Sparkling insight

One of the comments on a post a few days ago, generously contributed by Sparkler, demonstrated incredible insight into some aspects of my predicament. I'm going to address them one by one and see where it takes me:

This is a really tough time in the journey...all the newness has worn off, you're nearly there so you're probably pretty comfortable with your weight right now, so the urgency has dropped.

That is SOoooo right. Truth is, if I didn't lose another pound - I'd be a little disappointed but I wouldn't be devastated, because the worst of the weight has gone. I started at 20 stone, I now weigh about 12 and a half. I'd like to be ten and a half - but I'm thin enough that I can walk, jog, swim - and all with relative comfort. I can buy 'normal' clothes in 'normal' shops for the first time in my adult life and so the urgency has gone. Spot on Sparkler. But when I sit down and really think about it - I don't want to settle for this - it is less than I wanted when I started out and I want better. I am not looking for perfection but I do want to be in control of my eating and my weight. No, I wouldn't be devastated if I didn't lose another pound, but I don't think I would look upon my band experience as a complete success either.

Everything about the band is so familiar which means it doesn't take much thinking about.

Yes, you're right again. But this is the problem. I often THINK it doesn't need thinking about because it's so familiar - but actually it does. For example, I thought I'd 'cracked' the think about not drinking after eating - I thought it had become second nature. But in the last few months I have got back into bad habits again. Also, I have had more slime and regurgitation events in the last few months than I've ever had. This is not because my band is too tight - it's because sometimes I just forget it is there and get back to old eating habits (eating too much, too quick, the wrong type of food, eating while distracted etc). I probably need to get out my old 'band manual' and re-read it again from start to finish and keep on reminding myself that I have a little friend inside me - and it's going to be there for life....

I'd be interested to hear what your restriction is like now on an average day. Do you still eat the same small portion sizes or are you able to eat more at a sitting? Do you still have certain foods that are a no-go area? What's it like once it all becomes routine, mundane and everyday?

When I make good food choices I have excellent 'sweet spot' restriction. My meals are small and they fill me up. I can't guzzle a drink down fast like I used to but have to take it in smaller mouthfuls and slowly. I'm much more restricted in the morning and can't really eat much till mid-morning. IF (and it's a big IF) I don't eat chocolate and other 'bad' foods, I exist very happily on about 1200 calories a day and don't feel physically hungry at all. There's no sign of my band getting looser. There are very fews that are a no-go area - mainly chips (French fries), very fatty foods like battered fish (chip-shop style), and the skins of cherry tomatoes and grapes! I avoid white bread but can easily eat whoolemeal bread (though not in large quantity). Many of the things that I used to perceive as big problems or difficulties - just aren't! I can eat out but do so very cautiously. So far I have avoided having any embarrassing incidents while eating out and would like it to remain that way!

Good luck with getting that focus back to fight off that last stubborn stone and a half. Actually having a break from the strict regime probably won't do you any harm as once you get back to your walking and cut out the lovely but lethal chocolate you'll be like a new dieter who has a really rewarding first three weeks or so. A post-Easter resolution perhaps?

You may be right about having a break from the strict regime but I think I need to get back to it soon. Now that work has eased off I am finding time to get back to some exercise - walking, stepping and swimming mainly. I think you are right - I will wait until I am firmly back in the UK after my trip and then set a date to kick-start my band-life.

Many thanks for your insight and encouragement!

A few light snacks......

Here's what I went out and bought this afternoon to meet my 'needs' - a small buttons Easter egg (yes, there are still a few left in the shops), a box of Weight Watchers (ironic, I know) carrot cake slices, a packet of cashew nuts, a chocolate muffin mousse, two kitkats (I ate one of them on the way home), two Freddo bars, a plain chocolate bar (apparently they're less addictive...?), some maltesers, a Dairy Milk bar, three strawberry trifles and a bag of mini chocolate eggs. I expect much of this will have been consumed by this time tomorrow - on top of my normal 'meals'. Of course, my meals are generally quite 'healthy' and I experience a good level of restriction when I eat them. But this lot - no chance - no restriction whatever.

I looked up 'how do I stop emotional eating' on the web today and came across an organisation called Food Addicts in Recovery Anonymous - they're U.S-based and styled on A.A. (Alcoholics Anonymous). Unbelievably, there's a group operating in Liverpool so once I am back from my travels (I am away in Washington D.C. from Thursday for a week), I may give them a call and see if they can help.

I used to call my bingeing 'comfort eating' but I've given it a lot of thought and I know I don't just do it for 'comfort' - it's also when I'm lonely, stressed, fearful, bored, anxious, lacking courage, self esteem or confidence, and just about any other negative emotion you can think of. It's clearly a serious problem for me and one that threatens to jeopardise my band success so far. I have to get it sorted.

As I say, I'm off overseas for a week in a few days and my eating habits will be at the mercy of travel arrangements, hotels, conference organisers and the like - so I'll make do with what I get and when I get it. But once I return I have to tackle this problem head-on or I'll be back where I started. I'm thinking I may make an appointment with the hynotherapist I cancelled a few weeks ago - anyone got any experience of hynotherapy? Does it work? Can I be hypnotised to hate chocolate for the rest of my life? Will it help me gain* control of what food goes into my mouth?

*I was going to write 're-gain' - but I'm not sure I ever had any control to start with! I wonder why..... what happened in my childhood that made me this way? If I get control of eating, will I start to crave something else - will I become an alcoholic or smoker instead? .......or perhaps a sex-maniac - now that would be something!!!!!!

Back to bandland

Hello everybody - it's been a while! As I sit here wondering what to type, I look back on the past few months and ask myself what has happened? Why have I deserted my blog? It's not just the blog, I have also rarely visited the UKGastricBand forum in the last couple of months - which previously I had visited several times a day. I also kept a food diary - yes, that book in the kitchen that hasn't been touched for a couple of months now. I religiously weighed myself every morning - and now it's once or twice a week - if I dare. If I look through my cupboards in the kitchen, I notice some old favourites have crept back in - bottles of Diet Coke, and the dreaded chocolate. And yes, I know it's Easter, and we can all be forgiven a little luxuriating in the brown stuff at this time of year - but I've hardly stopped eating the stuff for weeks now.

So I ask again - what's going on? I think it's a combination of things - there's no straightforward answer. Here's a few stabs at what is going wrong:

1. The 'light-at-the-end-of-the-tunnel' blues. Looking at the UKGB forum, it's clear that this doesn't only apply to me. As we get closer to our goal weight - that elusive target that for the first time actually appears reachable - it somehow remains just out of our grasp. I've lost nearly eight stone and have a relatively paltry one-and-a-half left to go - yet it's the hardest few pounds of the lot. I've made all of the major changes to portion sizes, exercise, bad habits (though some have crept back in) - so every ounce now needs a monumental effort to lose. The result is, frustration begins to set in - and in my case - that leads to stress - which is relieved through eating. Back to the vicious circle.

2. Workaholicism (is that a new word I've invented?!). I know I can't blame everything on work - but this really has been the hardest extended period at work I've ever experienced. Since late August 2009 until the beginning of March this year - it has just been bedlam. I've literally done nothing but work, work, and work. Exercise has all but disappeared from my life, as has any social life, family life and relaxation. Don't get me wrong - I still manage to watch the goggle box from time to time - but it's not so much relaxation as complete collapse! On the bright side, work has definitely got better in the last three or four weeks and should remain so until the real pressure begins all over again in September (!). But I'm making the most of it and have already begun getting back on the exercise treadmill (not literally).

3. Chocaholicism (another new word). Mmm, yes, not sure how to lick this one (another awful pun!). I am clearly addicted to chocolate. Apparently it's not possible to be physiologically addicted to chocolate in the way that you can be addicted to drugs, caffeine, nicotine etc. But it IS possible to be emotionally addicted to chocolate - and I am. I actually booked an appointment with a hypnotherapist some weeks back, but then bottled out at the last minute and cancelled it! Having re-thought this - I'm going to have another go in the next few weeks definitely - what's the worst it can do? And it might actually help.

4. No longer a newbie. Sometimes I look on the UKGB forum and see the same old questions being posed by newbies - the questions I posed myself when I first started out on this journey. I answer questions occasionally but I'm not really sure what I can offer anymore. It's the same with this blog. I've probably said all of the really important things and I sometimes think can I really add anything useful anymore? However, one thing that strikes me, is that there is relatively little written on the web by long term bandits. I'd love to know what it's like to be bandit three or five or ten years on. It's also clear to me that the struggles I'm going through now are not the same as those I experienced earlier in my journey. That probably makes it worthwhile continuing to write. However, I'm aware that new bandits, or people thinking about getting banded, don't necessarily want to read about longer term bandits who are struggling and facing all sorts of problems. I'd hate to put anyone off - because whatever struggles I am facing now - I would not change one step of my band journey. If I time-travelled back to the start of my journey, knowing what I know now - I couldn't change a thing. It's been the best thing I ever did in my life.

So, there are several reasons why I will begin to write again - because I now have more time back to myself, because I still think it may help longer term bandits (and help newbies to better informed about the ups and downs of banding), and because I need to give myself some therapy. What's that last point I hear you ask? Well, I know that many of you have enjoyed reading my blog because you've told me so - and that's great. But it's also therapy for me. It's when I'm writing, or thinking about what to write, that I often make important breakthroughs in my own thinking, planning and behaviour analysis. Even as I write this, it has been brought home to me that I have drifted away from some of the cornerstones of my weight loss success so far - my food diary, daily blogging, daily trips to UKGB forum, and generally immersing myself in day-to-day thoughts, facts, ideas about weight loss, exercise, environmental control, habits, portion sizes, calorie counting and the rest. It's as though I've forgotten all of this - it has been put to one side for more important things to take its place. But what is more important than feeling good about oneself, being healthy and fit, looking good, having a respectable level of self esteem, and being able to wear great clothes?!

So, there are lots of reasons why I've been silent for a while but probably as many reasons why I need to get back on the case and start to get serious about my band, my eating, my exercise, and above all - sharing again. Thank you for staying with me.

Oh, and I'm seriously thinking about 'coming out' - watch this space.

Ups and downs

Hello people! This has been the longest I've ever left it between posts - I'm writing a Masters thesis so working every waking hour. It'll be done in a week so I can get back to blogging more often. Anyway, what have I been up to? Well in terms of physical activity - absolutely nothing. I've been sitting on my backside most of the time and not got my heart pumping for ages. My eating habits have been all over the place. Some days I've managed to put away 3000 calories or more, and other days I've got by on a third of that! One recent development which is helping things is that I've given up chocolate for Lent! Lent only began this Wednesday so I've gone without the brown stuff for just four days so far - another 36 to go....

Another new development is that in the past month, on days when I've over-eaten, I have had bad acid reflux at night. I've had to lay propped up on pillows and I've been taking Zantac pills to help. Of course when I eat more sensibly the acid disappears - so it's my body's natural warning to do just that. Makes sense really!

Today, somewhat out of the blue, I had one slime episode, and another slimy regurgitation episode. The first was triggered by nothing more than drinking some cold Ribena a little too fast, and the second was triggered by eating half a small yoghurt after my lunch.....?! Anyway, since then I've been eating somewhat cautiously the rest of the day.

Something else happened today which I found surprising. I was talking to a complete stranger at work. She'd obviously seen a head and shoulders photograph of me on the staff noticeboard and commented that I'd lost a lot of weight. I find this surprising because:

1. It was very observant on her part
2. I wasn't aware that it was so obvious - just from a head and shoulders shot
3. She asked how I'd lost the weight and I immediately blurted out 'I've got a gastric band!' - to a complete stranger! Oh well, I'm obviously getting a lot more relaxed about it!


I'll be back posting again soon. All the best.

Intertrigo, going going gone...

In 2004, I developed a horrendous, itchy, red fungal infection under the folds of my hanging stomach (I do hope you weren't eating anything!). It reached its climax when I was on holiday in Canada and I ended up in casualty. That in itself is a long story (about ten hours long if I recollect correctly), but I'll get on with the main point. This red fungal infection turned out to be something called intertrigo, a common fungal infection experienced by obese people with hanging folds of skin. You can get it under armpits, breasts, and groin as well as under the tummy where I got it and it thrives in hot, sweaty places! It doesn't look very nice but the worst part is that it is incredibly itchy - to the point where you feel physically sick.

I got some temporary relief for the condition while on holiday but had to wait till I got back for a longer term solution. In fact I was prescribed a steroid-based cream by my GP which I used, at her insistence, for nearly six months. By this time, the infection had not only resolutely stayed, but I had started to develop horrid, open blisters too. I began to suspect the cream was making things worse and did a bit of Internet research. I discovered to my horror, that the manufacturers recommended the cream not be used for more than ten days - because being steroid-based, it was prone to causing thinning of the skin (permanent) and open, ulcerated blisters!

Needless to say, I stopped using the cream immediately, and on the advice of a pharmacist, reverted to an off-the-shelf product instead. That did the trick and I've used a combination of cream and powder ever since to keep the condition under control. I've been left with permanent scarring under one part of my tummy but I don't suppose I'll be modelling bikinis any time soon - so I can live with it! However, over the past few weeks I have started to think I might be rid of the condition. My tummy still sticks out a bit - that will have to be sorted with some excess akin removal next year. But I don't have a hanging tummy any more. That means the area underneath no longer gets all hot and sweaty - and so it stays dry and fungus-free.

As a result I have started to grow in confidence recently, and gradually cut down on my use of the anti-fungal cream and powder. I've not used either now for the past two weeks and it would appear that my intertrigo has gone!! Yippee!! This is one of the most important outcomes of my weight loss. A few months ago I really thought I would be stuck with having to apply cream and powder to my tum for the rest of my life. I feel a weight (no pun intended) has been lifted off my shoulders.

Fat Man Slim

This evening I watched a documentary on Sky Three called Fat Man Slim. It was about an obese, 40 year old successful businessman who decided to change his life. He weighed 26.5 stone and vowed to lose 6 stone in 12 months. He also gave up work for a year so that he and his wife could focus on weight loss, health and fitness. In the event, he lost that amount in the first six months. He did it with his wife by eating non-processed goods, lots of fruit and veg, and doing lots of exercise. 

After achieving his one year target in six months he set a new target to lose another 20kg in the last six months. With two months to go he had just 5kg to go, so he changed it to 10kg because that would have added up to a total of ten stone for the year! He achieved his ten stone goal after one year. Amazing. This is a guy with bucketloads of determination. To continue losing weight at this rate he was going to the gym twice a day, five times a week, and eating three small meals a day. 

It was fascinating to see him go through the same clothes stages that I did - first they wouldn't fit, then they would, they they were too big! 

At the end of his journey his whole face appeared so much thinner and he looked younger and basically fab. Seeing a whole year condensed into an hour offered a fascinating insight into the way that the body can change, given the right treatment. The man, known as 'Squeeze' (!) said that over the year he passed through five emotional phases:
 
Shame
Guilt
Anger
Acceptance
Recovery process

He talked about the inner battle he has had with himself - not just in the past year but always - and not just about weight but with most things. He talked about how he has learnt how to manage this 'inner battle'. The layers of emotional baggage, fat, and constant over-compensation (e.g. for his weight, lack of fitness and self-worth) - they are all gone now. All that's left is him. On the one hand this is great because he's now just himself, but it's also a little scary.  

There was a fascinating meeting with his doctor at about the four month point. The doctor asked him how he was, what he thought of himself having lost so much weight? His response? "I loathe myself less". The doctor was a little taken aback and obviously had no real understanding of the self-loathing and low self-esteem issues faced by many obese people. The doctor afterwards said to the camera that it was surprising that despite all of his successes in life - work, home, marriage - he doesn't have a very high opinion of himself. I can relate to this totally. 
 
Squeeze said that it's not until you admit you have a problem and commit yourself to changing things, that you start to seriously think about how you see yourself. Maybe you're not so aware of self-loathing before, or perhaps you just bury it. He talked about how he was always seen as the fat fool, disguising inner struggles with humour and bravado: "Bravado is a wonderful tool for divorcing yourself from your situation and I used it in spades". 

And finally, some advice for weight losers who start to get over-confident: "Whenever I started feeling cocky I would stand in front of a full length mirror and jump up and down stark-b*****k naked. Believe me - that's motivation!"  

How many calories per day?

Thanks to another bandit who posted on the UKGastricBand forum, I've discovered a web site called Calories Count. It has a useful tool for calculating the number of calories required for weight maintenance, but I also found a calculator for determining the number of daily calories required for weight loss. I entered my height, weight and age, and said I was lightly active. This is what it said: Current weight 168lbs; healthy weight range 123-161lbs; activity level - lightly active. Current BMI: 25.9 Healthy BMI range: 18.5 - 24.9.

Daily calorie level to maintain current weight: 1989 calories.
To lose weight: 1489 calories.

"Please note you should not go below 1400 calories per day, as this is the minimum amount necessary to meet your daily nutrient requirements. If the calorie level determined for you is below 1400 calories, you may want to consider increasing your exercise. However, if you are unable to do that, you will still lose weight, it will just be at a slower pace (approximately 1/2 pound or .25 kg per week)."

"To lose one pound (.5 kg) a week, a person must burn 3,500 calories more than are consumed (500 calories per day over the course of a week)."

This is good news for me because I have been really struggling to maintain a 1200 calorie a day intake. I manage it on some days, and sometimes even have less. But on other days it seems woefully inadequate and I end up eating loads more. If I stick to about 1489 per day, then according to this web site, I should still lose one pound per week. I think that at this stage in the weight loss process (i.e. I can see the light at the end of the tunnel), it's no bad thing to increase my daily intake and try to be a bit more consistent - this should help when I get to the point of having to maintain.

Predisposed to gluttony

There was an interesting item on the One Show on BBC this evening. They are taking a look at the seven deadly sins - one each day - and it was gluttony's turn today. First the question was asked, why are we so gluttonous? Is this something we are predisposed to from an evolutionary point of view? Well, apparently yes. In ancient times food was relatively scarce, particularly in the winter months. Therefore we would eat what we could find and hunt in the summer months of relative plenty and gain weight. This extra fat would have seen us through the relatively lean days of the winter. The difficulty for modern (western) people is that food is never in shortage and therefore we simply gain weight and become obese.

The programme makers then asked if there was anything we can do to overcome this - so they performed a simple experiment. They got four people to fast for 24 hours. They were then allowed to eat as much as they wanted. Blood samples were taken during the fasting, during the eating and afterwards. They tested two groups of hormones, those that relate to hunger (ghelin) and several others that indicate satiety - or fullness. They found that, as expected, the ghelin was very high before eating - because they were hungry from their 24h fast. Ghelin levels then fell during eating and again afterwards. However, it took 30 minutes for this hormone to fall. At the same time, the levels of satiety hormones increased during and after eating - but again there was a delay of about 30 minutes before any change took place.

The problem with delay this was illustrated superbly by one of the participants, who, in less than 30 minutes, ate a substantial meal of steak, chips and peas, and no less than FIVE desserts!! This totalled more than 3,000 calories - far higher than the recommended total daily intake for a man of his height and weight! Adrian Chiles, one of the programme presenters joked that he usually tried to eat his food as quickly as possible so that he could eat it all before that 'full' feeling had time to kick in!!

So, the moral of this tale, is EAT SLOWLY! This is what our band providers tell us all the time and here is the reason why. So, message to self: Eat slowly, eat with small utensils to facilitate this, put the knife and fork down between mouthfuls, chew everything a lot to slow it down even further and finally, don't get distracted while eating because this tends to make us eat even faster!

Working with my band

Here is the essence of what I replied to an anonymous comment - you may find it useful:

Stretching your pouch: If you eat very slowly, which is what we are advised to do, then food will gradually pass from the upper pouch into the lower, main stomach. However, if you eat too quickly, or eat too much in one go, there is a small danger of stretching the pouch. This is usually temporary but if serious this can lead to band slippage. However, long before you get to the point of stretching your pouch it is likely that you would experience pain (often referred to by bandits as 'iron fist') behind the breastbone - this is your body's way of warning you that you should slow down when eating!

Anti-hunger pills: The whole point of the band is that by retaining food in the upper pouch, you 'trick' your brain into thinking that you are full, and so don't feel hungry. Therefore, if you work with the band, you shouldn't feel hungry and there should be no need to use additional drugs or supplements to reduce hunger. Personally, I would never use Reducteel or anything similar - I have paid a lot of money to have gastric band surgery and am determined to work with it.

The band and liquids: The band does not restrict liquids at all and we are always encouraged to drink plenty - therefore you should never experience thirst with the band - you can drink as much as you want (however, try to drink calorie-free drinks).

Dealing with hunger: I can honestly say that I have rarely experienced real hunger in my entire life. However, the biggest difficulty that many obese people experience is not real hunger, but what we often refer to as 'head hunger'. In other words - emotional hunger. This is something that the band cannot deal with. As a result of my emotional craving for food, yes, I have eaten loads on occasions, including binge-eating of chocolate. However, most of the foods we eat when over-eating and binging are foods that slip through the band easily anyway (e.g. chocolate, cakes, biscuits, crisps, fast food etc). Therefore, these foods generally don't increase the risk of pouch stretching - but of course they increase all sorts of other health risks.

Advice for new bandits: I think the important thing for a newly-banded person is to find out as much as you can about the band and how it is supposed to work - ideally from medically-trained people. The band will only do 30% of the work in weight loss - we have to work with the band to achieve the other 70% of effort necessary. This is far from easy and requires a considerable effort and commitment on our part. I've fallen flat on my face many times in my band journey because of my own weakness and lack of self-control, but at the same time I know that my band is my friend and if I work with it, it is a friend indeed.

As with all of the things I post on this blog, this is all just my opinion, based on my own research and most importantly, my experience. We all have very different bodies, needs, personalities and histories, so my experience may not be the same as yours! Always try to get support and advice from your band provider, dietician or bariatric nurse.

A long Sunday walk

On Sunday we tackled what will be the first of many Lake District walks this year. We climbed the summits of five Wainwright peaks - Grisedale Pike (791m), Crag Hill (839m), Sail (773m), Outerside (568m) and Barrow (455m). It took us 6.5 hours and included about 1150m of ascent in total, over about 9 miles. The Lake District, like much of the country now, was covered in deep snow, making some parts of the route very hard-going and we wore crampons most of the day. There were lots of other like-minded people out on the fells and the views were breathtakingly beautiful.

We completed the route in semi-darkness and wound our weary way home. Too tired to cook, we defeated some of the calorie-burning achieved by opting for a Chinese takeaway!! I think I have a beter idea now, of the enormity of the challenges I have set myself this year. In addition to completing this 214 challenge, it is also my intention to reach my goal weight - some 22 pounds from my current weight. Although this may seem small amount compared to what I have already lost, it is turning out to be SOooo much harder to shift. Just to make things even more difficult for myself, I also hope, by the end of the year, to have begun the process of removing some of my excess skin - as time goes on I am more convinced of the need for at least two lots of surgery to correct this.

So here we go, hold on for the roller coaster ride that is sure to be 2010!!