SOAPBOX TIME: NOTHING IS FOREVER

NOTHING IS FOREVER (unless you work at it) This is a speech I gave at Dr. Warnock's support group meeting in June - about the dangers of becoming complacent - and the things we need to do to guard against falling into old habits and regain. Hope it helps some. I had my surgery November 29, 2001 and lost about 160 pounds. I have spoken to the support group two previous times about the remarkable changes this surgery has brought to my live. This time is different; I'm not standing here proud as a pea**** about the weight I've lost and my success. That is not to say that I'm not proud of my success - I am. But I have another agenda today. We have been given a tremendous tool - one that can change our lives forever. But I want to caution you - nothing is forever without work and dedication. Dr. Warnock tells each of us that the surgery is a tool to help you lose a great percentage of your excess weight - it is NOT a cure for obesity. There is, or can be, an inherent pitfall in weight loss surgery. During the honeymoon period - those months of rapid weight loss during the first year, it is virtually impossible to NOT lose weight. During this time, not only can we eat less, but our intestines are not absorbing all the calories we ingest. So, you can eat small amounts of foods and lose - that even means that you ca n eat foods that aren't necessarily good for you - and still lose weight. Please don't get lulled into thinking that something is ok to eat because it is diet or sugar free. That is not necessarily the case. Calories count and always will. I am a prime example of what CAN happen if you become complacent about your weight loss. The first year or two, I was so very compliant. I did not eat junk food at all - and if I had an occasional piece of sugar free candy, it was just that - an occasional piece. But somewhere down the line, things changed. I relaxed. Stress became a major factor in my life - I am in constant pain from severe arthritis; while I was hospitalized having a knee replacement, my home was robbed and we lost virtually everything and the next day, my sister's apartment burned - my son was there and had to break out a window to escape. But even then, I managed to not do too badly til I was laid off from my job the following May. That was the proverbial straw that broke the camel's back, so to speak. I was out of work for 5 months and the stress was horrible. My unemployment paid my rent and utilities but we had to depend on my son's earnings from waiting tables for extras, like food. Guess what? Healthy food isn't inexpensive. But, stress wasn't the only factor in my saga - I made bad food choices. I became an ostrich with my head in the sand until one day, I got a favorite pair of slacks out and they were tight - very tight. Still I ignored the fact that I had to be gaining weight - I didn't want to deal with it I guess. I had started a new job and there again, stress was a factor. When I wasn't working, I found that I could have a protein drink for breakfast and not eat much for lunch or dinner and do ok. But when my days began starting at 5 AM instead of 8 or 9, I found that I was hungry if I only had a protein drink and didn't have lunch til 1. So I started eating oatmeal for breakfast because it kept me full. And, after all, oatmeal is good for you. Well, oatmeal is also very high in calories. And I found it convenient to go to the food bar at work and get lunch - they have a nice salad bar. However, there isn't much protein on it except eggs and cheese. Not the best choices in the world. And then there is the campus store with its tempting popcorn and chips. Yes, popcorn and chips - two major no-nos for me. I am a carboholic - sweets aren't that big an issue but salty foods are. I know some of you can eat two little crackers once a month and be content; I can't - I eat one and that leads to another and another and so on. My point is that most of us will have to work our tool diligently for the rest of our lives if we want to maintain our wonderful weight loss. I didn't make a conscious decision to eat the wrong foods and to gain weight; it crept up on me. And when it finally hit me, I was stunned, shocked and horrified. Reality hit when I had to go back to plus sizes for an outfit I wanted. And it was a very bitter pill to swallow. My warning to each of you is to stay the course with your eating plan after surgery. Don't fall into the trap of thinking that something is ok because it's sugar free or fat free. Read labels. Eat foods that will work toward keeping you slim and trim and healthy. That one bite of cake or cookie probably won't hurt you - but what happens when one bite turns to two or three or four, soon to become a whole piece of cake or two or three cookies? And what if that becomes a DAILY habit? The same thing applies to chips and popcorn and pretzels - one or two won't kill you. But it's my opinion that even allowing yourself a couple of pieces of these foods can lead you to allow yourself permission to indulge too much. And before you know it, old eating patterns are returning. I have two fears. The first is of becoming Morbidly Obese again. I live in dread of that. The second is of being hungry. I know that sounds strange but I really am afraid of becoming hungry when I'm out. At work, there is nothing that is safe for a snack- there are cookies, chips, candy and all sorts of junk but no way to buy an apple. It's way too tempting to say, "well, just this once, won't hurt". It will - at least for me, it will. There are two major keys to success. One, I believe, is planning. Plan for what you need to eat. Take the food you eat to work, and if you don't, then don't eat. Second, DON'T eat in the car. I also find it helpful to keep a food journal - there is a wonderful program online called Fitday.com. You can track your protein, caloric and carb intake there and know exactly what you are eating and how much of it. That way, if you need to make changes, you can. There is an old saying, "prevention is the best medicine". Well that applies to us. If you prevent yourself from regaining, then you don't have that bitter pill called "dieting" to deal with. You prevent yourself from having to work to lose weight. But if you have already gained, what do you do to lose it. It's simple - you eat less calories than you burn up. That is the bottom line. Sounds so easy doesn't it? Well, believe me, it isn't. Many people talk about going back to eating like they did as new post-ops to try to lose weight. Sounds like a good idea but you have to realize that you can't go back to the way you ate the first month or so; you will be hungry and then you will eat the wrong foods. So, what should we eat? Dr. Warnock has told me to have a protein drink for breakfast, salad and protein for lunch and protein for dinner. That leads to food choices: I used to eat a lot of cottage cheese - it's high protein and low calorie. But I've found that it doesn't keep me satisfied. I eat it and then in a couple of hours I'm hungry - and I mean really hungry. When you are a new post-op, yogurt is great - it's easy on the pouch and has a fair amount of protein. For those of us who are trying to lose regained pounds, I don't see it as a good option. Your pouch will treat it almost like a liquid and you will be hungry. And then you will want to eat again. Also, you have a lot of natural sugars in yogurt, even the low carb stuff. So, I would think that yogurt wouldn't be a good choice for us. For me, the best sources of protein are grilled meats, fish and shrimp. I have a George Foreman grill (a very good appliance for post-wls) and I prepare pork chops, chicken, beef, salmon filets and other fish on it. It's quick, easy and virtually fat free cooking. I also eat quite a bit of boiled shrimp. I try to avoid foods that are processed like sausage, hot dogs and luncheon meats. They are full of preservatives, salt, and even hidden sugars that we don't need. Nothing is better for us than freshly prepared foods. I buy the pre-packaged salad mixes and I try to avoid the ones that are heavy in iceberg lettuce. Iceberg lettuce is water and your pouch will treat it as such. I love the field greens and leaf lettuce and romaine. Add a little cucumber, some radishes, a little diced red pepper and some celery and you have a great, low calorie, high fiber salad. I am currently using fat free salad dressings because of the great savings in calories. I'd much rather get my calories from a good piece of meat than from liquid fat poured over my salad. Adding spices to your foods help with satisfaction also - keep your meals interesting. To me, these are good choices. I'm not saying that I always manage to stick to them. I do slip but I'm trying very hard to keep my slips to slight stumbles and not complete falls. When I was a new post-op, I evaluated every bite I put in my mouth. How much protein and nutrition was I getting for my calories? I established a ratio that I worked for. I wanted every 10 calories I ate to have at least 1 gram of protein. I don't think that's a bad ratio - it helps give an idea of how much benefit we can get from a food. Right now, my biggest struggle is with fruit. I am trying not to eat sugars at all and the fresh fruit looks so good. But until I get my losing jump-started, I will attempt to avoid it. Fruits to avoid are watermelon, cantaloupe, bananas and pineapple - they are very high in sugar and they don't offer enough good nutrients to make it worth the calories. The bottom line for each of you is to do what Dr. Warnock tells you. His 20+ years experience with wls will benefit each of us; he has learned and is learning so much and if we follow his guidelines, then we will become and will remain successful in our weight loss attempts. We are all different; our bodies metabolize foods differently and therefore, we should each do what Dr. W tells us to do; not what he told someone else. For example, what's right for Kim, obviously isn't right for me. Exercise is and has been a four-letter word for me because of the extreme pain I'm in at all times. For a while, though, I was attempting to walk about a mile a day and was doing it with great regularity. Now, I've had to give that up. My knee surgeon has told me to not walk anymore than I absolutely have to - and that walking for exercise is definitely taboo. I attribute the lack of movement to helping me gain weight. I know it's a factor. I'll venture to say that most of us didn't exercise when we were MO - it was too difficult, embarrassing or even impossible. It's difficult to break old habits especially when you are losing weigh so fast without exercise. But, please, if you can, do some kind of aerobic exercise on a regular basis. It will help with your weight loss initially but it will also help you form good habits - exercise can become a good stress reliever and is much healthier for you than that bag of M&Ms or chips you want to munch on when life gets tough. Remember that exercise not only burns calories but it also releases endorphins which help suppress the appetite. So, if you can, get up and move - and if you are already exercising, step it up some. I am so looking forward to having my knee replacement surgery and recovering from it so that I can try to start some sort of exercise program. I am convinced that is the key to long term success for me. Is there anyone here who would like to tell their story of making poor choices or of traveling down the wrong track. I know that for me, confession was very good for the soul - and it might be for you too. I want to congratulate each and every one of you for deciding to become healthier. That is what this surgery is all about - health. It's not about what size you wear; what your measurements are or what the scales say. Don't compare yourselves to others; you are an individual and whether you've lost 50 pounds, 100 pounds, 150 pounds or 200 pounds you are a success. And for those of you who are pre-op or even just investigating the surgery, you are taking the first steps toward a healthier life - and that's a good thing I stand here before you heavier than I was the last time I spoke to this group. I am not thrilled about that but I have decided to not let myself become depressed by it. I am human and I faltered. I can wallow in self-pity or I can become pro-active and lose the weight. I have chosen the latter. We have a group for Dr. Warnock's patients who are more than a year post-op. Lately, we have been concentrating on those of us who have gained or are in fear of gaining as longer term post-ops. Anyone who fits this category is welcome to join us. I try to post each day what I've eaten for the day; I find it helps me to see it in writing and it's a good way to get feedback from others. Since I originally wrote this, I've had some other thoughts. I think that it's possible that after the weight loss stops, we lose something else. We lose the EXCITEMENT of losing weight - we are no longer getting a lot of attention from others because of the rapid and extreme changes. In essence, we have become like everyone else and there's a certain amount of let down. The attention that we got from friends, co-workers, healthcare providers, family and others produced a "high" for us. After reaching goal (or at least a stable weight), that goes away. And I really believe that can be a factor in somewhat of a letdown. I know I miss the excitement of losing - and I, for one, was somewhat disappointed in where my weight loss stopped. I had an unrealistic expectation. I stopped about 20 - 30 pounds heavier than I wanted to be - and even though Dr. Warnock was more than pleased with my weight loss, I think, down deep, I wanted to the "skinny". I think I've gotten past that but I really do believe that the loss of that "high" and the excitement of losing is a downer. The last thing I want to talk about is support groups. I think that having good support (and not just the first few months post-op) is vital to success. I didn't have any problems maintaining my weight as long as I was able to come up here for the meetings; my gaining started after getting to the monthly meetings became impossible. I am hoping that I will get to come every other month now, if not every month. I need the support and encouragement, and I'll dare say, so do you. I know it's not possible to be here every month, especially for those of us from out of town. But try to find a WLS buddy, if nothing else. You need someone who is or has experienced what you are experiencing with whom to share feelings, fear, and, yes, success **These things were added after I wrote this so I'll just list them here: Sugar Free Milanos 170 Calories Reg. Milanos 170 Calories Sugar Free Jelly Beans have 10 MORE calories than regular ones. Dr. Warnock asked me to mention that people who are having problems losing or are regaining, to not eat the following fruits: bananas, watermelon, cantaloupe and pineapple. They are very high in sugar and are mostly water with almost no dietary fiber - all those calories run right through you right to your hips or waist. He also asked that I mention no eating in the car. And that exercise is good for several reasons; not only does it burn calories and help lose but it produces endorphins which create a sensation of fullness and wellbeing.

Good Post Patty, and thank you, I needed that today...

Thanks Val. I do believe you read that before I got up in front of 120 people and bared my soul. That wasn't easy - but as they say, confession is good for the soul. The good news is that it got several others who were having problems to open up and talk. After all, to me, that's what support meetings should be about - whether in person or in an online forum like this. Patty

THANKS FOR YOUR SOAPBOX. ALL IS WELCOMED HERE. ELLE

Elle, Read your ost last night about gaining. It's tough isn't it. Good going with the gym - I really do believe that exercise is vital. Never thought I'd say that. Give yourself some time and don't worry about the numbers - with the toning, you might keep the pounds but lose the inches. Most of all, keep on trying. Patty

THANKS PATTY. I WORKED OUT LONG AND HARD TODAY. IT MAKES ME FEEL GREAT. I THINK I OVER DID IT A BIT. I HAD A CYST REMOVED MY MY LEG THAT'S BEEN THERE SINCE I HAD MY THIGH LIFT 2 YEARS AGO. IT WAS A FLUID POCKET THAT'S BEEN DRAINED MANY MANY TIMES THAT KEPT COMING BACK, SO HE FINALLY CUT IT OUT. ABOUT A 2 IN*****ISION, AND I RODE THAT BIKE HARD AND HEAVY TODAY. NOW MY LEG IS A LITTLE SORE, BUT MAYBE THAT'S A GOOD THING. LOVE YA PATTY, ELLE

Patty this is a wonderful speech. It frustrates me to no end when I see people on the main board posting X number of pounds gone forever. They are in for a very rude awakening, I'm afraid.

I HAVE TO AGREE WITH YOU DELORES. IT JUST CURDLES MY STOMACH TO SEE SOMEONE POST THAT. NOTHING IS FOREVER, RIGHT? ELLE

Delores, A couple of months ago, I posted some thought similar to those in the speech on the main message board. I was roasted by a lot of people who were new to me. The main thing seemed to be "I had this surgery to be normal and I'm ging to eat what other people eat". Well, we aren't normal and we won't ever be. I dare say that most of us have eating disorders or we wouldn't have been MO to begin with. And our bodies don't metabolize food like "normal" people. That is especially true for those of us who have yo-yo dieted for years. Dr. warnock told me that we aren't normal now and we weren't normal when we tood a cheesecake or a bag of chips or cookies to bed and ate the whole thing. Of course, he's right. And the surgery didn't change the basic disorder - it gives us the tool to change ourselves. The ones who continue to think that they can be normal (whatever that is) and eat candy and cookies and ice cream are in for real trouble. I chose the title for the speech because of the X number of pounds gone forever. Like you, it irritates me no end. Nothing is guaranteed and it's definitely not forever if we don't work hard. Patty

Patty-Love your post. I'm gonna cut it out and post it somewhere. I got really roasted on the Florida board a couple weeks ago. For warning a newbie 2 weeks out that starting out trying various very bad food was not a good way to do it. I love the enthusiasm of the people getting surgery. What I don't understand is why so many of those people really think they have all the answers. Smart people learn from each other. Oh--and "normal" people don't have to have their insides rearranged in order to live a healthy life. For most of us "normal" is something we will never be on the inside. Have a great day!