Need some advice from my fellow Pennsylvanians about a revision to RNY
Hello all, I am seeking your advices as I begin the research process for a revision to my RNY.
I had RNY in Pittsburgh with Dr. Hamad in February 2002. The procedure went well and I lost weight consistently for just about 18 months. Then slowly, the weight began to inch back up. I was active, doing an hour of aerobics 3-5 times a week, monitoring my diet and it still crept up. There would be weeks where overnight I would gain 10 pounds and I just could not shake it off. About a year ago, I stopped aerobics after 2 stress fractures in less than a year. Since then, I admit, my exercise has been horribly lacking.
I had gotten to a weight loss of 180 pounds and have gained back over 100 pounds of it. I would be lying if I said I was 'perfect' on my eating, however, I do not have eating habits consistent with that weight gain. I have been working on thyroid issues since 2004/2005 and have been referred to a nutritionist from my primary care doctor. The nutritionist actually believes that I am not eating enough and has given me some ideas about portions/calorie intake. I rarely eat out, do very little processed foods, on occasion I drink something while eating, am not a sweet/junk eater. I try to minimize my carbs or select complex carbs,but do have not eliminated them altogether. I try to get in my proteins first and then everything else.
I have a PPO with Highmark Blue Shield and am wondering about options in Western PA or others recommendations. I have not been back to see my surgeon, as I've been trying to tackle it on my own and really feel like I've been a complete failure at this point. Not sure where to turn next. I'm at a loss, well with everything except my weight that is!
I've recently gotten engaged and am ready to move my life forward but hate how unhealthy I am and long to be back where I was in 2003/2004.
your help would be most welcome!
I had RNY in Pittsburgh with Dr. Hamad in February 2002. The procedure went well and I lost weight consistently for just about 18 months. Then slowly, the weight began to inch back up. I was active, doing an hour of aerobics 3-5 times a week, monitoring my diet and it still crept up. There would be weeks where overnight I would gain 10 pounds and I just could not shake it off. About a year ago, I stopped aerobics after 2 stress fractures in less than a year. Since then, I admit, my exercise has been horribly lacking.
I had gotten to a weight loss of 180 pounds and have gained back over 100 pounds of it. I would be lying if I said I was 'perfect' on my eating, however, I do not have eating habits consistent with that weight gain. I have been working on thyroid issues since 2004/2005 and have been referred to a nutritionist from my primary care doctor. The nutritionist actually believes that I am not eating enough and has given me some ideas about portions/calorie intake. I rarely eat out, do very little processed foods, on occasion I drink something while eating, am not a sweet/junk eater. I try to minimize my carbs or select complex carbs,but do have not eliminated them altogether. I try to get in my proteins first and then everything else.
I have a PPO with Highmark Blue Shield and am wondering about options in Western PA or others recommendations. I have not been back to see my surgeon, as I've been trying to tackle it on my own and really feel like I've been a complete failure at this point. Not sure where to turn next. I'm at a loss, well with everything except my weight that is!
I've recently gotten engaged and am ready to move my life forward but hate how unhealthy I am and long to be back where I was in 2003/2004.
your help would be most welcome!
Do you have any other health issues? Such as lymphedema? I have it and it can put a lot of weight on you suddenly. I went thru physical therapy for 3-4 months and started wearing a compression garment along with using nuematic compression theraphy at home. This condition can be triggered by many different things including spices, coffee, carbs of any sort, etc. Changes in the weather can effect it also. Are you experiencing swelling in your limbs? For a long time I thought I needed a revision, my weight loss was slow to none. Then when I started wearing the compression garment and going to therapy I dropped 40#, then another 20# when I had my kitchen remodeled and lost access to my stove, microwave and sink for 2 weeks. I found that if I eat the same thing repeatedly I did not lose weight. I found I need to constantly change my foods and keep my carbs extremely low. When my carbs exceed 50 gr. I stall out. I also need to keep my calories below 1,000 to lose. I have reached a point where I have no fat left to lose, however, I still carry extra weight due to the lymphedema.
Some days your the dog and some days your the hydrant.
Hi. Let me first say that I applaud your honesty and courage in posting - it's not easy to admit to "feeling like a failure" in this journey. But I think you'll find a lot of support - and a little "tough love" -- here, as we try to help you get back onto the path you want to be on. Sorry - this will be a long post....
My first question to you is "what did you do during those first 18 months that has changed?" Pretty much everyone loses weight during the "honeymoon" period... but only those who truly modify their nutrition, lifestyle, and relationship with food actually keep it off. We have a saying - the doctor only operated on our stomachs, not our heads. It's relatively easy to keep your head in the game when you're losing, but as the loss slows or stalls, it's also easy to get "defeated" and start allowing yourself to play head games. "It's only a cracker." "One bite of that won't hurt." "I deserve that food treat." "I'll indulge today and take it back off tomorrow." etc. This is where I've found that daily support group participation (online) and monthly in-person support groups really help me stay on track and honest with myself and with others.
Most of us are food addicts. I am addicted to sugar and white carbs. My only hope lay in completely eliminating sugar from my diet and severely restricting white carbs... without those two steps in recovery, I will find myself eating inappropriately, making bad choices, and letting bad habits creep back in.
Second question. What have you tried so far to get yourself back on track? You still have your tool. It still can/should work if given the chance. Have you done a 5-day pouch test? (google it for instructions) That might be helpful in getting your head back into the game and reasserting your habits. Have you tried going back for a longer time to the eating protocol your doctor had you follow post-op? (I've heard it recommended to go to what your recommendation was at 3 months out, then stick to that for a while.) If you haven't read it (or haven't read it lately)... "Anatomy of a Food Addiction" by Anne Katherine is an awesome book that can provide some amazing insights into the psychology and physiology of eating behaviors. Was a life-changing read for me.
Third question. Have you been weighing/measuring/journaling your food intake? If not, try it for a week or two. (I use sparkpeople.com which is free and very simple... other options out there are fitday.com and livestrong.com/dailyplate) Be completely and unflinchingly honest with yourself. If it goes in your mouth, calculate it and journal it. See where you actually are with your nutritional targets. That might tell you very quickly where the problem is (i.e., your calories are good, but your fats are too high, or your carbs and protein are out of proportion). Portion distortion is a VERY common problem, especially as we get farther out. We THINK we're eyeballing something as 3 oz of protein (a serving for us), but weigh it and it's actually 5 oz... that really adds up over time.
Final observation... exercise is really key to losing and maintaining. It ramps up your metabolism at the time, but more importantly it builds muscle. The same weight of muscle takes up less room than fat AND burns calories just by existing. So someone who has 60 pounds of muscle on their frame is burning more calories while sleeping than someone who has 30 pounds of muscle.... and will probably look about the same weight! Stress fractures are nasty, but there are LOTS of good (and fun) ways to get both aerobic and strength exercise without undue impact or stress on vulnerable body parts. I'd strongly suggest working with a physical therapist or personal trainer for a couple of sessions to get some safe ideas... and just to get out and walk aggressively in the meantime.... or get into a pool... or stretch on a mat in your livingroom... It's also a terrific mood booster and may help you get into the positive frame of mind you'll need to tackle this.
You have done this before, so you know it's in your power to do it and to succeed. It's not a sprint, it's a marathon, so just start by putting one foot in front of the other and before you know it you'll be well on your way. Literally take this one meal, one bite at a time. Whether you opt for revision surgery or just reactivate the tool you already have, these things will need to be part of your plan and they are things that are free and within your reach to start right now. Keep us posted!
Karen
My first question to you is "what did you do during those first 18 months that has changed?" Pretty much everyone loses weight during the "honeymoon" period... but only those who truly modify their nutrition, lifestyle, and relationship with food actually keep it off. We have a saying - the doctor only operated on our stomachs, not our heads. It's relatively easy to keep your head in the game when you're losing, but as the loss slows or stalls, it's also easy to get "defeated" and start allowing yourself to play head games. "It's only a cracker." "One bite of that won't hurt." "I deserve that food treat." "I'll indulge today and take it back off tomorrow." etc. This is where I've found that daily support group participation (online) and monthly in-person support groups really help me stay on track and honest with myself and with others.
Most of us are food addicts. I am addicted to sugar and white carbs. My only hope lay in completely eliminating sugar from my diet and severely restricting white carbs... without those two steps in recovery, I will find myself eating inappropriately, making bad choices, and letting bad habits creep back in.
Second question. What have you tried so far to get yourself back on track? You still have your tool. It still can/should work if given the chance. Have you done a 5-day pouch test? (google it for instructions) That might be helpful in getting your head back into the game and reasserting your habits. Have you tried going back for a longer time to the eating protocol your doctor had you follow post-op? (I've heard it recommended to go to what your recommendation was at 3 months out, then stick to that for a while.) If you haven't read it (or haven't read it lately)... "Anatomy of a Food Addiction" by Anne Katherine is an awesome book that can provide some amazing insights into the psychology and physiology of eating behaviors. Was a life-changing read for me.
Third question. Have you been weighing/measuring/journaling your food intake? If not, try it for a week or two. (I use sparkpeople.com which is free and very simple... other options out there are fitday.com and livestrong.com/dailyplate) Be completely and unflinchingly honest with yourself. If it goes in your mouth, calculate it and journal it. See where you actually are with your nutritional targets. That might tell you very quickly where the problem is (i.e., your calories are good, but your fats are too high, or your carbs and protein are out of proportion). Portion distortion is a VERY common problem, especially as we get farther out. We THINK we're eyeballing something as 3 oz of protein (a serving for us), but weigh it and it's actually 5 oz... that really adds up over time.
Final observation... exercise is really key to losing and maintaining. It ramps up your metabolism at the time, but more importantly it builds muscle. The same weight of muscle takes up less room than fat AND burns calories just by existing. So someone who has 60 pounds of muscle on their frame is burning more calories while sleeping than someone who has 30 pounds of muscle.... and will probably look about the same weight! Stress fractures are nasty, but there are LOTS of good (and fun) ways to get both aerobic and strength exercise without undue impact or stress on vulnerable body parts. I'd strongly suggest working with a physical therapist or personal trainer for a couple of sessions to get some safe ideas... and just to get out and walk aggressively in the meantime.... or get into a pool... or stretch on a mat in your livingroom... It's also a terrific mood booster and may help you get into the positive frame of mind you'll need to tackle this.
You have done this before, so you know it's in your power to do it and to succeed. It's not a sprint, it's a marathon, so just start by putting one foot in front of the other and before you know it you'll be well on your way. Literally take this one meal, one bite at a time. Whether you opt for revision surgery or just reactivate the tool you already have, these things will need to be part of your plan and they are things that are free and within your reach to start right now. Keep us posted!
Karen
I'm struggling with sme issues but my surgery was in 2008.........
I would definitely check back in with your surgeon.....make 100% certaint hat there is nothing anatomically failing about your surgery site. (Stretches, for example.) If you have a stretched pouch or stoma, it will be difficult to keep weight off.
I'm going back to basics.....and working to resolve my stretched stoma. Meeting with nurtitionist tomorrow.
If you'd like to communicate via PM.... feel free......
FYI --- my mom's family hails from Fryberg and Venus PA!!!!
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