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Things seem to be progressing and moving along, yet the surgery date feels so far away. Since my last entry I've completed my psychiatric evaluation, home sleep apnea link, had my monthly appointments, and attended a support group at my surgery center. I'm really disappointed with my psychiatric evaluation, as the doctor recommended I return for therapy prior to surgery to address potential binge eating behaviors. I was honest on all of the material of course, but I did not see myself as someone who has an issue with binge eating. Hopefully, one visit will cut it and I'll be cleared. My home sleep apnea link study went just as I had expected and I've been recommended for a full sleep study. This is something I look forward to doing, as I have long suffered through sleep issues and look forward to being helped in that department. My monthly visits have gone as expected and I've lost weight sticking to my goals each month. I have a lot of pride that I do not indulge in Starbucks Mocha Lattes every single morning and only reserve them for a once a month treat. The support group was also helpful and I was able to glean some useful information. The topic of the group was inspirational stories and a panel of 6 people who had surgery gave their stories on their surgeries. It truly was inspiring and reaffirmed that I made the right choice to have the sleeve rather than the gastric bypass. I have also scheduled my appointment with my PCP to get my weight history and a letter of medical necessity. I am content with where I am on my journey in all areas aside from the minor hiccup of the psychiatric evaluation and further therapy.

While shuffling down a longevity rabbit hole on PubMed, I found a fascinating recent study in the area of calorie restriction and longevity. What I wasn't expecting was its findings on low protein, high carbohydrate diets. The study found, amongst other things, that low protein, high carbohydrate (20% fat) was associated with the greatest longevity and best overall metabolic health in spite of a tendency to weight gain as fat. The improvement was equal to caloric restriction alone, and combining the two had no additional metabolic benefits (LPHC also tended to expend the most energy) The version of the experiment where LPHC was combined with CR had the same longevity, but also avoided the increase in body mass from the high carbohydrate Intake. They also had the best immune systems The low carbohydrate, high protein group were found to have reduced longevity and poorer cardiovascular and metabolic health, though again, LCHP group with CR fared better than those allowed to eat freely. The area where LCHP created an advantage was in reproduction. Not in fertility, but in the actual process of reproduction, which makes complete sense. You can read the whole report here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4472496/ It should be mentioned this study is still one part of decades of research on Calorie Restriction and dietary composition. From the strong evidence in favor of dietary restriction, we should all be seeing increased life spans (depending on age of intervention, some will be more modest than others). But I wonder how the evidence building up for HCLP can be applied to us. HCLP emphasizes low glycemic index carb sources and 5-15% protein intake, but at our level of consumption 600-1000 calories a day in maintenance depending on your needs), that would only be 12.5-37.5g protein which seems like it would result in a deficiency. The famous Okinawan Ratio is on the low end of that, though people studied consumed about twice the calories (if I remember right, and I might not) which is still only 25g protein/day. And yet, I'm not seeing any of these deficiencies in the literature. No deficiencies in the Okinawans either. Curiouser and curiouser. What do you think? What did this study make you wonder?

I have jumped through all of the hoops that were laid out by my insurance company. My surgeon's office submitted my information for insurance approval yesterday. Now, it's time to sit and wait. Except, I am not the "sit and wait" type. I shall prepare to divide and conquer. List making has begun: Items to pack for the hospital Books to read after surgery Movies/TV shows added to my Netflix queue Additional questions for my surgeon at my final pre-op appointment Food ideas for the full-liquid stage (which lasts for 5 weeks post-op!) I have also decided to implement life-long lifestyle changes now, rather than later. Per my nutritionist, adults can only handle 2-3 major changes at once, so I figure I by starting now, I am setting myself up for success. Some of these changes I will be working on over the next several weeks are: Eliminate caffeine Eliminate refined sugars Have several smaller meals throughout the day Chew food more thoroughly Eat slowly No liquids with meals No straws No gum Find replacement activities for when head hunger or the urge to boredom eat kicks in Start walking more Additionally, I have started the process of cleaning out my pantry and freezer, getting rid of any food items that are not in line with my new lifestyle. If it is something I shouldn't consume after surgery, I certainly do not need it now. I am not one to waste food, however, I do not want to "waste" my health any further and these items will be removed from my home. Anything that can go to the food pantry, will. Lastly, I have begun taste testing various protein shakes and "clear liquids" for those stages after surgery. I plan to use my blog as a place to post my reviews for me to revisit when the time comes. Here goes nothing. Or everything.

2 days till the 8 month mark. I've survived the two big events i had to do this year. Hopefully the rest of the year is a bit less hectic now. I needed to take a break and just not worry about weight for the last month or so. I still tried to eat well and drink my water but I knew I didn't have time to exercise or be totally focused so i just gave myself a break. I lost and gained the same 5 lbs over and over again. It was still depressing. Now that's over and I turned 39 on Sunday..I'm getting back to basics this week and tracking my food and water. Next week Ill start Yoga 3 times per week again and Tabata training (Still hate it!) 2 times per week, per the dietician. I THINK I maybe broke my stall this morning and made it below 170 but we will have to see if that will hold through till Monday at my actual weigh in. Admittedly, I started taking my adipex again (1/2 in the am & 1/2 in the Pm though Im prescribed 1 1/2 a day) to try and help with the cravings/head hunger. It helps. Im eating less which has always been an issue for me. The dietician wants to adjust my goal weight to 155 instead of 135. That would put me 15 lbs from my goal weight right now which is weird to say. She's more interested in my body fat percentage than anything though. At the beginning of April it was 38% and she wants it at 33%...like I said before, I'm solid. I think Ill be happy at 155 or so because im just not focused on the scale number and I want to be healthy. I'm certainly not losing weight at a rapid rate at this point and for me, it will probably still be a struggle to keep it off for the rest of my life. That's ok. I'm committed. Right now I need to focus on toning and building muscle back. I really really want to be able to do a pull up. It's a goal for my 39th year! One thing...when we went to the convention this year, I noticed how much more attention I got as compared to other years. There were a lot of compliments. I expect that from people who know me and have known me for years both heavy and slimmer...but i had complete strangers intentionally give me compliments. I had one woman walk across a crowded patio just to introduce herself to ONLY me. It was unnerving. Part of my brain wanted to scream "Damn it ! I was cute before too!" and i'm still working on just saying thank you without being self deprecating. Im working on looking at the big picture instead of focusing on the next lb down (or up) or the next calorie intake. I NEED to know those things, but I don't need to let them control my life. This years goals are being met, slowly but surely. Ill get there, no matter where there is.

I can't believe it's the day before surgery! Six months has flown by. As of this morning (according to my scale) I am at 262. Today is clear liquid only and if I thought the past week of two protein shakes and one meal was hard and I was hungry all day...I woke up hungry and can't eat anything for the next two weeks or more depending on when my followup appointment is. Ugh. At least after tomorrow morning it shouldn't be too bad from what I've heard since my tummy will be so much smaller. I hope everyone's right. LOL! I'm just looking forward to more energy. That is the biggest thing because for the last week I have had zero energy. Anyway, short entry for now. Talk to you laters!