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This article went out to all 3,000 employees at my state agency. Guess everyone knows now. Surgical maneuver: Amanda changes course with weight loss surgery Weight loss surgery is simply a cosmetic issue; it’s taking the easy way out. Amanda is witness to the fallacy of these notions. Candidates for surgery have exhausted other means of weight loss and are at risk of illnesses that can be life threatening. And treatment does not end with surgery. Success demands from patients a long-term commitment to a healthy lifestyle. For Amanda, weight loss surgery afforded her the opportunity to make the necessary and permanent change in her life that other methods had failed to do. Her body mass index was in the severe range. The three medicines she was taking were not stabilizing her high blood pressure. And Amanda’s doctor had diagnosed her as prediabetic. Amanda recalls, “I couldn’t even walk up five stairs to get into the building without [being winded]. Medically, I was completely unhealthy. And I had to do something to change that.” Choosing the right course Of the three main types of weight loss surgery, Amanda opted for the least invasive: laparoscopic gastric banding. She was concerned that sleeve gastrectomy, which involves removing about 75 percent of the stomach, is too new a procedure and is irreversible. And gastric bypass surgery, although more common, is also considered to be irreversible and has a higher risk of nutritional deficiency. Gastric bypass surgery involves sealing off the upper part of the stomach and connecting it to the lower part of the small intestine. Thus food skips part of the digestive tract, and the body absorbs fewer calories. Amanda chose laparoscopic gastric banding (lap bad surgery) not only because it is the least invasive but also because it is reversible and involves routine checkups. A band is placed near the top of the stomach and is inflated with a saline solution to create a pouch, or kind of funnel. When a patient eats, the pouch fills up with food much sooner than the entire stomach would. As a result, the patient feels full sooner. The food also takes longer to pass into the lower part of the stomach, which increases the amount of time that the patient feels satisfied between meals. The band is adjustable, allowing doctors to routinely evaluate and optimize its effectiveness. A tube runs from the band to an access port — a small, discreet incision under the skin on the patient’s stomach. The doctor inserts a needle into the port to add saline solution to the band. The solution tightens the band, which shrinks the size of the opening from the upper stomach to the lower stomach and so reduces the patient’s food consumption. The port can also be used to remove solution from the band if the band is too tight to allow food to move through the digestive tract or is causing problems, such as pain or vomiting. Regular checkups enable the doctor to find and maintain the “green zone,” the most effective opening size for the patient. The journey has just begun Amanda’s surgery was successful, but it was just the beginning. For the first two weeks after the operation, she could consume only clear liquids. She graduated to full liquids for the following two weeks. Only then could she move on to the luxury of mushy foods. Recalling her trial by diet, she says, “The first two weeks, [you’re not so hungry] because your stomach is full, and you don’t have an appetite. But once the swelling went down, the hunger returned with a vengeance.” Amanda did eventually get to move on to solid foods, but in order to avoid discomfort or potential problems, such as band slippage, she has had to adopt strict eating habits. She eats only about a cup of food per meal, which she serves on a side dish to appear more abundant. She chews her food very well, about 20 or 30 chews, before swallowing, and she must wait at least a minute between bites. She downloaded an app to help her time her bites. “The idea is that it takes you about 20 or 30 minutes to eat your meal. And then you’re full. If you follow those protocols, nine times out of ten you have no problem. Most complications are from patients’ not following the guidelines and not changing their eating habits.” Band or no band, most anyone would likely benefit from those eating practices. Steady as she goes Referencing Leslie Mitchell’s comment in a recent article about the Calorie Counter app, Amanda notes that surgery, like the app or any weight loss tool, is not a magic wand. The surgery helped Amanda lose 80 pounds in a year, but its success depended on her discipline to consistently make healthy choices, a discipline that she must enforce for the rest of her life. Amanda now exercises daily. Not only did she overcome those five steps that used to wind her entering the building, but she now climbs the stairs to her office each morning…on the eighth floor! And sometimes, she makes the trip more than once a day. “My exercise is walking. I don’t do gyms,” she laughs. Once a month, Amanda meets with a support group. Fellow members, who have all had lap band surgery, offer emotional and moral support as well as exchange recipes and ideas. Amanda also strictly monitors the food she eats. Since she is eating less food, she must ensure that every bite packs a nutritional punch. “I eat high protein — three to four ounces of protein per meal; then, veggies. Then if I’m still hungry, I add the carbohydrates. But most carbohydrates give you energy but don’t fill you. They make you hungry, especially…non-complex carbohydrates….If I’m going to eat something, I’m going to make sure it’s worth my while.” She’s even been known to turn down a piece of chocolate these days. Her rationale: A piece of chocolate may be only 45 calories, but that’s 45 calories of mostly empty nutritional value. The surgery, she explains, “doesn’t change the type of food you put in your mouth. You have to control that. Ice cream will go straight down — [the band] is a funnel. For a lot of the people who aren’t successful, it’s because they don’t change their eating habits. It’s the same with any of the surgeries. Like with the bypass — some people lose all this weight and then just gain it right back.” Although her new diet is strict, Amanda can still enjoy the occasional treat. “It all boils down to calories in versus calories out. It depends on how physical I am,” she explains. Eloquently articulating her new outlook, she says, “Now I eat to fuel the body and not the obsession.” Balancing the costs Unfortunately, costs for lap band surgery can be prohibitive. The procedure is expensive, and the amount of insurance coverage depends on the plan. To qualify under many plans, an individual must have a body mass index (BMI) of 35 or greater and two comorbid conditions, such as high blood pressure and prediabetes. Currently, the state of Texas plan uses a higher BMI minimum and includes some additional requirements. Naturally, other costs can include deductibles and copays. Individuals interested in weight loss surgery should consult their provider for details. The initial expense may be high, but the investment is sound. Weight loss surgery can be a valuable tool in promoting healthy lifestyles and likely reducing the high costs of long-term medical care. In addition, investing in healthy individuals can, as this agency has recognized with its successful wellness program, yield solid returns for all.

So.. I have signed up to do a 45 day challenge with my weight loss support group from my surgeon's office. The challenge is we have to exercise every day for 45 days. We then have to post a pic or a video of us doing the exercise or being active in some way on the group's facebook forum page. The prize is a chance to win a gift card. So today, I joined a gym. I have a friend who did the RNY surgery today. She goes to the same gym and will be working out with me when she is back on her feet. I don't really care about the gift card. I am excited to be excited about working out. This has never happened to me before. I usually hate the thought of any kind of physical activity. I feel good when i get up and out of the house for a while. I feel great after I dance with my daughter. I might not have dropped a ton of weight yet (who has at 4 weeks?), but I have a ton more energy. I am down 25 lbs so far. I am looking forward to seeing what I will look like and feel like after the 45 day challenge. Once it is over, I will post an album of the daily pictures so we can see the progress. If people want to see it. I thought it might be cool to see what a one and a half month transformation looks like.

I love food, I mean really love food (which is why I hit 247). I have always been a foodie. While sweets were never a huge pull for me, I find myself wanting them more now, but I have managed to stay away from them except special occassions. I am and always have been a protein / carb girl. I am mildly adventurous, willing to try new foods and such. Since being banded I have found I like: Greek Yogurt, couscous, beans. I eat a lot more fish (talapia, salmon, mackeral). Being that I love to cook I am always researching new things and new ways of cooking. I still, however, do enjoy going out to eat. What I like best is having someone else clean the kitchen! Last night, Valentines, the hub wanted to go to the 1st resturant we ever went to. That resturant is On the Border, which serves southwest style food. I love southwest/mexi, but it is loaded with salt and calories. I downloaded the nutrition and was shocked the my southwest chicken taco's were 1200 calories- ouch. I found that the fajita mix was a better choice, I was able to order the chicken with grilled onion, pepper, zuchini, with no sides (beans, rice, tortillas). I ate just the meat and veggie and ask for sauce on the side (which I only used a bit of). Since I hadn't been there since surgery this really showed how my eating has changes. Before surgery I would eat the meat, veggies, rice, beans, tortillas and a dessert. Last night I wasn't even able to get down all of the meat and veggies. Wow, what a change. My husband said he was so proud of me. I went home feeling good and not over stuffed. Yes, this morning my weight was up by a pound, the salt really worked on me. So today I am drinking my water like a made woman and cutting the salt back. I guess this is what life should be like, not giving up the food we love, just cutting back on the amount and making adjustment for the bad stuff. What in the heck did I learn this years ago??

SOOOOOO, I will be going back to work 2-20. My Dr told me it is perfectly fine to go back to work with my wound as long as I cover it properly. Typical packing gauze and bandage. Also to wear my abdominal binder for extra coverage. Home depot has this dust that gets on everything. In other news I am 241 today and according to my nutritionist I am right on track. They expect at this point for me to have lost 25% of my excess weight. The weigh in they first counted was 266 (I started this at 270). And that is a gastric bypass guideline!! She said that with sleeves normally its a little less so that makes me happy. (Sleeved 1/16) I see a lot of people on here worry about how much they are loosing. I find that the larger you are you will loose a lot more the first few months then a smaller sleever. Patience is a virtue. Soooo cliche but true I have obsessed over my weight this month and with being in and out of the hospital. All to find out I am doing good. I have even been taking in more than I should solid wise due to my gag reaction to protein. The dietitian told me that she understood why and was glad I was trying to stay healthy but try to find one protein shake a day so I can cut back to the 3 ounces of solid. In 2 weeks I can add raw veggies/fruits back in my diet. I cant add exercise back in til this wound heals I am sure that would make a huge difference but I may still be 3 weeks out from that. If I can keep up 25 lbs a month I would be ecstatic!!! My goal weight is 165. Honestly I still cant believe I am sleeved. -Nicole-

I have signed up for a 5k. I have 6 weeks to get ready. 6 months ago I would have never even considered it. Yey Me!!!!!

I had my second fill today, the nurse added 1.5 to my 10 cc band bringing my total up to 2.5. Same little ache in the band area after fill, which quickly fades. So, liquids today, mushies tomorrow and solids on Sunday. I have been adding some processed foods back in to try and combat the cravings. Taquitos the other night, and pizza last night. Some things lose their allure when I choose to eat them (taquitos), some things are still trigger foods (pizza), none of them satisfy and curb my hunger like non-processed nourishment. Well, I guess I will just have to sacrifice and eat more ribeyes.

Hi everyone. Surgery is 13 days away. I found out yesterday I tested positive for H Pylori. So I am taking 4 horse pills to combat this monster bacteria in my stomach. On a good note, I have been eating a low carb diet for 12 days now and I have lost 15 pounds. My overall weight loss is 42 pounds. So I ventured into the back of my closet the other day and pulled out some "skinny" jeans (isn't it strange I call size 24 my "skinny" jeans), anyway, they are my favorite jeans of all time and I was so excited when the slipped over my hips and fit comfortably. A lot of my friends have been telling me, "oh when you lose weight I want that leopard dress" or "I want that jacket and jeans." It got me to thinking, I have some clothes that I LOVE. I am going to hate parting with them. I know I will buy new, smaller, more stylish clothes but I'm really attached to some of these items. Am I crazy? Well yeah, my friends would say I am on any given day, but I mean for thinking this way about clothes. I also realized that other things are going to change. I'm such a big girl right now, I don't think anything about crossing a parking lot. I expect the cars to stop for me. This big girl makes a big dent if they hit me. I don't think their insurance is that good. I'm gonna have to learn to stop and look both ways when I get skinny. I also don't worry about someone grabbing me and kidnapping me. Have you ever heard of a 300 pound woman being taken? No! But once I'm skinny, this could be a real situation. Good thing I'm a pistol packing country girl. Of course my mom always taught me if a man was following me suspiciously to start scratching my crotch and pretend I was eating boogers. LOL! I'm betting that would deter them for sure.

I had a wonderful non scale victory this weekend! I was able to shop in a "normal" store! I went to Old Navy and bought some shirts and a blazer! It felt wonderful!!! No more shopping in the "big girls store" down 50 lbs!!!! whooo hooo!

So why do I have a blog??? No idea really.....Not feeling too hot today. The normal monthly poo that we women have to deal with, made worse by a yeast infection (that I never get unless I'm on anti biotics, and I'm not!) and a really sore knee (too much Just Dance) some of those moves are impossible! I woke up to flowers, a huge stuffed bear, a hand made card and my favorite sugar free licorice jelly bellys...love my man, he totally rocks. Every day is like Valentines day when you love your spouse and he loves you just as much if not more, like we do, I am truly blessed. I have always been a pajama wearer, I must have at least 40 pairs of pants and shirts. I think it stems from them being over sized, elasticated and my not wanting to go anywhere in public, so I live in them (until I have to pick the children up from school). I had to say goodbye to my old friends, size 2x purple and white fuzzies this morning, I will most likely keep them (it's the hoarder in me) but it's time to move on to the smaller size.. Hubby wants to go to dinner tonight. I'm just not feeling it. I would rather eat my chicken and green beans, maybe have a glass of wine and watch Impractical Jokers, the kids love to watch it too and after they are in bed we will probably catch up with some Game Of Thrones (we are still on season 1) On this Valentines day (and every day) love your family and love yourself..you both deserve it

I was shaving this morning and my wife came in and weighed herself, curious I asked how much? Her answer was 122.5 (she is 5' 5"), and that around Thanksgiving she noticed that her back was hurting so she dropped 5 pounds and had been holding steady ever since. You know how my wife dropped 5 pounds and then holds her weight steady? She simply eats less. Not a diet, not skipping meals, not exercising, she eats less of the things that she eats every day. If she wants a beer or a cocktail, she will skip dessert. This is how normal people interact with food. I am not normal, I am a mutant when it comes to food. The band is my tool to help me pass for normal person