Okay, for those of you following my journey, let me tell you about my struggle to get back on track after gaining 7 lbs in 5 days. Yes I went from 223 lbs (2 lbs under my pre-surgery goal weight) to 230 in 5 days. Since then I recommitted to drinking all my water and staying close to the diet. I've done really well. 3 days back on track and I've lost 4 of those lbs already. With any luck it was all water retention and I'll be back to my good old 223 lbs mark early next week. Or maybe a little longer. You never know.
It's nice to know I can fight the cravings and the occasional stress or boredom and come out on top. Yay!
WLS has been such a godsend for me. It's amazing that I can go on a date and hold hands through a movie and know that it's just as exciting for her to hold my hand as it is for me to hold hers. Very unlike before when all I'd do is wonder whether she would accept me as I was and wonder if I should even try to hold her hand. Such a change. Again, yay!
Sean
Weight Loss
My Playlist
Saturday, January 31, 2009
Friday, January 30, 2009
Ability to Control Weight
I work with a woman who had gastric bypass 8 years ago. She initially lost a lot of weight (I saw her pictures) but then gained back a chunk. She took charge and lost the weight again and then had a big emotional event happen in her life. She gained a lot back. Now she's again starting to take charge and get back down.
I relate this story in this forum because that's probably the BIGGEST change I see in myself after having WLS. The fact that I finally have control. Yes, I'm not always perfect. But when I think back on how I was pre-surgery, I wasn't even close. Now I have days when I am perfect (diet-wise) and plenty of days when I am close. I never got and buy a bag of oreos and eat the entire bag or feel like I have to sneak food when people are looking so they won't wonder why I would eat so much or so crappy. I can't eat most of a large pizza before and... when I want I can survive on 1500 or less calories in a day without my body screaming at me or really even feeling deprived.
It's amazing.
But the other reason (in conjunction with the one above) for relating that story is to let everyone know that if you lose your weight and then gain some of it back, you haven't failed. You still have the tool to get back on track and lose again. You are in control. And that might be (if you're anything like me) the sweetest thing you've ever heard.
Sean
I relate this story in this forum because that's probably the BIGGEST change I see in myself after having WLS. The fact that I finally have control. Yes, I'm not always perfect. But when I think back on how I was pre-surgery, I wasn't even close. Now I have days when I am perfect (diet-wise) and plenty of days when I am close. I never got and buy a bag of oreos and eat the entire bag or feel like I have to sneak food when people are looking so they won't wonder why I would eat so much or so crappy. I can't eat most of a large pizza before and... when I want I can survive on 1500 or less calories in a day without my body screaming at me or really even feeling deprived.
It's amazing.
But the other reason (in conjunction with the one above) for relating that story is to let everyone know that if you lose your weight and then gain some of it back, you haven't failed. You still have the tool to get back on track and lose again. You are in control. And that might be (if you're anything like me) the sweetest thing you've ever heard.
Sean
Thursday, January 29, 2009
Re-Committed
On Friday, January 23, 2009, I weighed myself in the morning and came in at a stellar 223.2 lbs. Over the next four days I gained 7 lbs. Yes, that's right, 7 lbs!!! I weighed on Tuesday, January 27, 2009 at 230.2 lbs. How can I gain 7 lbs in 4 days? That's a good question. It freaks me out everytime I see a fluctuation like that but I always know what causes it.
1. Poor diet. I wrote about this in an earlier blog (titled: Snacking). I was horrible for about a week or so. It ALWAYS takes time to show up.
2. Low Water. Yes, for the same week where my diet was poor, I wasn't drinking even close to the 64 ounce mark.
I know some of the weight gain is from water retention. Here are my steps to reversing what has happened (I always do this when this type of fluctuation happens):
The first step was to commit to myself that I wouldn't snack on sweets anymore. Today was day 1. Did it!! Woo-hoo! I had a really good day diet-wise. No sweets and pretty near perfect.
The second step is to increase my water intake. I did really well. I drank 80+ ounces today (32 ounces by 10am in the morning). I've already started shedding some of the retained water. By keeping up on my water, I help control my appetite as well.
I expect that it will take about a week to 10 days to get back down to where I was but I know I can do it. I'll keep you updated.
Sean
1. Poor diet. I wrote about this in an earlier blog (titled: Snacking). I was horrible for about a week or so. It ALWAYS takes time to show up.
2. Low Water. Yes, for the same week where my diet was poor, I wasn't drinking even close to the 64 ounce mark.
I know some of the weight gain is from water retention. Here are my steps to reversing what has happened (I always do this when this type of fluctuation happens):
The first step was to commit to myself that I wouldn't snack on sweets anymore. Today was day 1. Did it!! Woo-hoo! I had a really good day diet-wise. No sweets and pretty near perfect.
The second step is to increase my water intake. I did really well. I drank 80+ ounces today (32 ounces by 10am in the morning). I've already started shedding some of the retained water. By keeping up on my water, I help control my appetite as well.
I expect that it will take about a week to 10 days to get back down to where I was but I know I can do it. I'll keep you updated.
Sean
Wednesday, January 28, 2009
Thiamine Deficiency (Memory Loss/Dry BeriBeri)
Some of my fellow gastric bypass patients once had a discussion related to a burning type sensation they were having in their feet and lower legs. As we discussed and researched this, it was theorized that perhaps this might be a symptom of dry beriberi which is caused by a deficiency of the vitamin B1 (or Thiamine). One such patient had her blood tested prior to this discussion and had informed her surgeon's office that her B1 levels were low. She was told that she didn't need to be overly concerned. Being the go-getter that she is, after our discussion she brought the issue up with her primary care physician. He confirmed the dry beriberi and worked with her to normalize her B1 levels and the problem went away. Dry BeriBeri is rarely fatal but it can cause partial paralysis due to damage of the peripheral nerves.
Recently I have heard discussions regarding memory loss. The person who brought this issue up has been concerned. His surgeon's office responded to his inquiry by telling him that this was most likely caused by a B12 deficiency. He remarked that his B12 levels were fine. While without having his blood tested, there's no way to know for sure, I suggest that this is another case where a Thiamine deficiency can be the culprit.
In fact, according to US researchers, gastric bypass can lead to a B1 vitamin deficiency that can cause memory loss and confusion and an inability to coordinate movement. Known as thiamine, vitamin B1 is essential for carbohydrate metabolism and normal functioning of the nervous system. People who are most at risk for B1 deficiency are those who frequently vomit after having gastric bypass surgery as vomiting prevents the vitamins from being absorbed into the system. If untreated vitamin B1 deficiency can lead to Wernicke encephalopathy, a severe neurological condition.
I am not sure why surgeons who perform gastric bypass operations do not track B1 vitamin levels. Perhaps because B1 deficiencies are not as common as B12, vitamin D or Calcium deficiencies. However, a B1 deficiency can be more devestating due to its neurological impact especially if it develops into Wernicke encephalopathy which if left unchecked it can potentially lead to coma and death.
So PLEASE, Please, please have your blood work checked regularly and always insist on making sure your B1 (Thiamine) level is checked. If it is deficient your primary care physician can help you. Vitamin deficiency of any kind is a danger.
Sean
Recently I have heard discussions regarding memory loss. The person who brought this issue up has been concerned. His surgeon's office responded to his inquiry by telling him that this was most likely caused by a B12 deficiency. He remarked that his B12 levels were fine. While without having his blood tested, there's no way to know for sure, I suggest that this is another case where a Thiamine deficiency can be the culprit.
In fact, according to US researchers, gastric bypass can lead to a B1 vitamin deficiency that can cause memory loss and confusion and an inability to coordinate movement. Known as thiamine, vitamin B1 is essential for carbohydrate metabolism and normal functioning of the nervous system. People who are most at risk for B1 deficiency are those who frequently vomit after having gastric bypass surgery as vomiting prevents the vitamins from being absorbed into the system. If untreated vitamin B1 deficiency can lead to Wernicke encephalopathy, a severe neurological condition.
I am not sure why surgeons who perform gastric bypass operations do not track B1 vitamin levels. Perhaps because B1 deficiencies are not as common as B12, vitamin D or Calcium deficiencies. However, a B1 deficiency can be more devestating due to its neurological impact especially if it develops into Wernicke encephalopathy which if left unchecked it can potentially lead to coma and death.
So PLEASE, Please, please have your blood work checked regularly and always insist on making sure your B1 (Thiamine) level is checked. If it is deficient your primary care physician can help you. Vitamin deficiency of any kind is a danger.
Sean
Tuesday, January 27, 2009
Exercise
Ah! I didn't want to tell anyone this in case it set a bad example for someone but I don't exercise a lot. Yes, I've lost 250 lbs without much exercise. Yes, I do move a ton more. In essence I really do get a lot more exercise than when I was at my highest weight but still...
I do eat a lot of protein which helps so I don't lose a lot of muscle mass but now that I'm down to my initial goal weight, now I need to exercise to tone up my muscles and help augment my soon to be plastic surgery.
Plus... if you see my post about snacking below, you'll know why it's important to exercise. It has to be a life change as well as with the eating. The reason? Sure I've lost a ton of weight (1/8 of a ton actually) in just 21 months but I want to keep the weight off for as long as I live (which hopefully will be another 40 or so years).
Anyway, that's my two cents worth!
I do eat a lot of protein which helps so I don't lose a lot of muscle mass but now that I'm down to my initial goal weight, now I need to exercise to tone up my muscles and help augment my soon to be plastic surgery.
Plus... if you see my post about snacking below, you'll know why it's important to exercise. It has to be a life change as well as with the eating. The reason? Sure I've lost a ton of weight (1/8 of a ton actually) in just 21 months but I want to keep the weight off for as long as I live (which hopefully will be another 40 or so years).
Anyway, that's my two cents worth!
Snacking
I'm driving myself crazy. My work (which is in the field of healthcare [this is the ironic part]) has all kinds of sweets and carbonated drinks around (for free!). I don't have an issue with the soda but my job is stress filled on most days and so try as I might I always end up grazing a little. So far it hasn't hurt me but I keep thinking ... if I don't get this under control, it will doom me in the end.
I know, a little negative thinking but....
In talking to another RMAP patient about this, she related a story told by her surgeon, Dr. McKinley. He told her about the only person he had ever seen who gained all her weight back. Apparently it happened because she was eating about 5 lbs of peanut M&Ms every day. If I remember the story correct, that's about all she ate. A little at a time but all day long. As I think about that my inner voice tells me that I desperately need to get a handle on this because it's just a little now but it has the potential to grow into a bigger problem as time goes on. If it's hard to handle now, how much more difficult will it be down the road?
Wish me luck!
I know, a little negative thinking but....
In talking to another RMAP patient about this, she related a story told by her surgeon, Dr. McKinley. He told her about the only person he had ever seen who gained all her weight back. Apparently it happened because she was eating about 5 lbs of peanut M&Ms every day. If I remember the story correct, that's about all she ate. A little at a time but all day long. As I think about that my inner voice tells me that I desperately need to get a handle on this because it's just a little now but it has the potential to grow into a bigger problem as time goes on. If it's hard to handle now, how much more difficult will it be down the road?
Wish me luck!
Sunday, January 25, 2009
10 Top Tips
With WLS, the ability to lose weight finally becomes a battle that we not only can win but that is easier to win than I ever imagined. Here is my breakdown on how losing 250 lbs (for me) happened so easily (21 months).
1) Get into a routine. I stopped trying to think of food as exciting and taught myself to think of it as fuel for my body. I quickly learned that if food was boring and just something I had to eat in order to fuel my body, I didn't have the cravings.
2) Water. Pushing water between meals helps curb your appetite and keep you from eating too soon after each meal. Setting times for when you have to drink a certain amount of water helps, as does carrying water with you everywhere you go.
3) Types of Food. After about 3-4 months, start looking for foods that curb your appetite longer. For me, beef jerky and nuts were great for this. This gets more and more important as you get further and further out from your surgery.
4) Preparation/Grocery Shopping. We all have those times when we're super hungry and during those times it's much more difficult to stay away from eating the wrong thing. It's great if you can prepare your food, especially if you can freeze it for quick use later. However, don't find yourself unprepared. Have quick things like beef jerky, nuts, protein bars on hand for those times when preparation isn't possible. If you use them, be wise in your choice of protein bars. Atkins Advantage (Double Chocolate Crunch - yum!) are my favorite but High Protein Slim Fast are also good (the Peanut Granola, not the Chocolate -- trust me). And don't go grocery shopping hungry. Ever.
5) Exercise. Some people love to exercise, some don't. It's just the way it is. Like some people love purple but others hate it. But even if you don't like to formally exercise, do yourself a favor and move as much as possible during the day. Make it a point to park far away from the store or mall when you go shopping or far away when you go to work. Whenever you find yourself saying "oh I'll do that later" because you don't want to get up to do something (like perhaps get the laundry out of the dryer), make yourself just get up and do it. Move, move, move. As much as possible all day long.
6) Bad Days. Even after WLS, you'll have bad days. Especially as you get farther out from surgery. DON'T worry about it. It happens to everyone. Just chalk it up to a bad day, focus on how successful you've been so far, and recommit to doing better the next day.
7) Carb Addictions. There will also be periods where you will eat the wrong types of carbs (pasta, bread, sweets). Perhaps for a few days in a row. Those slips should be few and far between but you need to be realistic. They will happen. The important thing is to realize that when you have those slip ups, it's HARD to get back on track because your body is addicted to simple carbs. And when you start trying to get back on track, your body goes through withdrawals. For me, getting back on track after that is a process. I try to be perfect from day one but realistically it's usually day 3 before I get back to where I should be. I do better on day one than during the slip up and better on day two than on day three. Just keep that in mind and don't get discouraged as you try to get back on track. Discouragement just leads to failure. Think about what you've done so far, be proud of yourself, and know that you are now the one in control.
(8) Malabsorption. Okay, we all know this one. We've talked about it a lot. Don't mess around with it. Get your multi vitamin in. Push water every day so you can take your calcium (preferrably with Vitamin D). Take your daily B12 supplement. Don't take your calcium and multi-vitamin (or iron) at the same time. And never justify eating the wrong thing by saying "that's okay, my body won't absorb it all."
9) Revel in your Weight Loss. I've read a lot of posts about how hard it is when eating with your family or friends and not being able to enjoy the meal or feeling a little out of place. Stop thinking of it like that. How many of us know that skinny person who is the one in the crowd who doesn't eat sweets while everyone else is? Or perhaps the vegetarian who doesn't join in when everyone else is eating because there's nothing for them to eat? This is you now. It doesn't matter what you tell them, you don't really even need to explain. Personally, I like being seen as the skinny person who doesn't indulge and who is in control of what I eat and when. It doesn't offend anyone when I don't eat. They sometimes try to talk me into it but they respect me so much when I stand by what I know is best for me.
10) Your new body. Spend time each day noticing the changes in your body. Can you see your collar bone? How about your hands and feet? Are you noticing veins and bones there that you never saw before? Are you kneecaps more visible? How about your jawline? Can you feel your lymphnodes? Did you think they were tumors? How much easier is it for you to move? Does it excite you to be able to jog (or even walk) up a flight of stairs and notice that you no longer feel like you're about to have a coronary? When you lay down, is your stomach flat now whereas before it wasn't? Even if you noticed things the day before, spend time every day marveling in the changes.
Enjoy every day of the journey.
Sean
1) Get into a routine. I stopped trying to think of food as exciting and taught myself to think of it as fuel for my body. I quickly learned that if food was boring and just something I had to eat in order to fuel my body, I didn't have the cravings.
2) Water. Pushing water between meals helps curb your appetite and keep you from eating too soon after each meal. Setting times for when you have to drink a certain amount of water helps, as does carrying water with you everywhere you go.
3) Types of Food. After about 3-4 months, start looking for foods that curb your appetite longer. For me, beef jerky and nuts were great for this. This gets more and more important as you get further and further out from your surgery.
4) Preparation/Grocery Shopping. We all have those times when we're super hungry and during those times it's much more difficult to stay away from eating the wrong thing. It's great if you can prepare your food, especially if you can freeze it for quick use later. However, don't find yourself unprepared. Have quick things like beef jerky, nuts, protein bars on hand for those times when preparation isn't possible. If you use them, be wise in your choice of protein bars. Atkins Advantage (Double Chocolate Crunch - yum!) are my favorite but High Protein Slim Fast are also good (the Peanut Granola, not the Chocolate -- trust me). And don't go grocery shopping hungry. Ever.
5) Exercise. Some people love to exercise, some don't. It's just the way it is. Like some people love purple but others hate it. But even if you don't like to formally exercise, do yourself a favor and move as much as possible during the day. Make it a point to park far away from the store or mall when you go shopping or far away when you go to work. Whenever you find yourself saying "oh I'll do that later" because you don't want to get up to do something (like perhaps get the laundry out of the dryer), make yourself just get up and do it. Move, move, move. As much as possible all day long.
6) Bad Days. Even after WLS, you'll have bad days. Especially as you get farther out from surgery. DON'T worry about it. It happens to everyone. Just chalk it up to a bad day, focus on how successful you've been so far, and recommit to doing better the next day.
7) Carb Addictions. There will also be periods where you will eat the wrong types of carbs (pasta, bread, sweets). Perhaps for a few days in a row. Those slips should be few and far between but you need to be realistic. They will happen. The important thing is to realize that when you have those slip ups, it's HARD to get back on track because your body is addicted to simple carbs. And when you start trying to get back on track, your body goes through withdrawals. For me, getting back on track after that is a process. I try to be perfect from day one but realistically it's usually day 3 before I get back to where I should be. I do better on day one than during the slip up and better on day two than on day three. Just keep that in mind and don't get discouraged as you try to get back on track. Discouragement just leads to failure. Think about what you've done so far, be proud of yourself, and know that you are now the one in control.
(8) Malabsorption. Okay, we all know this one. We've talked about it a lot. Don't mess around with it. Get your multi vitamin in. Push water every day so you can take your calcium (preferrably with Vitamin D). Take your daily B12 supplement. Don't take your calcium and multi-vitamin (or iron) at the same time. And never justify eating the wrong thing by saying "that's okay, my body won't absorb it all."
9) Revel in your Weight Loss. I've read a lot of posts about how hard it is when eating with your family or friends and not being able to enjoy the meal or feeling a little out of place. Stop thinking of it like that. How many of us know that skinny person who is the one in the crowd who doesn't eat sweets while everyone else is? Or perhaps the vegetarian who doesn't join in when everyone else is eating because there's nothing for them to eat? This is you now. It doesn't matter what you tell them, you don't really even need to explain. Personally, I like being seen as the skinny person who doesn't indulge and who is in control of what I eat and when. It doesn't offend anyone when I don't eat. They sometimes try to talk me into it but they respect me so much when I stand by what I know is best for me.
10) Your new body. Spend time each day noticing the changes in your body. Can you see your collar bone? How about your hands and feet? Are you noticing veins and bones there that you never saw before? Are you kneecaps more visible? How about your jawline? Can you feel your lymphnodes? Did you think they were tumors? How much easier is it for you to move? Does it excite you to be able to jog (or even walk) up a flight of stairs and notice that you no longer feel like you're about to have a coronary? When you lay down, is your stomach flat now whereas before it wasn't? Even if you noticed things the day before, spend time every day marveling in the changes.
Enjoy every day of the journey.
Sean
Saturday, January 24, 2009
Sugar, Sugar, Sugar
Okay, so I'm going to let the secret out of the bag. I don't have the dumping syndrome. I've known it since about my third month after my surgery. I've still done fantastic but it bothers me that I can't completely cut sugar out of my life.
So today I went to the movies with my daughter. We stopped by the store and bought some candy out of the candy bins and took it with us. I knew I was going to eat some but I ended up eating enough that I got a severe pain in my gut. I got up and walked out of the theater for awhile but ultimately it took time for the pain to go away.
Argh!!! I'm telling you this so you will always know that NO ONE is perfect. We are all going to screw up. I know I need to learn from this (I've done it before too) and I need to remember that I have control enough to change this behavior. We can all change, work every day towards being better, and reach the goals we have for ourselves.
So today I went to the movies with my daughter. We stopped by the store and bought some candy out of the candy bins and took it with us. I knew I was going to eat some but I ended up eating enough that I got a severe pain in my gut. I got up and walked out of the theater for awhile but ultimately it took time for the pain to go away.
Argh!!! I'm telling you this so you will always know that NO ONE is perfect. We are all going to screw up. I know I need to learn from this (I've done it before too) and I need to remember that I have control enough to change this behavior. We can all change, work every day towards being better, and reach the goals we have for ourselves.
Thursday, January 22, 2009
DATING EXPERIENCE
I'm now at the point where I have a lot of confidence and so I started dating. My real complex is about all the loose skin but in clothes you can't really tell other than I do have more of a roll (because of the excess skin) around the middle that you can kind of see (it just makes me look bigger than I really am).
Anyway, so I met this girl I really really liked. Her name is Stacy. We really hit things off but when she found out about the surgery and the loose skin, things got cold really fast. She didn't want to come off as shallow so at first she just stopped having so much contact with me. Then when I told her I knew something was up and I just wanted a little honesty, she came up with another reason to make it sound like it was all about me.
At first I was a little hurt but then I realized what I've learned through this weight loss journey. It's all about me. I have a lot to give someone and if she doesn't realize that it's her loss. If she is that shallow and dishonest then I'm better off without her. Why would I want to put energy into a relationship with a person like that?
It's better to learn these things about people upfront. And keep aware of the warning signs. If they're obsessed with weight, if they say negative things about heavy people, these are not the type of people with whom you really want to have a relationship.
In this particular case the kicker for me was the dishonesty. If you can't be upfront and honest with someone at the beginning of a relationship, do we really delude ourselves into thinking that once we get into the relationship that magically that's suddenly going to change and happen differently? No. It just gets harder as you get further into the relationship. The fact that she just gave me the cold shoulder rather than communicating what was going on speaks volumes about where she's at as a person.
So I'm glad I learned these things about her in the beginning because it would have just been more difficult to end things down the road.I wish Stacy the best. She's fun. I have no doubt that she will find someone that's perfect for her and her little boy. It's just not me. I need someone with a little more depth and honesty.
Sean
Anyway, so I met this girl I really really liked. Her name is Stacy. We really hit things off but when she found out about the surgery and the loose skin, things got cold really fast. She didn't want to come off as shallow so at first she just stopped having so much contact with me. Then when I told her I knew something was up and I just wanted a little honesty, she came up with another reason to make it sound like it was all about me.
At first I was a little hurt but then I realized what I've learned through this weight loss journey. It's all about me. I have a lot to give someone and if she doesn't realize that it's her loss. If she is that shallow and dishonest then I'm better off without her. Why would I want to put energy into a relationship with a person like that?
It's better to learn these things about people upfront. And keep aware of the warning signs. If they're obsessed with weight, if they say negative things about heavy people, these are not the type of people with whom you really want to have a relationship.
In this particular case the kicker for me was the dishonesty. If you can't be upfront and honest with someone at the beginning of a relationship, do we really delude ourselves into thinking that once we get into the relationship that magically that's suddenly going to change and happen differently? No. It just gets harder as you get further into the relationship. The fact that she just gave me the cold shoulder rather than communicating what was going on speaks volumes about where she's at as a person.
So I'm glad I learned these things about her in the beginning because it would have just been more difficult to end things down the road.I wish Stacy the best. She's fun. I have no doubt that she will find someone that's perfect for her and her little boy. It's just not me. I need someone with a little more depth and honesty.
Sean
Tuesday, January 20, 2009
Goal Weight
Over the past couple of days my weight has fluctuated between 223.8 and 224.2. I wanted to wait until I was sure I was under the 225 barrier before posting this. I'm excited. I'm now down to my goal weight of 225. That's the goal I set in March 2007 about six weeks before surgery.
One of the main things I tell my fellow gastric bypass patients is that you can get to whatever realistic goal you set for yourself. It's easy to panic when you hit a plateau and wonder if you are done losing weight. We've all done it. But logically if you just figure out how many calories it takes to run your body over the course of a normal day and then you figure out how many calories you are eating, you quickly realize that as long as you are eating less than you are burning, you are going to lose weight.
Of course then it becomes important to figure out what your body is going to burn. Is it going to eat muscle? That's what it would like to burn because its the easiest. It takes effort for your body to burn fat. So you have to keep up with your protein levels and this is a huge reason why some type of exercise is important as well. But if your body isn't eating your muscles and the calorie deficit is there, it's going to eat your fat. Yay!
I still have issues with giving in and eating the wrong thing here and there but it's a million times better than it was before surgery. I can't believe what a new lease on life I have been given. I'm not going to waste this new life, I'm going to enjoy it as much as possible.
Sean
One of the main things I tell my fellow gastric bypass patients is that you can get to whatever realistic goal you set for yourself. It's easy to panic when you hit a plateau and wonder if you are done losing weight. We've all done it. But logically if you just figure out how many calories it takes to run your body over the course of a normal day and then you figure out how many calories you are eating, you quickly realize that as long as you are eating less than you are burning, you are going to lose weight.
Of course then it becomes important to figure out what your body is going to burn. Is it going to eat muscle? That's what it would like to burn because its the easiest. It takes effort for your body to burn fat. So you have to keep up with your protein levels and this is a huge reason why some type of exercise is important as well. But if your body isn't eating your muscles and the calorie deficit is there, it's going to eat your fat. Yay!
I still have issues with giving in and eating the wrong thing here and there but it's a million times better than it was before surgery. I can't believe what a new lease on life I have been given. I'm not going to waste this new life, I'm going to enjoy it as much as possible.
Sean
Monday, January 19, 2009
Why Is Water Important?
Many gastric bypass patients were not good at hydrating themselves before surgery and now, when it's near impossible to drink much at any given time, they find themselves drinking less than before. Why is water so important?
We won't get into the obvious which is that every part of your body including your organs depends on proper hydration. It is dangerous not to keep your body properly hydrated. Instead I'll touch on just a few areas. If any of you have additional things you'd like to say on this subject, please add comments.
Water is the best weight loss drug ever invented. Okay so it wasn't really invented. But during my weight loss journey, every time I hit a plateau, the way off was increasing my water intake. Everytime I hit a plateau it was because I wasn't drinking enough water (well, except for one, but that was because I had replaced my water and propel flavored water with vitamin water which is evil water). Think about it. If you are drinking enough water between meals, you aren't going to be as hungry. You are keeping your pouch moist and your body hydrated. This increases your health, benefits your sleeping, etc. Plus, it helps flush out your system. When you dehydrate yourself, your body retains water. When you drink tons, your body lets all of that out -- which doesn't just contain retained water but everything that was trapped in there with the water. And I didn't even mention that when your body is properly hydrated so is your skin. That helps it tighten to the biggest extent possible. And we all know we want that.
How to get your water in every day. This is a common complaint amongst gastric bypass patients. I've heard all kinds of justifications and excuses. What it comes down to is this: just do it! I had a hard time up front. Some days I don't make the conscious effort and still don't get enough water in. You have to be committed but the benefits are so worth it. What I did to get myself on track was to purchase a see through 32 ounce bottle from REI. I even bought a splash guard to make it easier to drink from. Here's my schedule (adjust the time to fit yours):
6am: breakfast
6:30-10:30am: 20-32 ounces of water
11:00am: lunch
11:30am-3:30pm: 20 ounces of water
4:00pm: snack
4:30pm-6:30pm: 20 ounces of water
7:00pm: dinner
7:30pm-bedtime: 20 ounces of water
For me, I sometimes switch around the snack and dinner. On occasion I might even add another snack before bedtime (depending on how late I stay up). But by knowing I need to break my water up like this, having clear cut goals that are based on how much water before a certain time of day, really helps. Am I perfect with this? Not even. But my water bottle has the measurements on the side, I can see the water level and I carry it with me EVERYWHERE. It helps, I promise.
Sean
We won't get into the obvious which is that every part of your body including your organs depends on proper hydration. It is dangerous not to keep your body properly hydrated. Instead I'll touch on just a few areas. If any of you have additional things you'd like to say on this subject, please add comments.
Water is the best weight loss drug ever invented. Okay so it wasn't really invented. But during my weight loss journey, every time I hit a plateau, the way off was increasing my water intake. Everytime I hit a plateau it was because I wasn't drinking enough water (well, except for one, but that was because I had replaced my water and propel flavored water with vitamin water which is evil water). Think about it. If you are drinking enough water between meals, you aren't going to be as hungry. You are keeping your pouch moist and your body hydrated. This increases your health, benefits your sleeping, etc. Plus, it helps flush out your system. When you dehydrate yourself, your body retains water. When you drink tons, your body lets all of that out -- which doesn't just contain retained water but everything that was trapped in there with the water. And I didn't even mention that when your body is properly hydrated so is your skin. That helps it tighten to the biggest extent possible. And we all know we want that.
How to get your water in every day. This is a common complaint amongst gastric bypass patients. I've heard all kinds of justifications and excuses. What it comes down to is this: just do it! I had a hard time up front. Some days I don't make the conscious effort and still don't get enough water in. You have to be committed but the benefits are so worth it. What I did to get myself on track was to purchase a see through 32 ounce bottle from REI. I even bought a splash guard to make it easier to drink from. Here's my schedule (adjust the time to fit yours):
6am: breakfast
6:30-10:30am: 20-32 ounces of water
11:00am: lunch
11:30am-3:30pm: 20 ounces of water
4:00pm: snack
4:30pm-6:30pm: 20 ounces of water
7:00pm: dinner
7:30pm-bedtime: 20 ounces of water
For me, I sometimes switch around the snack and dinner. On occasion I might even add another snack before bedtime (depending on how late I stay up). But by knowing I need to break my water up like this, having clear cut goals that are based on how much water before a certain time of day, really helps. Am I perfect with this? Not even. But my water bottle has the measurements on the side, I can see the water level and I carry it with me EVERYWHERE. It helps, I promise.
Sean
Finding Balance
A DEAR FRIEND ONCE WROTE:
I know that there are many on here who have found themselves in the role of caretaker for other members of your family. I am finding this to be the case for me in a big way. The problem I have is that it puts me in a situation where I start to neglect myself in order to help someone else. Don't get me wrong - there isn't anything I would rather do, than be there for my family.
That being said, I think it is also important to stay focused on my own goal as well. My question for anyone who would like to give input, is what has worked for you to find the balance? . . to serve where needed and still meet your own needs too? I am open to any suggestions. I know there is a lot of wisdom out there.
Please share, I value what you have to say.
MY RESPONSE MIGHT COME ACROSS A BIT HARSH BUT IT WAS WRITTEN FROM MY HEART. IT WAS MY HOPE TO HELP MY FRIEND:
I find this question is quite common. It comes down to this. When you are morbidly obese, the tendency is to take care of others because you don't often find that you're loveable as you are.
One of the best things you can learn to do as you lose weight is to come to the realization that you have to put yourself first. If you don't put yourself first and treat yourself right, then you can't be the best person for those you care about.
Now when I say put yourself first, I don't mean you have to neglect anyone. But it's about taking care of yourself, making sure you are healthy in all aspects, then taking on the care of others. I realize this can be a hard transition but I guarantee it will make your life healthier and your family's life healthier. As you have learned to neglect yourself, your family has come to think it's normal to have someone neglect themselves for them. That's not a good thing.
Be healthy yourself, take care of yourself and then you have a greater capacity to provide for others.
Sean
I know that there are many on here who have found themselves in the role of caretaker for other members of your family. I am finding this to be the case for me in a big way. The problem I have is that it puts me in a situation where I start to neglect myself in order to help someone else. Don't get me wrong - there isn't anything I would rather do, than be there for my family.
That being said, I think it is also important to stay focused on my own goal as well. My question for anyone who would like to give input, is what has worked for you to find the balance? . . to serve where needed and still meet your own needs too? I am open to any suggestions. I know there is a lot of wisdom out there.
Please share, I value what you have to say.
MY RESPONSE MIGHT COME ACROSS A BIT HARSH BUT IT WAS WRITTEN FROM MY HEART. IT WAS MY HOPE TO HELP MY FRIEND:
I find this question is quite common. It comes down to this. When you are morbidly obese, the tendency is to take care of others because you don't often find that you're loveable as you are.
One of the best things you can learn to do as you lose weight is to come to the realization that you have to put yourself first. If you don't put yourself first and treat yourself right, then you can't be the best person for those you care about.
Now when I say put yourself first, I don't mean you have to neglect anyone. But it's about taking care of yourself, making sure you are healthy in all aspects, then taking on the care of others. I realize this can be a hard transition but I guarantee it will make your life healthier and your family's life healthier. As you have learned to neglect yourself, your family has come to think it's normal to have someone neglect themselves for them. That's not a good thing.
Be healthy yourself, take care of yourself and then you have a greater capacity to provide for others.
Sean
Long-Term RNY/Gastric Bypass Complications?
ONE GASTRIC BYPASS PATIENT ASKED"
What are the main complications with RNY/gastric bypass long-term?
It would seem that the malabsorption issue could affect osteoporosis rates for instance due to less calcium being absorbed. I understand the need for supplementation i.e. calcium, iron, b vitamins, etc... to help prevent peripheral neuropathy, anemia, osteoporosis.
What I am trying to ask is what are the observed long-term complications with gastric bypass i.e. more than 10 years out? It seems that gastric procedures are becoming more common place to perform. I understand RMAP did at least one published study. What increased risk for osteoporosis is there? I am asking in part due to evidence showing up that the biphosphonates (i.e. alendronate AKA Fosamax) can cause osteonecrosis of the jaw.
Another concern would be fish oil. Fish oil has been touted to help with cardiac (heart healthy) and other applications as well. Do doctors simply increase the recommended dose for medications that are not well absorbed? I can think of levothyroxine (thyroid medication) and others that simply can be ordered in an increased dose based on lab work. Are providers recommending taking medications such as iron or others that need a more acidic environment to absorb well to take vitamin c with those medications? I am trying to look up medical articles about this and will post if I can find useful information.
THE INITIAL REPLY:
Here is the link to the article that was published in the New England Journal or Medicine. http://content.nejm.org/cgi/content/full/357/8/753 After reviewing your e mail with Dr. ******* he wanted to mention: The main long-term complications we see in Gastric Bypass is a deficiency in thiamine, folate, B-12 if patients do not follow the guidelines and do not take their supplements. I'm not aware of any evidence to show increase in osteoporosis- more research is needed. Fish oil and other supplements should be well absorbed in usual doses. More recent iron supplements such as Repliva have better absorption because of acidic supplement in tablets. I hope this answers your questions.
I WANTED TO ADD ON TO THAT:
For what it's worth:
* The body normally doesn't do a good job of calcium absorption. With gastric bypass patients, obviously that is even more true. With that said, it is important to keep up with your calcium after the surgery. If you do not, calcium deficiency can occur. When that happens, your body pulls the calcium it needs from your bones and teeth and the result can be osteoporosis. So yes, you are at more of a risk. But only if you don't follow the guidelines set forth. If you take your calcium as you are instructed, you'll be fine.
* I find that as long as I take my supplements (all supplements), my levels are fine. I apply that logic to your question on Fish oil. I'm a big believer in taking usual doses unless it turns out that you need to add a bit more. But you find that out by how well you end up absorbing the B12 and other supplements that you check periodically. For example, I know many who take 1,000mcg of B12 daily to keep their levels up. Me, I only take 500 mcg 3-4 times a week and my levels are very high (as they should be). Of course that most likely has to do with how much B12 I get in my daily diet.
I think you get my jist here. All in all the surgery is the best thing I have ever done for myself. If I had a choice to do it again or go a different route, I would do it again in a heartbeat. No hesitation whatsoever.
Sean
What are the main complications with RNY/gastric bypass long-term?
It would seem that the malabsorption issue could affect osteoporosis rates for instance due to less calcium being absorbed. I understand the need for supplementation i.e. calcium, iron, b vitamins, etc... to help prevent peripheral neuropathy, anemia, osteoporosis.
What I am trying to ask is what are the observed long-term complications with gastric bypass i.e. more than 10 years out? It seems that gastric procedures are becoming more common place to perform. I understand RMAP did at least one published study. What increased risk for osteoporosis is there? I am asking in part due to evidence showing up that the biphosphonates (i.e. alendronate AKA Fosamax) can cause osteonecrosis of the jaw.
Another concern would be fish oil. Fish oil has been touted to help with cardiac (heart healthy) and other applications as well. Do doctors simply increase the recommended dose for medications that are not well absorbed? I can think of levothyroxine (thyroid medication) and others that simply can be ordered in an increased dose based on lab work. Are providers recommending taking medications such as iron or others that need a more acidic environment to absorb well to take vitamin c with those medications? I am trying to look up medical articles about this and will post if I can find useful information.
THE INITIAL REPLY:
Here is the link to the article that was published in the New England Journal or Medicine. http://content.nejm.org/cgi/content/full/357/8/753 After reviewing your e mail with Dr. ******* he wanted to mention: The main long-term complications we see in Gastric Bypass is a deficiency in thiamine, folate, B-12 if patients do not follow the guidelines and do not take their supplements. I'm not aware of any evidence to show increase in osteoporosis- more research is needed. Fish oil and other supplements should be well absorbed in usual doses. More recent iron supplements such as Repliva have better absorption because of acidic supplement in tablets. I hope this answers your questions.
I WANTED TO ADD ON TO THAT:
For what it's worth:
* The body normally doesn't do a good job of calcium absorption. With gastric bypass patients, obviously that is even more true. With that said, it is important to keep up with your calcium after the surgery. If you do not, calcium deficiency can occur. When that happens, your body pulls the calcium it needs from your bones and teeth and the result can be osteoporosis. So yes, you are at more of a risk. But only if you don't follow the guidelines set forth. If you take your calcium as you are instructed, you'll be fine.
* I find that as long as I take my supplements (all supplements), my levels are fine. I apply that logic to your question on Fish oil. I'm a big believer in taking usual doses unless it turns out that you need to add a bit more. But you find that out by how well you end up absorbing the B12 and other supplements that you check periodically. For example, I know many who take 1,000mcg of B12 daily to keep their levels up. Me, I only take 500 mcg 3-4 times a week and my levels are very high (as they should be). Of course that most likely has to do with how much B12 I get in my daily diet.
I think you get my jist here. All in all the surgery is the best thing I have ever done for myself. If I had a choice to do it again or go a different route, I would do it again in a heartbeat. No hesitation whatsoever.
Sean
Calcium Absorption
I once ran across advice from a surgeon's nurse (name withheld) who said this about calcium:
"Taking more than 500mg at a time will not harm you, you just won't absorb anymore than that amount. The reason the doctor's say 1,200-1,600mg is because it comes in different forms, which comes in different dosages. We want you to take Calcium Citrate in the form that you feel comfortable. If that's cutting tablets into smaller halves, or chewable."
To her advice, a gastric bypass patient responded fearfully:
"Oh dear, I've been taking 600 mg's at a time for the past 5 months, when Dr Smith said I could start taking it! Have I done any damage or if I correct it now, will I be ok??? So the 1200 mg's a day is just the minimum, is it better to take more or is the 1200 enough? Thanks for the info. I feel horrible that I've been taking too much at a time and have only been getting 1000 mg's a day instead of 1200!! But now I know!"
I really wanted to put her at ease so I responded:
"Most of us take calcium citrate in pills that come 300mg each and the recommended amount on the bottle is 600mg per dose. It's not going to kill you to take 600mg just keep in mind that your body only absorbs a certain amount. And since we're on the topic of absorption, your body isn't going to absorb the entire 500mg or 600mg anyway. Our bodies are very inefficient at absorbing calcium. The reason why it's recommended to take Vitamin D with the calcium is to help with the absorption. Keep taking your two pills 2-3 times a day."
Sean
"Taking more than 500mg at a time will not harm you, you just won't absorb anymore than that amount. The reason the doctor's say 1,200-1,600mg is because it comes in different forms, which comes in different dosages. We want you to take Calcium Citrate in the form that you feel comfortable. If that's cutting tablets into smaller halves, or chewable."
To her advice, a gastric bypass patient responded fearfully:
"Oh dear, I've been taking 600 mg's at a time for the past 5 months, when Dr Smith said I could start taking it! Have I done any damage or if I correct it now, will I be ok??? So the 1200 mg's a day is just the minimum, is it better to take more or is the 1200 enough? Thanks for the info. I feel horrible that I've been taking too much at a time and have only been getting 1000 mg's a day instead of 1200!! But now I know!"
I really wanted to put her at ease so I responded:
"Most of us take calcium citrate in pills that come 300mg each and the recommended amount on the bottle is 600mg per dose. It's not going to kill you to take 600mg just keep in mind that your body only absorbs a certain amount. And since we're on the topic of absorption, your body isn't going to absorb the entire 500mg or 600mg anyway. Our bodies are very inefficient at absorbing calcium. The reason why it's recommended to take Vitamin D with the calcium is to help with the absorption. Keep taking your two pills 2-3 times a day."
Sean
How Often Should I Weigh?
This is something I posted awhile back on the RMAP website. Fortunately I saved it.
When I was 474.1 lbs, it was ridiculous to weigh every day. All it ever did was drive me crazy. I actually only weighed every 2-3 months. I focused on eating right and moving. HOWEVER, once I cleared 280 lbs, I started weighing once every week. Once I cleared 250 lbs, I started weighing every day (more or less). I don't weigh every day now (at 229 lbs) but I do probably 5-6 times a week. Sometimes just for fun I weigh twice a day to see what the fluctuations might be between morning and night, clothing and naked.
My reasonings: When you are 100+ lbs overweight (if you are anything like me), it drives you nuts to weigh every day and have to track yourself through a lb here or there. Plus you see EVERY SINGLE fluctuation and you drive yourself crazy thinking that this is going to be yet another thing you are going to fail at. Putting yourself in that type of psychological environment can actually cause you to fail. Especially if you are an emotional eater. Weighing once a month will allow you to see the big drops and bypass the daily fluctuations. I can't tell you how many times on this board I saw people posting "I haven't lost any weight in a week, what am I doing wrong?" And they were beside themselves with worry. I never had that... hmmm... wonder why.
However, like many others have said... once you get down to within a reasonable distance to your goal weight, it is beneficial to start weighing a lot more often because the fluctuations (+/- 5 lbs in a single day) will motivate you to be stricter with your diet and exercise. So there is a line there.
How often you weigh is a personal choice. There is no single "right way or wrong way" here. It is what works best for you.
Sean
When I was 474.1 lbs, it was ridiculous to weigh every day. All it ever did was drive me crazy. I actually only weighed every 2-3 months. I focused on eating right and moving. HOWEVER, once I cleared 280 lbs, I started weighing once every week. Once I cleared 250 lbs, I started weighing every day (more or less). I don't weigh every day now (at 229 lbs) but I do probably 5-6 times a week. Sometimes just for fun I weigh twice a day to see what the fluctuations might be between morning and night, clothing and naked.
My reasonings: When you are 100+ lbs overweight (if you are anything like me), it drives you nuts to weigh every day and have to track yourself through a lb here or there. Plus you see EVERY SINGLE fluctuation and you drive yourself crazy thinking that this is going to be yet another thing you are going to fail at. Putting yourself in that type of psychological environment can actually cause you to fail. Especially if you are an emotional eater. Weighing once a month will allow you to see the big drops and bypass the daily fluctuations. I can't tell you how many times on this board I saw people posting "I haven't lost any weight in a week, what am I doing wrong?" And they were beside themselves with worry. I never had that... hmmm... wonder why.
However, like many others have said... once you get down to within a reasonable distance to your goal weight, it is beneficial to start weighing a lot more often because the fluctuations (+/- 5 lbs in a single day) will motivate you to be stricter with your diet and exercise. So there is a line there.
How often you weigh is a personal choice. There is no single "right way or wrong way" here. It is what works best for you.
Sean
Sunday, January 18, 2009
Plateau Frustrations
A message that I read once and responded to. It was good advice then and still is so I'm reposting it here"
INITIAL POST:
"So. . . on the 18th it will be one year since my surgery and I am down 167 pounds!!! I have 53 left. I can't believe I am down to double digits! The only problem is that the scale is crazy!! I worked out for four hours a day four days in a row and gained three pounds!!! I am four pounds away from being under 200 pounds in as long as I can remember and I wanted to hit there by my anniversary. I have been so frustrated."
"The strangest thing is that I bought my first pair of Old Navy (well from any store) jeans in November. I put them on Saturday night for a date and they almost fell down!!! The inches are going, but the scale is just STAGNANT!! I entered an exercise competition at work and am working out double workouts (one at 3:30 am and the other at 3:30 pm for two hours each) so I can win. If I bulk up on too much muscle though, I won't ever get below 200 pounds!!"
"So. . . any advice?? I will be heartbroken if I can't make it down four pounds in 11 days!!"
MY RESPONSE:
You've been in this long enough that you should know that while goals are important, your weight is going to come off in its own time. Don't beat yourself up if you don't make a weight loss goal, especially when you are so close. Losing four lbs in eleven days is unrealistic at this point. Just be glad you're so close, focus on eating well, getting your water in, and doing what you can to be healthy.
As far as exercise, continue to work your long muscle groups and building your lean body mass. You're right, you don't need to bulk up in order to get stronger, more flexible. Let's put it this way, would you rather lose inches or weight? Me? Inches. Muscle weighs more than fat anyway.
Look. I've been stuck in the same 10 lbs range since October. But recently I've started sliding below 230 for the first time. Yay! Have I done anything different? Not really. Your body just does that as it gets lower in weight. My suggestion? Focus on your water, spacing your meals out (4-5 hours between meals) and don't eat simple carbs (or anything without protein really -- other than veggies and even then not too much). Do that and it will come off. Maybe not today, maybe not tomorrow but eventually. After all, you're in this for life, not just for the next eleven days.
Sean
INITIAL POST:
"So. . . on the 18th it will be one year since my surgery and I am down 167 pounds!!! I have 53 left. I can't believe I am down to double digits! The only problem is that the scale is crazy!! I worked out for four hours a day four days in a row and gained three pounds!!! I am four pounds away from being under 200 pounds in as long as I can remember and I wanted to hit there by my anniversary. I have been so frustrated."
"The strangest thing is that I bought my first pair of Old Navy (well from any store) jeans in November. I put them on Saturday night for a date and they almost fell down!!! The inches are going, but the scale is just STAGNANT!! I entered an exercise competition at work and am working out double workouts (one at 3:30 am and the other at 3:30 pm for two hours each) so I can win. If I bulk up on too much muscle though, I won't ever get below 200 pounds!!"
"So. . . any advice?? I will be heartbroken if I can't make it down four pounds in 11 days!!"
MY RESPONSE:
You've been in this long enough that you should know that while goals are important, your weight is going to come off in its own time. Don't beat yourself up if you don't make a weight loss goal, especially when you are so close. Losing four lbs in eleven days is unrealistic at this point. Just be glad you're so close, focus on eating well, getting your water in, and doing what you can to be healthy.
As far as exercise, continue to work your long muscle groups and building your lean body mass. You're right, you don't need to bulk up in order to get stronger, more flexible. Let's put it this way, would you rather lose inches or weight? Me? Inches. Muscle weighs more than fat anyway.
Look. I've been stuck in the same 10 lbs range since October. But recently I've started sliding below 230 for the first time. Yay! Have I done anything different? Not really. Your body just does that as it gets lower in weight. My suggestion? Focus on your water, spacing your meals out (4-5 hours between meals) and don't eat simple carbs (or anything without protein really -- other than veggies and even then not too much). Do that and it will come off. Maybe not today, maybe not tomorrow but eventually. After all, you're in this for life, not just for the next eleven days.
Sean
Allow Yourself To Make Mistakes
So today I hit 223.8 lbs!!!
After starting at 474.1 lbs and setting a pre-surgery goal of 225 lbs and not having anyone believe I could make it, I'm pretty excited. At this point I'm not trying to lose weight anymore but we'll see where it will stop.Of course I'm one of those who really don't dump. I don't know if that's a blessing or a curse. If I eat too much sugar, I do get a bit of a rapid heart beat and depending on what I ate, I can feel icky but nothing major.
So of course what do I do to celebrate my milestone? You guess it. Stupid, stupid, stupid. Oh well, can't do anything about it now... just have to reset my determination to not do that anymore.
And that's what it's all about. Not beating yourself up when you make a mistake but learning and growing and doing better the next time. I'm convinced that beating yourself up over making a mistake just makes you feel bad about yourself and perpetuates a cycle of self-defeating behavior. You beat yourself up, then you feel bad about yourself, so you give up because you're going to fail anyway, and then you eat more crap. Allow yourself to be human and make mistakes. Don't justify making them but when you do, move on and determine to do better.
Anyway, that's the rant for today. Leaving the RMAP support message board several weeks ago was sad in that I really enjoyed helping others on their journey by letting them know what I learned over the past two (well almost) years. I wish I had every post I left on that board to put up on my blog. I think that would be so helpful. Instead I'll do the best to put my thoughts down here. If you have any questions, other posts contain my email address and I'll try to respond to any comments you might post here.
Post from a user on obesityhelp.com
This is a reply to my post on obesityhelp.com:
I was a lurker on the RMAP site and enjoyed reading your forum posts. I am pre-op, but decided to pursue another facility/doctor for my surgery (if I can get the insurance approval, of course), because RMAP did not offer the same support and follow up of the other Utah Center of Excellence.Anyway, I just want to say welcome and I'm happy to have you here. Take care and best wishes for much continued success!!
I was a lurker on the RMAP site and enjoyed reading your forum posts. I am pre-op, but decided to pursue another facility/doctor for my surgery (if I can get the insurance approval, of course), because RMAP did not offer the same support and follow up of the other Utah Center of Excellence.Anyway, I just want to say welcome and I'm happy to have you here. Take care and best wishes for much continued success!!
Another email from a RMAP patient
Another wonderful email from a RMAP patient. Thanks everyone for your support!
Hey Sean,I am sorry to hear that you have been banned. I noticed your posts had been deleted, because mine was in between and no longer made sense, but I didn't know you had been banned. Until someone posted it today.I just wanted to tell you how much I have appreciated your support. Particularly in the weeks leading up to my surgery, even before I started posting. This was a fairly quick decision for me and the information that you were sharing at the time, really helped me make this decision for which I am now so grateful. It was factual, well-researched and informative with the personal experience component. It's not easy for a lot of people to share - and you were always willing to. Thanks!I wish you well on your continued journey.
Hey Sean,I am sorry to hear that you have been banned. I noticed your posts had been deleted, because mine was in between and no longer made sense, but I didn't know you had been banned. Until someone posted it today.I just wanted to tell you how much I have appreciated your support. Particularly in the weeks leading up to my surgery, even before I started posting. This was a fairly quick decision for me and the information that you were sharing at the time, really helped me make this decision for which I am now so grateful. It was factual, well-researched and informative with the personal experience component. It's not easy for a lot of people to share - and you were always willing to. Thanks!I wish you well on your continued journey.
Saturday, January 17, 2009
Another RMAP patient shares views on Carly
I received an email from another RMAP patient today. Seems she has the same concerns about Carly as I do. I'm going to post her email but I'll leave her name out of it.
Sean, Sorry to hear about Carly. I have also had a few run ins with her and I think she is horribly rude. When they changed up the website and she announced that she was moderating, something inside me was like, "Oh No!!" I haven't posted anything since, and only been there to read a few times. I am using Obesity Help more now. But I have to say that your support was so important to me when I was preparing for my surgery adn soon after. Thanks so much!! sorry that Carly has to be so rude- if I treated people at work like she treats patients, I would be out of a job!! Thanks for sharing. Hope all is well.
Sean, Sorry to hear about Carly. I have also had a few run ins with her and I think she is horribly rude. When they changed up the website and she announced that she was moderating, something inside me was like, "Oh No!!" I haven't posted anything since, and only been there to read a few times. I am using Obesity Help more now. But I have to say that your support was so important to me when I was preparing for my surgery adn soon after. Thanks so much!! sorry that Carly has to be so rude- if I treated people at work like she treats patients, I would be out of a job!! Thanks for sharing. Hope all is well.
Wednesday, January 14, 2009
Banned from RMAP
LOL.
RMAP (really Carly) banned me from their message support board. No warning, nothing. Just a ban. Guess the truth hurts. I tell a true story and they delete it. I didn't repost it, but I guess I did mention that my post had been deleted. Suddenly other posts of mine were deleted. Then suddenly I was kicked off and banned. Nice. So much for the $500 giving you access to the support board or being able to tell a rather benign story. The moderator known as RMAPNURSE (aka Carly) rules the roost with an iron fist. There was no defamation going on there, no inflammatory language being used. But that doesn't matter. Banned.
Hmmmm. Anyway, for anyone who wants to ask questions or who misses my support, feel free to email me at sean_joyc@yahoo.com. After all, we shouldn't have to miss out on our support people because Carly has a complex.
RMAP (really Carly) banned me from their message support board. No warning, nothing. Just a ban. Guess the truth hurts. I tell a true story and they delete it. I didn't repost it, but I guess I did mention that my post had been deleted. Suddenly other posts of mine were deleted. Then suddenly I was kicked off and banned. Nice. So much for the $500 giving you access to the support board or being able to tell a rather benign story. The moderator known as RMAPNURSE (aka Carly) rules the roost with an iron fist. There was no defamation going on there, no inflammatory language being used. But that doesn't matter. Banned.
Hmmmm. Anyway, for anyone who wants to ask questions or who misses my support, feel free to email me at sean_joyc@yahoo.com. After all, we shouldn't have to miss out on our support people because Carly has a complex.
RMAP Educational Fee
On the RMAP website it was discussed what the $500 educational fee is actually for. I posted a response to that but was censored by the RMAP moderator (most likely Carly). I guess they don't like having it broken down so people will actually know. Since I think we all have a right to know about this fee, I'm breaking it down here.
1. Phone Support. Ummmm.. no. All doctor offices offer the same basic phone support that RMAP does and they don't charge for it.
2. Monthly Newsletter. Supposedly your educational fee pays for a 2 year subscription. How do you get that? They don't mail it out to you. You get it with your picture CD which you get just after surgery (and then you get past newsletters) and at your year mark. That isn't 2 years in my book.
3. The binder. Okay, while this does include information that I used for about the first 6 weeks to 3 months after surgery and it did answer some of my questions prior to surgery, it isn't worth more than maybe $30.
4. The little card to put in your wallet to let people know you're a gastric bypass patient. Give me a break. What did this cost? $2.50?
5. Online newsletters? Okay, well first off you should have the choice whether you are being charged for a newsletter. A forced subscription? Hmmm. Second, the monetary value of this isn't very high.
6. The support website. Give me a break. RMAP has to have a website otherwise they wouldn't be a center of excellence and their image would be poor. To be someone you have to have a website. By having a support portion for their patients, they get us to give the website hits which gives it a higher status with search engines. All in all, we help make the website more visible which makes them money. So that's a wash. Plus the website wasn't even moderated until recently and the moderation has honestly made the quality of the conversational piece go downhill.
Anyway, we could continue but let me get to my point. What is the $500 educational fee for? It's for the educational portion you get prior to surgery and the educational portion you get after surgery. Any claims that it's for anything else is utter crap. So is the $500 educational fee worthwhile? Yes, if you use it. RMAP requires that their patients are educated prior to the surgery. So we all use that portion of the fee. And it's up to you whether you use the support after surgery (of course your location and schedule plays a lot in that decision). If you do, then you get value from the $500 educational fee. If you don't, not so much.
RMAP requires the $500 educational fee because their experience shows that the patients who participate in this type of support have better success. I have no problem with them requiring it. My only issue here is that they try to make it sound like you're getting more than you really are. Many practices don't require the educational support piece so they don't charge you. Others offer the educational support piece but charge more. I didn't have a problem with the $500 educational fee when I paid it and I still don't. Which I think if the message base moderator would have actually read the entirety of my post, she would have noticed that I agree with the fee and wasn't arguing against it. Of course, since I'm sure the moderator was Carly, I'm sure it was deleted because of my story about Dr. Smith, her and my 18 month mark (that's included here in my blog (see below)).
1. Phone Support. Ummmm.. no. All doctor offices offer the same basic phone support that RMAP does and they don't charge for it.
2. Monthly Newsletter. Supposedly your educational fee pays for a 2 year subscription. How do you get that? They don't mail it out to you. You get it with your picture CD which you get just after surgery (and then you get past newsletters) and at your year mark. That isn't 2 years in my book.
3. The binder. Okay, while this does include information that I used for about the first 6 weeks to 3 months after surgery and it did answer some of my questions prior to surgery, it isn't worth more than maybe $30.
4. The little card to put in your wallet to let people know you're a gastric bypass patient. Give me a break. What did this cost? $2.50?
5. Online newsletters? Okay, well first off you should have the choice whether you are being charged for a newsletter. A forced subscription? Hmmm. Second, the monetary value of this isn't very high.
6. The support website. Give me a break. RMAP has to have a website otherwise they wouldn't be a center of excellence and their image would be poor. To be someone you have to have a website. By having a support portion for their patients, they get us to give the website hits which gives it a higher status with search engines. All in all, we help make the website more visible which makes them money. So that's a wash. Plus the website wasn't even moderated until recently and the moderation has honestly made the quality of the conversational piece go downhill.
Anyway, we could continue but let me get to my point. What is the $500 educational fee for? It's for the educational portion you get prior to surgery and the educational portion you get after surgery. Any claims that it's for anything else is utter crap. So is the $500 educational fee worthwhile? Yes, if you use it. RMAP requires that their patients are educated prior to the surgery. So we all use that portion of the fee. And it's up to you whether you use the support after surgery (of course your location and schedule plays a lot in that decision). If you do, then you get value from the $500 educational fee. If you don't, not so much.
RMAP requires the $500 educational fee because their experience shows that the patients who participate in this type of support have better success. I have no problem with them requiring it. My only issue here is that they try to make it sound like you're getting more than you really are. Many practices don't require the educational support piece so they don't charge you. Others offer the educational support piece but charge more. I didn't have a problem with the $500 educational fee when I paid it and I still don't. Which I think if the message base moderator would have actually read the entirety of my post, she would have noticed that I agree with the fee and wasn't arguing against it. Of course, since I'm sure the moderator was Carly, I'm sure it was deleted because of my story about Dr. Smith, her and my 18 month mark (that's included here in my blog (see below)).
My Experience with Carly
For my fellow RMAP web site friends:
On April 7, 2008, I went in to see Dr. Smith for my year mark. At the time I was at 288 lbs. Amazing progress. He was pleased I was under 300 lbs which was his initial goal for me. He told me he'd like to see me get to 250 lbs. I told him that I'd like to do ever better. At that, he kind of rolled his eyes and said "we'll see. I'll give you 6 months to get to 250 lbs. That's 38 lbs in 6 months. Check back with me in 6 months and we'll see where you're at."
Six months later I called to ask if he wanted me to just stop by. Carly, his good looking nurse, took the call. I told her Dr. Smith had told me to stop by after 6 months so we could see where I was at. She told me that if I came in, I'd be charged for a visit. Hold on. I don't need to see Dr. Smith as a doctor but he did tell me to check back with him (however he wanted me to do that) to see where I was weight-wise. Carly didn't check with Dr. Smith, just dismissed my call.
Personally, I'm a little irritated with what happened. I'm now at 225 lbs which was the goal weight I set for myself 2 months prior to my surgery. I'm almost 250 lbs lighter today than I was when I had my surgery (and I'm not 2 years out quite yet). Being one of RMAP's biggest success stories, I would think Dr. Smith might actually want me to stop by just to say "hi" and see where I'm at. But I'm willing to bet he doesn't even know I called to give him that option. But... I couldn't get past Carly.
All in all it's good. I just wanted to relay this story to you. The RMAP personal touch isn't what it should be or could be (with a little effort). But all in all my success through them has made me recommend them to multiple people. I also highly recommend Dr. Smith and even though she's extremely good looking (in my opinion), I'm not the biggest fan of Carly's people skills.
On April 7, 2008, I went in to see Dr. Smith for my year mark. At the time I was at 288 lbs. Amazing progress. He was pleased I was under 300 lbs which was his initial goal for me. He told me he'd like to see me get to 250 lbs. I told him that I'd like to do ever better. At that, he kind of rolled his eyes and said "we'll see. I'll give you 6 months to get to 250 lbs. That's 38 lbs in 6 months. Check back with me in 6 months and we'll see where you're at."
Six months later I called to ask if he wanted me to just stop by. Carly, his good looking nurse, took the call. I told her Dr. Smith had told me to stop by after 6 months so we could see where I was at. She told me that if I came in, I'd be charged for a visit. Hold on. I don't need to see Dr. Smith as a doctor but he did tell me to check back with him (however he wanted me to do that) to see where I was weight-wise. Carly didn't check with Dr. Smith, just dismissed my call.
Personally, I'm a little irritated with what happened. I'm now at 225 lbs which was the goal weight I set for myself 2 months prior to my surgery. I'm almost 250 lbs lighter today than I was when I had my surgery (and I'm not 2 years out quite yet). Being one of RMAP's biggest success stories, I would think Dr. Smith might actually want me to stop by just to say "hi" and see where I'm at. But I'm willing to bet he doesn't even know I called to give him that option. But... I couldn't get past Carly.
All in all it's good. I just wanted to relay this story to you. The RMAP personal touch isn't what it should be or could be (with a little effort). But all in all my success through them has made me recommend them to multiple people. I also highly recommend Dr. Smith and even though she's extremely good looking (in my opinion), I'm not the biggest fan of Carly's people skills.
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