For those of you who have followed my blog and are familiar with my journey, you know that I got down as low as 223 lbs but have fluctuated in the months since between 225 lbs and 232 lbs. It's been a little frustrating but I owe it to my diet and lack of water on a daily basis.
I really haven't had much weight change since December 2008. However, I did my measurements (waist, thighs, upper arms, neck, chest) in December and measured again just today. I've lost 2 inches in my waist alone. So while the weight hasn't gone down, the inches are still down. And inches are where it's at.
So keep this in mind anytime you hit a plateau. Sometimes the weight stabilizes but the inches continue to drop. Inches are better than weight.
Weight Loss
My Playlist
Sunday, February 22, 2009
How Others See Us / How We See Ourselves
How We See Ourselves
How many of you have lost a ton of weight but your mental image of yourself is still as an overweight person? I know it's still hard for me to wrap my mind around. I find myself still acting (in some ways) lke I did when I was overweight and sometimes thinking others view me as that overweight person.
How Others See Us
Isn't it amazing how others now see/treat us? Now that the weight is gone, suddenly we are more human, we aren't considered the invisibles. Opportunities in all areas of life are not available to us -- opportunities that were not available before. In all the years leading up to this moment, not once did anyone tell me that they thought I was good-looking. Not even when I was married. But since I dropped below the 250 lbs barrier I have had several comments. Wow. How much of a difference that makes. It's much like never being touched by another human being for 10-15 years and then all of a sudden getting a big hug.
Time and new experiences are what will ultimately change our perceptions of ourselves. I've noticed my perception of myself slowly changing over time. It's almost as wonderful as the weight loss journey itself.
Yay!
How many of you have lost a ton of weight but your mental image of yourself is still as an overweight person? I know it's still hard for me to wrap my mind around. I find myself still acting (in some ways) lke I did when I was overweight and sometimes thinking others view me as that overweight person.
How Others See Us
Isn't it amazing how others now see/treat us? Now that the weight is gone, suddenly we are more human, we aren't considered the invisibles. Opportunities in all areas of life are not available to us -- opportunities that were not available before. In all the years leading up to this moment, not once did anyone tell me that they thought I was good-looking. Not even when I was married. But since I dropped below the 250 lbs barrier I have had several comments. Wow. How much of a difference that makes. It's much like never being touched by another human being for 10-15 years and then all of a sudden getting a big hug.
Time and new experiences are what will ultimately change our perceptions of ourselves. I've noticed my perception of myself slowly changing over time. It's almost as wonderful as the weight loss journey itself.
Yay!
Update: Weight
For those of you who have been reading my blog on a regular basis, I altered my diet slightly over the past few days. I got away from eating so much beef jerky and I was really good with my water intake. The result has been shedding the water (finally) that I've been retaining. On the bad side was I was having to visit the restroom every hour for a day but the good news is that I lose 2.2 lbs just yesterday. Yes that means I weighed in at 227 lbs this morning. Yay! Below my scary weight. The funny thing was how all this affected the fitting of my pinkie ring that my daughter gave to me. Whereas it was perfectly snug before, now it's a little big.
I love the control that I have now. I eat like a normal person, can eat pretty much what I want... but now I eat the same portions as everyone else. I now can have conversations with others about how I'm eating and because I no longer have the large amounts of weight, I don't feel self-conscious about having the conversation. Yes, it's all good!
I love the control that I have now. I eat like a normal person, can eat pretty much what I want... but now I eat the same portions as everyone else. I now can have conversations with others about how I'm eating and because I no longer have the large amounts of weight, I don't feel self-conscious about having the conversation. Yes, it's all good!
Saturday, February 21, 2009
New Update
Sorry for the absence but life gets hectic sometimes. I haven't been doing very good on my pledge to stay true to the diet plan. I actually went up to 232 lbs. Started freaking out. 230 is my scary weight so it's been nerve racking to say the least. However, I had two really perfect days (today wasn't but the two days before that) and I weighed yesterday morning at 229 so at least I'm headed in the right direction.
NEW FOODS
Protein Bar. I have a new protein bar. It's a bar put out by Premier Nutrition called "Protein: High Protein Bar" I found it first at Costco for about $1.62 a bar (12 pack). But recently I discovered it at Sam's Club for about $0.94 a bar (15 pack). The bar is bigger (which is good for me because I can eat a lot more now than in the past) but the bar packs 30grams of protein. So I bought four boxes (should keep me for like a month), along with a block of cheese, a lot of beef jerky (peppered) and a bunch of my new yogurt (see below). That plus some veggies should pretty much keep me for a long time. I know, I know. I'm not very creative when it comes to food but the regimen is what works for me.
Yogurt. At first I was in to the Yoplait Light (Thick & Creamy because it has Sucralose instead of Aspartame) but then I discovered Weight Watchers (better tasting, uses Sucralose, and has a bit more protein). However, recently I've moved to Kroger's (only available at Smith's). It's called Carb Master. Stupid name but amazing yogurt. Only 4 grams of carbohydrates and more protein than any other yogurt I've found (and only 1 gram of sugar). It's not as sweet or yummy tasting as those other ones but now I don't cringe when I eat yogurt.
Okay.. there you have it. My update. More later. Thanks to everyone who has written me to let me know how they are doing. I appreciate it. Also I haven't heard from Meredith at RMAP since I accepted her resolution to my situation with Carly. I have nothing against anyone at RMAP, I really wish they could say the same.
NEW FOODS
Protein Bar. I have a new protein bar. It's a bar put out by Premier Nutrition called "Protein: High Protein Bar" I found it first at Costco for about $1.62 a bar (12 pack). But recently I discovered it at Sam's Club for about $0.94 a bar (15 pack). The bar is bigger (which is good for me because I can eat a lot more now than in the past) but the bar packs 30grams of protein. So I bought four boxes (should keep me for like a month), along with a block of cheese, a lot of beef jerky (peppered) and a bunch of my new yogurt (see below). That plus some veggies should pretty much keep me for a long time. I know, I know. I'm not very creative when it comes to food but the regimen is what works for me.
Yogurt. At first I was in to the Yoplait Light (Thick & Creamy because it has Sucralose instead of Aspartame) but then I discovered Weight Watchers (better tasting, uses Sucralose, and has a bit more protein). However, recently I've moved to Kroger's (only available at Smith's). It's called Carb Master. Stupid name but amazing yogurt. Only 4 grams of carbohydrates and more protein than any other yogurt I've found (and only 1 gram of sugar). It's not as sweet or yummy tasting as those other ones but now I don't cringe when I eat yogurt.
Okay.. there you have it. My update. More later. Thanks to everyone who has written me to let me know how they are doing. I appreciate it. Also I haven't heard from Meredith at RMAP since I accepted her resolution to my situation with Carly. I have nothing against anyone at RMAP, I really wish they could say the same.
Sunday, February 15, 2009
When Weight Loss Ends
I've recently found that my weight loss has stalled. I got down to 223 lbs (which was 2 lbs under my goal weight) but more recently I'm up to 230 where I have settled. I'm perfectly happy at this weight. Other than my excess skin which I'm hoping to have removed as soon as I can afford it, I'm very happy and feel great. But I've wondered why the stall. I've only lost 85-90% of my excess weight. (keep in mind I'm not quibbling about it, just wondering)
So I started taking a micro look at the calories I ingest every day. I am prone to eat simple carbs here and there throughout the day. Especially at work. Not a ton, mind you, but a few little cheats here and there. As I analyzed it, I realized how many calories I am letting into my diet without even really knowing it. One piece of bread is like 100 calories. All in all, I think that's how anyone eventually gains some of the weight back. It gets to where you can eat normally and so you do. You can't eat as much but you get into this false sense of security because of how easy it was to lose the weight. Now you have to pay attention.
This is why I've advocated a food journal though most people (myself included) don't do this. But with the success I had using a food journal and turning it in daily to a friend (having a competition with her for best journal really helped too), I think I'm going to go back to that, see if I can get back to 223 again.Wish me luck.
So I started taking a micro look at the calories I ingest every day. I am prone to eat simple carbs here and there throughout the day. Especially at work. Not a ton, mind you, but a few little cheats here and there. As I analyzed it, I realized how many calories I am letting into my diet without even really knowing it. One piece of bread is like 100 calories. All in all, I think that's how anyone eventually gains some of the weight back. It gets to where you can eat normally and so you do. You can't eat as much but you get into this false sense of security because of how easy it was to lose the weight. Now you have to pay attention.
This is why I've advocated a food journal though most people (myself included) don't do this. But with the success I had using a food journal and turning it in daily to a friend (having a competition with her for best journal really helped too), I think I'm going to go back to that, see if I can get back to 223 again.Wish me luck.
Saturday, February 14, 2009
Changes in Libido
One other thing that they don't tell you is that your libido will be affected. I've heard a few say that their libido decreased. I'm not sure if that's because of everything you suddenly have in your life that wasn't there before or what but for most of us our libido will increase.
Yes, INCREASE! It's kind of scary in a way. But it can also be a wonderful thing.
I haven't had a libido like this since I was 18. It has to be because my body is truly healthy. Healthier than it's been in a really, really long time.Anyway, the reason I bring this up is because you really need to keep this in mind and be ready to deal with it otherwise you might end up making decisions that aren't good for you.
Yes, INCREASE! It's kind of scary in a way. But it can also be a wonderful thing.
I haven't had a libido like this since I was 18. It has to be because my body is truly healthy. Healthier than it's been in a really, really long time.Anyway, the reason I bring this up is because you really need to keep this in mind and be ready to deal with it otherwise you might end up making decisions that aren't good for you.
Friday, February 13, 2009
My Tailbone
Sorry I've been so neglectful with my blog lately. Life has been hectic. My work sent me out to Boston. I flew out to Baltimore and then took a connecting flight to Boston. On the way back, I flew from Boston to Atlanta and then to Salt Lake City.
One thing they don't tell you going into this surgery is that when you lose your weight, you feel your tailbone a lot more. I'm always finding I'm sore there. And the flight from Atlanta to Salt Lake City was no different. I thought I was going to die it hurt so bad.
But there is always a bright side. In this case it's that I fit in the seat without a problem. Even on the Baltimore to Atlanta flight when I was in the middle. It's so awesome sitting in a seat without overflowing. Yay!
I hope you all are finding little things like this on your journey. Revel in each and every little wonderful thing that happens to you. It's a great ride.
Sean
One thing they don't tell you going into this surgery is that when you lose your weight, you feel your tailbone a lot more. I'm always finding I'm sore there. And the flight from Atlanta to Salt Lake City was no different. I thought I was going to die it hurt so bad.
But there is always a bright side. In this case it's that I fit in the seat without a problem. Even on the Baltimore to Atlanta flight when I was in the middle. It's so awesome sitting in a seat without overflowing. Yay!
I hope you all are finding little things like this on your journey. Revel in each and every little wonderful thing that happens to you. It's a great ride.
Sean
Tuesday, February 10, 2009
Beef Jerky/Sodium
If you eat a lot of beef jerky, you might notice your weight loss slowing down. If you're eating the appropriate amounts, at the appropriate times, and not deviating much for your diet, then the problem most likely is the high sodium content in the beef jerky.
I LOVE beef jerky and eat a ton of it every week. It's and easy food (already prepared), tasty, and it has a ton of protein. However, it does have a tendency to cause water retention. So you can still be losing fat (your body still has to eat) but the scale might not reflect as much because of the water retention.
There are two ways I've found to fight this. (1) Up your water content. As long as you flush your body with a ton of water, it has a hard time retaining water. I usually find if I'm retaining water (even with the beef jerky) it's because I'm not drinking enough. (2) Every so often I go off beef jerky and focus on other things (and stay super close to the eating plan including my water level). This really gives your body a flush and if you've been retaining water you usually notice a huge drop in weight (though I'll warn you if you're retaining water you'll be visiting the little boys/girls room a lot over the course of the next couple of days).
I hope that helps.
Sean
I LOVE beef jerky and eat a ton of it every week. It's and easy food (already prepared), tasty, and it has a ton of protein. However, it does have a tendency to cause water retention. So you can still be losing fat (your body still has to eat) but the scale might not reflect as much because of the water retention.
There are two ways I've found to fight this. (1) Up your water content. As long as you flush your body with a ton of water, it has a hard time retaining water. I usually find if I'm retaining water (even with the beef jerky) it's because I'm not drinking enough. (2) Every so often I go off beef jerky and focus on other things (and stay super close to the eating plan including my water level). This really gives your body a flush and if you've been retaining water you usually notice a huge drop in weight (though I'll warn you if you're retaining water you'll be visiting the little boys/girls room a lot over the course of the next couple of days).
I hope that helps.
Sean
Sunday, February 8, 2009
Yogurt
Over the past year or so, I've had numerous conversations with WLS patients about yogurt. Some like it, some don't. Some believe you should eat it, some don't. It's been referred to as a "slider" food (a food that doesn't have enough consistency to stay in your pouch for long).
For what it's worth, here's my take on yogurt.
UP UNTIL NOW:
My body seems to crave yogurt. For a long time I believed it was because of the calcium. While that might be the case, I'm not of the belief that's because of its sweetness. Most yogurts are insanely sweet. Case in point, Kroger's regular yogurt has 43 grams of sugar.
I personally prefer yogurts without Aspartame in them (the light thick & creamy by yoplait or the Weight Watchers). Each of these yogurts (6 ounces) are 100 calories and are sweetened by sucralose (splenda). While both taste great (I think the Weight Watchers is better), both of them are also sweet tasting. I believe that makes it easier to eat more and have it curb your appetite for less time. Weight Watchers has 6 grams of protein, 3 grams dietary fiber, 17 grams of carbohydrates (12 grams of sugar) -- and it's the better of these two (by a slight margin).
CURRENTLY
Recently, a dear friend of mine put me onto a new type of yogurt. Kroger's (available at Smith's only) has a yogurt called "Carb Master." Yes, it actually says Carb Master on the label. It only has 4 grams of carbohydrates (3 grams sugar) and 1 gram of dietary fiber but get this, it has 10-12 grams of protein. The result is a yogurt that isn't as good tasting (since it's not as sweet) but I've found that it's way more filling and curbs your hunger for longer than those other brands. And it only has 80 calories (6 ounces). I highly recommend it.
As I've always maintained, the more simple carbs you eat (and sugars count here), the more you trigger your hunger. Your body burns off simple carbs FAST and it raises your blood sugar level quickly. Once they've been burned off you have a crash and your blood sugar level drops and your body suddenly wants more. It's like a drug. That's why things like nuts, beef jerky and other meats stay with you longer.
For what it's worth, here's my take on yogurt.
UP UNTIL NOW:
My body seems to crave yogurt. For a long time I believed it was because of the calcium. While that might be the case, I'm not of the belief that's because of its sweetness. Most yogurts are insanely sweet. Case in point, Kroger's regular yogurt has 43 grams of sugar.
I personally prefer yogurts without Aspartame in them (the light thick & creamy by yoplait or the Weight Watchers). Each of these yogurts (6 ounces) are 100 calories and are sweetened by sucralose (splenda). While both taste great (I think the Weight Watchers is better), both of them are also sweet tasting. I believe that makes it easier to eat more and have it curb your appetite for less time. Weight Watchers has 6 grams of protein, 3 grams dietary fiber, 17 grams of carbohydrates (12 grams of sugar) -- and it's the better of these two (by a slight margin).
CURRENTLY
Recently, a dear friend of mine put me onto a new type of yogurt. Kroger's (available at Smith's only) has a yogurt called "Carb Master." Yes, it actually says Carb Master on the label. It only has 4 grams of carbohydrates (3 grams sugar) and 1 gram of dietary fiber but get this, it has 10-12 grams of protein. The result is a yogurt that isn't as good tasting (since it's not as sweet) but I've found that it's way more filling and curbs your hunger for longer than those other brands. And it only has 80 calories (6 ounces). I highly recommend it.
As I've always maintained, the more simple carbs you eat (and sugars count here), the more you trigger your hunger. Your body burns off simple carbs FAST and it raises your blood sugar level quickly. Once they've been burned off you have a crash and your blood sugar level drops and your body suddenly wants more. It's like a drug. That's why things like nuts, beef jerky and other meats stay with you longer.
Friday, February 6, 2009
Conversation with Meredith (part 4)
There you have it. What happens from here on out is up to Meredith and RMAP. Thanks to everyone who urged me to write a letter to RMAP about what was going on between me and Carly. If not for the 20 plus emails that I received regarding that, I don't think I would have reached out to Meredith. I'm glad I did, regardless of what she decides to do.
---------------------------------------
Meredith.
Sorry about the long reply email before. Look. This has been a very intriguing but unbelievable issue between Carly and myself. She was certainly welcome to reach out to me and let me know that she felt I was personally attacking her as that was never my intent. Your offer for resolution is fine as I have never thought negatively about Carly. My only desire through it all has been to give back to RMAP and I have done a lot of work in that area towards supporting the patients and giving glowing recommendations of RMAP as well as Doctors Smith, McKinley and Simper (especially Dr. Smith). Those recommendations have come from my mother's conversations with various nurses at St. Mark's and LDS hospital (she worked as an anesthesiologist for many many years and keeps in touch with many within the medical community) and her personal knowledge of working with Dr. Smith at the SL Surgical Center as well as the former RMAP I know and those in the medical community I work with since I'm in the field of healthcare.
As stated, I contacted you in order to try and continue to give back to RMAP. That offer still stands. I believe in RMAP and have always felt that to give back is the least I can do for what I was able to accomplish with their help.
Sean
---------------------------------------
Meredith.
Sorry about the long reply email before. Look. This has been a very intriguing but unbelievable issue between Carly and myself. She was certainly welcome to reach out to me and let me know that she felt I was personally attacking her as that was never my intent. Your offer for resolution is fine as I have never thought negatively about Carly. My only desire through it all has been to give back to RMAP and I have done a lot of work in that area towards supporting the patients and giving glowing recommendations of RMAP as well as Doctors Smith, McKinley and Simper (especially Dr. Smith). Those recommendations have come from my mother's conversations with various nurses at St. Mark's and LDS hospital (she worked as an anesthesiologist for many many years and keeps in touch with many within the medical community) and her personal knowledge of working with Dr. Smith at the SL Surgical Center as well as the former RMAP I know and those in the medical community I work with since I'm in the field of healthcare.
As stated, I contacted you in order to try and continue to give back to RMAP. That offer still stands. I believe in RMAP and have always felt that to give back is the least I can do for what I was able to accomplish with their help.
Sean
Conversation with Meredith (part 3)
This is my reply to Meredith. I was astounded by the information that she sent in her email which confirmed my suspicious that she would get and take Carly's side. I'll admit that in reading the first part of her email my defenses went up and that's where this response came from. While this response is true in everything, it was merely me getting defensive. I completely missed the part of her email wherein she offered a resolution. Once I read her email a second time and caught that part, I sent a second follow up email (see part 4)
--------------------------------------------
Meredith.
My email in no way was an attempt to have anything done to Carly. I have never harbored ill will of Carly. Period. However, I will point out that despite the fact that you and Carly both have the best interests of RMAP in mind, not thinking there is room for improvement is not the best place to start. No one on this planet (myself included) is infallible or error free. There have been many complaints about customer service with RMAP -- including complaints against Carly. NO ONE (especially myself) has ever slandered Carly or anyone at RMAP for these failings but merely have brought them to light in hopes that RMAP will continue to improve (as they improved in order to become a center of excellence). The complaints seen on the board include not being responsive to calls, unnecessary delays in paperwork, perceived rudeness (at times - no one is saying all the time) from nurses or even perceived poor bedside manner by certain surgeons. Case in point, there are multiple posts on the message board talking about Dr. Smith's perceived lack of caring and poor bedside manner (an opinion not shared by me -- in fact I vehemently countered these claims by my own personal knowledge of Dr. Smith) but yet no one was ever banned for their perceptions.
However, I do take issue with your definition of slander. The dictionary (and the legal world) define slander as a malicious, false, and defamatory statement or report (i.e., a slander against his/her good name). If a comment is true, if it is not malicious, and if it is not defamatory, it cannot be slander. I have never written a post that could be classified as slander (as I have never posted anything that wasn't (a) true; (b) defamatory; or (c) malicious).
I can guarantee that you never read the post in question. I actually have a copy of it. If you had, you would have read my accounting of my phone call with Carly that day. It did not say she was unable to do her job, it did not say anything bad about her at all. It stated that I hoped that RMAP had room for improvement in the customer service area and I hoped that they would continue to improve there. It was not a personal attack on Carly a fact that everyone on the board (other than Carly) who read it shares. As for the phone call between Carly and myself, there was no courtesy involved. I did not ask for Dr. Smith's time. I told Carly that I did not "need" an appointment with Dr. Smith as everything was fine but since he had "asked" me to check in with him after 6 months about where my weight was, I wanted to know if he really needed to see me. Though I rephrased this question three separate times, Carly completely ignored the request and merely repeated that if I came in I would have to pay for the visit. There was no attempt to set up a block of time. My post reflected that and also made the jump in logic that it would have been nice if she would have just asked Dr. Smith if he wanted to see me due to this or if we were good. Now, since I know you are obviously going to lean towards the side of your colleague (why wouldn't you, you don't know me but you work with her) I know you'll dismiss my statements. That's fine. However, since the incident, I have had several (unsolicited) people contact me and leave me comments about Carly. Every single one of them have brought up her need to improve on her courtesy and customer service skills. None of them (mine included) have said she is a bad person. There has been no slander. And to ban people who point out flaws in the hope for improvement is merely to turn a blind eye to an area that can make RMAP (as a whole) better.
Anyway... the only reason I related that to you was to let you know why I am no longer providing support for RMAP patients via the message board. It wasn't to argue my side or to convince you that I should be reinstated. I was on the board as a way to give back to RMAP. It certainly took a great deal of my time but it was something I felt I owed. After all, my mother worked directly with Paula, Dr. Halverson and Dr. Smith which is why I went with RMAP in the first place. I have posted in several forums my direct knowledge of Dr. Smith's excellence as a surgeon (based not just on my experience but from my knowledge captured from may places).
My reason for contacting you was to offer my help (if ever needed). It was yet another attempt on my part to give back to RMAP. However, if it's not wanted or needed, that's fine. One day I hope Carly will recognize that I never harbored any ill will towards her and that the only malicious thing that happened on the message board was her banning me for leaving a post that she took personal but was actually not personal.
Anyway, enjoy your weekend.
Sean
--------------------------------------------
Meredith.
My email in no way was an attempt to have anything done to Carly. I have never harbored ill will of Carly. Period. However, I will point out that despite the fact that you and Carly both have the best interests of RMAP in mind, not thinking there is room for improvement is not the best place to start. No one on this planet (myself included) is infallible or error free. There have been many complaints about customer service with RMAP -- including complaints against Carly. NO ONE (especially myself) has ever slandered Carly or anyone at RMAP for these failings but merely have brought them to light in hopes that RMAP will continue to improve (as they improved in order to become a center of excellence). The complaints seen on the board include not being responsive to calls, unnecessary delays in paperwork, perceived rudeness (at times - no one is saying all the time) from nurses or even perceived poor bedside manner by certain surgeons. Case in point, there are multiple posts on the message board talking about Dr. Smith's perceived lack of caring and poor bedside manner (an opinion not shared by me -- in fact I vehemently countered these claims by my own personal knowledge of Dr. Smith) but yet no one was ever banned for their perceptions.
However, I do take issue with your definition of slander. The dictionary (and the legal world) define slander as a malicious, false, and defamatory statement or report (i.e., a slander against his/her good name). If a comment is true, if it is not malicious, and if it is not defamatory, it cannot be slander. I have never written a post that could be classified as slander (as I have never posted anything that wasn't (a) true; (b) defamatory; or (c) malicious).
I can guarantee that you never read the post in question. I actually have a copy of it. If you had, you would have read my accounting of my phone call with Carly that day. It did not say she was unable to do her job, it did not say anything bad about her at all. It stated that I hoped that RMAP had room for improvement in the customer service area and I hoped that they would continue to improve there. It was not a personal attack on Carly a fact that everyone on the board (other than Carly) who read it shares. As for the phone call between Carly and myself, there was no courtesy involved. I did not ask for Dr. Smith's time. I told Carly that I did not "need" an appointment with Dr. Smith as everything was fine but since he had "asked" me to check in with him after 6 months about where my weight was, I wanted to know if he really needed to see me. Though I rephrased this question three separate times, Carly completely ignored the request and merely repeated that if I came in I would have to pay for the visit. There was no attempt to set up a block of time. My post reflected that and also made the jump in logic that it would have been nice if she would have just asked Dr. Smith if he wanted to see me due to this or if we were good. Now, since I know you are obviously going to lean towards the side of your colleague (why wouldn't you, you don't know me but you work with her) I know you'll dismiss my statements. That's fine. However, since the incident, I have had several (unsolicited) people contact me and leave me comments about Carly. Every single one of them have brought up her need to improve on her courtesy and customer service skills. None of them (mine included) have said she is a bad person. There has been no slander. And to ban people who point out flaws in the hope for improvement is merely to turn a blind eye to an area that can make RMAP (as a whole) better.
Anyway... the only reason I related that to you was to let you know why I am no longer providing support for RMAP patients via the message board. It wasn't to argue my side or to convince you that I should be reinstated. I was on the board as a way to give back to RMAP. It certainly took a great deal of my time but it was something I felt I owed. After all, my mother worked directly with Paula, Dr. Halverson and Dr. Smith which is why I went with RMAP in the first place. I have posted in several forums my direct knowledge of Dr. Smith's excellence as a surgeon (based not just on my experience but from my knowledge captured from may places).
My reason for contacting you was to offer my help (if ever needed). It was yet another attempt on my part to give back to RMAP. However, if it's not wanted or needed, that's fine. One day I hope Carly will recognize that I never harbored any ill will towards her and that the only malicious thing that happened on the message board was her banning me for leaving a post that she took personal but was actually not personal.
Anyway, enjoy your weekend.
Sean
Conversation with Meredith (part 2)
Apparently Meredith spoke with Carly after reading my email and she then sent this reply. It's about what I expected. I find it interesting that she thought I was trying to get Carly fired. Was there ANYTHING in my first email that would give ANYONE that thought? Can you say paranoia? By the way, the definition of "slander" (keep this in mind as you read it) is making a false, malicious, defamatory statement against someone's good name.
_________________________________
Sean,
I appreciate the time you spent to contact me. First things first: Congratulations on such an INCREDIBLE journey to find the new you- inside and out! The task you undertook (and will continue to undertake) was certainly far from easy and I am sure it was bathed with bumps along the way. Dr. Smith, the blessed man that he is, did provide the means to change your life, but ultimately, it was you who changed your own life. And in that you should take great pride.
I am aware of the recent forum situation and would like to shed some light on it for you, if I may. Not only is Freedom of Speech permissible on our RMAP forums, but it is a right provided to us in this country. But just like the God-given right to speak freely, there are respectful limitations. None of us are perfect, and that definitely includes us at RMAP and our interactions with our patients. I fully recognize that you felt you were not given appropriate customer service during a conversation with Carley, and that always feels frustrating, no matter the situation. However, I would hope you can put yourself in her shoes and try to understand the demands of a medical practice. Unfortunately, for all involved, our doctors live hectic lives and lead very busy schedules, which puts a damper on the amount of time they can spend with patients. From what I understand, Carley simply wanted to set a block of time, just for you, to meet with Dr. Smith. It appears this courtesy may not have been received properly, and for that we do apologize.
I do feel it necessary to share with you that in the short time I have been with RMAP (4 months in the summer, and now since middle of January upon graduation), RMAP needs Carley. She has bright ideas for improvement and has the fortitude and determination to promote and execute change. She and I have very similar goals for RMAP, as we look to the future as a big picture, and we are constantly looking for improvement. I am not sure if you are trying to have us let her go, or not; but I must tell you, she will be the last person to be let go. Again, RMAP needs her. The difficulty found in voicing your opinion about one of OUR employees in a negative light on OUR forum, is the setting. Just like you have seen, people feed off of one another on the message boards and will only add fuel to the fire (good and bad). Hence, when stating your disappointment in one interaction with Carley on a public forum, is slanderous. Put yourself in Carley’s shoes, would you want to be a moderator of a forum to only find hate messages posted about you? From patients you care about deeply? It comes across as backstabbing. Of course, all of us can improve our customer service skills, but if presented in a constructive critique. Your approach did not appear to be a constructive critique.
And I do know, that it only makes it more difficult for us to feel that your criticism was constructive when you currently still permit other patients to degrade Carley on your blog. Do not get me wrong, blogs are personal and they are for your own particular use. I have a blog- and what I choose to write about it is my own business. However, frequently adding more anti-Carley posts is degrading, hurtful and malicious in nature. I do hope you can appreciate that and, again, see it from her perspective.
In terms of your thoughts regarding the $500 education fee, that truly did not play a role in the removal of your membership from the forums. We were already aware of the problem in the education department; hence, I was brought on. Just as much as I hope you take great pride in your weight loss journey, I take great pride in improving our education program. My priority is to provide various useful resources for our patients, and to be utilized as a resource for knowledge, a listening ear, and to offer advice when needed. Support group has become my “baby,” and do hope you can find a way to attend. I am excited with the direction it is going and am always looking for ways to improve it. Please do not hesitate to flood me with ideas, questions and concerns to help better RMAP. I so value patient input, as their satisfaction means my satisfaction. But I do hope that such input will be directed toward a single entity, like myself, and can be addressed in a constructive way.
I want to acknowledge and extend my gratitude for the many good works you have done for RMAP and our patients. It sounds like you are a great asset for those patients who know you and look up to you. And my hope for a resolution in this matter is as follows: No more negative posts about Carley, as we clearly have witnessed both negative and positive testimonials pertaining to her; all of us are striving to be better. And I hope to maintain your trust in RMAP. We are on your side, we are your allies and we want to help you succeed in any useful manner possible. We choose to do what we do, here at RMAP, because we find joy in serving you. Your experiences will be of great use to me- I hope you didn’t bite off more than you could chew when you offered your services!
Meredith, RN
Education Director
1160 East 3900 South STE 4100
Salt Lake City, UT 84124
Phone: (801) 268-3800 Fax: (801) 268-3997
_________________________________
Sean,
I appreciate the time you spent to contact me. First things first: Congratulations on such an INCREDIBLE journey to find the new you- inside and out! The task you undertook (and will continue to undertake) was certainly far from easy and I am sure it was bathed with bumps along the way. Dr. Smith, the blessed man that he is, did provide the means to change your life, but ultimately, it was you who changed your own life. And in that you should take great pride.
I am aware of the recent forum situation and would like to shed some light on it for you, if I may. Not only is Freedom of Speech permissible on our RMAP forums, but it is a right provided to us in this country. But just like the God-given right to speak freely, there are respectful limitations. None of us are perfect, and that definitely includes us at RMAP and our interactions with our patients. I fully recognize that you felt you were not given appropriate customer service during a conversation with Carley, and that always feels frustrating, no matter the situation. However, I would hope you can put yourself in her shoes and try to understand the demands of a medical practice. Unfortunately, for all involved, our doctors live hectic lives and lead very busy schedules, which puts a damper on the amount of time they can spend with patients. From what I understand, Carley simply wanted to set a block of time, just for you, to meet with Dr. Smith. It appears this courtesy may not have been received properly, and for that we do apologize.
I do feel it necessary to share with you that in the short time I have been with RMAP (4 months in the summer, and now since middle of January upon graduation), RMAP needs Carley. She has bright ideas for improvement and has the fortitude and determination to promote and execute change. She and I have very similar goals for RMAP, as we look to the future as a big picture, and we are constantly looking for improvement. I am not sure if you are trying to have us let her go, or not; but I must tell you, she will be the last person to be let go. Again, RMAP needs her. The difficulty found in voicing your opinion about one of OUR employees in a negative light on OUR forum, is the setting. Just like you have seen, people feed off of one another on the message boards and will only add fuel to the fire (good and bad). Hence, when stating your disappointment in one interaction with Carley on a public forum, is slanderous. Put yourself in Carley’s shoes, would you want to be a moderator of a forum to only find hate messages posted about you? From patients you care about deeply? It comes across as backstabbing. Of course, all of us can improve our customer service skills, but if presented in a constructive critique. Your approach did not appear to be a constructive critique.
And I do know, that it only makes it more difficult for us to feel that your criticism was constructive when you currently still permit other patients to degrade Carley on your blog. Do not get me wrong, blogs are personal and they are for your own particular use. I have a blog- and what I choose to write about it is my own business. However, frequently adding more anti-Carley posts is degrading, hurtful and malicious in nature. I do hope you can appreciate that and, again, see it from her perspective.
In terms of your thoughts regarding the $500 education fee, that truly did not play a role in the removal of your membership from the forums. We were already aware of the problem in the education department; hence, I was brought on. Just as much as I hope you take great pride in your weight loss journey, I take great pride in improving our education program. My priority is to provide various useful resources for our patients, and to be utilized as a resource for knowledge, a listening ear, and to offer advice when needed. Support group has become my “baby,” and do hope you can find a way to attend. I am excited with the direction it is going and am always looking for ways to improve it. Please do not hesitate to flood me with ideas, questions and concerns to help better RMAP. I so value patient input, as their satisfaction means my satisfaction. But I do hope that such input will be directed toward a single entity, like myself, and can be addressed in a constructive way.
I want to acknowledge and extend my gratitude for the many good works you have done for RMAP and our patients. It sounds like you are a great asset for those patients who know you and look up to you. And my hope for a resolution in this matter is as follows: No more negative posts about Carley, as we clearly have witnessed both negative and positive testimonials pertaining to her; all of us are striving to be better. And I hope to maintain your trust in RMAP. We are on your side, we are your allies and we want to help you succeed in any useful manner possible. We choose to do what we do, here at RMAP, because we find joy in serving you. Your experiences will be of great use to me- I hope you didn’t bite off more than you could chew when you offered your services!
Meredith, RN
Education Director
1160 East 3900 South STE 4100
Salt Lake City, UT 84124
Phone: (801) 268-3800 Fax: (801) 268-3997
Conversation with Meredith (part I)
I reached out to Meredith (the new Director of Education) today. My reason for reaching out to her was to offer her my help if it was ever deemed that it would be beneficial to RMAP. In whatever capacity. I don't have the ability (time) to go to support groups so in the past I have tried giving back by being active on the support board. Obviously since the ban by Carly, I haven't been able to do that. I gave Meredith a little background on the ban. Here's the email I sent:
________________________
Meredith.
I apologize for not being able to speak with you yesterday. Work has been crazy as of late. I just wanted to introduce myself. I had gastric bypass with Dr. Smith on April 11, 2007. My weight at the time was 474.1 lbs. As of today, my weight is at 223.2 lbs (which is 2 lbs below the goal I set for myself). The journey has been amazing and I have learned a lot about myself and how to keep myself situated on this end of the spectrum for the rest of my life.
Anyway, after surgery I spent a great deal of time on the RMAP message support board and several of the old timers helped me out a great deal. As I got further along in the journey, I found myself giving back the support I had received. There came a point where I stopped frequenting the message board and only responded when I received private messages from other patients. Over the next couple of months I had so many RMAP patients emailing me asking for me to come back to the message board that I did. However, I apparently offended Carly when I relayed a frustrating experience at my 18 month mark. The experience I related spoke about how at my year mark Dr. Smith told me to check back with him in six months just to see where I was with my weight. That conversation happened only because I told Dr. Smith I wanted to go beyond the 250 lbs mark that he had set for me. I didn't need an appointment with him but called RMAP only because he told me to check with him in 6 months regarding my weight. Anyway, Carly informed me that I'd have to pay for an appointment if I wanted to see Dr. Smith. I asked her to just ask him what he wanted because I didn't necessarily need an appointment but he had told me to check with him about my weight. If he wanted me to just stop by so he could see where I was at, great. If not, fine. Anyway, long story short... it just wasn't the most ideal customer service moment. The other portion of that email was stripping down the $500 educational fee that some of the members were complaining about. In my message, I broke down what the fee was really for -- which is the pre- and post- surgery educational component and stated that if you take advantage of that component, it's worthwhile otherwise it's not. I also stated that RMAP believes that the educational component is necessary for long-term success and require it for their patients. The result of this email was a ban from the message forum.
It doesn't really bother me that I am banned from the message board. I've completed my journey. However, after the ban many RMAP patients continue to email me to ask me questions about my journey and to get my support during theirs. I offer them my (as needed) support through a personal blog and email. One RMAP patient created a Facebook group for everyone.
Sorry for the really long email. Where I'm going with this is that I have had an amazing journey. I believe in giving back in life which is why I was on the message board to begin with. Patients do need their doctors and nurses to provide them with medical help and advice but they also need the support and help of those who have gone before. If you read through the messages left by Michelle Christensen from the start of her journey to today you will clearly see what I'm talking about. Anyway... for what it's worth, I have been and am still willing to be there for RMAP patients. I do not usually have the time to go to the support meeting each month which is why I was on the message board. But if you ever need assistance from someone who has lost 250 lbs and understands the journey (from a personal level -- not a medical level), let me know.
Also, would you please let Dr. Smith know how much he has changed my life? I owe him a lot. Losing this weight has been everything I ever dreamed and more. I've attached a few pictures so you can see the transformation.
Thanks.
Sean Joyce
________________________
Meredith.
I apologize for not being able to speak with you yesterday. Work has been crazy as of late. I just wanted to introduce myself. I had gastric bypass with Dr. Smith on April 11, 2007. My weight at the time was 474.1 lbs. As of today, my weight is at 223.2 lbs (which is 2 lbs below the goal I set for myself). The journey has been amazing and I have learned a lot about myself and how to keep myself situated on this end of the spectrum for the rest of my life.
Anyway, after surgery I spent a great deal of time on the RMAP message support board and several of the old timers helped me out a great deal. As I got further along in the journey, I found myself giving back the support I had received. There came a point where I stopped frequenting the message board and only responded when I received private messages from other patients. Over the next couple of months I had so many RMAP patients emailing me asking for me to come back to the message board that I did. However, I apparently offended Carly when I relayed a frustrating experience at my 18 month mark. The experience I related spoke about how at my year mark Dr. Smith told me to check back with him in six months just to see where I was with my weight. That conversation happened only because I told Dr. Smith I wanted to go beyond the 250 lbs mark that he had set for me. I didn't need an appointment with him but called RMAP only because he told me to check with him in 6 months regarding my weight. Anyway, Carly informed me that I'd have to pay for an appointment if I wanted to see Dr. Smith. I asked her to just ask him what he wanted because I didn't necessarily need an appointment but he had told me to check with him about my weight. If he wanted me to just stop by so he could see where I was at, great. If not, fine. Anyway, long story short... it just wasn't the most ideal customer service moment. The other portion of that email was stripping down the $500 educational fee that some of the members were complaining about. In my message, I broke down what the fee was really for -- which is the pre- and post- surgery educational component and stated that if you take advantage of that component, it's worthwhile otherwise it's not. I also stated that RMAP believes that the educational component is necessary for long-term success and require it for their patients. The result of this email was a ban from the message forum.
It doesn't really bother me that I am banned from the message board. I've completed my journey. However, after the ban many RMAP patients continue to email me to ask me questions about my journey and to get my support during theirs. I offer them my (as needed) support through a personal blog and email. One RMAP patient created a Facebook group for everyone.
Sorry for the really long email. Where I'm going with this is that I have had an amazing journey. I believe in giving back in life which is why I was on the message board to begin with. Patients do need their doctors and nurses to provide them with medical help and advice but they also need the support and help of those who have gone before. If you read through the messages left by Michelle Christensen from the start of her journey to today you will clearly see what I'm talking about. Anyway... for what it's worth, I have been and am still willing to be there for RMAP patients. I do not usually have the time to go to the support meeting each month which is why I was on the message board. But if you ever need assistance from someone who has lost 250 lbs and understands the journey (from a personal level -- not a medical level), let me know.
Also, would you please let Dr. Smith know how much he has changed my life? I owe him a lot. Losing this weight has been everything I ever dreamed and more. I've attached a few pictures so you can see the transformation.
Thanks.
Sean Joyce
Basic Gastric Bypass Information
Nutritional effects
After surgery, patients feel fullness after ingesting only a small volume of food, followed soon thereafter by a sense of satiety and loss of appetite. Total food intake is markedly reduced. Due to the reduced size of the newly created stomach pouch, and reduced food intake, adequate nutrition demands that the patient follow the surgeon's instructions for food consumption, including the number of meals to be taken daily, adequate protein intake, and the use of vitamin and mineral supplements.
Protein nutrition
Proteins are essential food substances, contained in foods such as meat, fish and poultry, dairy products, soy, nuts, and eggs. With reduced ability to eat a large volume of food, gastric bypass patients must focus on eating their protein requirements first, and with each meal. Proximal GBP rarely leads to protein deficiency if this simple precaution is followed. Distal GBP is more likely to lead to protein deficiency, particularly if fat intake is excessive, and the position of the Y-connection is farther downstream. In some cases, surgeons may recommend use of a liquid protein supplement.
Calorie nutrition
The profound weight loss which occurs after bariatric surgery is due to taking in much less energy (calories) than the body needs to use every day. Fat tissue must be burned, to offset the deficit, and weight loss results. Eventually, as the body becomes smaller, its energy requirements are decreased, while the patient simultaneously finds it possible to eat somewhat more food. When the energy consumed is equal to the calories eaten, weight loss will stop. Proximal GBP typically results in loss of 60 to 80% of excess body weight, and very rarely leads to excessive weight loss. The risk of excessive weight loss is slightly greater with Distal GBP.
Vitamins
Vitamins are normally contained in the foods we eat, as well as any supplements we may choose to take. The amount of food which will be eaten after GBP is severely reduced, and vitamin content is correspondingly reduced. Supplements should therefore be taken, to completely cover minimum daily requirements of all vitamins and minerals. Absorption of most vitamins is not seriously affected after proximal GBP, although vitamin B12 may not be well-absorbed in some persons. Sublingual preparations of B12 will usually provide adequate absorption. After the distal GBP, fat-soluble vitamins A, D and E may not be well-absorbed, particularly if fat intake is large. Water-dispersed forms of these vitamins may be indicated, on specific physician recommendation.
Minerals
All versions of the GBP bypass the duodenum, which is the primary site of absorption of both iron and calcium. Iron replacement is essential in menstruating females, and supplementation of iron and calcium is preferable in all patients. Ferrous sulfate is poorly tolerated. Alternative forms of iron (fumarate, gluconate, chelates) are less irritating and probably better absorbed. Calcium carbonate preparations should also be avoided; calcium as citrate or gluconate, 1200 mg as calcium, has greater bioavailability independent of acid in the stomach, and will likely be better absorbed.
After surgery, patients feel fullness after ingesting only a small volume of food, followed soon thereafter by a sense of satiety and loss of appetite. Total food intake is markedly reduced. Due to the reduced size of the newly created stomach pouch, and reduced food intake, adequate nutrition demands that the patient follow the surgeon's instructions for food consumption, including the number of meals to be taken daily, adequate protein intake, and the use of vitamin and mineral supplements.
Protein nutrition
Proteins are essential food substances, contained in foods such as meat, fish and poultry, dairy products, soy, nuts, and eggs. With reduced ability to eat a large volume of food, gastric bypass patients must focus on eating their protein requirements first, and with each meal. Proximal GBP rarely leads to protein deficiency if this simple precaution is followed. Distal GBP is more likely to lead to protein deficiency, particularly if fat intake is excessive, and the position of the Y-connection is farther downstream. In some cases, surgeons may recommend use of a liquid protein supplement.
Calorie nutrition
The profound weight loss which occurs after bariatric surgery is due to taking in much less energy (calories) than the body needs to use every day. Fat tissue must be burned, to offset the deficit, and weight loss results. Eventually, as the body becomes smaller, its energy requirements are decreased, while the patient simultaneously finds it possible to eat somewhat more food. When the energy consumed is equal to the calories eaten, weight loss will stop. Proximal GBP typically results in loss of 60 to 80% of excess body weight, and very rarely leads to excessive weight loss. The risk of excessive weight loss is slightly greater with Distal GBP.
Vitamins
Vitamins are normally contained in the foods we eat, as well as any supplements we may choose to take. The amount of food which will be eaten after GBP is severely reduced, and vitamin content is correspondingly reduced. Supplements should therefore be taken, to completely cover minimum daily requirements of all vitamins and minerals. Absorption of most vitamins is not seriously affected after proximal GBP, although vitamin B12 may not be well-absorbed in some persons. Sublingual preparations of B12 will usually provide adequate absorption. After the distal GBP, fat-soluble vitamins A, D and E may not be well-absorbed, particularly if fat intake is large. Water-dispersed forms of these vitamins may be indicated, on specific physician recommendation.
Minerals
All versions of the GBP bypass the duodenum, which is the primary site of absorption of both iron and calcium. Iron replacement is essential in menstruating females, and supplementation of iron and calcium is preferable in all patients. Ferrous sulfate is poorly tolerated. Alternative forms of iron (fumarate, gluconate, chelates) are less irritating and probably better absorbed. Calcium carbonate preparations should also be avoided; calcium as citrate or gluconate, 1200 mg as calcium, has greater bioavailability independent of acid in the stomach, and will likely be better absorbed.
Nutritional Deficiencies
Nutritional deficiencies:
* Hyperparathyroidism, due to inadequate absorption of calcium, may occur in over 30% of GBP patients. Calcium is primarily absorbed in the duodenum, which is bypassed by the surgery. Most patients can achieve adequate calcium absorption by supplementation with Vitamin D and Calcium Citrate (carbonate may not be absorbed - it requires an acidic stomach, which is bypassed).
* Iron frequently is seriously deficient, particularly in menstruating females, and must be supplemented. Again, it is normally absorbed in the duodenum. Ferrous sulfate can cause considerable GI distress in normal doses; alternatives include ferrous fumarate, or a chelated form of iron. Occasionally, a female patient develops severe anemia, even with supplements, and must be treated with parenteral iron.
* Vitamin B12 requires intrinsic factor from the gastric mucosa to be absorbed. In patients with a small gastric pouch, it may not be absorbed, even if supplemented orally, and deficiencies can result in pernicious anemia and neuropathies. Sublingual B12 appears to be adequately absorbed.
* Thiamine deficiency (also known as beriberi) will, rarely, occur as the result of its absorption site in the jejunum being bypassed. This deficiency can also result from inadequate nutritional supplements being taken post operatively.
* Protein malnutrition is a real risk. Some patients suffer troublesome vomiting after surgery, until their GI tract adjusts to the changes, and cannot eat adequate amounts even with 6 meals a day. Many patients require protein supplementation during the early phases of rapid weight loss, to prevent excessive loss of muscle mass.
* Vitamin A deficiencies generally occur as a result of the deficiencies that involve the fat-soluble vitamins. This often comes after intestinal bypass procedures such as jejunoileal bypass (no longer performed) or biliopancreatic diversion/duodenal switch procedures. In these procedures, fat absorption is markedly impaired. There is also the possibility of a vitamin A deficiency with use of Xenical or Alli weight loss medications.
* Hyperparathyroidism, due to inadequate absorption of calcium, may occur in over 30% of GBP patients. Calcium is primarily absorbed in the duodenum, which is bypassed by the surgery. Most patients can achieve adequate calcium absorption by supplementation with Vitamin D and Calcium Citrate (carbonate may not be absorbed - it requires an acidic stomach, which is bypassed).
* Iron frequently is seriously deficient, particularly in menstruating females, and must be supplemented. Again, it is normally absorbed in the duodenum. Ferrous sulfate can cause considerable GI distress in normal doses; alternatives include ferrous fumarate, or a chelated form of iron. Occasionally, a female patient develops severe anemia, even with supplements, and must be treated with parenteral iron.
* Vitamin B12 requires intrinsic factor from the gastric mucosa to be absorbed. In patients with a small gastric pouch, it may not be absorbed, even if supplemented orally, and deficiencies can result in pernicious anemia and neuropathies. Sublingual B12 appears to be adequately absorbed.
* Thiamine deficiency (also known as beriberi) will, rarely, occur as the result of its absorption site in the jejunum being bypassed. This deficiency can also result from inadequate nutritional supplements being taken post operatively.
* Protein malnutrition is a real risk. Some patients suffer troublesome vomiting after surgery, until their GI tract adjusts to the changes, and cannot eat adequate amounts even with 6 meals a day. Many patients require protein supplementation during the early phases of rapid weight loss, to prevent excessive loss of muscle mass.
* Vitamin A deficiencies generally occur as a result of the deficiencies that involve the fat-soluble vitamins. This often comes after intestinal bypass procedures such as jejunoileal bypass (no longer performed) or biliopancreatic diversion/duodenal switch procedures. In these procedures, fat absorption is markedly impaired. There is also the possibility of a vitamin A deficiency with use of Xenical or Alli weight loss medications.
Living with Gastric Bypass
Gastric bypass surgery has an emotional, as well as a physiological, impact on the individual. Many who have undergone the surgery suffer from depression in the following months. This is a result of a change in the role food plays in their emotional well-being. Strict limitations on the diet can place great emotional strain on the patient. Energy levels in the period following the surgery will be low. This is due again to the restriction of food intake, but the negative change in emotional state will also have an impact here.
It may take as long as three months for emotional levels to rebound. Muscular weakness in the months following surgery is common. This is caused by a number of factors, including a restriction on protein intake, a resulting loss in muscle mass and decline in energy levels. The weakness may result in balance problems, difficulty climbing stairs or lifting heavy objects, and increased fatigue following simple physical tasks. Many of these issues will pass over time as food intake gradually increases.
However, the first months following the surgery can be very difficult, an issue not often mentioned by physicians suggesting the surgery. The benefits and risks of this surgery are well established; however, the psychological effects are not well understood, and potential patients should ensure a strong support system before agreeing to the procedure.
It may take as long as three months for emotional levels to rebound. Muscular weakness in the months following surgery is common. This is caused by a number of factors, including a restriction on protein intake, a resulting loss in muscle mass and decline in energy levels. The weakness may result in balance problems, difficulty climbing stairs or lifting heavy objects, and increased fatigue following simple physical tasks. Many of these issues will pass over time as food intake gradually increases.
However, the first months following the surgery can be very difficult, an issue not often mentioned by physicians suggesting the surgery. The benefits and risks of this surgery are well established; however, the psychological effects are not well understood, and potential patients should ensure a strong support system before agreeing to the procedure.
Sugar Alcohol
In commercial foodstuffs sugar alcohols are commonly used in place of table sugar (sucrose), often in combination with high intensity artificial sweeteners to counter the low sweetness. Sugar alcohols do not contribute to tooth decay.
As a group, sugar alcohols are not as sweet as sucrose, and they contain fewer calories than sucrose. Their flavor is like sucrose, and they can be used to mask the unpleasant aftertastes of some high intensity sweeteners. Sugar alcohols are not metabolized by oral bacteria, and so they do not contribute to tooth decay. They do not brown or caramelize when heated. In addition to their sweetness, some sugar alcohols can produce a noticeable cooling sensation in the mouth when highly concentrated, for instance in sugar-free hard candy or chewing gum.
Sugar alcohols are usually incompletely absorbed into the blood stream from the small intestines which generally results in a smaller change in blood glucose than "regular" sugar (sucrose). This property makes them popular sweeteners among diabetics and people on low-carbohydrate diets. However, as for many other incompletely digestible substances (such as dietary fiber), overconsumption of sugar alcohols can lead to bloating, diarrhea and flatulence because they are not absorbed in the small intestine. Some individuals experience such symptoms even in a single-serving quantity. With continued use, most people develop a degree of tolerance to sugar alcohols and no longer experience these symptoms. As an exception, erythritol is actually absorbed in the small intestine and excreted unchanged through urine, so it has no side effects at typical levels of consumption.
People who have undergone gastric bypass surgery, specifically Roux-en-Y (RGB), should be careful not to eat too many sugar alcohols as doing so can lead to "dumping".
As a group, sugar alcohols are not as sweet as sucrose, and they contain fewer calories than sucrose. Their flavor is like sucrose, and they can be used to mask the unpleasant aftertastes of some high intensity sweeteners. Sugar alcohols are not metabolized by oral bacteria, and so they do not contribute to tooth decay. They do not brown or caramelize when heated. In addition to their sweetness, some sugar alcohols can produce a noticeable cooling sensation in the mouth when highly concentrated, for instance in sugar-free hard candy or chewing gum.
Sugar alcohols are usually incompletely absorbed into the blood stream from the small intestines which generally results in a smaller change in blood glucose than "regular" sugar (sucrose). This property makes them popular sweeteners among diabetics and people on low-carbohydrate diets. However, as for many other incompletely digestible substances (such as dietary fiber), overconsumption of sugar alcohols can lead to bloating, diarrhea and flatulence because they are not absorbed in the small intestine. Some individuals experience such symptoms even in a single-serving quantity. With continued use, most people develop a degree of tolerance to sugar alcohols and no longer experience these symptoms. As an exception, erythritol is actually absorbed in the small intestine and excreted unchanged through urine, so it has no side effects at typical levels of consumption.
People who have undergone gastric bypass surgery, specifically Roux-en-Y (RGB), should be careful not to eat too many sugar alcohols as doing so can lead to "dumping".
Thursday, February 5, 2009
ALL THINGS SUPPORT GROUP
Utah County Support Group Established
Finally, the moment many of us have all been waiting for...
Beginning in March, we are pleased to offer a Utah County Support Group!
When: 1st Wednesday/Month @ 7pm
Where: Timpanogos Regional Hospital, Women's Center Classroom
The program will mirror Salt Lake City's support group, so you will receive the same benefits and not miss out on unique opportunities.
Leaders: Lesa Hazen, (801) 423-2580, mom2hazen@comcast.net
Tess McCormick, (801)-766-9876, tessr5871@yahoo.com
Jeannine Whittaker, (801) 373-6759, jfrogmusic@msn.com
Special Announcement: You can now find a 12-month Support Group Program on our website UtahBariatrics.com, under Home and RMAP Announcements.
February Support Group
Salt Lake City: February 11, 2009 @ St. Mark's, Room G04C, 6pm
Speaker: Leslie Miller, LCSW (WLS patient)
Leader: Meredith Mangum, RN (801) 268-3800,
meredith@rmapinc.com
Kim Cundick (801) 268-3800, kim@rmapinc.com
Ogden: February 10, 2009 @ Ogden Regional, Oak Room, 7pm
Speaker: Chuck Nuttall, MD (Psychiatrist and WLS patient)
Leader: Gloria Merritt, (801) 737-0351, mokimom@sisna.com
Finally, the moment many of us have all been waiting for...
Beginning in March, we are pleased to offer a Utah County Support Group!
When: 1st Wednesday/Month @ 7pm
Where: Timpanogos Regional Hospital, Women's Center Classroom
The program will mirror Salt Lake City's support group, so you will receive the same benefits and not miss out on unique opportunities.
Leaders: Lesa Hazen, (801) 423-2580, mom2hazen@comcast.net
Tess McCormick, (801)-766-9876, tessr5871@yahoo.com
Jeannine Whittaker, (801) 373-6759, jfrogmusic@msn.com
Special Announcement: You can now find a 12-month Support Group Program on our website UtahBariatrics.com, under Home and RMAP Announcements.
February Support Group
Salt Lake City: February 11, 2009 @ St. Mark's, Room G04C, 6pm
Speaker: Leslie Miller, LCSW (WLS patient)
Leader: Meredith Mangum, RN (801) 268-3800,
meredith@rmapinc.com
Kim Cundick (801) 268-3800, kim@rmapinc.com
Ogden: February 10, 2009 @ Ogden Regional, Oak Room, 7pm
Speaker: Chuck Nuttall, MD (Psychiatrist and WLS patient)
Leader: Gloria Merritt, (801) 737-0351, mokimom@sisna.com
RMAP EDUCATIONAL DIRECTOR
Introducing Meredith Mangum, RN
Due to changing needs and Centers of Excellence requirements, we are pleased to announce the new Rocky Mountain Associated Physicians' Education Director, Meredith Mangum.
During the Summer of 2008, she worked as Dr. Steven Simper's medical assistant. Upon graduation from Boise State University's Nursing Program, she joins us again as a Registered Nurse. We are very excited for the direction and passion she brings to our Education Department and to help better serve you!
Feel free to contact her with any questions or concerns: meredith@rmapinc.com
(801) 268-3800
Due to changing needs and Centers of Excellence requirements, we are pleased to announce the new Rocky Mountain Associated Physicians' Education Director, Meredith Mangum.
During the Summer of 2008, she worked as Dr. Steven Simper's medical assistant. Upon graduation from Boise State University's Nursing Program, she joins us again as a Registered Nurse. We are very excited for the direction and passion she brings to our Education Department and to help better serve you!
Feel free to contact her with any questions or concerns: meredith@rmapinc.com
(801) 268-3800
Wednesday, February 4, 2009
Another Viewpoint
I thought about not posting this but ultimately figured that I don't want anyone else to have the experience I did -- and by making others aware of it perhaps somewhere down the line RMAP will realize it needs to address it. With that said, I did ask the author if I could post this but promised to keep his/her name private.
---------------------------------
Hi,
So that is funny that I'm reading your post and I had a bad experience with Carly too at RMAP. She is young, rude and doesn't have any kind of sympathy for FAT people. They should not have her as a nurse there. They need people who will be compassionate toward heavy people. She just is not.
I can't believe they hired her.
Uh!!!!!!!!!!!!!!
---------------------------------
Hi,
So that is funny that I'm reading your post and I had a bad experience with Carly too at RMAP. She is young, rude and doesn't have any kind of sympathy for FAT people. They should not have her as a nurse there. They need people who will be compassionate toward heavy people. She just is not.
I can't believe they hired her.
Uh!!!!!!!!!!!!!!
Frustrations
So two days after reaching 225 lbs again, I find myself back up to 229. What happened?!? It's frustrating because I've been so good. I haven't had much carbs at all, the calories have been within the desired range and my water has been good. I'm almost positive it's water retention but why? I'm not going to beat myself up too much about it, I know I'm on the right path. If I was eating a bunch of stuff that was boosting my daily caloric intake to unknown heights, I'd be worried. It's just frustrating.
Valentine's Day
Valentine's Day is coming up next week. How many of you are NOT looking forward to it (by show of hands)? Wow, that many. Interesting. Same here. I haven't ever been in a relationship where Valentine's Day was amazing so it's never been my favorite holiday. When I was married, my wife was the worst at making any day special. I've been dating but I'm not deep into any relationship at the moment so it's kind of a ho-hum deal this year as well. But keep your eyes on the future, you never know when this day might elevate itself to a much better day.
Improvements
One thing I would really like to hear about from everyone is a list of things that have gotten better in your life since the surgery. Whether that is being able to go to Lagoon, running up a flight of stairs, being able to walk, having the opposite gender pay you more attention, or just plain sex (have you noticed PALIN [as in Sarah] uses the same letters as PLAIN? I just noticed that). Anyway, please email me your lists. It will be fun to compile them and find out how many of us have these things in common. You can find my email address by clicking on my profile under my picture.
Valentine's Day
Valentine's Day is coming up next week. How many of you are NOT looking forward to it (by show of hands)? Wow, that many. Interesting. Same here. I haven't ever been in a relationship where Valentine's Day was amazing so it's never been my favorite holiday. When I was married, my wife was the worst at making any day special. I've been dating but I'm not deep into any relationship at the moment so it's kind of a ho-hum deal this year as well. But keep your eyes on the future, you never know when this day might elevate itself to a much better day.
Improvements
One thing I would really like to hear about from everyone is a list of things that have gotten better in your life since the surgery. Whether that is being able to go to Lagoon, running up a flight of stairs, being able to walk, having the opposite gender pay you more attention, or just plain sex (have you noticed PALIN [as in Sarah] uses the same letters as PLAIN? I just noticed that). Anyway, please email me your lists. It will be fun to compile them and find out how many of us have these things in common. You can find my email address by clicking on my profile under my picture.
Monday, February 2, 2009
Continuation of my Journey
Okay, so quick update. As of today (2/2/09), I'm back at 225 lbs. Yay! I'll tell you, it is amazingly easy to put the weight back on even now than it is to take it off. But at least I know that I can do it whenever I want.
Now... for today's thoughts:
When I went into surgery I told myself that I wasn't going to date for 24 months. I figured with the amount of weight I wanted to lose, I was in it for 24 months. I think that was a wise choice. I'm starting to date a bit now and I've actually met someone really nice who I've started to date a bit. I hope that will work out. My self-esteem and confidence about myself is at an all new level and I've lost all the weight that I started out to lose. Now I just need to figure out to pay for and schedule the surgery to at least remove a good portion of my excess skin.
It's funny to me that people tell you that you shouldn't let your weight keep you from things but those people have never been 474 lbs. The difference in how you are perceived and treated is amazing. Even by those who it doesn't really matter much to. Since losing the weight, I feel like I've been phased into the same reality as all those who I watched live life for so many years. Finally I can experience and be a part of the same world I saw for so many years. It's exciting.
The future has taken on a million new colors and now it's up to me to make sure I make the right choices in who I elect to date, etc. And most of all it remains a MUST to be forever vigilante as to my weight, what I'm eating, how much I'm drinking. It truly is a lifelong commitment. It sounds like a daunting task but carrying around an extra 250 lbs is a daunting task. This is nothing.
Take care.
Sean
Now... for today's thoughts:
When I went into surgery I told myself that I wasn't going to date for 24 months. I figured with the amount of weight I wanted to lose, I was in it for 24 months. I think that was a wise choice. I'm starting to date a bit now and I've actually met someone really nice who I've started to date a bit. I hope that will work out. My self-esteem and confidence about myself is at an all new level and I've lost all the weight that I started out to lose. Now I just need to figure out to pay for and schedule the surgery to at least remove a good portion of my excess skin.
It's funny to me that people tell you that you shouldn't let your weight keep you from things but those people have never been 474 lbs. The difference in how you are perceived and treated is amazing. Even by those who it doesn't really matter much to. Since losing the weight, I feel like I've been phased into the same reality as all those who I watched live life for so many years. Finally I can experience and be a part of the same world I saw for so many years. It's exciting.
The future has taken on a million new colors and now it's up to me to make sure I make the right choices in who I elect to date, etc. And most of all it remains a MUST to be forever vigilante as to my weight, what I'm eating, how much I'm drinking. It truly is a lifelong commitment. It sounds like a daunting task but carrying around an extra 250 lbs is a daunting task. This is nothing.
Take care.
Sean
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