What I Ate: 5/30/2009

Today was my last day at Truman Scholar camp (very sadly), and I had a cup of decaf coffee during "breakfast" this morning as my last meal there. So, all of the food I ate today was completely outside of the camp context.

• 2 Mini Babybel Light cheese rounds (100 kcals, 12g protein)
• 1 scoop Isopure dutch chocolate protein powder in Midwest Airlines decaf coffee with Splenda added (110 kcals, 25g protein)
• 2 Mini Babybel Light cheese rounds (100 kcals, 12g protein)
• 3 oz. pan-cooked turkey breast (120 kcals, 25g protein)
• 3 oz. pan-cooked turkey breast (120 kcals, 25g protein)

Total: 550 kcals, 99g protein, 72.0% kcals from protein.

One thing I noticed at dinner today is that I found it very difficult to finish the 3 oz. of turkey. It stuffed me. I'm going to go back to my 2 oz. servings for a while because I need to be careful not to stretch out my restructured stomach!

What I Ate: 5/29/2009

• 2 Mini Babybel Light cheese rounds (100 kcals, 12g protein)
• 1.5 oz. deli-sliced roast beef (about 75 kcals, about 12g protein) and 1.5 oz. deli-sliced ham (75 kcals, 9g protein)
• 1 scoop Isopure dutch chocolate protein supplement in water with sugar substitute (110 kcals, 25g protein)
• 3 oz. deli-sliced roast beef with tomatoes (about 150 kcals, about 24g protein)
• 4 large strawberries (25 kcals, 0.5g protein)
  
• About 8 cherries (40 kcals, 0.5g protein)
  

Total: 575 kcals, 83g protein, 57.7% kcals from protein.

The camp had a dance tonight, and I exhausted myself at it. So I at least burned some calories. Today was the last full day here, so I should be *away* from the scary fruit now!

What I Ate: 5/28/2009

• 2 Mini Babybel Light cheese rounds (100 kcals, 12g protein)
• 3 oz. deli-sliced ham and 1 slice fresh tomato - I have NO idea how many calories and all this had, so this is my best guesstimate (130 kcals, 12g protein)
• 1 scoop Nectar chocolate truffle protein supplement in 4 oz. unsweetened chocolate Almond Breeze (123 kcals, 24g protein)
• 3 oz. roasted chicken breast (120 kcals, 24g protein)
• 3 oz. watermelon (about 40 kcals, 0g protein)
• 1 scoop Nectar chocolate truffle protein supplement in water (100 kcals, 23g protein)

Total: 613 kcals, 95g protein (!), 62.0% kcals from protein.

Almost 100 grams of protein today!

I brought food with me to the camp only to discover late last night that most of it had spoiled, complete with mold spots (gross!) The place I'm staying has no fridge. So, unfortunately, I had to navigate the dining hall instead of eating the wonderful wls-friendly food I weighed, portioned, packaged, and carried in my luggage. But - fortunately, I think the food was still pretty wls-friendly. I unfortunately didn't effectively avoid the watermelon.

What I Ate: 5/27/2009

• 2 oz. Boca Bruschetta patty (56 kcals, 8g protein)
• 2 oz. Morningstar Farms "sausage" links (100 kcals, 11.25g protein)
• 1 scoop Nectar chocolate truffle protein powder in 4 oz. unsweetened chocolate Almond Breeze (123 kcals, 24g protein)
• 2 oz. deli chicken and fat-free cheese (65 kcals, 6.7g protein)
• Terrible fruit grazing episode (1 strawberry, several cherries, 1/3 of a medium-sized peach)
• About 1.5 oz. cheese and sauce from the top of a pizza

Total: Bad. Grazing at night is bad. This camp is bad for me and food and I didn't even drink my last protein shake!

I did, at least, do 35 minutes of walk aerobics. I guess that's...better than nothing.

What I Ate: 5/26/2009

• 2 oz. Quorn "chicken" patty (64 kcals, 8.8g protein)
• 1 scoop Nectar chocolate truffle protein powder in 4 oz. unsweetened vanilla Almond Breeze (120 kcals, 23.5g protein) and 1 Laughing Cow Mini Babybel Light cheese round (50 kcals, 6g protein)
• 2 oz. Boca Bruschetta patty (56 kcals, 8g protein)
• 3 oz. green beans (30 kcals, 0g protein)
• 2 oz. Morningstar Farms "sausage" links (100 kcals, 11.25g protein)
• 1 scoop Nectar chocolate truffle protein powder in 4 oz. unsweetened vanilla Almond Breeze (120 kcals, 23.5g protein)

Total: 550 kcals, 81.05g protein, 58.9% kcals from protein.

I also went on a 45-minute walk today at the campus track, burning at least a few calories. The green beans and watermelon weren't planned, so they were a misstep. But of the missteps I could have had, I'm glad it was green beans and a miniscule piece of watermelon.

By the Way . . . It's Official!

I am no longer an airplane seatbelt extender-wearer. Never again!

Those of you who know the humiliation that accompanies requesting an extender will feel me on this.

Today, on my six-week "surgiversary," I flew for the first time post-op from DC to Kansas City. I did not need an extender. In fact, I even had some room left over to tighten the belt. Wow.

I'm still in disbelief. I don't feel like I've lost any weight at all, but I must have lost something! Yay!

What I Ate: 5/25/2009

• 1 Mini Babybel Cheddar cheese round (70 kcals, 5g protein)
• 1/2 Roma tomato (18 kcals, 0.5g protein) with 1/4 oz. smoked salmon (about 15 kcals, about 2.5g protein), 1/4 oz. ricotta cheese (10 kcals, 1g protein), and 0.5 oz. avocado (about 25 kcals, about 1g protein)
• 1 scoop Nectar protein (fuzzy navel/strawberry kiwi) with 1/2 packet Crystal Light (95 kcals, 23g protein)
• 2.5 oz. grilled salmon (125 kcals, 16g protein)
• 3 oz. grilled shrimp (about 150 kcals - they were probably coated with oil; about 14g protein)
• 1 scoop Nectar chocolate truffle protein supplement with 4 oz. unsweetened vanilla Almond Breeze (120 kcals, 23.5g protein)

Total: 628 kcals, 86.5g protein, 55.1% kcals from protein.

All I can say about this is...yikes! I guess between trying to get rid of the leftover brunch and struggling to find WLS-friendly food at an Italian restaurant in the Midwest, I didn't do an awesome job. Really, the main issue here is that my portions were larger than normal at all meals. At lunch, I got the "full" feeling for the first time since surgery. I am going to bring my scale to each meal and make sure I'm staying at the 2 oz. mark as much as possible for the rest of my time here (I'm off in Kansas City for the week being a camp counselor.)

My dismay at having consumed over 600 calories today is mitigated by the fact that I'm pretty sure this isn't an outrageous amount to most six-week post-ops. And I did *great* on protein!

What I Ate: 5/24/2009

• 1.25 oz. mustard BBQ pulled chicken breast (about 35 kcals, about 5g protein) with 1 Belgian endive leaf with artichoke-spinach-parmesan filling (1 oz.) - there was a tiny bit of protein in this because I used Greek yogurt to make the sauce, lots of lowfat parmesan pieces, and also artichoke hearts have a little protein (about 20 kcals, about 1g protein)
• 3/4 scoop Nectar chocolate truffle with 1/4 scoop Unjury chocolate protein powder (my DC nutritionist gave me Unjury samples at our consultation) in 4 oz. unsweetened vanilla Almond Breeze (120 kcals, about 22g protein)
• 1 soft-scrambled egg (70 kcals, 6g protein) with 1/2 fat-free Kraft Sharp single (15 kcals, 2.5g protein)
• 1/4 cup fruit salad (about 75 kcals, about 0g protein)
• 1 scoop Isopure Dutch Chocolate protein powder in 4 oz. unsweetened vanilla Almond Breeze (130 kcals, 25.5g protein)

Total: 465 kcals, 62g protein, 53.3% kcals from protein.

I aim for 70g protein a day, and obviously this isn't that. I was trying to get rid of some of the food from yesterday's brunch. I'm not happy that I had that instinct because it's a bad habit, but I'm not going to beat myself up about it. I will just prepare less food next time!

Me and a couple friends went for a long walk in Georgetown today, so that has to count as my exercise for today.

What I Ate: 5/23/2009

I hosted brunch for a group of my SC friends who live in DC this afternoon. I made a light, summery meal: fruit salad with apples, strawberries, mango, kiwi, and orange zest; grilled zucchini with lemon-tomato vinaigrette; Belgian endive with spinach-artichoke-parmesan filling; Roma tomatoes stuffed with cilantro-lime ricotta, smoked salmon, and avocado; and a crustless quiche filled with turkey bacon, mushrooms, mozzarella cheese, and basil and topped with a sauce made of nonfat Fage, mustard, and seasonings.

Of course, the only thing that was completely eaten was the one high protein food on the list - the quiche.

Here's what I ate today:

• 2 Belgian endive leaves with about 1.5 oz. spinach-artichoke-parmesan filling
• About 1.5 oz. of fruit salad
• About 1 oz. quiche
• 2 scoops Nectar chocolate truffle protein shake, 1 with unsweetened chocolate Almond Breeze; 1 with unsweetened vanilla Almond Breeze

I am aware that this isn't enough protein! Hopefully one day off the wagon won't be the end of the world...

What I Ate: 5/22/2009

• 1 oz. mustard BBQ pulled chicken breast (about 35 kcals, about 5g protein) with 1 Mini Babybel Light cheese round (50 kcals, 6g protein)
• 1 scoop Nectar chocolate truffle in 4 oz. unsweetened chocolate Almond Breeze (123 kcals, 24g protein)
• 2 oz. homemade chicken curry - my serving had more vegetables than chicken, unfortunately (about 60 kcals, 4g protein)
• 1 bowl Tom Yom Goong soup from Thai Tanic (what a foolish name) - went out with friends for dinner. Totally delicious, best Thai I've had in a very, very long time! Perfect for the WLS patient too - lots of broth-based soup choices and lots of nice-sounding salads. My portion had 2 huge beautiful boiled shrimp (about 2 oz.), so I also had a great protein meal.

What I Ate: 5/21/2009

• 1 Mini Babybel Cheddar cheese round (70 kcals, 5g protein) and 1 Mini Babybel Light cheese round (50 kcals, 6g protein)
• 1 oz. smoked salmon (45 kcals, 6.5g protein) with 1 large hard-boiled egg (70 kcals, 6g protein)
• 1 medium-sized (1.75 oz.) sea scallop, prepared (like yesterday) with turkey bacon and tomato sauce (about 60 kcals, about 12g protein)
• 2 scoops Nectar chocolate truffle protein shake, in 4 oz. unsweetened chocolate Almond Breeze and 2 oz. water - had to double up because I missed my earlier shake and didn't want to drink another shake at 3 AM! (223 kcals, 47g protein)

Total: 538 kcals, 82.5g protein, 61.3% kcals from protein.

Whew! This is a lot of calories for me. I want to be having about 30-40 calories less than this - my goal is 500. The foods I had for breakfast and lunch were very calorie-heavy.

Today was my last day at work - mostly happy for the break, but also kind of sad. Last day meant projects to finish, so I didn't get home till a little after 8:30 PM. Hence, another missed gym day. But tomorrow, I'll be back!

What I Ate: 5/20/2009

• 1 large hard-boiled egg (70 kcals, 6g protein) with 1 Mini Babybel Light cheese round (50 kcals, 6g protein)
• 2 oz. mustard BBQ pulled chicken breast (about 65 kcals, about 10g protein)
• 1 scoop Nectar chocolate truffle protein shake, in 4 oz. of water (100 kcals, 23g protein)
• 1.5 oz. skim milk, for my afternoon Starbucks venti decaf iced americano (12 kcals, 1g protein)
• 1 large (2 oz.) seared sea scallop with 1 strip of thin & crispy turkey bacon and 1/2 tbsp. tomato sauce - scrumptious! (about 70 kcals, about 14g protein)
• 1 scoop Nectar chocolate truffle protein shake, in 4 oz. of unsweetened chocolate almond milk, for a change! This was *insanely* delicious - I might transition completely for just 23 extra calories! (123 kcals, 24g protein)

Total: 490 kcals, 84g protein, 68.6% kcals from protein.

This was the highest daily protein intake I've had since surgery! I'm looking forward to getting back to the gym, hopefully tomorrow but most likely on Friday. But I'm trying to make sure I don't go into "starvation mode," hence the upped calories.

I went to Whole Foods today and got the fresh scallops, smoked salmon, and both the vanilla and chocolate unsweetened Almond Breeze (almond milk.) I adore grocery shopping post-op!

What I Ate: 5/19/2009

• 1 Mini Babybel Light cheese round (50 kcals, 6g protein) with 1 Mini Babybel Cheddar cheese round (70 kcals, 5g protein) - this was the first time post-op that I've eaten something that sort of didn't feel awesome. I definitely didn't get sick or even a real stomachache, but I just didn't enjoy eating this. Odd, because it's soft cheese. I think my body was just still trying to wake up.
• 2 oz. mustard BBQ pulled chicken breast (about 65 kcals, about 10g protein)
• 1 scoop Nectar chocolate truffle protein powder mixed with water (100 kcals, 23g protein)
• 1 oz. skim cow's milk (went into my afternoon Starbucks venti decaf Americano) (10 kcals, 1g protein)
• 2 Bariatric Advantage Calcium Citrate Chocolate Chewy Bites (30 kcals, 0g protein)
• 2 oz. mustard BBQ pulled chicken breast (about 65 kcals, about 10g protein)
• 1 scoop Nectar fuzzy navel protein shake (90 kcals, 23g protein)

Total: 480 kcals, 78g protein, 65% kcals from protein.

I'm in the process of upping my calories and protein. My goal is to be slightly over 500 kcals and over 70g of protein daily. I will probably keep going with the Babybel cheese for breakfast and/or a hard-boiled egg for the next few days.

But - no workout today. I didn't leave the office until almost 9 PM!

Update: Week 5 - Seeing Beyond the Scale.

I broke my scale, y'all.

This is how I know my scale-obsession had gotten out of hand: Most of last week, I was weighing myself multiple times every day, sometimes five times a day, getting off and on multiple times, feeling glee when it said I weighed 0.2 lbs less and horror when it said I weighed 0.2 lbs more. This crazy behavior resulted in the scale I've had for only about a month going on the fritz, eventually telling me I weighed 285 one minute and 245 the next.

So I bought another scale on Thursday, a little more expensive this time.

This one was messed up from the start. It would weigh me 20 pounds differently in the span of five minutes. I then learned from some research that we should wait 15 minutes before re-weighing ourselves, so I started doing that. The results weren't much better.

All of this to say, I've been forced to ignore the scale for a while. It's probably best for my mental health anyway. God was definitely trying to tell me something.

It's hard to remember this sometimes, but gastric bypass isn't just about seeing the number on the scale go down. It's about becoming a healthier person and living a fuller life. Because I can't obsess about my numbers, I have to focus more on how I feel in my clothes, and how well I can get around. I'm also going to try focusing on eating high-quality, healthy food and enjoying my new self - even 30 pounds makes a big difference. Seeing past the scale might help me celebrate what RNY is doing for me in the present.

Sure, it would be fabulous if I were dropping more weight faster; even the fastest losers wish for that. But what WLS has given me most of all is hope. Now, I can envision a future in which I am not morbidly obese, a future where:

• I don't dread flying because of seatbelts and "uncomfortable" seatmates;
• A guy that I like might actually find me attractive and see me as more than his fat friend;
• If someone suggests that I date a skinny guy, I'm not able to retort: "No skinny guys - we would look like the number 10";
• I can wear a business suit or business-casual clothing and stand out in the workplace, not because of my weight or my odd-looking clothes (a la last summer), but because I do awesome work;
• I can walk into a regular-people's store with a friend and shop, instead of hanging out by the accessories to avoid snide comments (e.g., "What is she doing in here? She knows we don't have her size!");
• I can go walking somewhere with my friends and keep up, instead of needing to stop and take breaks or getting left behind because I can't walk fast enough;
• I can satisfy my outdoorsy urges by going hiking and camping with real outdoorspeople, something I've always been reticent to try solely because of my weight;
• If something goes wrong, I don't just blame it on my weight, but rather take it seriously and deal with what's really going on;
• I don't cringe in apprehension anytime I walk past a group of teenage boys, fearing that they will yell something inappropriate about my body; and
• I don't worry so much about fat people's health problems like high blood pressure, Type 2 diabetes, or gastroesophageal reflux disease.

I decided to take the drastic step of having RNY because I could no longer see this future.

Through 20+ years of failed weight loss efforts, I still had a positive vision of the future, even though I didn't know how I was going to get there. That is, until about 9 or 10 months ago. Not only did I lose faith that the things above would happen for me, but I also started to fear that I wouldn't even live too long because of my weight. I honestly started to worry that obesity was going to prematurely kill me. That sounds a bit melodramatic, but it's real and the statistics support my fear.

My decision to have WLS was about more than the number on the scale. It was about regaining my vision and my hope. That has happened for me already, and that's so much more important than this week's numbers.

Obese People Especially at Risk for Swine Flu?

The Washington Post has just reported that obesity was a surprisingly frequent condition among those hospitalized with swine flu in California, along with other pre-existing conditions like heart disease and diabetes (correlated with obesity) and pregnancy (definitely not correlated with obesity.)

Uhh...guess I should get in line early for that eventual swine flu vaccine?

Or not. There's a lot of sensationalism about obesity out there these days. I get probably 5-10 articles a day about a new study that suggests that obesity leads to something catastrophic, when in truth obesity is just correlated with some of these things. It's not surprising that obese people have more health problems than normal-sized folks, but we have to find the line between legitimate science and shrillness/scare tactics.

For example, just today I saw an article stating that obesity is "loosely correlated" to myopia (near-sightedness) among obese Indonesian girls. The "expert" went on to say that "obese girls should be examined for their ophthalmological status."

I'm not going to argue that obese girls shouldn't have their eyes checked, because every girl needs to have her eyes checked. But any college student who has taken the most basic statistics class knows that a "loose correlation" isn't sufficient basis for a movement toward eye exams for fat girls.

I digress. Excerpt re: swine flu and fatties below.

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Hospitalized Swine Flu Patients in Calif. Had Underlying Conditions
David Brown and Robin Shulman
The Washington Post

A survey of people hospitalized because of swine flu in California has found that obesity was almost as common in them as diabetes, heart disease and pregnancy, all conditions known to raise a person's risk of complications from influenza.

In all, about two-thirds of the patients had some underlying medical condition, according to a report today in the weekly bulletin of he Centers for Disease Control and Prevention.

"We were surprised by the frequency of obesity among the severe cases that we've been tracking," said Anne Schuchat, one of the CDC epidemiologists managing the swine flu outbreak.

She said the possibility that obese people should be at the head of the line along with other high-risk groups if a swine flu vaccine becomes available is something "we're looking into."

Click here to read the full article.

Sen. Jeff Bingaman Introduces Anti-Obesity Bill

On Monday, May 18, 2009, Sen. Jeff Bingaman (D-NM) introduced the Obesity Prevention, Treatment and Research Act of 2009. Among other things, it:

• Establishes the United States Council on Overweight & Obesity Prevention;
• Improves access to nutrition counseling and other services for people on Medicare and Medicaid;
• Establishes a grant fund for various entities like schools, universities, community centers, etc. to do anti-obesity work (could be a great way to start a charter school for obese kids!); and
• Develops and expands the Department of Agriculture’s Fresh Fruit and Vegetable Program.

I haven't read the bill yet, but at first glance, it's fascinating. I'm not sure about the need to create another bureaucratic structure, but I do like more access to nutrition counseling for poor people and the elderly, and the grants especially. I'm going to a conference next week on public service, and I wish I'd known about this to make it my policy topic instead of what I selected (though I like the other topic too - Legal Aid restrictions.)

Apparently Sen. Bingaman introduced another version of this bill in the previous Congress. I'm not sure if there were any policy differences. He had no co-sponsors, and it never got out of the HELP Committee. I wonder if it will have more juice now, with obesity an even hotter topic than it was last year?

Click here to read the press release at Sen. Bingaman's website.

What I Ate: 5/18/2009

• 1 scoop/4 oz. Nectar chocolate truffle protein shake (100 kcals, 23g protein)
• 3 medium (1.75 oz.) tarragon teriyaki shrimp - I was trying a little Asian-French fusion (about 55 kcals, about 9g protein)
• 1 oz. pulled chicken BBQ (cooked in my mustard sauce) (about 45 kcals, about 5g protein)
• 1.25 oz. homemade chicken curry with green peppers and tomato (about 45 kcals, about 5g protein)
• 1 Mini Babybel Light cheese round (50 kcals, 6g protein)
• 1 scoop/4 oz. Nectar chocolate truffle protein shake (100 kcals, 23g protein)

Total: 395 kcals, 71g protein, 71.9% kcals from protein.

Nothing Could Be Finer than Carolina-ish BBQ

My native state, South Carolina, is the only state that produces all four major types of barbecue sauce: (1) Ketchup-based, the kind that comes to mind first to most people; (2) Vinegar and pepper, which is epitomized in the barbecue produced at the political hotspot Brown's BBQ in Kingstree, South Carolina; (3) Tomato, which is the vinegar and pepper with tomato added to it; and (4) Mustard. It's the South Carolina King of Barbecue Sauces, because it's the only one that's uniquely South Carolina. Click here to see a map of the SC barbecue sauce regions.

I'm partial to the mustard sauce, both because of its uniqueness and because it's based in the Midlands region. I spent my first 22 years in the Upstate, Ketchup Country, but I'm emotionally a Midlands person. Not that anyone cares about that!

Anyway, I made an awesome homemade mustard bbq sauce tonight. I used my sauce on some chicken breast tenderloin: cooked the chicken in a pot of diluted sauce, then pulled the juicy tenderloins with two forks to mimic pulled pork. Finally, I reduced the sauce back down and spooned it atop the pulled chicken. I also made a chicken curry, but the flavor profile isn't right. I'll experiment with it more and let you know...

Here's my bbq sauce recipe. Disclaimer: It's not at all authentic, but it is tasty and mustard-based!

Monica's Carolina-ish Mustard BBQ Sauce

Stuff you need:

• 1/4 cup spicy brown mustard
• 2 tbsp. regular yellow mustard
• 1 tbsp. whole grain mustard
• 3 bay leaves
• 1 tbsp. dried ground sage
• 3 tbsp. Worcestershire sauce
• 1/4 cup Splenda or other sweetener (maybe Stevia?)
• freshly cracked black pepper to taste
• 1/4 large red onion, diced
• 1 tbsp. chili powder
• 1/2 clove of garlic, rough chopped
• 1 tbsp. cumin
• 1 tbsp. tomato paste
• 1 packet chicken stock concentrate (I use Trader Joe's low-sodium version.) You can obviously use veggie stock bullion or concentrate to keep this on the vegan side.
• 2 tbsp. apple cider vinegar
• 1 tiny pinch of celery seeds
• 2 cups of water, divided

What you do:

Saute the onions and garlic in the chicken stock concentrate on medium-high heat until translucent. The concentrate should start sticking to the pan. Deglaze with 1/2 cup of water and stir vigorously to get the concentrate off the bottom of the pan. Then mix in all of the ingredients except the rest of the water and the Splenda. Cook them together for about 5 minutes, then add the rest of the water. Cook this down on medium heat for 7 minutes, or until it starts to thicken up and seems a little thinner than the "right" consistency for a slatherable BBQ sauce. Add the Splenda. Cook until the sauce is a good, slatherable, pourable consistency. Remember to remove the bay leaves before serving.

What I Ate: 5/17/2009

• 1 oz. eggs - part of a Spanish omelet that my friend made, but I couldn't eat the potatoes which was the bulk of it (about 75 kcals, about 5g protein)
• 1.5 oz. grilled vegetable lasagna: I made Shelly's "lazytarian" version with a few changes - instead of just summer squash, I used zucchini, spinach, and roasted red peppers; all fat-free and reduced-fat cheeses; no parsley, pizza seasoning, or olive oil (subbed with nonstick spray), and most importantly, I made my own chunky tomato sauce (about 60 kcals, about 3g protein)
• 1 scoop Nectar chocolate truffle shake, 4 oz. (100 kcals, 23g protein)
• 2-3 oz. fruit - cantaloupe, kiwi, mango, and strawberry (about 60 kcals, 0g protein)
• 1 scoop Nectar chocolate truffle shake, 4 oz. (100 kcals, 23g protein)

Total: 395 kcals, 54g protein, 54.7% kcals from protein.

I spent basically all day at a brunch party, so all of my measures are complete estimates. At least the food was very healthy!

No gym today because of the super-long brunch (left home at 10:30 AM, left last buddy at midnight.)

What I Ate: 5/16/2009

Back to more real food today:

• 1.25 oz. scrambled eggs with mustard/Greek yogurt sauce - yep, leftovers from last weekend's brunch (about 70 kcals, about 5.5g protein) with 1 wedge (0.75 oz.) Laughing Cow Light Swiss (35 kcals, 2.5g protein)
• 4 oz. protein drink - did the Nectar chocolate + Nectar cappuccino again (100 kcals, 23g protein)
• 1 sugar-free Fudgesicle (35 kcals, 1g protein)
• 1 oz. turkey bacon (50 kcals, 3g protein), 1 wedge (0.75 oz.) Laughing Cow Light Swiss (35 kcals, 2.5g protein), 1 tbsp. homemade tomato sauce (10 kcals, 0g protein)
• 4 oz. Nectar fuzzy navel protein drink (90 kcals, 23g protein)

Total: 425 kcals, 60.5g protein, 56.9% kcals from protein.

On the gym run today, I did my elliptical again. Just 35 minutes today because I was running late, and I was extra-tired today for some reason. Total burn, as reported by the crazy machine, was 317 kcals.

Turkey bacon is salty. I expect water retention to show on the scale tomorrow morning...

What I Ate: 5/15/2009

• 4 oz. protein shake: 1/2 scoop Nectar chocolate truffle, 1/2 scoop Nectar cappuccino. I realized I still had a Nectar cappuccino sample. This was crazy delicious! Cut the sweetness of the chocolate a bit (100 kcals, 23g protein)
• 1 oz. mustard teriyaki salmon with 1 oz. poached tilapia in tomato-herb-cream sauce - can you tell I'm cleaning out my fridge? (95 kcals, 12g protein)
• 2 of those Bariatric Advantage chocolate calcium chews (30 kcals, 0g protein)
• 4 oz. protein shake with 1/2 scoop Nectar chocolate truffle, 1/2 school Nectar cappuccino, and a splash of sugar-free hazelnut syrup (100 kcals, 23g protein)

Total: 325 kcals, 58g protein, 71.4% kcals from protein.

Got myself back together today, so back to the gym: 65 minutes on the elliptical (again, long and slow.) The calorie counter said I burned 548 kcals. I try to keep in mind that they can be off by up to 50%, and tend to be the most inaccurate for obese women...

What I Ate: 5/14/2009

• 4 oz./1 scoop Nectar chocolate truffle protein shake (100 kcals, 23g protein)
• 4 oz./1 scoop Nectar chocolate truffle protein shake (100 kcals, 23g protein)
• 2 oz. mustard teriyaki salmon (110 kcals, 14g protein)

Total: 310 kcals, 60g protein, 77.4% kcals from protein.

Yup, same menu as yesterday, but at least I ate at more reasonable hours. Last night I didn't have my last shake until 1:30 AM...

The life craziness should go on a brief hiatus tomorrow, so I'll maybe add more real food back up in there. I can't wait to meet with this nutritionist character on Monday, so I'll have a better idea of how many calories I should be getting. I also need to figure out good ways to incorporate fiber into my diet...jsia ;-)

Bill Clinton: Soda Tax Isn't the Way to Go

Fascinating article. I haven't thought in any depth about the soda tax, so no comments from me just yet. If anyone reads this and cares, what do you think? :-)

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Bill Clinton: Soda Tax Isn't the Way to Go
Teddy Davis, ABC News

Though former President Clinton has focused on reducing childhood obesity since leaving the White House, he told ABC News Wednesday he does not favor the tax on soda that a nutrition group has publicly supported to pay for health care reform.

"I'm doing everything I can on this obesity thing," Clinton told ABC News. "I think the better thing to do is to give incentives right across the board for prevention and wellness."

"That's what I would do," he said.

Clinton weighed in on the debate over taxing soda one day after the Center for Science in the Public Interest urged a key congressional panel to adopt a tax on nondiet soft drinks. The group believes a soda tax along with a tax on alcoholic beverages would both promote health and generate revenues to help fund expanded health care coverage.

Click here to read the full article.

What I Ate: 5/13/2009

I'm kind of stressed right now, so I don't feel like thinking about food. Packing my food and planning my menu post-op is a lot of work. I will no longer be gorging myself with garbage to relieve the tension as I would have done pre-op, so I've decided to put myself on mostly liquids with just a little food for a few days to get recentered. Thus:

• 4 oz./1 scoop Nectar chocolate truffle protein shake (100 kcals, 23g protein)
• 2 oz. mustard teriyaki salmon (110 kcals, 14g protein)
• 4 oz./1 scoop Nectar chocolate truffle protein shake (100 kcals, 23g protein)

Total: 310 kcals, 60g protein, 77.4% kcals from protein.

Can you tell that I really, really love Nectar chocolate truffle? :-)

No gym today, because as much as I need to get in shape, I also need to graduate.

Also, today was my one month surgiversary! I didn't celebrate because I'm lame and had to focus on other things. Very sad.

A Confession...

Last night, I participated in the same compulsive eating behavior that caused me to regain over 100 pounds in law school. I will admit that the incident itself is not disastrous, but it's terrible behavior given that the whole point of the surgery is to force changed eating habits.

I'll save you the stupid details, but I was told last night by my school that I am at risk of not graduating. I was already pushing it on some assignments, but they gave me some (ultimately inaccurate) information that made everything seem even more like a nightmare. I decided that one of my assignments needed an all-nighter from me, so I did it.

At around 1:30 or 1:45 AM it was time for my last protein shake (I know, that's ridiculous.) But before I had the shake, I had an overwhelming urge to eat something comforting - so I had a sugar-free Fudgesicle and 4 tiny spoonfuls of my fat-free, low-sugar cream cheese dessert (probably about an ounce altogether.) My stomach started to hurt a little after the fourth bite of the cream cheese dessert because it knew I wasn't supposed to be eating then, so I stopped there.

Is this the end of the world? No. I didn't take in that many calories (maybe 75?) and I've now disposed of the cream cheese dessert stuff. But it's bad because weight loss surgery is all about changing your habits, and I absolutely must learn to turn somewhere other than the fridge when I'm feeling stressed. Hopefully I'll improve.

What I Ate: 5/12/2009

• 1 oz./2 tbsp. chocolate protein-enriched pudding - I made mine with chocolate fudge instant sugar-free/fat-free Jello and EAS Myoplex Carb Control Chocolate Fudge ready-to-drink protein shake (idea from BariatricEating.com) but I used a lighter and less tasty protein drink (23 kcals, 2.3g protein) with 1 oz./2 stalks turkey bacon-wrapped asparagus - the asparagus is shriveling before my eyes, so I'm trying to eat it all now since it was so pricey (44 kcals, 3g protein)
• 2 Bariatric Advantage Chocolate Chewy Bites - felt that I needed to acknowledge these calories today because I had 2 of these instead of just one - very unfortunate decision! (30 kcals, 0g protein)
• 4 oz./1 scoop Nectar fuzzy navel protein shake (90 kcals, 23g protein)
• 2 oz. poached tilapia with tomato-herb-cream sauce (about 75 kcals, 12g protein)
• 2 stalks (1 oz.) turkey bacon-wrapped asparagus (44 kcals, 3g protein)
• 4 oz./1 scoop Nectar chocolate truffle protein shake (100 kcals, 23g protein)

Total: 406 kcals, 66.3g protein, 65.3% kcals from protein.

No workout. Today I had to focus on handling my business before everything crashes.

I'm thinking about going back to liquids for a few days to jump start myself. Eating is a lot of work anyway. I'm concerned that turkey bacon might be a trigger food for me. Or at least, turkey bacon-wrapped asparagus. Fortunately, only one more stalk left.

What I Ate: 5/11/2009

• 1.5 oz. scrambled eggs with spinach (about 75 kcals, 5g protein) and 1 stalk turkey bacon-wrapped asparagus (0.5 oz) (22 kcals, 1.5g protein)
• 4 oz./1 scoop Nectar chocolate truffle shake (100 kcals, 23g protein)
• 2 oz. tuna-artichoke salad (about 60 kcals, about 9g protein)
• 2 oz. tofu teriyaki (about 65 kcals, 5g protein)
• 4 oz./1 scoop Nectar chocolate truffle shake (100 kcals, 23g protein)

Total: 422 kcals, 66.5g protein, 63.0% kcals from protein.

Gym time: Today was another long and slow day. I was trying to make sure my heart rate didn't go too high, so I was moving pretty slowly. It was unfortunate because going fast is more fun - but this was fun too. 60 minutes on the elliptical for a supposed burn of 505 kcals.

Looking for a Tasty Multivitamin

I've been on top of my vitamins so far. As a generally risk-averse person, the horror stories I've heard about calcium, thiamine, iron, and other deficiencies are enough to keep me on track and even taking extra.

However, I'm having some issues with my multivitamins. I haven't found anything I like other than the unspeakable yummy chewables - which, I should note, are what my surgeon recommends. But I'd feel more comfortable taking something for adults.

Before surgery, I ordered the Bariatric Advantage chewable multivitamins in the orange flavor. Their taste is passable, but their consistency is a problem. They are extremely gritty and feel like they are breaking my teeth - a sensation I'm not interested in having twice a day if avoidable. A couple of weeks ago, I ordered the Celebrate Multivitamins in Cafe Latte. They are just gross, in my opinion. They smell and taste like soured milk. The Celebrate orange-flavored multivitamins are rumored to taste like Dreamsicles, and I don't like Dreamsicles. So I'm hesitant to even buy those.

So, this leaves me with the unspeakable yummy chewables. In order to get more benefit from them, I've been taking 6 a day, 3 in the morning and 3 at night. I've compared the amounts of vitamins and minerals in this regimen with the vitamins and minerals in the bariatric vitamins, and with my trumped-up dosage it's about the same, other than the all-important B-12 and thiamine. I'm fine with that because I supplement those other ways.

Unfortunately, I can't afford to take 6 of those a day! I'm running through a $7 bottle in 10 days. That means $21 a month. That's not a ton more than a 30-day supply of Bariatric Advantage multivitamins ($16.95), but at least those are specially formulated for WLS patients.

I've looked at product reviews, but the selection seems small. What's out there that tastes good and won't break my teeth?

Update: Week 4

This morning, the numbers on my unreliable scale averaged to 272.4, for a loss of 2.9 pounds this week.

I'm not happy with this. It's fine overall, but I'm annoyed because this is the highest my weight has been since Thursday. On Friday, my weight had gotten down to around 271.2. On Saturday, it was 271.8. Yesterday, it was 272.0. And today, it's 272.4??? Why is my weight trending upward? On Friday, I was kind of hopeful that I could get close to the 260s this week. Now, it's looking like I might not even make my goal of getting below 270 by Week 5.

I'm also displeased because I don't know what I'm doing wrong. Even the ratatouille pizza wasn't a big enough misstep to make me stop losing weight. Perhaps it's not enough fluids? I'm really cognizant of them but I still miss my mark from time to time. Maybe I've had too much sodium the past couple of days? Maybe it's just the natural order of things. Argh. Argh. Argh.

But I suppose I should keep this in perspective. Losing 2.9 pounds in a week, even with this weird semi-stall, is a lot better than gaining 2.9 pounds in a week, which I've been known to do in the past. I'm still sad though.

What I Ate: 5/10/2009

• 4 oz. Nectar chocolate truffle protein shake (100 kcals, 23g protein)
• 1.5 oz. "Portabellos Benedict" (roughly 70 kcals and 3g protein) and 1 stalk (0.5 oz.) of turkey bacon-wrapped asparagus - these are crazy good, and they taste very unhealthy. I used the Butterball Thin & Crispy turkey bacon, which is why they didn't have more calories and why the asparagus didn't get overcooked (22 kcals, 1.5g protein)
• 1 oz. of my fruit salad - see here for the recipe (about 30 kcals, 0g protein) with 0.75 oz. cream cheese/whipped cream dessert (about 30 kcals, 1g protein)
• 1 oz. poached tilapia with tomato-herb-cream sauce (about 40 kcals, 6g protein) with 2 stalks (1 oz.) of turkey bacon-wrapped asparagus (39 kcals, 3g protein)
• 4 oz. Nectar chocolate truffle protein shake (100 kcals, 23g protein)

Total: 431 kcals, 60.5g protein, 56.1% kcals from protein.

A few more calories than I've been having, but probably not too many. I feel like I'm back in the game. :-)

No gym today, but I wasn't planning on it because cleaning, buying groceries, cooking, and having brunch took all day.

"Dance Your Ass Off" - Whaaaa?

First, there was The Biggest Loser. Then there was the now-defunct Celebrity Fit Club. Now, there's Dance Your Ass Off.

Yep, that's right - Dance Your Ass Off. Oxygen, the network that brought us Janice Dickinson Modeling Agency and Bad Girls Club, is entering the weight loss reality market. The show features obese people dancing and then getting weighed. Might a more apt title be "Dancing With The Fatties"?

I will reserve judgment until I see it, but... I dunno. On one hand, the producer is right that people need to see that exercise doesn't have to be torture (that is, being active doesn't require being yelled at by a trainer or getting a stress fracture.) Also, it's good for fat people to realize that we can dance and enjoy moving our bodies, and hopefully this show will help with that.

On the other hand - who exactly is the target audience for this show? Might it be the same group of people that gets off on making fun of fat people dancing on YouTube? See, for example, Scarlet Takes A Tumble, Fat Kid Dancing HILARIOUS, and Fat Girls Dancing (glance at the comments.)

Also, will the show be transformative for those who struggle with obesity if the focus is on fat people pole dancing (yes, that's one of the categories) instead of focusing on eating healthfully? Maybe the next reality show should try to jazz up the diet component, especially given the recent, widely covered World Health Organization report that obesity in America can be traced more to overeating than to inactivity.

Brunchin' with the Ladies

Today was my first day cooking for others post-op. I have never cooked something for other people that I can't eat or don't like, and today was the same. I kept it light and WLS-friendly, and I think they were pleased with the food. But more importantly, we had an awesome time catching up. :-)

My girlfriends brought juice and pastries, so that was the only non-WLS-friendly food present.

I made "Portabellos Benedict" (recipe below), fruit salad (recipe below), and grilled asparagus wrapped with turkey bacon.

My fruit salad 1
Stuff you need:

• 3 Granny Smith apples, diced
• 6 kiwis, cut into slices
• 1 orange, cut into wedges
• Zest of one orange
• Juice of 1/2 lemon
• 1/2 cup Splenda
• Tiny pinch of cinnamon

What you do:

1. Mix everything together and serve. Ta-dah! Lol.

I served this with my cream cheese dessert stuff, but it tastes fantastic on its own. I might add strawberries, grapes, or cantaloupe next time. I got the cinnamon tip from my stepsister-in-law. She makes a delicious summer fruit salad with watermelon, grapes, and strawberries, and the cinnamon is random but makes it taste so amazing.

Portabellos Benedict
"Portabellos Benedict" is a concept that I borrowed from Ellie Krieger, who hosts the show Healthy Appetite with Ellie Krieger on the Food Network. Her version has a little olive oil, Canadian bacon, and pesto sauce. My version has cooking spray, turkey bacon, and a creamy sauce made with nonfat Greek yogurt, spicy mustard, and beef stock concentrate that is designed to have a consistency more similar to hollandaise. I just took random stuff from my cupboards for seasoning, and if you make this, you should do the same.

Here’s the recipe for my version.

Stuff you need:

• 3 Portobello mushroom caps with the gills and stems removed
• 6 whole eggs
• 6 slices of turkey bacon (I used Butterball thin and crispy)
• 1 bag of pre-washed spinach
• 2 cloves of garlic, minced
• 1 firm-fleshed tomato, sliced ¼ to 1/3-inch thick
• A little reduced-fat shredded mozzarella, or fresh mozzarella if you have it
• A few pieces of turkey bacon
• 1 container of nonfat Greek yogurt, separated
• 2 tbsp. spicy brown mustard
• 1 packet beef stock concentrate (I got mine from Trader Joe’s)
• 1 packet chicken stock concentrate (I got mine from Trader Joe’s)
• Fresh basil, cut into ribbons
• Salt and pepper
• Celery seed, if you already have it on hand
• 2 tsp. fat-free ricotta cheese, if you have it on hand (American cheese would be tastier, but all I had was fat-free American and it’s too much of an acquired taste to serve to other people)
• 2 tsp. nonfat half and half, if you have it on hand
• A sprinkle of paprika, if you have it on hand

What you do:

1. Saute the mushrooms caps whole with salt, pepper, and celery seeds until they are juicy and done. Keep them warm in the oven.
2. Saute the garlic in some nonstick spray and water.
3. Add the spinach to the pan with garlic and let it reduce down. Cook until it’s done with a salt and pepper to taste. Keep it warm in the oven.
4. Grill the tomatoes on a stovetop grill (or you can just sauté the slices.)
5. When you turn them over, add the shredded mozzarella and let it melt. (This would also work great if you have an oven pan with a broiler.)
6. Sprinkle the tomatoes with some of the basil. Set them aside.
7. Crisp the turkey bacon in a little nonstick spray. Set it aside.
8. Mix together ¾ container of nonfat Greek yogurt with the spicy brown mustard and the beef stock concentrate. Sprinkle paprika on top for garnish and a bit of flavor. This is the fake hollandaise sauce.
9. Crack open the eggs and start to beat them.
10. Add ricotta, ¼ container of nonfat Greek yogurt, the half and half, and salt and pepper to the eggs and whip them until frothy.
11. Scramble the eggs and top them with the remaining basil.
12. Assemble in this order, leaving out any ingredients you don’t want: Mushroom, turkey bacon, tomato, spinach, eggs, sauce.

As you see, it’s a bunch of simple tasty components that you stack together. It’s a fabulous choice for brunch entertaining because it’s a comprehensive concept, but people can construct their own dishes to match their preferences. For example, my friend who doesn’t like bacon just left that layer out and it was no big deal.

I had a miniscule portion of all the layers together and it was faaaabulous!

What I Ate: 5/9/2009 (Bad Day)

• 2 oz. mustard teriyaki salmon (110 kcals, 14g protein)
• 1 sugar-free Fudgesicle (35 kcals, 1g protein)
• 2 oz. fat-free refried beans with salsa and cilantro (55 kcals, 3g protein)
• Some toppings off a ratatouille pizza, mostly squash, zucchini, and tomato, with a little bit of mozzarella cheese.

Total: Who knows, but it ain't good.

This was a bad day. A very bad day.

First, I didn't go to the gym today. I hadn't planned to go, but after we decided to go to the restaurant I should have made time to go.

Second, I screwed up and had a sugar-free Fudgesicle (argh, 2 more are left) instead of a protein shake. I had a serious snacky urge/head hunger moment this afternoon, and then I ate the Fudgesicle and the beans. I felt stuffed and gross afterward.

Third, as you'll note in the post below, we had planned to go to Ben's Next Door after the play, and I was going to have the roasted tomato soup. Unfortunately, the play ran really long and we wound up having to go to another place in the same area, Ulah Bistro. Not only was I going to an unexpected place, but by the time we got there they were running their "late night" menu--and you can guess what that means in terms of food healthfulness and quality. I wound up eating some of the toppings of a ratatouille pizza. I don't know how much. I felt fine when eating it, but now I feel fatter than ever and disappointed with myself.

Am I going to let this fail too? After all I went through to have the surgery???

First Post-Op DC Restaurant Outing Tonight

I'm going to see a play tonight. Afterward, we're going to Ben's Next Door, a cool new restaurant in the U Street Corridor. Ben's Next Door is owned by the owners of the legendary Ben's Chili Bowl, and in fact, the establishments are "next door" to each other.

As one might expect, the food isn't known for being healthy. At the original Ben's, there's lots of chili, fries, hamburgers, hot dogs, and combinations thereof (though they do have nice vegan chili, veggie burgers, and turkey burgers and dogs.) At Ben's Next Door, the food is basically upscale soul food. The menu includes ribs, wings, crabcakes, and dishes with the words "fried," "crispy," and "creamy" in them. Macaroni and cheese is offered as a side. Obviously, this is not the ideal choice for a first foray back on the DC dining scene--even things that sound like they could be okay, like seared sea scallops and roasted chicken, are probably drenched in butter and oil.

There is always the salad option. Unfortunately, I'm not yet at the stage where I can have raw vegetables, so that's a definite no-go.

If I were going out with just my regular group, I would probably just not eat or ask if we could go somewhere else. But this is me and a friend tagging along with my friend's coworker and the coworker's friend. I either go there or go home, and I promised myself I wouldn't let RNY make me antisocial.

My current plan to order the roast tomato soup and pretend to eat it, maybe taking a sip or two. It's good prop food because it's the cheapest thing on the menu. They have a salmon that could be okay. But it's $19 (!), and I can't justify spending that much on food that I don't want to eat. Plus, I already have about 4 servings of delicious salmon here at home, some of which I already had for breakfast today.

Yep, the tomato soup/pretending to eat option is looking good. I'll have to distract them by being extra chatty. Then I'll come home and have a protein shake. Yay!

What I Ate: 5/8/2009

• 1 oz. mustard teriyaki salmon filet with 1 wedge of Laughing Cow Light Swiss (0.75 oz.) and 0.25 oz. of my teriyaki sauce - yep, I love fish and cheese together! (90 kcals, 8.5g protein)
• 1 oz. pesto cannellini beans mixed with 1 oz. fat-free refried beans with salsa and cilantro - not as tasty an idea as it seemed at the time (55 kcals, 3g protein)
• 4 oz. Nectar strawberry kiwi protein shake (1 scoop) (90 kcals, 23g protein)
• 2 oz. yummy yummy delicious poached tilapia with herb-infused tomato cream sauce (about 75 kcals, 12g protein)
• 4 oz. Nectar chocolate truffle protein shake (1 scoop) with DaVinci sugar-free hazelnut syrup - reminiscent of Nutella. I had this with a delicious chocolate Bariatric Advantage Calcium Citrate Chewy Bite...heavenly! [Note: The Chewy Bite has 15 kcals, but I don't count my vitamins in my daily calories because I think it's kind of a disincentive to taking them. So every day I have a few more calories than I'm actually listing here. I only allow myself Chewy Bites once in a while though. I usually take Bariatric Advantage cinnamon lozenges, which are also delicious, in an Altoid-esque way.] (100 kcals, 23g protein)

Total: 410 kcals, 69.5g protein, 67.8% kcals from protein.

At the gym today, I went slowly for 40 minutes on the elliptical. Annoyingly, I've forgotten what the unreliable calorie counter said. I believe it claimed that I burned 345 calories.

Also, I was off work today, which means I didn't have the exhausting commute. To compensate for that, I went on about an hour-long stroll this afternoon. It was gorgeous out today!

Weight Bias in Healthcare: An Important Clinical Concern

Medscape Today, a news service from WebMD, today posted a piece by Dr. Rebecca Puhl, Director of Research and Weight Stigma Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. (I'm a huge, huge fan of the Rudd Center and hate that I didn't know about their work before I was basically done at Yale. There's lots of legal research-y stuff to be done for them. In fact, one of my first-year professors, Robert Post, is counsel on briefs with them.)

Anyway, Dr. Puhl's piece discusses the Center's recent informational videos about weight bias. Everyone should watch them ASAP. You can see them on YouTube and you can also order a free dvd by emailing the Center.

Here's the first paragraph of her article:

Weight Bias in Healthcare: An Important Clinical Concern

Despite increased attention to the obesity epidemic, little has been done to address the bias, prejudice, and discrimination that obese children and adults face every day. Weight bias is prevalent in our society, but it often goes unnoticed and ignored. As a result, overweight and obese individuals face discrimination in employment, barriers in education, stereotypes in the media, stigma in interpersonal relationships, and even bias from healthcare providers. This unfair treatment reduces quality of life for obese persons and jeopardizes their emotional and physical health.

Click here to read the full piece from Medscape Today.

What I Ate: 5/7/2009

• 4 oz. Nectar chocolate truffle shake with hazelnut and 1/2 tsp. decaf instant coffee (100 kcals, 23g protein)
• 2 oz. refried beans with salsa (about 50 kcals, 3g protein)
• 2 oz. tuna-artichoke salad (about 60 kcals, 9g protein)
• 4 oz. Nectar fuzzy navel protein shake (90 kcals, 23g protein)
• 2 oz. poached tilapia in tomato-herb-cream sauce - this was killer delicious (about 75 kcals, about 12g protein)

Total: 375 kcals, 70g protein, 74.7% kcals from protein.

I'm at peace with these results. Perhaps not enough calories - I just don't know - but this is the most protein I've had in one day and I'm happy to have done that while keeping the calories in check. My little plan about food scheduling didn't work out as I'd planned: It was 9:30am (shake), 12:30pm, 3:30pm, 6pm (shake), and 11:00pm today. I just couldn't get out of bed and woken up in time to eat before 9:30. I hate eating as soon as I wake up.

I'd planned to have the Lean Dessert fresh cinnamon roll shake today, which would have added 130 calories and a few carbs. Unfortunately, I don't like it anymore! It still smells delicious, but it tastes like cardboard to me. People say tastebuds can change after surgery, but I hadn't noticed that until today. Instead of thinking it was too sweet - the usual complaint from post-ops about stuff like Lean Dessert - I think it's wayyy bland. Perhaps a giveaway is in order.

Went to the gym today. Was moving slowly because, as I mentioned in the previous post, I get overheated easily these days. My heart rate was again elevated before I even started. Used the elliptical for 45 minutes for a supposed burn of 381 calories.

So Tired...

One thing I've noticed since surgery is that I get tired (and disgustingly sweaty) a lot more easily than I did before.

This fact was driven home this morning. In order to get to work, I walk about 15-18 minutes to the Metro, take the train for less than 20 minutes, and then walk about 7-10 minutes to the office up a slight incline. Pre-op, this was nothing. This morning, I was literally dripping sweat after the walk to the Metro stop and for the rest of the way. I had to put my head on my desk for about five minutes once I got to work. I need a shower. I want to go home. I don't know how I'm going to bring myself to go to the gym this evening.

I'm not too worried about this yet because I understand that it's normal for people to experience fatigue for the first 3-4 weeks after surgery. If this is still going on in a week or so, I might start worrying more. Just to be safe, I'm going to get some second, third, and fourth opinions about nutrition and supplementation stuff.

What I Ate: 5/6/2009

• 2 oz. Rachel's cottage cheese, cucumber dill flavor (44 kcals, 5.5g protein)
• 4 oz. Nectar fuzzy navel protein shake (90 kcals, 23g protein)
• 2 oz. tuna/artichoke salad (about 60 kcals, about 9g protein)
• 2 oz. asparagus baked ricotta (about 45 kcals, about 3g protein)

Total: 239 kcals, 40.5g protein, 66.8% kcals from protein.

Calories were lower today than I intended. I'd planned to have a Lean Dessert fresh cinnamon roll protein shake for my last meal, but I wound up getting home really late. I'm scheduled to have the shake at 11:30 pm (I'm behind schedule on food, as usual), and then I'd need to stay up to let it digest a bit. I would rather go to bed and sip some Crystal Light - I'm exhausted.

I think I need to adjust my food scheduling. I am supposed to eat at 4 pm, but I usually don't eat until 5:30 which pushes dinnertime from 7 or 7:30 to 8:30 or 9! And there's still a shake time after that! Tomorrow I'm doing to try this timing out: 7 am (shake), 10 am, 1 pm, 5 pm (shake), and final meal at 8:30 or 9 pm.

My protein is also lower than I'd like, but it's not so low that I'm worried about it. I figure I can compensate for the missing 9.5 grams another day.

At the gym today, I did 36 minutes on the elliptical for a supposed calorie expenditure of 334 kcals. Still moving slowly and getting tired quickly. But I did it!

First Mini-Goal Met: Down 30 Pounds!

Got some great news this morning when I stepped on the scale! (Yes, I'm still weighing every day.)

This morning, my weight was 273.4.

You know what that means? I am down 30.6 pounds. Yay :-)

My next mini-goal is to be in the 260s by my Week 5 update, because that's where my weight was the last time I felt competent as a potential lawyer. More on that later!

What I Ate: 5/5/2009

• 4 oz. Nectar chocolate truffle protein shake (100 kcals, 23g protein)
• 2 oz. refried beans with salsa and fat-free cheese (about 50 kcals, 3g protein)
• 2 oz. tuna-artichoke salad (about 60 kcals, about 9g protein)
• 2 oz. tofu teriyaki (about 65 kcals, 5g protein)
• 4 oz. hazelnut mocha protein shake - still with Nectar chocolate truffle (100 kcals, 23g protein)

Total: 375 kcals, 63g protein, 67.2% of kcals from protein.

Bariatric Surgery in Australia and India

I've read a great deal about efforts to curb obesity in the US and in the UK, but two recent stories about efforts in other countries recently caught my eye.

Today, the AFP reports that Australia, purportedly one of the fattest countries in the world (and according to a report by Australia's Baker Heart Institute, even fatter than the US), is considering government-funded lap-band surgery. According to Australian newspaper the Herald Sun, Parliament is expected to approve this measure next week. I'm sure some people, even bariatric surgery patients, will be shocked by the fact that government would pay for lap-bands in Australia. But it's important to note that Australia's healthcare system is largely funded by the government, so other procedures are subsidized or completely paid for by the government as well.

Also, on May 2, a piece in on the Hindu News Update Service reported on a conference focused on curbing obesity in India. (Apparently, now "obesity is as much a problem in India as is malnutrition.") Referring to lap-band as "one of the newest techniques," the conference attendees discussed ways to make the surgery more affordable. One expert, a leading bariatric surgeon in India, promoted the surgery by sharing statistics on the success of the surgery in the US: After three years, the average weight loss of lap-band patients was 36.2% of their excess weight.

A couple of comments about these stories.

First: It's interesting that both countries are focusing on the lap-band. Obviously the lap-band works great for some people, but it would be interesting to think about why the government and Indian experts are ignoring other procedures. A lot of people have misconceptions about the safety of procedures like RNY and DS. Then there's the sleeve, which involves less "messing around" than the RNY or DS. Are these procedures off the table? Will Indian leaders focus only on making the lap-band affordable, but not other procedures? Will Australia pay for only the lap-band?

Second, I wonder what kinds of supports these countries will have in place for bariatric surgery patients, particularly Australia, since it will be picking up the tab. The AFP story described lap-band as a surgery that works because it helps obese people fill full faster - but all of us who have dealt with weight issues know that people don't eat just because they are hungry. So, aftercare is really important. I hope that the government is planning to fund a full-blown program, not just the procedure itself.

Third, it's fascinating that the Indian surgeon cited the American statistic about average lap-band weight loss over three years to support making the surgery more available. Weight loss surgeons, at least in the US, consider surgery "successful" when a patient has lost 50% of her excess weight and maintained the loss for at least five years. By that measure, the statistic given in the India story is not even of "successful" patients. Also, I'd love to see that statistic broken down. Were the bulk of cases people who were still in the process of losing weight, people who were on a plateau, or people who had lost more than 36% of their excess weight but had started to regain?

What I Ate: 5/4/2009

• 4 oz. hazelnut mocha protein shake (4 oz. water, 1/2 or so tsp. instant decaf coffee, a splash or two of Torani sugar-free hazelnut syrup, and 1 scoop of Nectar Chocolate Truffle protein powder) (100 kcals, 23g protein)
• 1 oz. curried egg salad, 1 wedge of Laughing Cow Light Swiss (0.75 oz.), 1 tsp spicy brown mustard (100 kcals, 7.5g protein)
• 2 oz. Rachel's cottage cheese, sundried tomato pesto flavor (52 kcals, 6g protein)
• 2 oz. tofu teriyaki (roughly 55 kcals, 5g protein)
• 4 oz. hazelnut mocha peanut butter protein shake (4 oz. water, 1 tsp. instant decaf coffee, splash of Torani sugar-free hazlenut syrup, 1/2 scoop of Syntha-6 Chocolate Peanut Butter protein shake - I got a sample from Vitalady) (100 kcals, 11g protein) [note that 11g is really low for a protein shake, but I only used half a scoop because a full one-scoop serving of Syntha-6 has a ridiculous amount of calories.]

Total: 407 kcals, 52.5g protein, 51.6% kcals from protein.

I give myself an "A-" for today's food. ;-) Seriously, I'm happier with this combination of overall protein grams, percentage of calories from protein, and still managing to keep the calories relatively low. However, I did not work out today. I definitely could have made time. And I only got about 48 oz. of fluid in, which is terrible compared because I've been getting all 64 oz. in the past several days. So overall, today was more like a C-/D+ day.

In other news, I start on fish tomorrow! Dishes for this week include tuna-artichoke salad, poached tilapia in tomato-herb cream sauce, and Asian-inspired glazed salmon - all my recipes. Yumm...and lots of protein...

Update: Week 3

This morning, the numbers on my unreliable scale averaged to 275.3, for a loss of 6.7 pounds this week. Right on.

I'm not as excited about this as I was when I first saw the scale trending downward earlier this week. That's because, as you can see by looking at my What I Ate entries, I haven't been eating much protein because that's the way my diet is structured. I have been getting less than 30 grams of protein most days. I'm worried that the weight I lost was muscle, not fat.

Yesterday I decided to add protein shakes now - even though I'm not supposed to - because I want to get my protein above 50g a day. That will mean 2 shakes a day, which will add 200 kcals a day. I'm not happy about that at all.

So, mixed feelings today. On one hand, I lost almost 7 pounds in a week, and that's awesome. On the other hand: (1) The weight I lost was probably all muscle; (2) I won't be losing weight at this pace again - and may even gain or plateau for a while - because I'm adding calories now; and (3) I'm being a renegade and breaking the rules of my diet, which makes me very uncomfortable, but I feel that I have no other choice.

There's my update.

What I Ate: 5/3/2009

• 1 hard-boiled egg with 1 oz. of wls-friendly creamed spinach with PURE unflavored whey protein (roughly 95 kcals, 10g protein)
• 1 sugar-free Fudgesicle (35 kcals, 2g protein)
• 2 oz. asparagus baked ricotta (45 kcals, 3g protein)
• 4 oz. Nectar chocolate truffle protein shake (100 kcals, 23g protein)
• 2 oz. pesto cannellini beans (55 kcals, 3g protein)
• 8 oz. low-sodium miso soup - this is basically broth, but like the sugar-free gelatin it's also sort of like food (25 kcals, 2g protein)

Total: 355 kcals, 43g protein, 48.5% kcals from protein.

What I Ate: 5/2/2009

• 1 large hard-boiled egg (1 oz.) with 1 wedge of Laughing Cow Light Swiss (0.75 oz.) and 1 teaspoon of spicy brown mustard with Splenda (bootleg honey mustard) (about 110 kcals, 9.5g protein)
• 2 tbsp. nonfat half and half - in a venti decaf iced americano with sugar-free hazelnut syrup from Starbucks - a great way to get those liquids in (20 kcals, 1g protein)
• 2 oz. fat-free refried beans with nonfat Greek yogurt and salsa (about 50 kcals, 3g protein)
• 1 sugar-free Fudgesicle - definitely need to get rid of these (35 kcals, 2g protein)
• 1 oz. cream cheese dessert with 1 oz. protein-infused cooked cinnamon apples - I used the PURE unflavored whey protein from Bariatric Eating after the apples were cooked and cooled to make sure the protein maintained its integrity (yummy. Remember the Applebee's Apple Chimi Cheesecake? It's reminiscent of that, obviously without the pastry.) (about 60 kcals, 8g protein)

Total: 275 kcals, 23g protein, 33.5% kcals from protein. Grade for today = ??? (I know this is far from being enough protein, but I think these results are in line with what my surgeon expects right now.)

Also, an activity report: Went to the gym again today, but it didn't go as well as the first time. Did the same thing - about 37 minutes on the elliptical at level 5. But I was already sweating (gross) and my heart rate was elevated when I got there, presumably from the 15-minute walk from my house to the gym. That sucks. But anyway, I took it *really* slow and never even got up to 100 strides per minute. Untrustworthy machine said I burned 302 calories.

A Tribute to Fage ("Fa-yeh") Greek Yogurt

Fage Greek yogurt, how I love thee.

Greek yogurt is a WLS post-op's dream, in my opinion. I always use the Fage 0% (nonfat) plain version, so that's what I'm shouting out. But I'm sure other Greek yogurt is just as tribute-worthy.

I am less than 3 weeks post-op, but I have already used this wonderful stuff in practically everything I've cooked and/or eaten, including:

• curried egg salad
• refried beans
• my modification of Shelly's baked ricotta (both in the ricotta base to make the fat-free ricotta creamier and in the tomato/asparagus sauce to make it richer)
• creamed spinach
• cream cheese dessert

I don't even like yogurt. Never have. I will probably never eat this stuff by itself or as the main part of a dish. But as a supporting player, it is awesome. It's reminiscent of sour cream.

Next up: I'm going to use it as the base of a thyme and rosemary-infused cream sauce for poached tilapia once I can start eating fish on Tuesday. Wish me luck. :-)

HHS: Complications and Costs for Obesity Surgery Declining

On April 29, a federal government study was released showing lower costs and complication rates of bariatric surgery over a period from 2002-2006. An excerpt from the press release is below.

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Complications and Costs for Obesity Surgery Declining

A new study by the Department of Health & Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ) found that the average rate of post-surgical and other complications in patients who have obesity surgery, also known as bariatric surgery, declined 21 percent between 2002 and 2006. They also found that payments to hospitals dropped by as much as 13 percent for bariatric surgery patients during that time period, in part because fewer complications meant fewer readmissions.

Click here to read the full release from the AHRQ.

What I Ate: 5/1/2009

• 1 large hard-boiled egg (1 oz.) with 1 wedge of Laughing Cow Light Swiss (0.75 oz.) and 1 teaspoon of spicy brown mustard with Splenda (bootleg honey mustard) (about 110 kcals)
• 3 oz. strawberry acai sugar-free Jell-o (this is a liquid for all intents and purposes, but it's also food in a way, so I'm including it) (10 kcals)
• 1 cup of clear Japanese broth - again, a liquid posing as a food (5 kcals)
• 1 sugar-free Fudgesicle - these seemed like a good idea at the time, but I'm a little afraid of them. Probably won't buy them again for a while. (35 kcals)
• 2 oz. baked ricotta with tomato/asparagus sauce - this was my spin on Shelly's Baked Ricotta from The World According to Eggface blog. I used fat-free ricotta and reduced-fat mozzarella, baked it at a lower temp, and added asparagus and other seasonings to the sauce, but it's basically the same. It was incredibly delicious, but I got a bit over-full for the first time. Maybe I ate it too fast. (guesstimating 85 kcals)
• 1 oz. fat-free refried beans mixed with a little Greek yogurt (of course) and topped with salsa (about 23 kcals)
• 1 beef broth packet (25 kcals)