The Fluffy Nature Goddess Update

Wow, I cannot believe it has been almost two years since my last post. I debated on whether a new post was even necessary. I recently spent a couple of days de-publishing over 300 old blogs from the last 14 years that contained a lot of self-hate directed at my weight, and bad science about dieting. I found my writing cathartic at the time, however, in reading it back now, it seems like a lot of unnecessary complaining. I can't say this post is going to end up being much different, but I love a good update. This is going to be a little long (if you know me, you won't be surprised). Here is a "how we got here" recap (shout out to Sam and Dean), and an update for you. Sorry if you've heard the story before, but this post is the backbone of what may become something bigger later on.

For my entire life I have “battled” obesity. I was always told that it was my fault because I couldn’t control myself. Eat less. Exercise more. I just had to try a little harder with the willpower thing. I was on Weight Watchers by the time I was 13. I was drinking disgusting and unhealthy Slim Fast throughout my childhood. I was on phen fen by the time I was 21. I had gastric bypass surgery at the age of 27. I lost 165+ pounds after that surgery, although I did gain some weight back. I went from close to 350 pounds, down to 180. At my lightest, I started taking antidepressants for the first time in my life, and started gaining weight again.  Eventually, I found a comfortable weight around 225 pounds. In 2013, I had foot surgery, and I rebounded up to 260, but I went gluten-free, increased my fat intake, and exercised a tiny bit more to get back down to my comfortable weight in 2016.

For my whole life, I have been sold the narrative that calories in versus calories out – calorie deficit and over-exercising – were the only way to lose weight (i.e., that willpower I apparently never had). I am not delusional – I understand food and exercise are part of the equation, but it is not 100% of the equation in a "fat" person's body. I was in the gym six to seven days a week when I was at my biggest. I was told that cardio was the best way to lose weight, and that women doing too many weight-bearing exercises were going to "look like a man."  All false. No one talks about how food is now engineered to have less nutritional value and more awful preservatives. How it’s created to make you want to eat more of the bad sugary (and non-filling) stuff.

I had three siblings who had the same parents and lived in the same household. They aren’t fat. So why am I? We ate the same food. My mom always said I preferred reading books to playing sports (even though I see pictures of myself playing softball as a kid). I just wasn’t an “active kid” apparently. However, I don’t necessarily remember being a completely sedentary kid either. My friend had horses, and I went to her house to ride and play outside. I walked to school most days. I had a paper route at the age of 11 that required me to either walk or ride my bike carrying heavy rolled-up papers. My grandparents had an apricot ranch, and I remember helping them – mowing the lawn (well, on a riding lawn mower but they had eight acres, so it was still pretty active), and cutting apricots to dry. I really didn’t think of myself as a lazy kid.

I was also tall for my age – often being mistaken for being older than I was. I remember hearing a story about someone thinking I was 8 when I was only 4. At the age of 8, I have a photo of me standing next to my best friend who is a few days older than me, and I was easily double her size. My parents split at the age of 12. My dad claims this is when he really noticed me starting to get chubby. However, I got my period at the age of 13. I was put on birth control at the age of 15. These are all things that might change the body (and weight) of a child.

I remember being 16 or 17 and I started going to step aerobics, so I lost some weight. I was probably also doing slim fast, maybe even Weight Watchers too. I was a junior in high school. One of the gym teachers could not believe it was me. He kept remarking on how much thinner I looked. He was so proud of me. It felt gross while also feeling great. I loved the praise. 

Post-gastric bypass, I saw how people treated you differently as a thinner person. People were nicer. I had men tripping over themselves to open doors for me, something that had never happened before. I could never figure out if it was my change in attitude, or their approval of me as a thinner person. It set me up for a lot of trust issues.

Currently, in 2024, at the age of 47, I am suddenly “battling” my weight again. When covid hit in 2020, and I was sent home to work, I ended up putting on about 40 pounds over two years. I got an Apple Watch, and started trying to be cognizant of my movement. I stabilized and was sitting around 265 pounds for the last couple of years. However, in 2023, I started to realize I had a lot of weird symptoms. Loss of strength, night sweats, insomnia, joint pain, hair loss, the before-mentioned weight gain (especially in the midsection, which makes me look very oddly shaped thanks to the plastic surgeries I had years ago), exhaustion to the point of it interfering with my life, extreme grumpiness to the point of fearing it was going to get me in trouble at work, brain fog, snoring, anxiety. Never had I been told that these symptoms could be related to perimenopause. And since they each came on slowly at different times, I just kept telling myself, well our bodies change when we get older. I thought menopause was something I wouldn’t have to deal with until I was in my 50’s or 60’s.

In September 2023, I took a Facebook quiz with the website By Winona, and realized I was having perimenopausal issues (but thanks to taking birth control for 24 years, I don't actually know if my body knows how to function without "hormonal issues"). All of these issues are related. Why is no one talking about this? If you talk to traditional doctors, they will often offer you birth control pills or anti-depressants, and tell you this is the best they can do. I didn't want to go back on birth control pills, but they promised it was a lower dose, and not the same. I had spent so many years abusing my body with medical advances, why not start using those advances to actually help me. Winona was offering a cream (estrogen/progesterone) that seemed like a better idea for me (post-gastric bypass, I can sometimes be malabsorptive in the vitamin/pill department). They were also offering a supplement called DHEA. I signed up. Within two weeks, I was feeling better. I didn’t even realize the exhaustion and joint pain were so bad until I felt better. Two weeks after starting, I was able to run down two flights of stairs to catch a BART train, something I could not have done before the hormone replacement therapy (HRT). I suddenly didn’t need Sunday to recover if I did ANYTHING on Saturday. I wasn’t feeling like biting off the head of every human I crossed paths with. It felt like a miracle.

However, after starting HRT, I suddenly gained another 15 pounds (my body loves to do everything in 15-pound increments). I am the heaviest I have been in the 20 years since gastric bypass surgery. I am unhappy (or am I?). I recognize that my joints do hurt a lot more when I am heavier. Also, my skin hurts and I feel like a sausage when I gain weight so quickly. I feel like I need to "do something" but none of my prior tricks are working. I am a decently active person. I do yoga, swim, and ride bikes. I wear an Apple Watch to make sure I am getting my steps in. In the last few years, I have tried tricks that worked in the past: 16:8 intermittent fasting, cleanses, the chicken taco diet, cutting alcohol, lowering sugar intake, increasing fat and protein intake. Nothing has really moved the scale in the “right” direction.

The American Medical Association declared obesity a disease in 2013 (and apparently this was affirmed in 2023). (Although many will argue that obesity is merely a symptom of other diseases, not a disease itself, I teeter totter on how I feel about that.) For my whole life, I was told that I was the one doing everything wrong. When I contacted a Kaiser doctor last year, asking if I could be considered for Wegovy (a GLP1 medication related to the popular diabetic drug Ozempic, which stabilizes blood sugar and has the side effect of weight loss), I was told I would have to jump through many hoops before I could be considered for Wegovy, including paying thousands of dollars out-of-pocket for Kaiser’s weight loss program, and for what I assume is highly processed, disgusting food. Even if I cleared all their hurdles, the out-of-pocket cost to me for Wegovy would be very high. Essentially, I was being told my very clearly chronicled lifelong disease had a potential new treatment, but I wasn’t (again) working hard enough for it. I mean, I was willing to scramble my insides, and I'm still "sick," so did I not show I was serious about my treatments?

I watched a TV show about stars who are taking Ozempic. One reality star, Heather Gay, made a comment in response to someone saying that she was taking the easy way out. This is not a direct quote, but she essentially said that if someone thinks she’s taking the easy way out then they likely have been blessed with a naturally thin body (or high metabolism). And I couldn’t agree more. I was heavily judged for having weight loss surgery, and will likely be judged for asking to take one of these GLP1s (Ozempic, Mounjaro, Wegovy, Zepbound…). However, that judgment likely comes from someone who has not spent their entire lives “battling” their weight, mind, and body.

I think back to being a 13-year-old on Weight Watchers. The embarrassment of having to step on that scale in front of people. I think of their awful slogans, such as: “Nothing tastes as good as being thin feels.” I was always felt like a nuisance because clothes were not made for children my size (my height, not even just my weight). I now have nieces who are nine, five, four, three and two. The nine-year-old is already being called fat at school (and this kid is so active…jiujitsu, softball, soccer, basketball). Society can be awful – and it is so easy to point fingers at people and tell them they aren’t good enough. As if being fat is the worst thing you could be. I sometimes wonder how different my life could have been if I didn’t have this weight (no pun intended) hanging over me. I don’t want my nieces in particular to struggle this hard for their entire lives.

I listen to a podcast called Plain English with Derek Thompson. In episode "S2 E68: The Weight-Loss Drug Revolution, Part 1: Why These Drugs Work So Well" (published 12/12/2023), I was floored as I heard for the first time in my life that I am not simply the fat girl who can’t stop eating. Biologically, I may be unable to keep the weight off without further intervention (the drug appears to target compulsive behaviors in general, including smoking, drinking, shopping, gambling). I feel understood for the first time in my life. Gastric bypass made my stomach shrink so that I could not eat as much, however it did not fix the issues inside my brain that told me to keep eating. I have been part of a weight loss surgery support group since 2003 – one year before my surgery. I have watched so many people come into the group, lose weight, start gaining, then disappear because they were too embarrassed to face the group. I always felt sad, and I was always honest with the group about my struggles. I always felt like the problems were never truly being addressed. I talked about addiction transfer, and losing food as your coping mechanism. I begged people to get therapy as they lost weight. I usually felt like I was the only one preaching this, and that the doctors approving this surgery should have been taking the mental aspect a little more seriously. I feel validated.

I just hit the 20th anniversary of my gastric bypass surgery on March 17.  I have always been told that many people gain all or more of their weight back, and the fact that I am still significantly less than what I used to weigh, I am considered a success. I don't even know if those are facts, or just "what people say." I don't even know how studies define a "successful" weight loss surgery patient. However, I do consider myself a success. I have watched a lot of people get sick and/or die from other technically unrelated health issues, but I always felt their inability to get the nutrients their body needs contributed to their body's inability to heal. I have spent 20 years dialing in my vitamins, and trying to take care of myself the best I can.  I just got my blood work back and I had all perfect numbers for maybe the first time since surgery.  Even my liver looks good again! On paper, I am the healthiest I have ever been.

However, I am getting a little frantic about this recent weight gain. It is easy to scream about health at every size, but my knees hurt, and I can acknowledge the extra weight is contributing to that. I am unwilling to go off the HRT. I have reaped so many other benefits, so I need to deal with the weight another way. This podcast about the GLP1s was well-timed, as I had already made an appointment with my doctor to discuss options about weight loss in the perimenopause world.  

These new GLP1s are targeting gut peptides. For years, I have been hearing that we need to heal our guts in order to heal ourselves. It seems this is true. And, though I have been conditioned to feel like a failure for asking for medical intervention, I feel like there is no choice. In my 20’s, I was gaining 15 pounds per year, and was already 350 pounds at the age of 26. I could foresee a future of hitting 500 pounds in ten years if I didn’t get medical intervention. Now I am 47, and back up to 280 pounds. I have been without much help from my previous “medical intervention” for many years. The body is resilient, and I have heard many stories about how calorie malabsorption after gastric bypass only lasts about a year because the little cilia in the intestine just grows further down, allowing the calories to be absorbed again. The pouch doesn’t just stretch out, but the metabolism slows as it gets used to the lower calorie intake, meaning you can gain weight off eating a somewhat “normal” amount of food. You can’t win against this.

The podcast talks about “food noise,” or more importantly, the absence of food noise once they are taking a GLP1, an example given of thinking about what you’re going to have for lunch while you’re eating breakfast. Food and weight have consumed my entire life. I feel like I don’t have the luxury of not thinking about food, and half the time, it’s talking myself out of eating things I know I shouldn’t eat. I also get frustrated by being asked: “What do you want to eat?” As a food addict, I should have tons of opinions on what to eat, or where to go. However, I hate that decision. I don’t want to be responsible for making food decisions. I want others to make the decision, and then I will find something to eat once we are there. It even happens when I am alone in my own house. I don’t want to make a decision about what to eat for breakfast (when I know it should be a protein shake), so I don’t do anything until I end up eating some Ritz crackers (or other overly processed food), which I know isn’t a great choice for me. When I attended years ago, Overeaters Anonymous had a saying about food addiction. It was something like, when you have a drug addiction, you can put the tiger in a cage and lock it up, but when you have a food addiction, you have to take the tiger out of the cage and walk it three times a day. For some reason I always hated this statement. This just makes food the enemy. At the same time, I get it and I just want the food noise to go away so that the decision paralysis also (hopefully) goes away.

I have always tried to be careful not to reward myself with food (I am not a dog). I think my favorite part of the podcast is where Dr. Tchang says that there is a mental change once on the GLP1s where the brain sees food as only sustenance and not a source of comfort. I need that. I used to say: “Food is for fuel, not pleasure.” Not that it got me anywhere. I have over ten years of blogs showing my obsession with finding the answer to fixing my broken body and mind. I put “food is” into the search bar of my Google doc and over 1,000 hits came up. Most of them found entries for “food issues.” This makes me so sad. This has shaped my entire life, including this blog. I think I believed my blog was helping others who had the same issues I did, and maybe it did a little. I felt like the writing was cathartic. When I recently went through my almost 1,000 published blogs, I de-published over 300 of them where I felt like I was just whining about being fat, and pushing the narrative that I was being lazy. I have been told by society for my entire life that fat people are lazy, and apparently I believe that narrative about myself. I spend so much time making sure I’m never sitting at home on the couch watching too much TV, when rest and relaxation is a normal part of life that “even fat people” should get to enjoy without guilt or shame. I had gastric bypass so that food and weight would not be my main focus in life, yet it seems like food and weight have remained in the starring role no matter what I do.

I went to Kaiser last week to discuss the GLP1 injections with my doctor. I was worried I was going to have a battle on my hands. She was actually sympathetic and willing to help, but her hands are tied by the insurance company (this is why HMOs should not be making our health decisions). I have to jump through hoops to get to the GLP1s. She handed me a to do list, which included a visit with a "health educator." That visit happened this week, and it was...enlightening, or maybe terrifying.

I was told by a Kaiser health educator that I should be doing one hour of cardio, seven days a week. Not a single mention of weight bearing exercises. I think 50 years of people running on treadmills has taught us that cardio is not the gold standard for weight loss. In fact, when I was my fattest (pre-weight loss surgery), I was going to the gym six to seven days a week. It certainly did not prevent the need for surgery. I was told that intermittent fasting is making people fat (sure, could be a problem for some, but not for others). I was told that half of my dinner plate should be vegetables (as a gastric bypass patient, we are taught that protein is first). I was also told not to eat too many nuts or avocados (she also lumped milk products in here, as if they are the same as nuts or avocados).  She claims she has noticed a lot of people gaining weight from avocados. I would be willing to go out on a limb and say not a single person seeking help from Kaiser got fat from eating avocados.  She also believes that a plant-based diet is best, although she understands how "Americans like their meat." I personally know two people who were vegetarian or vegan, and benefitted from adding some meat to their diet. No one says you have to run out and start eating rare steaks, but some bodies do benefit from animal protein. Never once did she ask me about my sugar intake. I feel like that should have been her first question.

I was a little shocked by the information given to me. I chose not to argue with her, and I feel sorry for anyone who doesn't know anything about nutrition and might believe everything that came out of her mouth. I swear she read a book about dieting from 1980 and just regurgitated it. One size fits all is just irresponsible, and I am saddened that a person who is supposed to be a health educator said any one of those things, let alone all of them in a single conversation.

I have a follow-up with my own doctor next month, and hope she will have something to help me move the scale in the "right" direction again. Before they consider the GLP1 injections, I have to try an oral medication. I don't need to be skinny, but I would like to feel less creaky. I am tired of feeling like I'm 80 years old every time I stand up. 

Years ago, when I had gained weight after my foot surgery, I went gluten-free (well, gluten-less), and started eating a bunch of chicken tacos. However, I didn't otherwise change my life a ton. I was still going out, drinking and eating in restaurants. I was mostly doing whatever activity I was already doing (yoga and pole dancing). But I was able to shed about 30 pounds. I tried the chicken taco diet in January. Not a single pound lost. I went from drinking alcohol every night while we made dinner to once a week or less. No weight loss. I am swimming, doing yoga, riding bikes. No weight loss. Calories in versus calories out logic tells me that one of those things should have at least given me the courtesy of a few lost pounds. But I got nothing. I even started cold plunging in January. Certainly, I could freeze this fat off. I was gonna ramp up that metabolism and lose 50 pounds in two months! Nothing. (However, I will say that there are other benefits that keep me cold plunging.  I will probably need to write a separate blog about that.)

After all this has been said, I already know that my happiness is not tied to the number on the scale. I am the happiest and most content now – at the second fattest weight I have ever been in my life. I am in a healthy relationship, I own a home, I have a good job, I live near several family members and get to see them almost daily. In fact, the only time in my life that I needed antidepressants was when I was at my lowest weight. So why is being thin still such an attractive ideal for me? I can't really answer that question, but I love that these new drugs are finally recognizing that weight issues are as complex as the people they reside in.

I don't really know about the future of this blog. I don't want to pretend that I have a huge audience out there still following me, waiting with bated breath for signs of life. However, I do miss the Nature Goddess hiking posts. Living farther away from my favorite places to hike (and having a dog who can't go to some of those favorite places with me), has slowed down my big (or far away) hiking adventures. For the time being, I will just leave it open ended. I hope to have some more posts along the way, but if I stop posting, it doesn't necessarily mean anything terrible has happened. Life is happening in the best possible way, and you can always check in on the Nature Goddess Facebook page for those updates.

Mobility

Mobility.  I'm losing mobility.  I feel old even saying that.  Today is one year since California shut down for two weeks to "bend the curve."  Friday the 13th was the last day I was in my office working a traditional "8-5," and California issued a mass quarantine order relating to the covid-19 pandemic effective Tuesday, March 17, 2020.  Also, today is the 17th anniversary of my weight loss surgery -- a journey that helped me lose 165 pounds.  

I have had so many surgeries in my lifetime.  Ten times, I have gone under anesthesia to allow a surgeon to cut into my body, sometimes having multiple procedures during the surgery.  Each cut is a scar.  Each scar locks my body down a little bit more.  You know, when my plastic surgeon did my "arm lift," he cut a "Z" into my arm pit.  This was so that I wouldn't lose the ability to raise my arms over my head.  Whenever I get a new massage therapist, even when I warn them, I feel them pause dramatically when they get to my lower body lift scar.  The scar itself is thin and well-done, so looking at it isn't all that exciting.  However, when you touch it, you can feel the thick scar tissue underneath.  It holds one part of my body tight, pushing gained fat into weird places my body normally wouldn't have carried it.  

The last year has been rough.  I've gained weight (with fat in places I've never seen it squish into before).  This is certainly not the highest post-gastric bypass weight I've ever been, but I'm not trying to make that a contest.  However, when I look at photos of myself from just a year ago, I can tell a huge difference (no pun intended).  In the world of loving your body, I know I shouldn't judge myself, but let's be real -- I'm judging myself (plus I feel like crap and everything hurts).  I'm not moving as much.  I'm consuming too much sugar.  My knees and hips ache.  My hamstrings are weak and short.  My calves are knotted.  My core is weak.  My mid-back hurts (if I'm being honest, so does my lower back).  I'm pretty sure I have a SLAP tear.  I shuffle like an old lady when I first stand up.  I couldn't squat without intense pain.  My hips are so tight, that thinking I could handle frog pose is a fun little joke I play on myself (which is a move I could do ten short years ago).  My new neck pain is sometimes unbearable.  I assumed it was my pillow and have tried all different brands.  I used the foam roller and a lacrosse ball for self-massage.  I saw a chiropractor and did all the exercises to strengthen my back, which was supposed to lead to less strain on my neck.  Didn't really help.  Finally, I saw a physical/massage therapist.  Her brand of massage is more therapy - what I imagine Thai massage might be like.  She contorts me into strange positions, then starts to work out the knots.  When I first walked into her office, she said, your chest is pulling your entire body forward!  She's right.  My shoulders and back round forward, toward all of those scars around my chest, arms and side, which is putting strain on my neck.  The two types of mesh anchored to my insides aren't helping either.  It all hurts.  All the time.  

2019

My running joke for years has been how I will feel like I'm doing the craziest, deepest backbend and someone will take a photo, and I will just be standing up stick straight.  In fact, I bought this little contraption that you can lay on that will give you a little back arch.  I figured it would be good to use if I'm going to be doing something like watching TV.  It has three levels.  Level 1 makes me feel like I'm doing a deep, painful backbend.  It causes maybe a two inch arch in my back.  Level 3 might kill me (I've never even tried it), but its hardly full wheel pose.  I have contraptions all over the house.  Foam rollers, yoga mats, straps, blocks, yoga wheel, neck traction hammock.  I even have a brace to wear to remind me to keep my shoulders back.  We just re-did the bonus room (i.e., my office and yoga room) so that I would have more room for my exercises.  All in the name of erasing pain.

Recently, I decided it was time to change up whatever I'm doing.  I purchased a physical therapy system.  It was designed to rehab a single certain injury.  I decided my entire body was the injury.  So I have some basic exercises I'm doing each morning to separately rehab my feet, hips, shoulders, hamstrings, knees, neck and back.  I also found a website offering mobility exercises (probably the first time I'm glad Facebook was listening to me complain since it showed up as a suggested ad).  It's called KaisaFit.  I have been doing those three times a week and am now going to subscribe to her entire site so I can have access to additional classes.  I'm still doing yoga with my favorite instructor, but I let myself get out of shape so I needed a little different care.  

2021

In November, I had a self-diagnosed LCL strain (knee), right before a big hike I had planned for Nature Goddess Adventures.  The pain was excruciating.  It killed me to cancel that hike, but I didn't have a choice.  I wouldn't have made a ten mile hike.  Shoot, I wouldn't have made it a mile.  Now only a few months later, I did a deep squat (all the way to the ground) without pain for the first time.  Sure, my heels pop up and I can't keep my feet as wide as I'd like, but I was able to squat.  That was a huge win for me.  I feel a little silly saying this but some days my exercises include things like: "sit on your knees."  I can't do it for long, but I can do it again.  I can also relax in child's pose (and am almost completely flat in pigeon on the right side).  I had continued yoga after my injury, but child's pose was painful (and I couldn't lay my chest on the floor in pigeon).  Now I am just back to regular stiffness during yoga, not pain.  They say (whoever "they" are) that one of the signs of how you're doing as you age is the ability to get up off the floor.  So I am on the floor all the time.  Nothing makes you feel older than saying one of your exercises is just getting up off the floor!  How am I facing this at the age of 44??  I faced the same question with my hip around the age of 33.  I thought I was going to be in a wheelchair by the time I was 40, but I completely cured myself (with help).  I can do it again.  Perhaps it is metaphysical, perhaps it's a real injury.  I need to do some soul searching to figure it out.    

Twice in the last few years, I have purchased those "do the splits in four weeks" or "be more flexible" types of programs.  In four weeks, I'm no closer to doing the splits than when I started, and I usually feel like I've pulled something (no matter how much I warm up beforehand).  I should know better.  I know my body.  Forcing it into weird shapes is never the right way for me.  My new programs are different.  More gentle.  And more appreciative of what my body can do instead of what it can't.  

The last year has been a lot (for everyone in the world).  There have been a lot of changes for me personally.  Yes, covid changed everything, but I bought this house and moved to suburbia.  I started working from home more often.  I was moving a lot less.  Maybe I'm happy in my relationship so I let myself get fat (also, all those people who said if you make more food at home, you'll lose weight, lied).  Maybe some of it is age.  But I wonder if this is how people get diagnosed with diseases like fibromyalgia.  Everything huts but there's no obvious cause for the pain.  I have been through this similarly before with my hip, although that was an acute pain and this is more like a general ache all over my body, especially in my knees and hips - they just kind of feel tired all the time.  I don't necessarily think it's my joints.  When I eat gluten, my hands hurt, and I believe that is joint pain.  The knees and hips are something else.  Generally, I can gauge inflammation by a psoriasis flare.  It is also an indication that I am stressed out.  But my skin looks okay right now, so that is confusing.  I also went through a minute of adult acne (I now believe it was related to wearing a mask, but I was worried it was hormonal), and that also caused some concern.  I've always had clear skin, so I get worried when issues pop up for no known reason.  I know I need to figure out what to balance to put my body back into homeostasis.  

January 2018

I sometimes wonder how I got to where I am in my life (like, how my body works).  Sure, we are born with certain limitations, but I believe most of mine were probably nurture over nature.  (The day after I wrote this blog, my friend Ellen sent a newsletter with a most fantastic subtitle: Genetics loads the gun, lifestyle pulls the trigger.)   I was the oldest child and took some weird mental responsibility for my family's well-being.  I was put on birth control at 15, which was probably one of the worst things that could have happened to my body.  Although I took on the chunky kid role around the time my parents split when I was 12 years old, I really gained weight after I started taking the pill.  Even worse, I stayed on it 24 years, completely messing up my hormones and my body's natural ability to regulate itself.  I preferred reading books over playing softball.  I took a job at 18 that causes me to sit all day, which has clearly blessed me with a shortened psoas.  I went to college and worked full time, choosing lots of fast food as my easy meal option.  I gained all that weight in my late teens and early 20's, leading to a decision to re-arrange my insides at the age of 27.  I then decided to have even more surgery to remove the sagging skin at the age of 30 (and multiple other times), which gave me all these scars.  I sometimes wonder what my life would have been like if even one of those choices had been different.  My mom is thin and had knee replacements in her 50's, as well as hip replacements in her 60's.  Perhaps I was destined to have these issues, but my life choices contributed to the problem.

August 2018

Anyway, here we are.  Seventeen years after weight loss surgery changed my life (not necessarily for the better since lower weight doesn't automatically equal healthier body).  One year after covid changed it some more.  I've thrown around the idea of joining a program like Noom, or maybe even doing a cleanse.  I've already tried intermittent fasting with almost no weight loss (I thought giving up my morning sugary vitamin waters again should have given me something).  But I worry about what diet culture does to my mindset.  I know when I try to "diet" (i.e., concentrate on losing weight/count calories), I end up in a binge and a huge gain.  Instead of the number on the scale, I try to gauge my health by how I'm feeling (currently, like a sausage) and how my vitamin levels are (iron was low last year and it is time to get them checked again).  I'm currently taking tons of vitamins and recently added my protein shakes back into my meal plan.  My best bet is usually to "set it and forget it:" come up with a plan to make healthier choices and allow that to flow into my life.  I lost 35-40 pounds five to six years ago without counting calories.  I can do it again.  

I keep pondering how long I will keep up this blog.  I know I'm not writing much anymore.  I feel compelled to write on occasion just so it doesn't completely die (since I have been here for 11 years!), but I have no clue if the clicks I'm getting are real people still reading what I have to say.  I feel like, at one point, I was helping the cause, whether you were a plus sized poler, a gastric bypass patient, or just a regular person dealing with body issues.  Now I feel like I'm mostly using this like an online diary complaining about getting old, fat, and ugly.  Plus, I can tell Facebook hides my links in order to get me to pay for ads, which further lowers my audience reach.  So, if you're still out there reading these posts, feel free to leave a comment!  How's the last year been for you?  

Happy Feet...Kinda

Some of you have watched the saga of me getting older and my body essentially punching me repeatedly in the face. My hip has issues. My feet have issues. My doctor constantly tells me I am too young to be in his office as often as I am (currently, I am still visiting him weekly for hip and foot issues, where he also gives me B12 shots to help with healing). Today is an update about my new adventures with the Graston Technique on my left foot (right foot had surgery in 2013).  It took about a year for my right foot to stop hurting post-surgery. On top of all of this BS, my right foot has once again started hurting (so I only got about four or five months pain-free with that foot). I guess when you mess with your alignment, it can cause other issues.

So the left hip started randomly giving me trouble about five years ago (no injury to blame it on). I saw Keith and he got me back into a place where I could live relatively pain-free. After starting that new job in San Francisco in 2012, and going from wearing flip flops every day to real shoes, my right foot started really hurting. After having surgery and limping around in a moon boot for awhile, my left hip flared up again but I just kind of ignored it. My doctor warned me if I didn't take care of it, I would develop arthritis, and he started performing myofascial release on that hip this year. It has been life-changing. (We don't even have to mention how my little fall in Vegas put me back months and I'm still paying the price for that with my tight toes.) Something my doctor mentioned at one visit was how the tightness in my foot was related to my tight calves. Interestingly enough, I had just started having the Graston technique performed on my foot and calf the same week my doctor mentioned this.

I am about six weeks in to having the Graston technique performed on my foot (about once a week, although the holidays have made that a little difficult) and I really do feel like it is making a difference in the pain in my feet. The actual technique can be kind of painful. I have these crazy knots in my calves. I have always felt like my muscles practically melted after gastric bypass. Losing weight that quickly just destroys your body. My theory is that when the muscles started coming back, they fused in weird ways. When I used to get Charlie horses in my calf, it would be the back of the leg. After gastric bypass, Charlie horses moved into this place in between my muscles, which was completely unreachable and never could be rubbed out.

Although I am certainly not yet cured of foot pain, on the weeks I have Angela work on me, I am in significantly less pain than on the weeks I haven't been able to make it in. I am continuing with my yoga in order to keep myself somewhat stretched out. I am also using the Bledsoe brace on my left foot to keep pressure on the fascia. It is frustrating to be going through this on my other foot, but I really do hope that, if I keep up the Graston visits, I may be able to avoid future surgery on that foot.

Got any tricks for foot pain? I'm open to trying almost anything! I have been throwing around the idea of trying acupuncture. That should be fun...I really love needles. Not.

Bone spurs on the right foot. The left foot has similar, although smaller, spurs

Awesome bruise after a Graston visit

Sugar or Eating Disorder?

Let's play a game.  It's called "sugar or eating disorder."  I have been a compulsive overeater for pretty much my entire life.  I am more of a grazer than a binge eater.  No disappearing into the closet to consume an entire pizza and half a cake for me, thankyouverymuch.  It doesn't mean that I didn't/don't have disordered eating though.  For a long time, I just didn't realize that not being a binger didn't mean I didn't have food issues (that's a lot of "didn'ts" -- sorry!).  It does mean I would have the compulsion to put food in my mouth pretty much every other minute of every single day.  When I wasn't eating, I was deciding what I would eat next.  It literally took all of my energy figuring out all my food stuff.  [You can read more on my sugar adventure HERE.]



Silly monkey, eat the right food!

So fast forward to now.  I'm almost three months in to following Ellen's eating advice.  She never took anything away from me.  She just made some suggestions and let me follow my own path.  Sugar makes you tired?  Hey, maybe you shouldn't eat that!  Suddenly, less sugar was making me more tired.  Maybe cut down some more!  Then suddenly, now if I eat too much sugar, I get a blinding headache.  All in the span of about two months.  But I never felt like Ellen told me I couldn't eat sugar.  I just started making the choice not to eat something that made me feel like shit.  In fact, at Ellen's birthday over the weekend, I ate about one-quarter of a cupcake and it was too much for me (at least I only got sweaty and tired, I didn't get the headache, but I stopped because I knew my limit).  This coming from a girl who could at least eat one entire cupcake only three months ago.  It didn't take my body long to celebrate the loss of a "food source" it didn't need and start reminding me not to eat it whenever I did.  I've lost about 15 pounds, and that's all from changing the foods I eat, not reducing the calories I eat. 

Yesterday I was listening to a podcast from the 2nd Annual Eating Psychology Online Conference.  He was interviewing a woman about eating disorders.  Granted, they were mostly talking about binge eating disorder, but other disorders were mentioned, and I realized something I hadn't noticed before -- I don't feel that way at all anymore.  No constant compulsion to eat anything and everything at all hours of the day.  I'm not rabidly searching my shelves for sugary snacks at work.  I don't think about what I'm going to eat next as I am eating my current meal/snack.  I actually now have defined meals and snacks instead of leaving food on my desk and literally munching all day long.  I certainly still have A LOT to learn about what to eat and when to eat (just because I work so much and have too many side activities), but I am now eating because my stomach is hungry, not because my head told me I needed to eat.  I am also still making the majority of my meals at home, I have cut out fast food almost completely, and when I do eat out, I am making better choices for myself.  Also -- and this is huge -- when stress hits me, jellybeans are no longer my first thought.

I pondered whether I ever had an eating disorder at all, or if the sugar was just always controlling me. 

I guess that in itself is probably an eating disorder, or at least disordered eating -- whatever you feel comfortable calling it.  And I certainly felt like I transferred addictions after gastric bypass [HERE is another post you can read on the subject].  When I couldn't eat, I shopped.  When I couldn't shop anymore, I started eating again and gained weight.  I took anti-depressants and gained more weight.  I tried diet products and gained even more weight.  But all of that could still have been fueled by too much sugar and processed food in my diet (including the "necessity" of the anti-depressants, which are terrible for my body).  I guess I'll never truly know.  I have so many health issues related to gastric bypass and my food choices.  I can honestly say I probably would not have lived into my 80's or 90's like my grandmothers before me if Ellen had not intervened.  I realize none of us know when our time will come but now I at least feel like I have a fighting chance.  I will be forever grateful to Ellen for sending me down the right path in the food department. 

So saying I never had an eating disorder or have now been cured of one might be dangerous but I certainly do feel better about my life in general since cutting down on sugar.  If you have had similar experiences with sugar, please share them with me.  I love hearing from all of you!

Long term weight loss almost impossible...

Recently, I read an article on CBC News.  The title:  "Obesity research confirms long-term weight loss almost impossible."  (Side note: there is A LOT I find wrong with that article but just wanted to use it to start a conversation.)  FINALLY!  People are saying this out loud.  I posted it on Facebook and someone immediately stated that they aren't inclined to believe it until they see it published in a medical journal.  I don't need to see it published anywhere.  I can just look around and see that it appears to be true.  People who try to lose weight very often gain it back, plus some.  I have played the game for my entire life.  This can't just be that all fatties have no willpower. 

We all think we know someone in that rare group. They become the legends — the friend of a friend, the brother-in-law, the neighbour — the ones who really did it.

But if we check back after five or 10 years, there's a good chance they will have put the weight back on. Only about five per cent of people who try to lose weight ultimately succeed, according to the research. Those people are the outliers, but we cling to their stories as proof that losing weight is possible.

"Those kinds of stories really keep the myth alive," says University of Alberta professor Tim Caulfield, who researches and writes about health misconceptions. "You have this confirmation bias going on where people point to these very specific examples as if it's proof. But in fact those are really exceptions."

*****

"An appropriate rebalancing of the primal needs of humans with food availability is essential," University of Oxford epidemiologist Klim McPherson wrote in a Lancet commentary following last week's study. But to do that, he suggested, "would entail curtailing many aspects of production and marketing for food industries."

Perhaps, though, the emerging scientific reality should also be made clear, so we can navigate this obesogenic world armed with the stark truth — that we are held hostage to our biology, which is adapted to gain weight, an old evolutionary advantage that has become a dangerous metabolic liability.

When they say that five percent of people who lose weight succeed, they are also saying that 95% of them fail!  But the diet industry keeps raking in those billions, promising quick weight loss.  And we all just keep sending them our money.  I personally feel like all that yo-yo dieting is way more dangerous than just being fat. 

Here I am, a woman in her late 30's, who has battled her weight for pretty much her entire life.  I started getting chubby at age 12.  I was considered obese by my late teens/early 20's.  I did phen fen.  I did Slim Fast.  I did Weight Watchers.  Yet every year, I was somehow a little fatter.  At my heaviest weight -- 350 pounds -- I did decide to have gastric bypass/weight loss surgery.  I lost 165 pounds.  I didn't come out thin and healthy, though.  In fact, I ended up with more health problems than when I was fat.  And then the weight started creeping on again.  So I started over-exercising to take it off.  I got back down to 200 pounds.  Then I started taking a medication that jump started the weight gain again.  I had gotten back up to 263 pounds.  Now I'm 252 pounds.  And rather than battle my body, I'm focusing on eating right and getting proper exercise.  So, even though weight loss is not my focus, it is still happening.  I want to say that this time, it truly is a lifestyle change and there will not be another episode of weight gain.  But I would have told you that at least three times before...yet here I stand.

I would truly like to believe that I can have Health At Every Size.  But my blood tests tell me I'm not fully healthy.  If sugar is causing inflammation in my body, and I stop eating sugar and lose some weight and my CRP comes down, wouldn't that potentially indicate that maybe *I* can't have health at EVERY size?  I don't know.  I am only speaking about my own situation.  Everyone has their own life to deal with. 

So I am continuing with my quest to eat right and exercise.  I have had some emotional times in the last few weeks and it was actually pretty rough not to turn to my sugary treats.  I gave in once and bought a box of Mike N Ike's, but I'm back on track.  I feel so much better when I leave the sugar alone.  I am always searching for new recipes to try though.  If anyone has any yummy recipes to share, please post them in the comments below! 

I'm turning 10 today

No, not really, but kinda. On this date, ten years ago, instead of drinking beer for St. Paddy's Day, I was knocked out on the table having my guts rearranged. What have I learned in the last ten years? That my stomach wasn't the problem. It was always my brain. And that I wish I had taken care of that problem a long, long time ago. Food was my drug of choice until I could no longer eat, then I turned to shopping. When that was taken away from me four years ago, I turned back to food. So here I am, almost 80 pounds heavier than my lightest post-surgery weight, wondering how the hell I fucked this up.

HERE is my update from year nine.  I feel like nothing and everything has changed in the last year. I had my foot surgery and got out of a job I absolutely hated. I am fully aware of my issues, yet I can't make them go away. I continue to be at odds with half my family, and fully expect I will never speak to most of them for the rest of my life. Yet the thing that keeps bothering me most is the war I've waged up myself - upon my body. I have spent my entire life hating myself. I really wish I could make that go away.

I'm in a weird place in my life right now. I am unhappy with my appearance and lack of strength (working on it!!).  But I am stoked to be in new job with a healthier atmosphere. However, my boyfriend is interviewing for jobs that will move him out of the area. And his cat keeps pissing on all of my stuff (so then I may not be so sad he's going to move). I am trying to write for the PDBA and keep up on various projects. I have my own blog, which I'm not managing well. I am trying to teach at Twirly Girls, take classes and keep up the social media stuff for the studio. I also have other projects in the works. I could not have even guessed the mountain of work that would come with putting on NCPP. My weekend to-do lists are so long that I never get to everything, and yet I also don't get to relax so I don't get to rejuvenate before the next week is upon me. I don't know. I know I sound like I'm bitching -- probably because I am -- but I sometimes wonder why life is never easy for me. I guess I'm the one making it that way. 

So yes, in the ten years since I had gastric bypass, I have learned that food was never my enemy. I was always my own worst enemy. I'm almost 40 years old, so I certainly hope I can figure this out and end the war.

Thank you for being on this journey with me. It means a lot to know I have so many supportive friends in my life.

How does the lack of calcium cause bone spurs?

When I first heard I had a bone spur in my heel, the doctor told me it was a lack of calcium that caused them.  When I told other people that, they laughed at me.  Things don't GROW on your body when you LACK other things, silly girl.  So, then I thought maybe I misunderstood and bone spurs were from EXTRA calcium, so I did a little research.  

As many of you know, I had surgery to deal with my bone spur.  I am at four months out.  There has been little change since my three-month update.  My "good" foot hurts almost daily and my "bad" foot doesn't hurt much but is still swollen.  I am back to working out five to six days a week.  I have again recently confirmed with my doctor that bone spurs are from a lack of calcium, not an abundance of it.  So I decided to do a little more research (and by "research," I just mean I "Googled" it) to find out how bone spurs are formed.

Ice and rest after over-doing it

My assumption was that bone spurs were caused when calcium was somehow leeched out of the bones and then re-deposited when it had nowhere else to go.  I don't believe that is fully true, but the truth may not be so far from that.  Here is one explanation: 

"A heel spur is a hook of bone that forms on the heel bone, an X-ray will show a point of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone. The heel spur itself is not thought to be the primary cause of pain, rather inflammation and irritation of the plantar fascia is thought to be the primary problem cause by the tearing of the micro ligamentous tissue from the heal bone. The heel spur then forms because the body is trying to heal itself and has calcium deficiency. After the heel spur is formed and stress is placed on the plantar fascia from walking the heel spur just adds to the irritation and inflammation."

More interesting information:

"Researchers located the root cause. They found that calcium deposits are most common in women aged 35 to 65 – the group most prone to osteoporosis. Knowing that osteoporosis is primarily caused by calcium and mineral deficiency, they realized that two conditions share one cause.  Calcium and minerals are needed for every vital function of your body, from the pumping of your heart to cell division to DNA replication. If you’re not ingesting enough calcium to fuel these functions, your body robs your bones! This survival mechanism is the acknowledged root of osteoporosis, and now we know it causes bone spurs, too."

"Bone spurs are your body's cry for calcium and minerals. Ignore it – and you may become a prime candidate for osteoporosis, heart disease, cancer, arthritis, and more than 160 other degenerative diseases related to mineral deficiencies!" 

Information about absorption of calcium (and I don't know how to adjust for gastric bypass patients, but I assume we absorb even less):

The exercises and stretches help a lot

"Calcium is the most abundant mineral in the body, but it may also be severely lacking. The amount of calcium that we absorb from our food varies widely. One factor that affects this is age. An adolescent may absorb up to 75% of the calcium obtained from foods, while in adults the maximum absorption rate ranges from 20% to 30%. Even though our bones feel solid and seem permanent, they're just like any other body tissue - they're constantly being broken down and formed again. In an adult, 20% of bone calcium is withdrawn from bones and replaced each year. Thus, every five years the bones are renewed."

So there you go.  Bone spurs are most definitely caused by a lack of calcium, AND it appears that I may be at higher risk for osteoporosis.  I get blood tests every year and I don't believe my labs have come back showing I was lacking in calcium, so I'm not sure if the test is flawed or if my body needs more calcium than the average person.  That's a whole other issue I'm not prepared to deal with.  I remember being told not to "worry" about osteoporosis because fat people don't get it....frail old white ladies get it (I believe I was told this by my previous (two doctors ago) tiny Asian lady doctor, who gave me bad medical advice on many, many occasions).  Apparently all the weight my body bears just walking around on a daily basis is literally saving it from ever getting osteoporosis.  I'm not really sure that's actually true, although perhaps it is somewhat more helpful than being tiny.  

It does seem like the exercising I am doing is probably the best thing I can do for myself.  Yoga, spin and pole appear to be great exercises for strengthening the body and the bones.   

What old wives' tales were you told that you believed, just because you didn't know better?  How did you find out it might be wrong? 

Vitamins after Gastric Bypass

This was my first year (at nine years post-op) not being deficient in some vitamin or another.  I definitely have a crazy vitamin regiment.  I wanted to pull all of my vitamin related posts into one.  So here we go:

April 2011:  http://lolorashel.blogspot.com/2011/04/vitamins-and-gastric-bypass-surgery.html

November 2011 (guest post):  http://lolorashel.blogspot.com/2011/11/taking-care-of-ourselves-in-gastric.html

January 2013:  http://lolorashel.blogspot.com/2013/01/pole-sweat-and-magnesium.html

March 2013:  http://lolorashel.blogspot.com/2013/03/bone-spurs-calcium-heart-attacks-and.html

March 2013:  http://lolorashel.blogspot.com/2013/03/update-vitamins-and-gastric-bypass.html

March 2013:  http://lolorashel.blogspot.com/2013/03/malabsorption-after-gastric-bypass.html

March 2013:  http://lolorashel.blogspot.com/2013/03/vitamin-d3-dry-and-gastric-bypass.html

April 2013:  http://lolorashel.blogspot.com/2013/04/vitamin-d-and-sun.html

Here's a photo of the vitamins I take everyday and I'm actually light a few pills...need to get to the store soon

Enlarged heart versus inflamed heart

Recently, I blogged about my latest "condition," an inflamed heart.  I talked about how I had decided to have gastric bypass years ago after being diagnosed with an enlarged heart.  I figured they were the same issue.  And apparently they are not. 

I took phen fen years ago, which caused heart valve defects in some patients.  As part of the class action lawsuit settlement, I was entitled to a free heart scan (woohooo!).  Although my valve was in tact, I was told my heart was "enlarged and flabby."  You know, if my heart was working so hard hauling my lard ass around, it should have been svelte and in-shape.  I remember my doctor telling me that I needed exercise to lose weight but that I shouldn't let my heart rate get over 130 beats per minute.  Oh ok, as soon as I get up in the morning, I think my heart rate jumps that high.  Again, I should have been a walking, talking fat-burning machine if all of those books and heart rate estimates are correct. 

Anyway, so what is an "enlarged heart?"

According to the Mayo Clinic:

Enlarged heart (cardiomegaly) isn't a disease, but rather a symptom of another condition.

The term "cardiomegaly" most commonly refers to an enlarged heart seen on chest X-ray before other tests are performed to diagnose the specific condition causing your cardiomegaly. You may develop an enlarged heart temporarily because of a stress on your body, such as pregnancy, or because of a medical condition, such as the weakening of the heart muscle, coronary artery disease, heart valve problems or abnormal heart rhythms.

While having an enlarged heart may not always be preventable, it's usually treatable. Treatment for enlarged heart is aimed at correcting the underlying cause. Treatment for an enlarged heart can include medications, medical procedures or surgery.

While I did not openly have any of the listed causes, being over weight is a generally-accepted "excuse" or reason for "heart problems" in the medical world.  So, I opted for the weight loss cure through gastric bypass.

Fast forward nine years.  I lost 165 pounds, then gained 65 back.  I'm still 100 pounds lighter than I used to be.  Recently, another doctor ran some tests and found that my heart was inflamed.  Enlarged.  Inflamed.  All words just saying I have a BIG HEART.  Turns out, that is not correct.

What is heart inflammation?

According to Heart.org:

...inflammation is common for heart disease and stroke patients and is thought to be a sign or atherogenic response. It’s important to know what inflammation is and what it can do to your heart. 

According to Alive.com:

Excess body fat can lead to a host of heart diseases. Veins and arteries become compromised, and blood vessels in legs and microcapillaries in eyes can wear out three times faster in overweight individuals. There is also an increased risk of high blood pressure with each additional pound of fat.

Most of us know the effects of being overweight where the heart is concerned. Unfortunately, what is less well known is the effect of excess inflammation on the heart. You may associate inflammation with the redness, swelling, or heat you see or feel when you get a cut, bite, or minor infection, or with the pain you feel in a swollen joint (as in arthritis). But uncontrolled inflammation is also at the root of heart disease.

Research published in a 2004 issue of the journal Circulation indicates that the immune cells of obese individuals seem to exist in a proinflammatory state, which places these individuals at an increased risk of developing heart disease and diabetes. Increasingly, researchers are showing that fat cells are prime production sites for proinflammatory messengers such as IL-6, TNF-a, and C-reactive protein (CRP levels are a well-known indicator of heart disease).

I had my c-reactive protein tested. Over 3 was bad. Mine was almost 5.

So, although enlarged hearts (think fatty, neglected, over-worked heart) and inflamed hearts (think not-well-cared-for, abused-with-bad-food-and-no-exercise, swollen heart) [*that's sarcasm, by the way*] are potentially related, they are not exactly the same thing.  And again, heating healthier and exercising (which they say will lead to weight loss) is the generally "cure."  Medications can be prescribed in more severe situations.  I don't have a lot of the symptoms that they claim go along with these issues.  For example, no high blood pressure, no high cholesterol.  But heart issues do seem to run in my family.  So, maybe my weight doesn't matter and my heart just isn't built to tick right. 

To be real and honest, my family history does play a part in this and apparently exercising (even if not to lose weight) and eating less fatty food (again, even without the intention to lose a single pound) is important.  I am trying to be very aware of the food I put in my mouth and make more time for exercise.  I have added krill oil to my diet and I now take a baby aspirin every day (not good for gastric bypass patients, yes, but I guess a potential stomach ulcer is better than a potential heart attack). 
I'm 36.  I feel like I shouldn't be dealing with these kinds of issues.  Is it pre-destined?  Did I do this to myself?  I guess it doesn't matter but if I want to stick around awhile longer, I better take my health a little more seriously.  Anyone else had these issues?  How do you deal?

Vitamin D and the Sun

I am a child of the summer.  I was born on August 31...right at the end of summer, and usually during the hottest part of the season.  If I could live my life in a bathing suit and flip flops, I would.  Yeah, I know, I should be worried about skin cancer.  But I remember being a kid and having the outline of my swimsuit suntanned into my skin well into winter time.  I miss those days.

Now that I've had gastric bypass, one of the vitamins I seem to be deficient in is Vitamin D.  That comes from the sun, right?!  I definitely struggle in the winter without my sun.  I also struggle now that I'm an adult that has to go to a job all day, every day and I get much less time to lay around by the water, relaxing and soaking up the rays. 

I have often justified going to tanning booths to help with my psoriasis.  Studies show that some of the beds aren't the same as the sun when it comes to helping kill psoriasis (the funny thing is, the doctor's offices DO offer a certain type of tanning bed but it is generally NOT the same one in your run of the mill tanning salon), but the real reason I was going was for the brown skin.  Yeah, I'm sure, I'm dealing with wrinkles and all that, but I do love being tan. 

A couple of years ago, I decided that since I was in my mid-30's, I should be taking better care of my skin.  No more tanning.  I now look like a vampire.  In fact, when we go to Disneyland and the rides take photos of us, you usually can't see my nose or mouth because I am SO white.  There has to be some middle ground.

I wrote about Vitamin D recently and wondered how much sun you "need" to get enough Vitamin D the natural way.  And so, as per my usual protocol, I Googled it.  I love Google...that bitch knows EVERYTHING. 

http://nutrition.about.com/od/askyournutritionist/f/sunlight.htm

Your body makes vitamin D when your skin is exposed to the ultraviolet B (UVB) rays in sunlight. You probably need from 5 to 30 minutes of exposure to the skin on your face, arms, back or legs (without sunscreen) two times every week.

http://www.drweil.com/drw/u/QAA400732/How-Much-Sun-Exposure-for-Vitamin-D.html

Dr. Holick advises estimating the time it would take your skin to turn pink in the sun. Then divide that time by 25 to 50 percent, depending on your skin type. So, someone like you who has fair skin, burns easily and lives in Pennsylvania would be advised to spend 20-30 minutes in the sun with your arms and legs exposed (not your face) between the hours of 11 a.m. and 3 p.m. two to three times a week from March through May and September through October but only 15-20 minutes in July and August when the sun in strongest. If you remain outdoors longer than the specified time, apply sunscreen. (Don't even try to get sun time from November through February; in your area, you won't get enough UV to help, and you'll probably get pretty cold outside with bare arms and legs.)

http://www.shanghaiexpat.com/article/vitamin-d-and-sun-exposure-20667.html

Given that there is a matrix of variables that need to be considered, it is impossible to prescribe a one-size-fits-all guideline that would balance the sun exposure needs versus risks for all people. However, because there are diseases related to both insufficient and excessive exposure, it is important for each of us to get a sense of how much sun our skin needs to produce adequate amounts of vitamin D without increasing the risk for skin cancer.

So, it appears that I can get my Vitamin D from the sun but I will probably have to continue my Vitamin D3/dry supplements, as I am probably not going to be able to increase my time in the sun any time soon.  I have started back to the tanning beds, but only once a week.  I don't do that for the vitamins or my psoriasis.  I just do that because it makes me happy.  And sometimes you have to do that for yourself. 

Tan and in Mexico in 2007

Pale in 2012

Gastric Bypass: What is Dumping Syndrome?

Post-gastric bypass, you noticed that sometime after eating certain foods, you get sweaty and tired.  Could mean you ate too much sugar.  Dumping syndrome is defined by the Mayo Clinic as:

...a group of symptoms that are most likely to develop if you've had surgery to remove all or part of your stomach, or if your stomach has been surgically bypassed to help lose weight. Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach move too rapidly into your small bowel. Common symptoms include abdominal cramps, nausea and diarrhea.

I have been in the same support group for about ten years.  I started about a year before surgery and am now nine years post-op.  I've noticed in the past four years or so that post-ops don't seem to experience dumping syndrome as severely as patients from my time.  I believe this is due to surgeons choosing to bypass the intestine at a different spot. 

For me, dumping syndrome is caused by eating too much sugar/carbs and/or drinking alcohol (God forbid I try all of those at once, I might literally blow up).  It seems like there may be other causes, but this has just been my personal experience.  For me, the process goes like this:  I eat or drink whatever it is that I'm not supposed to...and within 15 minutes, there's a little sweat on my brow.  If I continue to do what I'm not supposed to, I will sweat more and start getting very tired.  Usually, it's a lot of yawning, but I can fight it off.  Nine years ago, I would have been drenched in sweat and would have been forced to lie down and sleep it off.  In worst-case scenarios, I could be in the bathroom within a few minutes of eating said bad item(s).  Sometimes, it just has to come up. 

I always felt a little grateful that I got dumping syndrome somewhat easily.  I felt like it kind of kept me honest, since sugar is my downfall.  Even though I can definitely eat a lot more sugar now than I could nine years ago, I do feel like dumping has helped me keep 100 pounds off.  I can go on and on about how disappointed I am at being up 65 pounds but the truth is, I'm still 100 pounds lower than my highest weight.  That's a pretty big success in my book. 

Have you ever experienced dumping syndrome?  Did your surgeon explain it and did you realize what was happening?  How do you "make it better?"

Vitamin D3 (dry) and Gastric Bypass

Yesterday, I updated my vitamin list and today, I wanted to talk about why Vitamin D dry (or at least a non-softgel) is a better fit for gastric bypass patients.  We are malabsorptive in general of vitamins and nutrients after our intestines are re-routed, so certain vitamins don't absorb as well as others.  That includes Vitamin D in a softgel. 

I found a link comparing various Vitamin D supplements for gastric bypass patients.  Why re-invent the wheel?  Check out that article HERE. 

The American Society for Metabolic and Bariatric Surgery points out that gastric bypass patients are at greater risk for vitamin D deficiency due to having part of their small intestine bypassed. They should get regular blood tests to monitor their vitamin D levels and supplement as necessary.

Linus Pauling Institute explains that D3 is absorbed best by everyone, including but not limited to gastric bypass patients.

...softgels filled with oil ... don't work well for gastric bypass patients since they malabsorb fats.

And from the ThinnerTimes forum, read the entire post HERE.

50,000IU gelcaps of vitamin D are always D2 (Ergocalciferol).

We absorb the dry form D3 (Cholecalciferol) far better. D3 is the human form; D2 is the non-human form found in plants and is cheaper!

But apart from that, people with malabsorptive procedures absorb the dry forms of the fat soluable vitamins A, C, D and E over the oil based supplements.

Regarding vitamin D, this is from the American Journal of Clinical Nutrition: The case against ergocalciferol (vitamin D2) as a vitamin supplement -- Houghton and Vieth 84 (4): 694 -- American Journal of Clinical Nutrition

The top two bariatric supplement companies: Celebrate and Bariatric Advantage only use D3 (Cholecalciferol).

The cheapest 50,000IU dry form D3 I know of is from vitalady - $21.49/100 tabs: Vitalady.com - Protein Supplements, Vitamins & Minerals and Safe Snacks!

So, there you go.  Sounds like dry Vitamin D3 is our best option for absorption.  What I need to research next is whether sitting in the sun is as effective or better than taking a supplement.  I'm always looking for reasons to get a little extra sunlight. 

Does anyone else have anything to add to this?  I had to add Vitamin D into my vitamin regimin two or three years ago.  I was low and my doctor said to add it in.  My levels are back to normal but I still take a dry D3 every day. 

Update: Vitamins and Gastric Bypass

In 2011, I wrote a post about the vitamins I take.  Although I mostly take the same vitamins (so you can read the old post HERE about why I take them), I wanted to post an update to types and amounts. 

I still take a Target/generic brand prenatal pill as my multi-vitamin.

I, for a short time, started taking iron due to slight anemia last year, but am back to normal and have discontinued taking iron.

I also still take echinacea.  Who knows if it works, but I take an immuno-suppressant to help with my psoriasis and I feel like any help I can get to ward away colds is a necessary evil.  The Stelara shot suppresses my immune system and can make me stay sick longer.  So I try to avoid getting sick.

I also still take a daily dose of L-Lysine (1,000 mg) to ward off cold sores.  Since I have a stressful job, keeping those at bay is one of my number one concerns.  I know it seems silly, but I REALLY hate cold sores.

I have been lax on the acidophilus.  It's in my fridge.  I kind of forget about it. 

I take B12 daily.  1,000 mcg.  Post-surgery instructions suggested twice a week, but I figure it can't hurt to take it more often. 

Even though I find myself to be a bit sensitive to niacin (B3), I am back to taking a B-complex vitamin.  I was low in B1 awhile back, so its one of those vitamins that I need to take.  Sometimes if I'm vitamin shopping at somewhere like Target, I can't find B1 alone, so I'll just lazily grab a B-complex.

I also take calcium-citrate (500 mg) with Vitamin D and Magnesium.  Read HERE about calcium.

I still take a Vitamin D3 (2,000 IU) pill, but have switched to the "dry" version.  Most Vitamin D pills are oily capsules that look like mini Vitamin E's.  Apparently gastric bypass patients can have a hard time absorbing those (I'm hoping to write a post about that soon). 

I still take a Vitamin E dl-alpha (400 IU) pill.  It is an oily capsule, so who knows if I am absorbing it properly.

I have stopped taking the joint supplement.  It's expensive and I'm not sure it was helping that much.

I am still taking an omega-three supplement.  I have switched from regular fish oil to krill oil.  It contains 420 mg of Phospholipids.  The switch is due to my newly-found heart issue (I was also informed that my new issue is not necessarily related to my old issue....I now have an inflamed heart.  Before I had an enlarged heart.).  Anyway, the krill oil is supposed to help with inflammation.

I have added magnesium to the mix (250 mg each...but I take two to three per day).  You can read about my adventures with magnesium and sweat HERE.

I also added 50 mg of zinc and a CoQ10 supplement (100 mg).  I try to remember to take a little Vitamin C from time to time as well. 

I basically take my cache of pills and eat them at work with dried apricots and almonds or pistachios (I do not take most vitamins on the weekend).  Some vitamins are fat-soluble so eating a little fat with them will help with absorption.  Along with everything else, I'm taking a daily baby aspirin for the heart issue and take Aleve for body aches -- mostly my foot issue (yes, I am aware I shouldn't take either).  I rarely get headaches but will take Tylenol for that.  I take allergy pills for my year-round "seasonal" allergies. 

Vitamins are VERY important post-surgery.  (Read Melissa's story HERE.)  I am nine years post-op and still get my blood tested every year.  Every year I'm low in something new.  I am hoping to be in normal ranges for all tests this year.  I am certainly taking more than enough pills to make that happen!

What vitamins are you taking and are there some you think you should be taking but aren't?  Tell me about them here!