eaten. I had a salad with grilled prawns, spinach, feta cheese, artichoke hearts (fresh, not oily and marinated) and kalamata olives tossed in a chickpea vinaigrette that was amazing. The flavors blended perfectly without losing their character. Amber's mom, Merry, ordered the chicken penne pasta and raved about it the entire trip. Amber had the Thai lettuce wraps, which featured tender chopped marinated chicken breast, a spicy peanut sauce and a spicy sesame sauce, bibb lettuce, carrots, and soft asian noodles. The food was so good that not a single one of us had entree envy.

New York New York -- The interior design is awesome, making me feel like I was actually in the Big Apple. The shops and eateries are piled on top of one another, giving the crowded feeling of a major city, and an indoor waterway and trees are reminiscent of Central Park in the spring. We ate at Il Fornaio, which overlooks the waterway. I wasn't impressed with my meal, but Merry said the cheese pizza she ordered was delicious. Unfortunately, the piano bar (which had come highly recommended) wasn't open when we there so we didn't get to experience the dueling pianos.

Caesars Palace -- The first casino we visited, it was difficult not to be overwhelmed by the Forum shops. I touched a horrendously ugly pair of Jimmy Choo boots that were $1,200. Amber and I giggled that we would not have paid $12 for them but it was fun to touch.

Pictures say 1,000 words

New & Improved

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Stupid is as stupid does

Originally published March 17, 2007, in Our Town for the Tracy Press.

The word "stupid" is not one I use often. It was an "ugly word" in my childhood home, meaning it was barely better than profanity. The word still makes me cringe. I’ve even got my husband trained not to use it in my presence.

But sometimes, there is just no other word that fits.
And I’m here now to confess that when looking back on when I fell ill in late January, I am stupefied by my own stupidity.

False sense of normalcy
A lot of gastric-bypass patients talk of being normal, but most of us realize our view of normality is skewed. Normal people don’t eat whatever they want without gaining a pound, no matter what those of us who have been obese tell ourselves. I came to terms with that fact about a year ago.

What I didn’t come to terms with, however, is that I’m not anatomically normal and never will be again. That’s easy to forget after losing close to 200 pounds in a two-year period. My exterior looks normal to the rest of the world. Few people would guess I’ve been morbidly obese for most of my life, and sometimes, I buy into that fantasy.

Take that night in late January when I first realized I was seriously ill. As I mulled over whether I was in serious enough shape to warrant my best friend and husband trekking into the mountains on a work night to pick me up, I had some moments of clarity that didn’t make me feel like the brightest bulb in the drawer.

What’s the worst that can happen?
Trying to convince myself of how silly it would be to have them drive all that way for nothing, I tried to imagine the worst-case scenario. I was one of the few guests at a rural cabin resort. There were no neighbors to hear my cries for help if I were to become truly incapacitated. No phone in the room to call the operator for help. I had my cell phone but didn’t have the manager’s number programmed in it.

Then my thoughts darkened. What if I were to lose consciousness? Nobody would even consider looking for me until an hour after checkout. Looking at the clock, I realized that a lot could happen in the next 14 hours or so. I also knew I was dehydrated, having consumed only about 4 ounces of water in the previous day.

Helping those who help us
I tried to be objective. If I were to pass out, either from the pain or from whatever ailed me, what would emergency personnel think? How would they help me? I didn’t have a MedicAlert bracelet to tell rescuers I was a gastric-bypass patient. My doctors warned me to order one before I even had surgery so that in an emergency situation, it could speak for me if I could not speak for myself. But I never made the time to place the order. It seemed inconvenient to figure out what to have inscribed on it, and though it wasn’t pricey, there always seemed to be better uses of my money.

I considered typing out my medical information and symptoms on my laptop but would medics really think to look there for clues? There was no way to be sure.

I finally called my husband and told him to come get me. Though I still had no idea of the severity of my condition, I realized I was safer at home with someone to help me than all alone in an unfamiliar, isolated area.

Stupid is as stupid does
To be stupid is to act in an unintelligent manner. Ignorance, on the other hand, is to be uneducated. Ignorance is forgivable; stupidity is not.

In hindsight, here were my stupid moves:

• Not seeking help sooner — There is no guarantee that earlier medical attention would have led to an earlier diagnosis, but I knew the dangers of dehydration and the signs of bowel obstructions long before I ever had gastric-bypass surgery. The moment I realized I could not keep water down, I should have called my husband to pick me up.
• Staying alone in an isolated area — When I was told to choose temporary lodging for my business trip, a quiet mountain resort sounded like the perfect getaway. And in some circumstances it could have been. But it was not the smartest move for a woman traveling alone.
• Not ordering a MedicAlert bracelet — Gastric-bypass patients have some serious limitations when it comes to medical care. NSAIDs like Aleve, Advil and Motrin can ulcerate our delicate gastric pouches. Nasogastric tubes, which are inserted through the nasal passage and into the stomach, cannot be used, since access to the remnant stomach is cut off by gastric-bypass procedures. Attempting to insert an NG tube blindly can perforate the gastric pouch — not a good thing. The other benefit to a MedicAlert bracelet is that it can list allergies. Because I’m allergic to a couple of commonly used drugs, that’s something that should be a higher priority for me.
• Not packing my vitamins — What happened to me had absolutely nothing to do with vitamins. However, I know better than to miss a single dose. The malabsorptive nature of my altered anatomy puts me at risk of vitamin deficiencies. There are few things more important than taking my vitamins each day. I knew when I left Tracy that I had forgotten to pack them. I decided that it wasn’t worth the effort to go back home to retrieve them. After all, I was only going to be gone five days. Five days without vitamins would not kill me, but it’s still stupid to rob my body of vital nutrients out of laziness.

No immunity from complications

Originally published March 3, 2007, in Our Town for the Tracy Press.

I’ve been fortunate since having gastric-bypass surgery two years ago. I haven’t had to deal with nutritional deficiencies, strictures, profuse vomiting or any of the other common problems post-operative patients face.

But my luck, it seems, has limits. And about a month ago, it ran out.
I woke up Jan. 23 like any other day, except I had some abdominal pain. I dismissed it, and made myself some peppermint tea to soothe me. By the time I got to work, though, the pain had increased. Every time I took a drink, I’d feel cramping low in my stomach.
Deciding it must be the stomach flu, I sipped protein drinks throughout the day and figured I’d let it pass.

Something serious
By 8 p.m., I was doubled over in pain. I wasn’t at home, though. I was on a business trip in the Santa Cruz Mountains. So I was alone in a rural cabin and determined to stick it out.
I was up most of the night, fighting both pain and nausea.

I called in sick Thursday and dozed most of the day. I seemed to do OK lying on my right side, and the pain would come and go, allowing me to sleep between spasms. On a scale of 1 to 10, the pain varied from a 7 to 10. I couldn’t get any water down, and I had uncontrollable belching.

By Thursday evening, I could no longer walk and had taken to crawling.
In the previous 24 hours, I had only consumed four ounces of water. Looking at the veins bulging in my chest and upper arms, I realized I had become dehydrated. On top of that, my stomach was distended and felt as if it were in flames.

Finally, I let my husband and best friend drive to the mountains to get me so I could see my local doctor the next day. It took them a few hours to reach me, and my condition continued to worsen. One look in my best friend’s eyes when she saw me told me I looked as bad as I felt. They packed my things while I laid in the bed, barely able to speak without sending myself into spasms of pain.

To get to the car, I had to bend at a 90-degree angle and shuffle the few yards outside. My husband asked why I was walking like his osteoporitic grandmother.

"This is the only way I can walk," I mumbled.

The ride to Tracy was miserable. Instead of going home as planned, we went straight to the hospital. Addressing my dehydration was the first priority. It took three nurses to get an IV in my arm. After that, I was led to radiology for a CT scan. Having to lay flat, even for 10 seconds, was the most excruciating experience of my life.

Afterward, I was hooked up to a bag of fluids and dilaudid, a painkiller 25 percent stronger than morphine. It didn’t do a lot for the pain but it allowed me to sleep.

The diagnosis
The CT scan showed I had a kink in my intestines. I was so happy to have a diagnosis that I didn’t fully process what that meant. I was admitted into the hospital for the night and scheduled to see a surgeon the next day.

After talking with the surgeon, it became clear that I would need a specialist. Unfortunately, there are no bariatric surgeons in Tracy. Finally it dawned on me that Dr. Prithvi Legha, who performed my gastric bypass, was now in private practice in the Bay Area. I had the surgeon contact him for advice.

Everything happened so fast from that point that there wasn’t even time to contact family.

I was transferred to El Camino Hospital in Mountain View the evening of Jan. 25. I didn’t know it at the time, but I was going on three days with an obstructed bowel — a dangerous problem.

Emergency surgery
I arrived at the hospital via ambulance at 9:30 p.m. Dr. Legha was already there and told me his assumption was that I had a bowel obstruction and at least one internal hernia. In laymen’s terms, my intestines had tangled into a gigantic knot and then started to twist inside out. Surgery was the only answer.

"I’m going to try to go in laparoscopically," Dr. Legha told me, "but I think you’re too far gone. I may have to open you up."

I nodded and told him to do what he had to do.

"When are we going to do this?" I asked, thinking I’d be scheduled for surgery the next morning.

Instead, he said, "now," and with that, I was wheeled into the operating room. I hadn’t even been at the hospital 30 minutes.

During the three-hour operation, Dr. Legha first tried a lap procedure, puncturing my abdomen six times. However, my bowels were so swollen and inflamed, he was afraid they would fray and break open. He cut me about five inches down the middle. He discovered two intestinal hernias in addition to the bowel obstruction. My intestines were purple from lack of blood. But I was lucky. As soon as the knot was untangled, they pinked up. I had no infection, no tissue death.

Dr. Legha is not one to mince words. He has let me know numerous times in the past month how close I was to death. Another 12 hours, and somebody at the Tracy Press would have had to write my obituary.

The road to recovery
This is one of the toughest surgeries to recover from. Not only are there incisions to heal, but the intestines must be retrained. It seems they forget to do their job after being shut down for a few days.

I was in the hospital about a week. I had nothing by mouth the first five days, but I wasn’t complaining. The thought of eating at that time seemed an impossible feat. Once it became apparent that my intestines were still asleep on the job, I was given intravenous nutrition to preserve my muscle mass and body weight. I was released from the hospital after moving from clear liquids to pureed food with little problem.

A month later, I’m back at work but still recovering. I’m slowly introducing solid food into my diet, and my body is learning to process it all. Earlier this week, I had to go home early one day after my intestines protested the chicken I had for lunch.

I tire easily, and I struggle with dizzy spells caused by low blood sugar. I’m eating between 6 and 9 ounces of food per day, not nearly enough to fuel my body. At Dr. Legha’s suggestion, I’m trying to consume most of my required protein through supplements. This will prevent my muscles from cannibalizing themselves, and it also keeps the dizzy spells at bay.

The future
This experience has taught me a variety of lessons, many of which I’ll share in upcoming columns. But for now, my focus is on building my strength and improving my health. Can’t expect much more than that.

The Unbearable Thinness of Being a Model

New York Magazine has published an interesting, yet also disturbing look, at the recent controversy surrounding the size of fashion models and its effects on Fashion Week:

http://nymag.com/fashion/07/spring/28149/index.html

Surgery paves way for career switch

Originally published Jan. 27 in Our Town for the Tracy Press.

Six years ago, Susan Maria Leach was pushing 40 and tipping the scale at 278 pounds. She felt
imprisoned in her body but didn’t know what to do about her misery. She had tried every diet on the market, with marginal success, and she was tired of it. Then Carnie Wilson’s gastric-bypass surgery success story graced the cover of People Magazine, introducing Leach to a permanent solution to her obesity.

Today, she is feeling fit and fabulous. She’s a published author with a second book on the way, proprietor of an online store — www.bariatriceating.com — that features bariatric-friendly foods and has also started her own nutrition company.

“I am at the perfect place in my life with my health, marriage and business,” she declared during a recent e-mail interview.

Her book, “Before and After: Living & Eating Well After Weight Loss Surgery,” is part diary,
part cookbook and considered one of the best bariatric books on the market. Some surgeons
even carry copies to sell to their patients. The book’s success paved the way for Leach’s Web site and online message board, which is motivating an army of bariatric patients to follow her path.

“It never ceases to amaze me that I have influenced so many people,” Leach said. “I tear up at least once a day while reading an email or letter or post on our message board and love seeing that I help so many find their own inner strength to be successful.”

Leach’s path began simply enough. After surgery, she was determined to find ways to continue
her passion for cooking. She focused her attention on creating delicious high-protein, low-carbohydrate meals and desserts that helped her stay on track. She tested her creations on friends, family and support group members. It didn’t take long for her to build a reputation as a bariatric gourmet, which is how she got her book deal.

“Working with HarperCollins has been an incredible experience,” she said. “I happened to be in the right place at the right time with a positive, no-nonsense attitude.”

She created her online store three years ago in an effort to make compliance convenient for post-ops.

“Rather than everyone having to buy (products) from 10 different sources, we gathered all the good proteins and vitamins in one store, so bariatric patients could shop with ease, knowing that everything was the proper nutrition and … actually tasted good,” she said.

She opened a storefront in Pompano Beach, Fla., last year and is now expanding the space for the fifth time.

The other anticipated highlight of this year is the release of her second book, which is in its first round of edits. It’s an update of her first book — complete with newer, easier recipes and new information she’s found since the original printing.

“Even though I wrote the material in the first 18 months after my surgery,” Leach said, “the
basics I outlined are still very solid right now.”

Leach knows about the value of the basics. She’s maintained a loss of 143 pounds over the past six years, despite a discouraging setback about 18 months ago.

“I had a weight gain over the course of a couple of months that put me right out of my new wardrobe,” Leach revealed. “I knew that I ate properly and had not strayed from the path but didn’t know what to make of the situation.”

Leach admits that she panicked, resorting to denial. She didn’t connect her unexplained weight gain with having had thyroid cancer two years before weight-loss surgery. The cancer required removal of the butterfly-shaped gland in her neck along with a large tumor that was choking her. Her doctors stopped prescribing synthetic thyroid hormones after her bariatric surgery, which is what led to her drastic weight gain.

“I dropped almost all of the weight gain in the first month (after resuming hormone therapy),
and I am now back to maintaining,” Leach said.

But it’s taken a long time for her to go public with her struggle.

“I was embarrassed, even though there was a plausible reason, because ‘thyroid problems’ is the
catchphrase excuse for a lot of people who are fat,” she said. “Lately, I’ve talked about it in public a little, knowing there are probably other bariatric post-ops who have undiagnosed thyroid conditions.”

Leach believes the secret to her success is as simple as consuming 80 to 100 grams of high-quality protein per day and limiting her simple carbohydrates.

“If I eat half a slice of whole-grain bread or even a few pretzels, in a half-hour I’m starving and
looking for more food,” she said. “Even if they are whole-grain carbohydrates, or fruits and vegetables that are healthy but higher in carbs, I find that I can create hunger for myself.”

Leach has no patience for those who say they can’t follow her lead because of kids or family members. There are no Doritos or Little Debbie snacks in her cupboard. She cooks for her husband much the same as she cooks for herself.

“I never think of my lifestyle as a diet and do in theory give myself permission to have a taste of whatever I want,” she said. “However, I find that I don’t want to eat bad foods. It’s amazing what happens when you remove the diet stigma and just make it part of your lifestyle.

Living life

Originally published Jan. 13, 2007, in Our Town for the Tracy Press.

It’s been almost two years since I had gastric-bypass surgery. And it’s been about six months since I’ve written a column for print. So much has happened in that time. It’s almost too much to detail. But when I think about it, I realize that’s the point.

I had weight-loss surgery so I could live life instead of observe it. And now that I’ve gotten more comfortable in my new body, living it has taken center stage. I’m hardly ever home anymore. When I am, I’m trying to catch my breath from whatever I’ve been doing.

Here’s a brief rundown of what I’ve been doing:

Being a big kid
My husband and I took a trip with his family in December to the “Happiest Place on Earth.” I hadn’t been to Disneyland since Grad Night in high school. Back then, I was 210 pounds — far from my heaviest weight of 335 — but the difference was still amazing.
I was able to enter the park by walking straight through the turnstiles — no need to shuffle sideways to get my hips through the tight space. My rear end fit comfortably in all rides, and I had no trouble lowering the safety bars on my lap.

My husband and I worked our way through all of the rides in Disneyland in a single day. We ran back and forth across the park and stood in line, all without any problem. The only time we took a breather was for meals. And even then, it was just to munch on a protein bar or some beef jerky — no time for a sit-down meal.

We had a blast at California Adventure, riding grown-up rides such as Soaring over California, Mulholland Madness, Tower of Terror, Grizzly River Run and others. I have never laughed so hard in my life. I felt half my age the entire time.

The bonus was my ability to bond with my niece and nephew like never before. Jennavieve, who is 4, doesn’t remember the plus-size Auntie Tonya very well, but she’s never known me as one to play much. When she was an infant and toddler, I was the cuddly one; my husband was the human jungle gym.

At Disneyland, I was able to take her on rides and chase her around. Her brother, Gavin, who turns 2 in March, seemed to get the biggest kick out of me being silly with him. It’s nice to no longer be a bystander in their lives.

Enjoying fresh air
My husband and I spent most of the summer hiking in Mount Diablo State Park. The scenery was incredible at Mount Diablo, and I loved being able to hike for a few hours without needing to stop to catch my breath or rest my joints.

The only break we took was when we realized we had hiked through lunchtime. We sat on some rocks on the edge of the mountain to enjoy a relaxing meal of protein bars and trail mix.
Even my husband commented on the experience, adding that such activities would never have been an option before my surgery.

Knights Ferry is another favorite hiking spot of ours. We take advantage of the park picnic grounds and barbecue lunch in the shade before heading out to explore the golden hills. The trails can be a little dicey. I often choose to descend hills on my hind end, rather than risk tumbling head over hiney.

Meeting inspiring people
I attended various conferences over the summer that addressed issues of morbid obesity and surgical weight loss. I met my bariatric-world hero, Susan Maria Leach, at a surgical conference in San Francisco. She’s the author of “Before and After” and the owner of Before and After Nutrition. Look for a column profiling her in the coming weeks. I saw Carnie Wilson — looking fit and happy — at the same conference. I spoke with surgeons and others whom I never would have had the courage to meet before I had lost weight.

At patient-focused conferences in Tulare and Fairfield, I met other inspiring post-ops and experts in the field. I learned about advances in bariatrics and new developments in the study of side effects. I made some incredible friends and contacts, many of whom have graciously agreed to be sources for upcoming columns and offer different perspectives on the challenges and successes of post-op life.

As you can see, 2006 was a busy year for me. This one shows no signs of being any different, but I wouldn’t have it any other way.

Sweet Drinks Put Kids' Health at Risk

According to a WebMD article, drinking lots of soda and juice sets the stage for health problems later in life for children.

The article, which cites a recent study published in the December issue of "Pediatrics," says children who consume large amounts of surgery drinks may suffer from diabetes and obesity as early as the age of 13.

One nutritionist quoted in the article was quick to say the study doesn't mean that all soda is bad — it's just that kids get too much soda too often.

"There is no kid-sized soda bottle, and few 6-ounce glasses at home," said Leslie Bonci, director of sports nutrition at the University of Pittsburgh Medical Center. "So kids get used to drinking soda in whatever size glass they have at home, whatever size bottle or can -- and that is not a single serving, it's a tureen.

"And no child needs to be consuming a tureen of soda," she says.

She also said that soda and juice is calorie-dense but doesn't fill kids up.

"Nobody drinks half of a 20-ounce bottle of soda and says, 'Whoa, I'm stuffed!'" Bonci says. "The kids consume a lot of calories and are not feeling full. So every other aspect of food intake may stay the same."