Good girl, bad girl

You've said it, done it. You're a good girl (or boy) when you stick to your diet, or exercise, or stop-smoking program. You're a bad girl (or boy) when you screw up that program.

The reward-punishment cycle is hard to stop when it's so deeply ingrained in us, but it is possible to end or at least reduce the occurence of the negative stuff. One of the things that has helped me regain control over my eating behavior (on many levels) is keeping a food log.

Entering my food intake (including time of day, amounts, the eating environment, my physical hunger, any eating problems, and how I felt emotionally before, during, and after eating) has forced me to put on my scientist hat. I've always thought of myself as an intuitive, creative person, not a scientific one, but sometimes when I act a part, I become the part. When I've written down all this data about my eating, it's easier for me to see it with an objective eye. Patterns that are invisible to me when I'm in the middle of a situation become clear when I've backed far enough away from it. Things that I didn't understand when they happened to me yesterday have new meaning when I study them today.

Things that I don't want to understand also become clearer to me when I see them in my food log. For example, after my weight loss surgery it became increasingly difficult for me to eat when sharing a meal with my elderly mother. Twenty years earlier, eating with her was a joy because we both loved food and the conversation that surrounds a meal. As she grew older, fussier, more confused, more demanding, the joy drained away and I found myself in the middle of painful stuck episodes every single time we ate together. A few hours after each incident, I would find myself seeking comfort in food, like stopping at Baskin-Robbin's for a 670-calorie Cappuccino Blast after leaving Mom in the capable hands of her assisted living facility staff.

I loved my mom, I loved our old ritual of enjoying meals together, but it was just wasn't working any more. Time to make a change. After that realization, when it was time for family meal, I spent the time fussing over Mom instead of trying to eat my own meal. I ate my meal later, when Mom was safely tucked in bed.

The take-home message here is this. Try to avoid the extremes of "good girl, bad girl" thinking, not just in your eating but in your exercise, work, parenting, and anything else you undertake. Sometimes a little bit good can be good enough, and a little bit bad doesn't signifty the collapse of western civilization. Try to be a kind, tolerant, bur firm parent to yourself. Instead of screaming, "Bad girl!" when you fall off the bandwagon, give yourself a boost back up onto the wagon by saying, "That wasn't good, but I know you can do better, so go do it!"

Hosting a holiday party

If you will be the host of a party this holiday season, you'll have plenty of control over the agenda and menu that you would as someone else's guest. Although your kids might clamor for your famous fudge, pecan pie or cornbread stuffing, you can plan a menu that also includes healthy choices. You can also drastically simplify the menu. When fellow humans somewhere are dying of malnutrition, it's almost arrogant to serve 3 meats, 3 starches, 3 cooked veggies, 3 salads, 3 beverages, and 3 desserts for Christmas dinner.

If you're Christian, think for a minute about the meals Jesus enjoyed in his time...fish, bread, water, wine...would he expect green bean casserole, pineapple ham, sweet potatoes with marshmallow topping and death-by-chocolate-cake for his birthday party?

If you present a simple, wholesome meal, you'll reduce your own food temptations and give yourself more time to enjoy the company of your family friends. This may be the first year in the history of your family that you'll be able to get down on the floor to help a child or grandchild discover the wonders of her or his new toys. Is a plate of cookies truly better and more lasting than that kind of miracle?

If you don't spend 4 hours eating at your holiday gathering, what else are you going to do? There are lots of possibilities: pose for and take photographs or videos, play charades, learn more about each other by asking and answering questions in a Chat Pack (questmarc.com), sing Christmas carols or karaoke style pop tunes, ask the oldest members of your group to describe the holiday celebrations of their youths. Don't waste your social time vegetating in front of the television for hours unless the program you watch will celebrate the season and/or stimulate interaction amongst your guests. If all else fails and the natives are restless, go for a walk together. We live out in the country now, but when we lived in a suburban setting, my husband and I liked to walk the neighborhood and admire (or critique) our neighbors' landscaping and seasonal decorations. It might be fun to take those antsy kids for a neighborhood cruise and ask them to vote for the best and worst outdoor holiday decorations.

Whatever you do, remember the reason for the season: the birth of Jesus, the festival of lights, the seven principles of Kwanzaa, the turning-point of the winter solstice...

Just a Little Thing

I've been looking for a long-sleeved light or medium pink tee shirt to layer under other clothes because I'm so cold all the time. JC Penney's juniors and misses departments have dark pink in various shades, but too dark for me. So the other day I wandered over to the children's department and found the perfect shirt, marked down to $5.19. It's a girl's XL and it fits perfectly!

I felt triumphant about that for 10 minutes or so...then I thought, hey, you're not child sized...it's kind of sad that today's children need sizes so large that a medium-sized adult can wear them.

According to a customer I helped earlier this week, I'm "just a little thing." When customers are shopping for gifts and don't know what size the recipient wears, they use my body as a point of reference. This customer was holding a misses size small pajama set and didn't believe me when I told her I wear a medium. Apparently, I'm the size of her granddaughter..."just a little thing."

Weight loss without exercise?

People often ask, "Why do I have to exercise? Can't I just eat less to lose weight?"

I asked fitness expert Caroline Duncan, BS, CFI, CPT about this. Her response? Of course you can lose weight without exercising if you drop your food intake enough. But that victory comes with a big price tag: your health. Losing weight that way is equivalent to starving yourself. You lose water (which you can and must replace) and bone (hard to replace), and you cause an electrolyte imbalance that makes it impossible for your body to maintain important functions in your heart, muscles, nerves, kidneys, and so on. When you lose weight without exercising, you're not building the muscle mass you need to power your body's everyday movements and boost your metabolism.

Caroline explains:

The human body is truly unique in that it has internal built-in mechanisms in which it communicates on an intracellular level to function and respond to specific needs. For example, during times of dehydration, the brain signals to the cells and kidneys to conserve water. While thirst becomes evident, the kidneys conserve water and the energy level slows. During weight loss, the brain communicates to the body organs and other cells by sending messages as if to say, "Hang on to every ounce of water, fat, and other valuable nutrients" as it senses that "famine" is about to take place.

For some individuals, it is the first few pounds that are the lardest to lose. Afterwards, the body adjusts and adapts by slowlty responding to the change. The human body takes on a mental and physiologic preparedness in times of stress whether it's from weight loss, illness, or body assault such as surgery or traumatic injuries.

While the human body was meant to move, not everyone enjoys exercising. Exercising as we know it comes in different forms; it can be strenuous or not. The most important message is to do something active daily - without exercise, muscle atrophy occurs. Think of exercise like brushing your teeth. If you don't brush, plaque forms on your teeth, and if you eat and don't move your body, plaque forms in your arteries. Find something you like to do - walk the dog, do body stretches while watching television, or simply walk around in the house. You don't have to belong to a gym to move your body or become active. The combination of proper nutrition and movement of the body will make you stronger. It's the small, subtle changes that can make a significant difference.

The take-home message? As Caroline says, to date, there is no man-made, engineered machine that can replicate the uniqueness of the human body. You only get one body in this lifetime. If you take care of it, feeding and exercising it well, it will help you accomplish all your goals, not just in weight loss but in every part of your life.

Back to my fighting weight

This morning I weighed 133.6 pounds....only 1.6 pounds away from my lowest post-op weight. When I got dressed for work, I thought, "Dang, girl, you're looking cute!" So I had my husband take these photos of me. Aside from the turkey neck (I am 57 yrs old, after all), I think I look pretty good for an old broad. This is an outfit I never would have dared to try before now, never mind wear it to work. And speaking of work, here's a funny story that falls into the NSV category.

Many of my coworkers are college kids, each one cuter than the last. I saw one of them in the break room and said, "Kassyndra, I haven't seen you all day. Have you been avoiding me?"

Kassyndra (who is black) occasionally speaks ebonics, usually for dramatic effect. She said, "Miss Jean, you just too fly for me today. I ain't want you around me cuz nobody be noticing me, all they eyes be on you!"

The Band versus the Sleeve

I'm glad we have choices of different bariatric surgery procedures, but sometimes having choices makes our decisions harder. I'm working on a weight loss surgery decision making tool to help bariatric patients weigh their options, risks, benefits, and so on. In the meantime, I'll just talk a bit about my own WLS decision.

When my surgeon explained the vertical sleeve gastrectomy (VSG) procedure at the educational seminar I attended at the start of my WLS journey, I thought it sounded interesting, but the idea of losing most of my stomach forever unnerved me, whereas the band (and its adjustability) just seemed right for me. I felt that I intellectually understood how the band works (though later I realized that I had understood only a fraction of that), and I had an intuitive sense that it was going to work for me.

For a year or so after my band surgery, I thought that if (God forbid) I ever lost my band, I would revise to the sleeve. Then I learned that the sleeve causes acid reflux in many patients, so that sleeve patients are automatically prescribed acid reducing medication from day one. I could not tolerate one day of acid reflux, and one of my goals in losing weight was to lose some or all of my meds, not gain a new med!

But I also must mention that the sleeve still might be a good choice for me, especially if getting the fills and aftercare the band requires would be difficult for me (logistically or financially). I don't personally know anyone who's had sleeve surgery, so (sadly) I have no stories to tell about it.

My poop-eating dog

Georgie, my poop-eating dog, usually appears on my pet blog, 9dogshowling.blogspot.com, but since I mentioned him in my Green Eyed Monster post, I feel I should share a picture of him with you. If nothing else, it will remind you that even supremely handsome men like Georgie can have nasty habits.

The Green-Eyed Monster

Shakespeare called jealousy the green-eyed monster. I use the same term rather loosely, to describe the malevolent beast who chews on my heart when I'm jealous or envious. Officially, though, jealousy and envy are different things.

Jealousy is what you feel when you fear that something or someone (like your spouse, or the job that you and a coworker named Debbie are competing for) will be taken away from you. Envy is what you feel when you want something or someone that another person already has: their weight loss success, their bank account, their fancy car, their 9-bedroom home.

In my experience, both jealousy and envy get me on a never-ending, tiresome treadmill of comparison and criticism. It becomes an obsession so blinding that I can't see any of the good things happening in my life. I compare myself to others, like my ex-husband's beautiful and devoted female lab assistant, or Debbie's MBA degree that I'm sure will earn her the promotion I want, or Marcia's 148 pound weight loss which is 100 pounds more than mine. Adding up my skills, talents and accomplishments results in a negative number every time, and those flashing red numerals reinforce my often unrealistic concept of all the pluses on Debbie's and Marcia's side. I hate them for it. I hate myself. Instead of making a new plan, I end up planning an appropriately painful and extremely unlikely demise for my rival.

Hearing me say that I hate myself may surprise you. I'm well aware that I have the reputation of being a Little Mary Sunshine, or the relentlessly cheerfuyl storybook heroine, Pollyanna, who triumphed over every adversity with a smile on her face and a "thank you" on her lips. Am I telling you to deny that you're envious, to smile even as your rival receives a round of applause at the Weight Watcher's meeting when she reaches her weight goal? After all, I've implied that you're suspicious of successful people and bear a grudge against them, as if you're the child who didn't win a prize playing Pin the Tail on the Donkey at your sister's birthday party...your evil sister who not only won the prize but also received hundreds of marvelous birthday presents and the first piece of birthday cake, the big corner piece with all the extra pink frosting roses on it. Your evil sister who deserves to get food poisoning from that cake and die a horrible, slow, painful death. Am I saying that you should just grow up and get over it, or that you're weak and spineless for feeling something as unworthy as envy?

No, actually, I'm not. I'm just suggesting that this one time you try stating your wish plainly, preferably out loud, and framed as intent instead of as secret longing. Give up the "I wish Jean wouuld gain 500 pounds and have to be transported with a crane." And no, saying, "I wish I were as successful as Jean" won't work either, though it's certainly better than devising cunning punishments for me. Try something more like, "I will lose another 62 pounds and celebrate that next year just as we're celebrating Jean's success today." Tell that to your reflection in your mirror and to a friend who'll be sure to say, "Go for it!"

I'm an analytical as well as an optimistic person (I choose to see that as a felicitous if conflicting combination of my parents' strongest traits), and when evaluating myself, my past, and my prospects for the future, I tend to get stuck on the "Why? Why am I this way? Why am I acting like this?" and on and on and on. But as the old Budweiser commercial said, Why Ask Why?
Don't torture yourself by asking, "Why am I so envious? Why can't I let it go and be the positive, optimistic person Jean says I should be?" The asking probably won't get you very far. The answer could just be as simple as, "Because you're a living, feeling human being." Nothing wrong with that! Although I do like art museums for an hour or so, it's boring to spend a lot of time with inanimate (if beautiful) marble statues. I want friends who are flawed (like me) and capable of both deep feeling and high aspirations.

On the other hand, don't spend too much time with the loyal, well-intentioned people who feed your envy by saying, "You're so right, she doesn't deserve that success, she hasn't worked nearly as hard as you have, and did you know she has six toes on her left foot and even worse halitosis than my poop-eating dog?"

Oops! Did I say "poop-eating dog"? Indeed I did. Which brings me (finally) to my final point. Try to see the humor in the situation. Admit it, if Tracey Ullman were up on the stage acting out the part of an envious character and using your words, you'd be laughing your a** off now.

Jean's Band Story - the short version

I've been writing this blog since May 2009. I'm a quick (some might say impulsive) decision maker. I just jumped in blogging my band stories...full speed ahead. When I began it, I wrote a short bio for one of the "gadget" blocks on the left hand side of the blog, but I don't think I ever posted anything more detailed than that. So let me rectify that now.

Today I'm 57 years old. I'm 5'2-1/2" tall, weigh 135 pounds, wear misses size 10 clothing and a size 7 shoe. Aside from a chronic pain problem, I'm disgustingly healthy. I enjoy exercising 5 days a week, work a part-time job as a bra fit specialist at JC Penney, plan and eat healthy meals about 90% of the time, and will do almost anything for a laugh. Born in Massachusetts, I now live in Tennessee with 10 dogs, 5 cats, and a sadly neglected husband.

I've written four books and published two so far: a novel, No Ransom, and Bandwagon, a self-help book for adjustable gastric band patients. I'm working on several Bandwagon follow-up projects and also publish a free weekly e-newsletter, Bandwagon on the Road (to subscribe to it, click on the envelope image in the brown box at the left side of the blog page).

I'm also a collage artist with an online gallery at: artofcollage.blogspot.com. There aren't enough hours in the day for me to accomplish everything I want to do. My chronic pain makes it impossible for me to sit for longer than 5-10 minutes, but so far, that's not a big problem because I'm so busy running around and catching up on all the things I missed out on when I was a morbidly obese couch potato.

Yes indeed, I used to be a fat girl. When I turned 50, I weighed 221 pounds, wore size 3X clothing and size 8 shoes. I had a BMI of 40.5, Type 2 Diabetes, high cholesterol & triglycerides, joint pain, stress incontinence, sleep apnea and a glamorous but extremely demanding job as a designer and buyer of decorative home accessories. My hobbies were eating, cooking, reading (with a dog or two on my big lap), eating, cooking...and did I mention eating? I was fat, depressed and miserable.

In September 2007, at age 54, I had Lap-Band surgery. Since then I've lost 90 pounds, regained 25 after a band slip and flipped port in 2009 (it was a bad year anyway - my mom died that November). My band slip was cured by a complete unfill and rest period, my flipped port was fixed by outpatient surgery in April 2010, and I've re-lost 22 of the pounds I had regained. In the course of all that, I've learned a lot about the adjustable gastric band, and a lot of stuff about myself that I'd really rather not know, but on the whole, I'm the better for it.

As my 60th birthday marches relentlessly towards me, I'm determined to make up for all that lost time - all the years I wasted on overeating and self-loathing. Perhaps those years weren't really wasted - I think I had to survive all of that in order to arrive at my current location. Sometimes you can go around the mountain, and sometimes you just have to climb up it. And the climb was worthwhile, because the view here is marvelous.

Should you know your band's fill level?

I've always known my band size and fill amounts, not because anyone volunteered that information but because I asked for it. I'm a very curious person who loves information (especially when it pertains to me!) and I ask a lot of questions. If my parents were still alive, I'm sure they'd testify to that.

Quite often I've heard bandsters ask, "Why won't my surgeon tell me how much fill is in my band? When I ask, he/she says it doesn't matter."

In a way, those doctors are right, because how much fill you have at 2:00 pm on October 3rd is only one of the things that affects your restriction that day, and at 2:00 pm on October 4th, with the exact same amount of fill, your experience of restriction could be completely different than it was the day before. The most important thing about your fill level is: does it produce the early and prolonged satiety that helps you lose weight?

But those doctors are also wrong.

That band is inside YOUR body. You (or your insurance company) paid for it, and it is YOUR property. Legally, you have a right to see all your medical records, including file notes about your band size and fill level. Some medical practices charge the patient a fee for photocopying or printing those records, but whether the info is free or costs you $5 or $15, it should be available to you upon demand (be reasonable though: the office person who has to do that for you probably already has a zillion items on her/his to-do list).

You also should have your fill level data because at some point, it might have a direct influence on how you evaluate your weight loss success and how you make decisions about how to deal with inadequate weight loss. For example: you have a 10cc band, have had 14 fills, and have not yet experienced any restriction. Is that because your surgeon has been doling out miniscule fills (like .1 cc at a time)? Is it because your band's tubing is leaking? Is it because the band just doesn't work for you?

Let's say that after a year of struggle, you have lost 5 pounds and have 1.4 cc in your 10 cc band. A whole year has been wasted because you didn't have enough information to advocate for bigger fills. Or let's say you discover that you have 9.75 cc in that 10 cc band...now what do you do? Will your insurance pay for you to revise to a different WLS procedure? Are you going to have to start all over again with your research, tests and evaluations, insurance approval, scheduling and undergoing surgery, recovering, and getting back on some kind of wagon, be it the sleeve or the bypass or the duodenal switch wagon? If you had known your fill level 3 months or 6 months earlier, would you have started all those chores before and/or had a heart-to-heart chat with your surgeon at that time instead of at this late date?

Time for a new wardrobe

Yesterday at work I was mildly uncomfortable for several hours before I realized that it was because the black dress pants I bought in September were falling off me, so that I had to keep hiking them up - such an attractive look in a public place like JC Penney. So I'm sad and glad to report that it's time for a new wardrobe. Sad because I'll have to spend money to get it, even at the Good Will Store. Glad because it's so much fun to shop for size 10 clothes!

I did get a good deal at JCP the other day, though. I found a pair of dressy white "city shorts" on the clearance rack for $1.97. They're size 10 and I got them because I figured I'd fit into them by next spring. When I got them home and tried them on, I was delighted to find that they fit me perfectly!

The closer she comes, the scarier she looks

When I was growing up, lo those many years ago, there was a popular commercial for Clairol hair color. In this commercial, a beautiful woman and a handsome man ran towards each other through a field of flowers, with smiling joyous faces, arms outstretched, shiny hair streaming in the breeze (well, hers was, anyway). The tag line was, "The closer she comes, the better she looks," which implied that Clairol hair color was so convincingly real, its user's hair would actually look even better on closer inspection.

Later, someone did a spoof of the commercial in which the man and woman ran right past each other into someone else's arms, and I had a lot of fun re-enacting that scene with a coworker named Joe Riley when we caught sight of each other in the hallway one day...one of those spontaneously silly things that makes my life worth living. I'm not sure that our business associates thought it was funny as we did, but as Joe would've said, "To hell with you if you can't take a joke."

But anyway, back to the actual subject of this post. The closer the holidays come, the scarier they look. When I looked up my JC Penney work schedule for the next 2 weeks (including a 3:45 am to 1:00 pm shift on Black Friday), my heart sank. I should be grateful for all the extra work hours (and resulting pay), especially when so many people are desperate for a job, but all I could think of was the break room tables loaded with baskets of potato chips & candy bars, with pans of brownies and plates of cookies... I remembered being desperate last year for fuel, any kind of fuel, and comfort, especially in the form of junk food...

I considered printing up my plan for how to handle the holidays this year and taping it to the inside of my locker door, but since my locker is on the bottom row, I'd have to hunker down to read it, thereby sticking my butt (smaller, but not tiny) into the narrow path between the lockers and the kitchenette, which is also the vital and well-traveled pathway to the vending machines and employee rest room.

So instead, I'm going to make multiple copies of the plan on index cards and tuck them into my purse, in my car, in my netbook case, on my bathroom mirror. After all, I'm 57 years old, with short term memory deficiencies. The other day at JCP I was helping 2 customers in the shoe department. I got out to the stockroom, climbed a 10 foot ladder, reached for a box of shoes, and suddenly thought, "Wait...is this the one who wants a size 8 pump in black, or the one who wants a size 9-1/2 boot in brown?"

My weight loss eating plan

Bariatric centers vary greatly in their post-op weight loss eating plans. How many calories you should eat in a day will depend on your weight, gender, activity levels, and weight loss goal. My weight loss eating plan was 900 calories a day, 35% of the calories from protein (78 grams total), 35% from carbs (80 grams), and 30% from fats (30 grams). That worked very well for me. As I began to work out harder and more often, my calorie intake ranged from 900 to 1100 per day and I still lost weight.

Here's an example of a day's menu:

B: 1 serving carb (1 slice whole grain bread, toasted), 1 serving protein (1 soft-boiled egg)
S: 1 serving fruit (1/2 banana)
L: 1/2 serving starchy carb (1/4 c. chick peas), 1/2 serving non-starchy carb (1/4 c. fresh
tomato), 2 servings protein (2 oz. chicken breast)
S: 1 serving fruit (1 c. cantaloupe chunks)
D: 1/2 serving starchy carb (1/4 c. sweet potato), 1/2 serving non-starchy carb (1/4 c. green
beans), 2 servings protein (2 oz. halibut)
S: 1 scoop protein powder mixed with 8 oz. skim milk

Self-Sabotage

As I explained in Bandwagon, self-sabotage is the deliberate destruction of property or the hindrance of operations by an enemy. As you start your weight loss surgery journey, you might believe that your mother and her famous biscuits and gravy, or your husband and his Pizza Palace Frequent Customer card, or your children with their 9:00 p.m. demands of "Mom, I need some cookies for our class Christmas party tomorrow", will be your worst saboteurs.

But beware! There is another saboteur who is with you 24 hours a day, 365 days a year. Who is it? Go look in the mirror. The saboteur is you. That earnest, innocent face hides a food demon who is determined to prove what you believed for so long...that you are destined to fail at weight loss...that you don't deserve to be slim and healthy....that without your protective layer of fat, you'll be too easily hurt or too easily noticed...that once you're up on the Pedestal of Success, you'll lose your balance and tumble back down into obesity anyway while all your friends and enemies point and laugh at you.

Some signs of self-sabotaging thinking are: jealousy (comparing yourself to others), extreme anxiety, negativity, procrastination, giving up easily, ignoring feedback, feelings of worthlessness, living in the past, blaming others, and the all-time favorite: DENIAL.

How can you overcome bad stuff like that? Professional counseling has helped me tremendously. Attending Overeaters Anonymous has also helped me. Checking in daily with my Accountability Partner helps me.

Holiday Eating

Today is November 7th. I survived Halloween and a minor incident with some evil candy corn, but the holiday season with all its social eating challenges looms on my horizon. Last year I had just started a new retail job, had little fill in my band, was struggling with untreated and undiagnosed fibromyalgia pain, lost my mother, and lost control of my eating during the holiday season. I responded to my unpredictable work schedule and my physical and emotional pain by using my old friend, Food. So I hurtled through potluck meals at work and church, and eating on the run, with my mouth open, cramming everything and anything I could grab into it. I couldn't seem to get or stay organized well enough to come up with an eating plan and stick with it, but planning is the #1 tool that helps me in social eating situations.

Thank goodness, I'm facing the 2010 holiday season with a well-filled band, medical issues under control, emotional issues that aren't as overwhelming, and greater mastery of my retail job now that in 2009. Here's my plan for the coming months:

1. I will not let myself get too hungry, especially before social events.
2. I will bring something healthy that I can eat to every potluck meal.
3. I will keep a supply of protein bars in my purse and my locker at work.
4. I will plan each day's meals in advance, commit them to my accountability partner every day,
and report to her the next day how that day's eating went.

Fill philosophies

Bandsters are often puzzled by the difference in bariatric surgeon's fill philosophies. Some surgeons are very conservative, giving fills in small amounts over a longish period of time. Others are more aggressive, giving larger fills over a shorter period of time. The best way to understand your own surgeon's philosophy is to ask him/her about it, but you may get a vague answer like, "We do it this way because we find it has the best outcome."

I've had 2 bariatric surgeons and they both took a fairly conservative approach....but not so conservative that you have to wonder if they administer saline one drop at a time in order to increase their income.

When you're excited about losing weight, you might want to get your show on the road going 200 mph with a first fill of 8 cc in a 10 cc band, but your surgeon is probably not going to go along with that. An aggressive fill like that would be a problem on at least 2 levels:
1. Overly aggressive fills are associated with complications like band erosion
2. The patient needs time to adjust to the effect of the filled band on their eating
ability. One day you can eat anything, the next day you get a big fill, and the
day after that you take a nice big bite of steak, chew it 3 times, swallow, and
BAM! Your bandwagon has just crashed into a brick wall.

Not so happy Halloween

My friend Majorie, an avowed cat-lover, has dressed up as Cruella de Ville this Halloween.

I think she pulls it off very well, but our white & black spotted Miss Patch is quaking in her boots...um, paws...

Strutting my stuff

At the JC Penney store where I work, we dress up in costumes several times a year. We had a pajama party theme last Halloween, beach party theme in the late spring, and this year, our Halloween theme was Western - cowboys and Indians. A good time is had by all, the customers think it's a hoot, and during the event, we don't have to dress up according to the company's fashion standard.

Unlike my associates, I do not posess (nor do any of my friends or family) anything remotely western (to say nothing of Indian/native American), and I wasn't willing to spend money on cowboy boots/hats, etc. So I decided to do country-western and dress as Dolly Parton. I got a tight-fitting mini dress at the Goodwill store, spike heels with a faux cow-hide finish, and borrowed a friend's blonde wig. I stuffed my bra with a dozen socks, struggled to put on pantyhose and the stupid shoes, did a dramatic makeup job, put on my glitziest jewelry (glitzy is not my style), and finally the wig.

Then I went hunting for my husband to take a photo of me in that getup, but he was out in the "back 40" and there was no way I could go fetch him while wearing those shoes, so I took some photos of myself in a full-length mirror. They all had some major flash action (I believe I stated before that I'm a terrible photographer), but this photo gives you the general idea.

When I was finished putting myself together, I thought, "You don't look like Dolly Parton. You look like an out-of-work hooker." That didn't seem like the right message to convey at a family store like JCP, so I quickly changed into a plaid shirt and jeans (SIZE 10, y'all!) and hurried off to work.

I didn't win a costume prize, but I did win the prize (a $10 JCP gift card) for my decorated pumpkin. The lasting prize for this failed costume was looking at my body in the tight dress and high heels and thinking, "Dang! You look pretty hot for an old broad!"

Does the Band Really Work?

Recently a person who had attended a weight loss surgery seminar the previous night asked if I could help her make sense of what she heard there. The surgeon who spoke was very anti-band. He said the band is fickle, he would never perform band surgery, and he believed that in 10 years, the band would be obsolete in the US. The person who listened to his anti-band tirade was very discouraged about the band when she left the seminar. When she got home and researched the band on the internet, she found that it has only a 55% long-term success rate. She doesn't want her stomach and intestines cut up and rearranged, she's willing to make healthy diet and physical activity changes, but when she sees others struggling to work the band and hears a surgeon say it's useless, she doesn't know what to think.

Here's what I told her. I don't know the source of the 55% long term success rate you quoted, and since the surgeon who spoke at the seminar refuses to perform band surgery, you're not going to get any accurate info from him. From my own research, I learned that long term success with the band is about the same as with gastric bypass - 65% at 5 years post-op.

Why isn't that figure 100%? Because obesity is a chronic disease and no bariatric surgical procedure can cure it. Why does the bypass seem to work "better" than the band? Probably because of the malabsorption feature. Since you've decided you don't want your intestines re-routed, that leaves the band or the sleeve as your WLS choices. If you don't want your innards cut up permanently, that leaves the band as your only WLS choice.

The band worked for me because I was a volume eater and because I was committed to making the lifestyle changes needed for long term success. My surgeon told me at the outset that if I lost only 50% of my excess weight, he would consider my band surgery to be successful. You might think, "Why would I go through all of this just to lose 50% of my excess weight?" Well, consider the alternatives...disease, disability, death. When I had lost "only" 50% of my excess weight, my co-morbidities were all either gone or under control, and I felt great - I felt very successful!

Just because a statistic indicates that 100% weight loss and lifetime maintenance aren't guaranteed doesn't mean that the weight loss and maintenance are impossible. I don't pay much attention to statistics any more. I don't want numbers to run my life, and as an old boss of mine used to say, "Figures can lie and liars can figure."

That anti-band surgeon could be right. In 10 years, gastric banding might disappear forever as a treatment for obesity. In 10 years, someone might have invented a non-surgical cure for obesity. In 20 years, someone might have invented a vaccine that prevents obesity from ever happening. And that would be wonderful. But in 20 years, I'll be 77 years old. If I had put off obesity treatment that long, I probably wouldn't have lived long enough to benefit from the treatment. So I decided to make the best of the surgical treatments available now so that I can make the best of the next 20, 30, or 40 years of my life.

How to Stop Eating

How to stop eating? That's an ambitious topic. I could write a PhD dissertation on that, but I'll try to keep this brief.

A while back, a bandster buddy asked me a good question: how do you stop eating? How do you stop eating when you haven't yet had a fill? And after you've had some fills, exactly how do you know to stop eating? Does the band make you stop, or do you have to make yourself stop? The answer is simple and complex at the same time: at some point in your journey on the bandwagon (I wish I could predict when), the band will start doing a lot of the work for you. Some of the work will always be up to you. You will have to make good food choices, control your portion sizes, resist emotional eating, eat carefully, and so on. Your band will never do those things for you. All your band will do is provide early and prolonged satiety.

Satiety is the sensation of having eaten enough food for now. It is NOT the same as feeling "full." If you eat until you feel full, you have overeaten. Overeating, or pouch packing, will eventually lead to problems. The pressure of the extra food in the upper pouch can displace the band (a band slip) and/or enlarge the pouch or esophagus (dilation).You can start your band work even before you have a fill. If you master good eating habits and learn to pay close attention to how you feel as you eat now, it will be a lot easier to deal with conflicting signals from your brain and your band later on. You will learn the soft stop signals (runny nose, hiccup, burp, sneeze, sigh, etc.) and heed them before that one-bite-too-many triggers a hard stop (pain, PB, stuck, sliming). Don't expect any of this to feel comfortable, natural or automatic at first. Changing your behavior (whether it involves eating, exercising, interpersonal relationships, etc.) takes practice.

Here is a list of things that have helped me learn to control my portions and avoid overeating.

1. Don't prepare more food than you plan to eat at one meal. I'm responsible for feeding dinner to two adults, but I used to cook as if I was feeding the 101st Field Artlllery. All that extra food is just too hard to resist. If you do end up with extra food, immediately put it in a sealed storage container and stick it in the fridge or freezer.

2. Don't put serving dishes of food on the dining table. Again, it's just too hard to resist.

3. Weigh and/or measure your planned food, then put HALF of it on your plate. Take the plate to the dining table, sit down, eat it while following good band eating skills. If you don't get a "soft stop" sooner, eat until the food is gone. Then ask yourself: Am I still physically hungry? Is my stomach growling? Do I feel faint with hunger? If the answer to any of those is yes, go back and serve yourself the rest of the food, take it to the table, sit down again, start eating, and go through the whole process again. If the answer is "No, I'm not hungry, but the food is delicious and I'm going to eat the rest of it because it's in my meal plan for today," you'll have to remind yourself about the consequences of overeating (described above).

3. If you don't eat the entire planned, measured meal, throw away the extra food or put it in the fridge. It's OK to eat it later if you get hungry again in an hour or so. Just don't eat it now.

4. When the planned, measured food is gone, the meal is over. Immediately excuse yourself, get up from the table, take the plate to the sink, and wash it (or rinse it and put in the dishwasher). You can go sit back down and enjoy the companionship of your friends or family, or you can move on to something else. When I'm done eating, I clean up the kitchen and then as quickly as possible, remove myself from the scene and get involved in something else. Whatever you do, don't hang around food any longer than you have to.

5. Another technique to try: just before you sit down to eat, set a timer for 15 minutes. When the timer buzzes, go through your Am I Still Hungry routine. If your food is gone before the timer buzzes, you have eaten too fast!

6. When eating in a social situation (like at someone else's home), you can still do the plate removal. Get up, say something like, "Let me help you clear the table" or "Can I get anything from the kitchen while I'm up?" and get rid of that plate.

7. When eating in a restaurant, ask the server to bring you a to-go box with your meal. Eyeball the amount of food you're going to eat at that meal and put the rest of the food in the box. Seal the box and put it in a tote bag (I don't leave home without my tote bag!). If it's still too tempting, take it out to your car and lock it in there. Don't worry about it spoiling in the heat or freezing in the cold out there. You are NOT obliged to eat that food later. If you just can't bear the thought of wasting food, keep a small cooler in your car.

8. When eating in a restaurant, the instant you get a "soft stop", put your napkin over your plate. This sounds gruesome, like you're putting a shroud over a dead body. But the meal is OVER - say goodbye. If you can catch the attention of the waitperson, ask them to remove the plate. If you're really bold (like me), carry the plate to the nearest busperson's station (you'll know you've found it when you see a tray covered with dirty dishes).

Now, I completely understand that you may try all of these tricks and still WANT to go on eating no matter what your band or your body has to say about it. But dealing with the emotional or mental issues that might be going on is beyond the scope of this particular article.

When you've had a chance to monitor your eating and your stop signals, please share them with us!

2 NSV's in one day

Yesterday I worked at JCP from 3:30-9:00 pm. I love that job, but it seemed like every mean or stupid person in the county was in the store last night. Also, I have a stiff neck, with frequent painful spasms, so my patience was pretty thin. One customer argued with me over the price of a clearance item. The pink clearance price ticket said: 70% off = $14.20. She insisted that the price of the item was 70% of $14.20, not 70% off the original price. Apparently she had grown to adulthood without learning what an equal sign means. Gritting my teeth probably didn't help my stiff neck.
But anyway, on the positive side, I had 2 NSV's at work yesterday.
1. For the past week or so, my bra fitter apron has been sliding around on my torso, kind of annoying. I finally realized why. The waist ties are too long. I don't tie them - I put velcro on the ends when I first got the apron last fall. So I brought the apron home so I can cut the ties and put new Velcro on them. I hate that kind of chore, but I'm happy to do it because it reminds me that I'm a smaller person now than I was a year ago!
2. During a slow period last night, I wandered over to the shoe department to chat with the 2 college kids working there and the college girl working in jewelry. That kind of chatting is frowned upon - if a JCP Secret Shopper caught us doing that, we'd be in big time trouble - but it's hard to suppress the social instinct. We've all learned little tricks to make us look busy when we're socializing. While we talked, I straightened garments on a juniors clearance rack. I do that so mindlessly that sometimes I don't even see the garment - it's just background noise, so to speak. But last night I happened to notice that some nice skinny leg jeans had been put on clearance, so I pulled one out to look at it and check the price. When I did that, one of the college girls said, "You're at the wrong end of the rack, Miss Jean. You need to move down a few feet into the small sizes." I laughed. I had automatically pulled out a size 19 to evaluate it for fit and appearance!

Little Kittens & Little Grandma

Usually I would save this kind of photo for my critter blog (9dogshowling.blogspot.com), but I'm posting it here because it's one of those photos that reminds me, "Hey, you've lost a ton of weight and you look great!"

And of course, my mouth is open because I'm lecturing my poor husband about how to use the camera.

A scale victory

After my mom died last fall - when at the same time I was working crazy hours at my new retail job, didn't have much fill in my band, and couldn't get more fills because of my flipped port - I gained weight. I was just trying to survive from one day to the next and not putting much energy into good food choices. This April I had my port repositioned, started getting fills again in May, and got back on the bandwagon.

This morning when I weighed, I was delighted to see that I'm finally back in the 130's, only 8 pounds away from my lowest weight. I've lost 15 lbs since my port repair surgery. To celebrate, I tried on some of my size 10 pants and they fit! Not very comfortably, but I could get the zipper closed! Hurray for me!

Things are looking better today

Today, my printer reduced Bandwagon's cost so that I'm no longer losing money on Amazon orders, and also has indefinitely postponed the due date for the invoice for the last print run, so my cash flow problem is more bearable at the moment. And my rep told me that Amazon is running out of books already - the next shipment will arrive at their distribution center on Friday - so it's likely they'll be placing another reorder soon.

My rep said, "Guess what Bandwagon's Amazon ranking is today?"

Since it was 83,740 yesterday, I said, "40,000."

She said, "Guess again."

I said, "4,000."

She laughed. "No, not yet. Today it's 8,221!"

I am simply amazed by all of this. My rep said, "We're going to work with you on this so you don't lose money, because this is a book with legs."

Or wheels, as the case may be!

But the bad news is...

I just got a call from my customer service rep at NetPub (the company that does the printing and order fulfillment for Bandwagon). She wanted to know if I was aware that the deeply discounted price that Amazon pays for my book is lower than my cost to print it.

I said, "Yes, I was aware, though not to the penny. I don't want to lose money on this book, but I felt strongly that pricing it higher than $19.95 would greatly limit its sales."

She said, "A book of this size [576 pgs] is usually priced at $25 to $35."

I said, "Yeah, and I could price Bandwagon at $1 million and make a lot of money if I could just find one person to pay $1 million for it."

She laughed and told me that it's very difficult to change a book's retail price once it's in the market, so she's going to talk to her boss about reducing my printing cost. I thanked her for looking after me.

Thinking about it after we hung up, I wondered if I had made a bad decision when I listed the book with Amazon. I just felt that Bandwagon would get good exposure there... that the Amazon listing was a way to advertise it. But that advertising is not free!

Go, Bandwagon!

As I mentioned before, Amazon usually orders only 1 or 2 copies of a new book, but they ordered 20 copies of Bandwagon as their starting inventory. When I checked my book inventory on the fulfillment house's web site this morning, I saw that Amazon has ordered another 60 copies! And the book is ranked #83,470 on Amazon's best-seller list, whereas my novel (No Ransom) is #2,706,442!

YAHOO!

Aerobics Class

I like to brag that I love to exercise now. It's a major change for a former couch potato whose most strenuous exercise was lifting a fork to her face. I exercise 6 days a week - I'm actually trying to cut back to 5 days because my aging body appreciates the rest. Every week I look forward to my Wednesday morning step aerobics class. It is just the most fun I've ever had while exercising. I love the instructor, who is young enough to be my daughter and is also my hairdresser, manicurist, and town gossip & info source. I love the music - very loud, upbeat, fun. I love the moves - kind of dancey - and surviving one of those classes makes me feel like Superwoman.

But not today. Oh, no.

Because last night when one of our dogs was licking my feet (I absolutely HATE foot licking - I don't care if it's Goober the mutt or Richard Gere doing the licking), my husband of 24 years, the man I (previously) trusted with my life, said, "I know just the thing. I'll cut open one of these hot peppers, rub it on your feet, and the dogs won't go near your feet."

I said, "But won't it feel hot on my skin?"

He said, "Naw," and proceed to rub the pepper all over my feet and toes. And BETWEEN my toes (I think he actually had another agenda in mind, but we ain't goin' down that road anytime soon, oh no no no). And sure enough, the dogs sniffed my feet, wrinkled their noses, and found something else to lick. Good going, Mr. P.!

But what Mr. P. had NOT told me is that as soon as my feet were inside socks, inside sneakers, and doing some major sweating through a 50 minute aerobics class, they would feel MORE than hot. More like, ON FIRE! At the end of that hell-fire class, I ripped off my shoes and socks and saw huge red splotches on my feet, as if I'd been scalded. Which I had. In the shower, I tried to scrub the hot pepper off, but my feet hurt too much for scrubbing. I very gingerly dressed and slipped my burning feet into my sandals, wondering if I could get away with calling in sick due to hot pepper foot injury (um, no). Thankfully, my feet felt almost normal by noon. Of course, I did remember to mention all of this to Mr. P., who giggled the whole time. Mr. 59-years-old-going-on-9-years-old. But at that point in the day (6 pm) my feet felt fine, so I let it go. Now it is 8:20 pm and the toes on my left foot are burning again (why?). Mr. P. went to bed at 8:00 pm (he gets up at 3-4 am) but I'm thinking now that he needs to get up and apply ice cubes to those burning toes....in my mind, I tiptoe into the bedroom, gently shake his shoulder, and dump a 5-gallon bucket of ice cubes on him...but then the bedding would be wet...not sure how to proceed now...suggestions very welcome!

the 16th fill

16 fills in three years? That sounds kinda scary, doesn't it? But it doesn't scare me. The port is designed to withstand thousands of sticks when the fill person uses a non-coring Huber needle - and even the necessity for a Huber needle isn't proven. And optimal band restriction requires fine-tuning. It is not a one-stop shopping experience. And thank goodness for that!

My first dozen or so fills and unfills were done in my surgeon's office without any numbing medication, and none of them hurt. My new surgeon always administers a lidocaine (numbing) shot before doing a fill. The lidocaine stings. But since many of the fills (or fill attempts) I've had in the past year required a lot of poking (because my port flipped), I'm glad for the lidocaine.

While sitting in the waiting room, waiting for my turn, I listened to 3 other patients talk about their WLS experience. Were all AGB patients, and all 4 of us were delighted with our surgery.

Success is making me dizzy

Bandwagon's success is making me dizzy, and I'm already a dizzy blonde.

The book is already back-ordered on Amazon. Its popularity rank is 72,908 – compared to my novel, No Ransom, at 2,702,854! The fulfillment house that processes my shopping cart orders is sold out and has 23 copies on backorder. I’m down to my last book here at 9 Dogs Howling Publications. More will be printed this Thursday or Friday, and my customer service rep at the printer/fulfillment house, who was the one who persuaded Amazon to take 20 instead of their usual 2 to start with, thinks that in another week or so, they’ll come back and order 200+. The rep is delighted about Bandwagon’s success. I get the feeling she’s used to talking to academics who publish arcane textbooks and sell 20/year. I know she’s been reading Bandwagon herself because in our recent conversations, she’s using terminology that she only could have picked up from the book and has mentioned that the book is funny as well as helpful.

That’s the good news. The bad news is that I still cannot figure out why I can’t upload the book to Amazon’s Search Inside The Book program, and I didn’t get a chance to call Amazon today after I got back from Memphis (where I had my 16th fill). And more bad news: our clothes dryer died on Sunday afternoon. But there is other good news. Mr. Parker figured out why the dryer wouldn’t start (a little actuator arm broke off) and fixed it with Superglue and a popsicle stick (we do live in the South, after all), thereby saving us a $129 service charge. And other bad news. Trudy (the most recent arrival here at 9 Dogs Howling) now has these strange bumps, like brown moss growing in spots all over all 4 legs. I have never seen anything like it before. It could be a reaction to insect bites, but maybe not, and we don’t want it to spread to the other 9 dogs, so she’s off to the vet on Friday. She’s not in pain or scratching at the bumps, and the other day had enough energy to steal the foam pad out of one of the cat crates and shred it all over the back yard. Let me tell you, if that ever happens to you, don’t laugh out loud. Husbands who have to clean up the mess don’t think it’s nearly as funny as their wives do!

Inspiration from Nelson Mandela

Recently I wrote to an old friend about how overwhelmed I feel about the fantastic response to Bandwagon's publication. I knew when I wrote it that it would be a success even if only one person bought it and benefitted from it, but I guess I didn't dream big enough. The book is selling five times faster than I had forecast, a bariatric surgeon has asked me to do a workshop based on Bandwagon, a dietician has asked me to speak at a support group meeting, and an editor from Rodale Publishing (health books, magazines, & web sites) has asked me to help her with a special project developing recipes for bandsters. This is all wonderful, but I'm beginning to feel like I've created a literary monster, kind of a Frankenjeannie who's taken over my life and is heading out to terrorize the neighboring villages!

My friend's answer was to send me this quote from a Nelson Mandela speech.

Our deepest fear is not that we are inadequate, our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, "who am I to be brilliant, gorgeous, talented and fabulous?" "Actually, who are you NOT to be? You are a child of God. Your playing small does NOT serve the world. There is nothing enlightened about shrinking so that other people won't feel insecure. We were born to manifest the glory that is within us. And as we let our light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our pressure automatically liberates others.

There's a message in there for you, too. Every one of you. God (or your Higher Power or whoever/whatever you believe in) not only wants you to succeed at weight loss, he/she expects you to succeed, not just for your own benefit but also for the benefit of your fellow human beings.

So let your light shine, OK?

My 3rd bandiversary

Today is my 3rd bandiversary.

In the past 3 years, I've had many gains & losses, ups & downs, and I'm STILL happy to have my dinky old 4 cc Lap-Band (with 2.7 cc in it today).

I lost: 90 lbs, 34.25", 3 shoe sizes, 6 dress sizes, my co-morbidities, my CPAP, my original bariatric surgeon (not my decision), my PCP (my decision), a closet full of fat clothes, one cat, my mother, my old job, approximately 50% of my fear of change, 6 band unfills.

I gained: a love of exercise, a new job, a closet full of cute small clothes, 7+ dogs (they come and go), 3 cats, a new bariatric surgeon, a new internist, many new friends & a great online community OH, 15 band fills, and the confidence to tackle new projects and activities I never would have considered before.

The downs: a band slip (probably caused by my hiatal hernia, quickly cured by an unfill), a flipped port (fixed with repair surgery), a year of undiagnosed & untreated chronic pain (with an eventual diagnosis of fibromyalgia and myofascial pain syndrome), losing my mother, and pain when I sit for more than 30 minutes (so my reading hobby is pretty much gone).

The ups: overcoming the downs, writing my band book (Bandwagon), being offered opportunities to work as a band educator and cookbook author, a long life ahead of me with plenty of energy to devote to my writing, artwork, family & friends, a vacation in St. Lucia, 2 trips to Seattle to visit a special OH friend, meeting a dozen or more OH friends in person, treatment that reduces the chronic pain, and an improved relationship with my difficult (that's saying it mildly) brother.

Achievements: body fat dropped from 51.3% to 29% (or 20% by the caliper method), published my band book (Bandwagon), became a certified professional bra fit specialist at JC Penney (with lots of opportunities to help obese women), published 17 newsletters for my 9 Dogs Howling fans, created 64 art collages and sold 16 of them (room for improvement there!), and wrote 4 blogs.

The future holds: at least 2 more band books, a book about the life lessons I learned from my mom, a book about my world travels, at least 33 more years of healthy living with my husband, more travel, and participation in art shows, probably more cats & dogs (and food & vet bills), and…well, who knows?

On my first bandiversary, after 17 months of concentrating on getting and succeeding with my band, I asked myself, "What's next?" The answer for me (and maybe for you) was, "Life is next."

Expect the unexpected

From the moment I conceived the idea of writing a self-help adjustable gastric band book, I knew I would succeed. Previously I had written only novels, newsletters (personal & corporate), magazine articles & essays, and product catalog copy - but no self-help books. Looking forward, I could easily see myself doing the research, organization, and writing of Bandwagon. I knew how I would publish and distribute it. I knew I would have to find a bariatric surgeon to check the manuscript for accuracy and (hopefully) endorse the book. All of that worked out well (though more slowly than I would've liked). No surprises, really. I'm not even surprised that the book is selling so well. But the book is also producing some unexpected results.

Last week I sent copies of Bandwagon to several bariatric surgeons, including my own. Yesterday I received an e-mail from Dr. Weaver's office manager thanking me for the book and asking me if I'd be willing to do a workshop for them (based on the book) in January. They think Bandwagon will be a useful tool for their patients, and I agree! So I answered that yes, I'd be happy to do a workshop!

Fortunately I'm not afraid of public speaking, even though I'm a shy and quiet person in most social situations. I have my 7th & 9th grade English teacher, Mr. Zeitler, to thank for that. He insisted that every one of his pupils write and deliver a speech on a regular basis.

You think you're hot, but you're not

Yesterday I wore a black & red print silky tunic and black leggings to work. Of course, my bra fitter apron covered up most of this outfit, but I thought I looked HOT. So hot that I took a (lousy) photo of myself before I left for work. All day long, every time I caught sight of myself in a mirror (lots of mirrors in a department store), I smiled because I looked so HOT. I was in a great mood that day, and one of our cutest young associates told me, "That tunic looks so cute on you, Miss Jean!"

During that afternoon, I was walking through the shoe department when a customer summoned me to help her find brown shoes. I haven't been trained in that department but since it's next door to lingerie, I help out there quite often. This customer was an obese woman, about my age, wearing a short leopard print blouse, dark brown leggings, and chunky gold jewelry. It was not a flattering outfit - nothing I would wear in public - that showed all her (many) fat rolls. I brought her 3 sizes each of 3 pair of shoes and after a lot of dithering, she picked out 2 pairs of shoes. All the time we worked together, she seemed very anxious and was babbling about how she had to have these shoes today...like right now. At one point she said, "This has to be right, it's for a TV show in one hour, and I still have to eat lunch and do something about this hair (at that moment, styled in a messy I Dream of Jeannie updo). That statement brought me up short. I thought, "Please tell me you're not wearing this outfit on television," just as she said that this was the outfit she was going to wear on television. Eventually she paid for her shoes and left. I thought (as we southerners say of misguided acquaintances), "Bless her heart."

So, today I transferred the photo of me in that hot outfit to my computer, expecting to see Jennifer Aniston's body with my head on it. But what I saw was my same old body with my same old head on it, the head obscured by the camera flash. That was very humbling.

How to order Bandwagon

I hope to get my shopping cart feature set up on this blog by the end of this week, and Bandwagon will be available on amazon by mid-September, but in the meantime, you can order an autographed copy by sending an e-mail to:

jmcmillan159@gmail.com

When I receive your e-mail, I'll tell you where to send your check or money order. The book is $19.95. (It's a BIG book, because as you know, I always have a LOT to say on the subject of the adjustable gastric band.) Shipping/handling costs are $3.00 for media mail or $5.00 for priority mail.

Oh, happy day!

When I got home from a long day of retail drudgery this afternoon, a happy surprise awaited me...a carton full of my freshly printed book, Bandwagon! Although I almost immediately found a tiny but irritating typo (my fault) in the front pages, I am thrilled! On Monday I will start shipping orders for autographed copy, and next week will get a shopping cart feature set up here on my blog site, and when that's done, my Obesity Help ads will go live.

I finished writing the book exactly one year ago. Getting it published has taken longer than I would have liked, but it all seems worthwhile right now. Oh, happy day!

Before & After, again

Trying to look happy in 1995, versus actually being happy in 2011.

Emotional eating

I do most of my exercise at a new fitness studio owned by a woman named Caroline. She's about my age (50 something), has a BS in health & exercise science and 30 years experience in the fitness field. Her approach to exercise has made an enormous difference in my life and I think it's helping my fibromyalgia as well as my muscle tone, flexibility, balance, and cardio fitness. I have a lot of confidence in Caroline.

About a week ago, I had Caroline do a postural assessment of me because I think some of my pain problems may be postural, and on Friday I'm starting the first of 4 personal training sessions with her (if it goes well and I can afford it, we'll do more than 4). While talking about my fitness and health goals, Caroline asked me a few questions about my band surgery. One of them was, "What has been the hardest thing for you to deal with since your surgery?"

Good question. I answered, "The hardest thing has been learning ways to deal with stress, boredom, and emotions that don't involve food."

She said, "Huh. I never thought of it that way before." At the time I thought it was a slightly weird answer, but maybe I had misunderstood her. Had she meant that she'd thought that weight loss surgery removes ALL eating urges, physical and emotional?

A few days later we were alone in the studio while waiting for the rest of the class to arrive, and Caroline said, "I've been thinking what you said the other day, about the challenge of dealing with emotional eating when you're trying to lose weight. I just hadn't ever thought of that aspect of it before, but it's very interesting."

At that point, other students started coming in, so our conversation ended. But ever since then, I've been wondering how on earth Caroline could spend 30 years in the fitness field, including a bachelor's degree in health and years of working as a personal trainer with people trying to lose weight, and never before encounter the reality of emotional eating?

Food deprivation

I now have more fill in my band than I've had for over a year, and wow, what a difference. The kind of difference that makes a bandster cry, "So this is what it's all about!" I'm not eating much and not hungry much, I'm losing weight, I feel good, but I also feel a bit discombobulated. When I have to stop eating after only 3-4 bites of food, my mind says, "No, no, that's not enough." I feel deprived and am tempted to take another bite, but if I do that, I invariably regret it.

Last night I felt as if I must have eaten only 500 calories for the whole day, but when I logged my food, it totalled 1000 calories, with 70 grams of protein and a good assortment of healthy carbs and fats. So I have to reassure my anxious little brain that I am not starving to death!

Adjusting to my adjustment

I'm still adjusting to my last band adjustment (the fill).

Today is weigh day. I lost 1.6 lbs in the past week – hurray! In April I had bought some dressy “city shorts” to wear to work (on me, they’re more like capris!). When I put them on yesterday morning, they drooped big time. A waste of money to get so little wear out of them, but I like it when clothes get looser instead of tighter!

The droopy shorts were about the only good thing about yesterday...the store was a back-to-school zoo, and we had a customer appreciation promotion with extra discounts. All day long, I kept thinking that something was “off” with me (aside from my ineptitude with ringing up customer purchases), but I wasn’t having much pain, I wasn’t tired…finally I realized, I’m not hungry! I kind of missed it – the hunger, the anticipating of eating, the meal. I’ve had my band for almost 3 years now – I wanted so much to be released from hunger – and when hunger is gone, I miss it!

It was hard to eat anything yesterday, probably because of the stress, but I’m beginning to realize that I can’t eat real food until early to mid afternoon now, and not at all during my 15-min breaks at work no matter what time of day it is (I just can’t eat that fast), so I will have to plan accordingly. Sadly, the protein bars I've been having every morning on the way to work have got to go. I love them – they’re like a “legal” candy bar – but they’re just too dense. So I got some Kashi Go Lean Crunchy fiber & protein bars – not as yummy as the protein bars, but pretty tasty and because they’re so crunchy, it’s easier to eat them.

Also, I have discovered that I have mild lactose intolerance. For the past few months, I’ve had annoying flatulence. I did some internet research and decided to reduce my dairy consumption and to try Lactaid milk and take Lactaid pills when I have anything dairy. That worked very well. Then I ran out of Lactaid milk and was in too much of a rush to go to the supermarket for it. I picked up regular milk at a convenience store and even though I was taking the Lactaid pills, the flatulence came back the next day.

And finally, there’s the pill taking in general. I’ve been splitting my medication tablets in half, but even that isn’t small enough. I’m going to have to switch to quarter pieces. This is like learning to be a bandster all over again!

Fine-tuning my band book

I often say that the adjustable gastric band requires a lot of fine-tuning in order to work optimally. So, it turns out, does my band book.

Two days ago I received proofs of the cover and text from the printer. I'm about halfway through proof-reading the text. I proof-read it very carefully before I sent the file to the printer, but now I can see dozens of things in it that I could have done better. Occasionally I'll read a few paragraphs and think, "Did I write that? That's brilliant!" but mostly it's, "Ugh."

But I cannot spend the rest of my life perfecting this book. If I did that, the AGB will be an antique oddity by the time I finally publish the book.

Adjustments

An adjustment is when your surgeon adds fluid to your band, or takes some out. Most bandsters refer to this as fills and unfills, but the official term is adjustment. I had an adjustment on Tuesday that brought me back up to 2.7 cc in my 4 cc band - a fill level I haven't had since my first bandiversary (Sept. 2008). So far, it's what I would call a "kick ass" fill. Exactly what I wanted, but I'm having to make a lot of mental adjustments to it.

For several months, I'd been eating two basic meals for breakfast:
1. Greek yogurt with cottage cheese, berries, and chopped nuts, or:
2. Oatmeal with chopped fruit & nuts

I really, really enjoy those breakfasts, especially the yogurt concoction. Inspired by my bandster buddy, Nina, I was going to try a breakfast parfait of yogurt, berries, and granola. But not right now, I'm sad to say. This morning I faced up to the fact that I can't even eat yogurt (never mind the goodies mixed into it) for breakfast now. It's back to protein shakes.

My favorite protein shake is actually very tasty. In the blender, I whiz:
12 oz LF milk (I'm using Lactaid now because I think I've got mild lactose intolerance)
1 scoop Click espresso protein powder (supposedly mocha flavor, but all I taste is coffee)
1/2 scoop Unjury vanilla protein powder
2-3 ice cubes

Act your age? Maybe not.

The other day I wore a new outfit to work. It consisted of this drapey lime green tunic over a white tank top and white leggings, white sandals, turqouise earrings, and a multistrand necklace of turquoise & green beads. I thought I looked quite fetching in this get-up, though it did occur to me that I might be pushing my luck as far as the store dress code goes.

I stopped at Higher Ground, the Starbucks-type coffee shop, for my iced skinny latte. An attractive man, about my age, was sitting at one of the tables outside the shop, and as I walked across the parking lot, I became aware that he was watching me. And why not? There isn't much else to watch from that spot except street traffic: an endless flow of pickup trucks.

As I got closer to the shop, I could see the expression on the man's face, and realized that he was not looking at me like I was a pickup truck. He was looking at me with interest...and possibly with appreciation. He gave me a little smile as I went into the shop. Not the usual all-purpose Southern "Howareyoo?" greeting, but (it seemed to me) a smile just for me.

Well, I felt like a movie star as I waited for my latte. It's amazing what a little admiration can do for your ego. The man was talking on his cell phone when I left the shop. The only other person who seemed to appreciate my appearance that day was one of my college-girl coworkers ("I like your outfit, Miss Jean"). A few hours into my shift, I caught sight of myself in one of the store mirrors and suddenly thought, "That man was probably thinking, 'Look at that old fool, dressed like a teenager.' I should just dress and act my age."

But maybe not. Surely I have paid my dues to the Appropriate Dress Society. I don't wear white until after Memorial Day. I wear a bra (plus outer clothes) when in public. I don't wear plunging necklines, Daisy Duke shorts, spike heels, tattoos or body jewelry other than earrings. I don't wear blue jeans to church, or a bikini at the beach. I'm 56 years old and am no longer very interested in what other people think of my clothing choices. So every now and then, I think I'm entitled to dress like a girl 30-40 years younger than me. There is still a girl that age somewhere inside me, and she's delighted that I'm thin enough now to take more wardrobe risks.

"Why do you even bother?"

At work the other day, at break time I found two other associates in the breakroom eating their lunches. One of them is a slender 19-yr-old and the other is a pudgy 40-something. They were eating Taco Bell specials and sharing an order of sugary fried cinnamon tortilla strips (I have no idea what they're called officially, and certainly don't need to know).

I pulled my lunch out of the fridge and set it on the table near them. I had a sunflower seed coated cheese ball (1-1/2" to 2" in diameter) and 1/2 cup of chopped apple mixed with lite cool whip and sugar-free butterscotch pudding mix. My coworkers both studied my little containers and exclaimed: "Why do you even bother?" (said by the teen) and "A meal that size is just a teaser!" (said by the 40-something).

None of my coworkers there know that I had WLS. Well, one might suspect, because I used to work with her mom and my WLS is no secret at that company, and if that particular coworker has figured it out, I can trust her not to blab it to everyone else. I'm already famous at this store for my healthy meals ("What healthy thing you got for lunch today, Miss Jean?"). Now I'm famous for being weird, too!

But the funniest part (for me) was the fact that I was too full to finish the apple & Cool Whip stuff! I hid that from my coworkers, though, by taking my teeny containers to the kitchenette counter and hiding behind the fridge while scraping the leftovers into a paper towel before dropping the whole thing in the trash.

Falling in love with my band all over again

It may sound sappy, but I'm falling in love with my band all over again.

For breakfast this morning I made my usual cottage cheese & Greek yogurt with berries. Had to stop eating after 2 bites, so I think I'm going to have go back to Click protein shakes for breakfast and save the cottage cheese & yogurt thing for lunches.

I didn't cook any supper last night because I had to work from 3:30 - 9:00 pm. When I started getting hungry for lunch at 11:30 this morning, I looked in the fridge and remembered that we had finished all the leftovers of this and that yesterday. Finally I found a small container of chickpea, broccoli & feta salad - about 1/2 cup. I ate that (slowly and carefully), thought, "That wasn't enough to feed a gnat," and promised myself that I could eat some grapes and cheese for a snack mid-afternoon. Well, mid-afternoon came and went. At 4:00 pm I fed the dogs and realized I had completely forgotten about my snack. Bells went off in my head: I FORGOT A SNACK! I asked myself, did I want to eat the snack now? No, not especially. At 5:00 pm I started supper: a batch of eggface's cottage cheese pancakes, some cucumbers in vinegar, a lemon caper sauce made of Greek yogurt, and some smoked salmon. I had planned to eat two pancakes, 1 oz. of salmon, 1/4 cup of cucumbers, and 1 tablespoon of sauce. I ate all of that (slowly and carefully), but I was TOO FULL TO EAT BOTH PANCAKES!

I feel like telling my band: "It is wonderful to be reunited with you! I've missed you so much! I almost forgot what a dear friend you are!"

Another fill

The other day, I told a friend that I hoped my next fill would be a "kick ass" fill. I think I got my wish.

This morning I saw Dr. Weaver's nurse practitioner, Vanessa, for a fill. She put in another .3 cc, so I now have 2.4 cc in there. A long, long time ago, 2.55 cc was as close as I ever got to a "perfect" fill level (I put that in quotes because I'm not convinced there's any such thing as a perfect fill), so I didn't expect 2.4 cc to be quite this effective. Tonight I made baked ponzu-marinated salmon and a chickpea & veggy (finely chopped) salad for supper. I knew I should just stick to liquids, but the food smelled and looked wonderful, so I had a little bite of salmon. Everything down there in bandland protested loudly. As my British friend Kate would say, I am a very silly cow. When all seemed quiet again, I tried a few chickpeas. That went better, but having been strongly reminded about my band for the first time in a year, I wised up and stopped eating.

Holy Crapoli!

Holy crapoli!

So far I've gotten 3 EOB's from Anthem for my April 7th port repair surgery.
$34,628.70 - hospital outpatient surgery (insurance paid $3689.86; no co-pay for me)
$1,260.00 - not sure - think it's anesthesiologist (rejected by insurance because they need more info)
$5834.72 - surgeon's fee (insurance rejected $5,000 of it, I think because of a billing error, and paid $212.24)

That's a total of $41,723.42!

Like I said, holy crapoli!

Back on the bandwagon

After almost a year of no fill or not enough fill, I thought everything would be better after my port repair surgery on April 7th, but bad weather caused flooding that closed all the roads between here and Memphis, so I had to delay my follow-up appt. with my surgeon for 2 weeks. Good things are worth waiting for, right?

This Monday I saw Dr. Weaver, who said my incision looks good, my weight looks good (somehow I had managed to lose a pound since the port repair), I look good, and was I ready for a fill? Yes, ma'am! So I now have 2.1 cc in my band, and am feeling the difference already - early satiety, prolonged satiety, no negative symptoms, just my band doing what it's supposed to do. I feel like I have a new lease on life!

Making progress

My port incision looks much better now (though it's very itchy - I think I may be allergic to the surgical adhesive). The site is still swollen, as you can see in this photo. The fine red line below the incision is from my scratching - bad girl, Jean!

Port repair - day 4

A lot of the swelling has gone down, but I look like I've been beaten with a baseball bat. I'm 99.99% sure I didn't look like this after my original band surgery. I think I would've remembered that.
I guess I have less adipose (fatty) tissue to cushion the blows now, and clearly Dr. Weaver encountered a struggle when trying to extricate my port from its tilted position and fight it into the correct and obedient position. And as we say in the south, she's just a tiny little thang!

Survived my port repair

I survived my port repair surgery. My belly is not a pretty sight at the moment...not just because of the incision but because it's grotesquely distended, especially on the right side (port side). I only feel pain at the incision site when I exert myself physically (rolling over in bed, for example), but the pain from the intestinal gas is continuous. I have 2 GasX strips left and a whole bottle of Percocet. I'll have see if I can persuade my husband to do a rescue run to Walgreens tomorrow for more GasX.

The dogs have been pretty good about not jumping on me, but this afternoon Jinx greeted me happily and put his front paws right on top of my incision. That was not a good moment.

I'm so glad it's done! I go back to see my surgeon again in a month. Let's all keep our fingers crossed that I can get a fill then.

Good news about my AGB book!

Last fall, I gave my band book manuscript to a great bariatric surgeon to read, correct, edit, and comment on. Of course, he had a very full schedule already, so it's taken some time for him and one of his staff members to get through the manuscript. But last week we had a telephone consult in which he gave me answers to some questions, a few clarifications, and a big thumbs up to the book. He promised to write a foreword for the book, and said, "It's a very nice piece of work."

I'm so flattered by his endorsement, I can hardly contain myself. I'm working on the final revisions now, then will start work on the index (tedious but necessary) and hope to publish the book by May 2010. Hurray!

The magic of exercise

My day started off badly this morning. I didn't sleep well last night (due to fibromyalgia pain and a bad cold), and when I don't sleep well, I cannot handle even the tiniest task or challenge. For some reason I felt fat today, even though I weighed 1.4 lbs less this morning than I did yesterday morning. Somehow my inner vision of Fat Jean got projected into my mirror (I sure would like to know how to do that kind of magic). Our paper-loving dog stole my "to do" list off the kitchen table (we're wondering if Jinx has a vitamin/mineral deficiency, or some kind of weird eating disorder) and ate it. I screamed at him and caused our neurotic dog Meg to do her panicked-pee-on-the-rug thing at the sound of Psycho Grammy's voice. When I got dressed, I put my shirt on backwards (further reinforcing the poor self-image). My socks (too big, from fat days, but too good to throw out) kept getting wadded up inside my sneakers. I got out to my car only to realize I'd left my water bottle sitting on the kitchen table (just begging for attention from our plastic-loving dog, Berry). As I drove to the fitness studio, I slowed down for a 30 mph zone where I have twice been caught in speed traps (almost lost my license) and created a parade of angry motorists behind me. And so on, and so on.

None of those were disasters of cosmic proportion, but they felt that way. Until about 5 minutes into my body toning class. I guess the endorphins started firing then, because I found myself smiling even through the hardest moves. When I walked out the door after class, I was no longer Psycho Grammy. I'm not saying I was (or ever will be) completely sane, but I was much, much better than I had been when I fell out of bed this morning. All thanks to the magic of exercise.

If I could put that magic in a bottle and sell it, I'd be a multimillionaire. Unfortunately, the only way you can obtain it is to do it yourself.

Strong?

When you're still fairly new at the whole WLS thing, scale and non-scale victories pop up all over the place. It's very gratifying and it keeps you going when otherwise the business of losing weight seems endless and dreary.

I reached my goal weight at 12 months post-op, and the victory list has been shrinking ever since. Not because I've experienced failure, but because the entire landscape of my life has changed. At this point in my WLS journey, my social circle includes more people who never knew me when I was obese than those who did know me then. Most of them don't even know I had WLS. The subject doesn't come up - why would it? They look at me and see this trim (if short) lady whose eating and exercise habits are conspicuously healthy but otherwise not remarkable. They ask me if I have grandchildren, or where I got my hair cut, but very few of them question my eating (I told a curious coworker that I eat this way because I'm diabetic, which is the absolute if not the complete truth). They're more curious about my Yankee accent than my body weight. So after 30 years of hoping no one would notice how fat I was, I'm now tempted to shout, "Can't you see? I'm NOT FAT!"

Sometimes my fat world and my thin world collide. The guy who works the front desk at my health club used to work at the same local company as I did, pre-WLS. One day this shared history came up in conversation - I can't recall exactly how, but Randy said something about that company, and I said, "Oh, I used to work there, too. I was one of the product managers, working for (boss's name)." And Randy looked at me in astonishment and said, "You're THAT Jean McMillan?"

A new fitness center recently opened in this area, closer to my home and with a more attractive class offering than the other place, so I've been trying out those classes. This morning there were about 8 of us in the low impact aerobics class. Good class, good instructor, pleasant company. After class, one of the other students (whose age I guesstimate at about 40) came up to me and said, "You did really good in class!"I thanked her. She went on to say, "Did you used to be athletic?" I almost laughed. Used to be? You mean, before I got so old? I controlled myself and said instead, "I took a lot of dance classes when I was younger."She said, "I can tell! You're so good! And you're really STRONG!"

Then I did laugh. "Well, the strong part is a recent development."

To be praised for being strong was a great NSV. I've been a weakling all my life, even in my skinny periods. Being strong is almost as good as being skinny. Not quite...but almost.

Obesity Denial

I think I've mentioned before that when I was obese, I had no idea of how big I really was. When I looked at my reflection in the mirror, I literally could not see anything from my chin down. I was suffering from obesity denial.

Some 60 pounds before I reached my highest weight, a Taiwanese business associate asked me, So when will your baby be born?" I told him stiffly, "I am not pregnant!" I was indignant. How could he possibly think I was pregnant?

A month later, my husband took this photo of me holding our new puppy, Bessy Lou. Looking at it now, I can see exactly why Mr. Chen thought I was pregnant. Like, six or seven months pregnant!

Yet another challenge

Recently I switched primary care physicians. I liked the original guy as a person, but since I've been banded (and especially during my band slip), he has just not kept up to speed with me medically. He has been listening to my heart at least 2-3 times a year for the past 10 years and never uttered a word about any heart problem. When I asked him if I should have a cardiac evaluation because of the phen-fen I tooki years ago, he said no, my heart is fine.

So it was a surprise when the new doctor said, "Did anyone ever tell you you have a heart murmur?" He added that because it's a loud murmur, he wanted me to have an echocardiogram (sonagram of the heart). I had the echo done last week. I've never been interested in cardiology the way other medical topics interest me, but it was fascinating to see and hear my heart beating. Of course, the technician made no comments about my test other than to point out the different heart chambers. A few days later, the doctor's office called to say that my murmur is from a very strong heartbeat, caused by thickening of my heart wall, and that the doctor would discuss it with me when I see him in 2 weeks.

If it can wait 2 weeks, I guess I'm not at death's door, but about 5 minutes of research revealed that hypertrophic cardiomyopathy is often what kills healthy young athletes who drop dead in the middle of a game. It's usually congenital, caused by a defect in the fibers in the heart wall, but can also be caused by cocaine abuse and a few other things that are far outside my realm of experience (I know exactly how to score a candy bar, but have no idea how or where to score cocaine) Treatment is exercise (I think I'm already good in that department), medication, sometimes open heart surgery, sometimes a heart transplant.

The good news is that I don't have any symptoms of heart trouble - no shortness of breath, no exhaustion, no problems when exercising, and so on. But still, this distresses me. I turn my life around, have weight loss surgery, reform my eating, learn to enjoy daily exercise, lose my excess weight, regain my health (normal blood sugar, cholesterol, triglycerides, blood pressure), and then find myself dealing with chronic, daily pain (fibromyalgia). After a 10-month battle, I get that under control, and now I'm faced with a freaking defective heart. Thanks so much, God. I needed yet another challenge in my life.