Patient Advice for When You Hit an Exercise Plateu, Part I
Recently, I had a nice chat with a woman during the Heartland Walk for Health at the Indiana State Fair. Although she’s not a bariatric patient, she’s lost over 50 pounds since December through dieting. However, she’s been feeling a little “down” lately since her weight loss has slowed down. She’s hit the dreaded “WALL.”
I shared my post-surgery experience with her. I’m almost 18 months post-surgery and have lost about 155 pounds. And, I’ve seen at least a couple of plateaus in my 18 months. I told her this is common among those of us who have lost a lot of weight. Then I shared my approach for beating the “blues." I hope it’ll help her and maybe it might help someone else, too.
I call it…CELBRATE YOURSELF!
When you feel a little down because the weight loss has slowed, realize that your REAL goal is not to lose weight…it is to GET FIT. Your weight was just one of the things standing in your way of getting fit.
Then, think of some of the things you can do now, that you couldn’t do before your weight loss… and CONGRATULATE YOURSELF FOR IT! You’ve done a pretty good thing here. You should feel good about it. For example:
- I congratulate myself every time I mow the lawn now. A year ago I couldn’t mow the lawn!
- I built my wife a raised garden bed this spring. 1,800 pounds of stones and mortar, then shoveled in 2000 pounds of dirt. But, I built it as much FOR MYSELF as I did for my wife! Every time I look at it now I marvel at what I did. A year ago that wouldn’t have been even a dream!
- I can work around the garden for an entire day now. GOOD JOB! PAT MYSELF ON THE BACK! A year ago… no way I could have done that! (Unfortunately, I’ve discovered the poison ivy in my garden. But, a year ago I didn’t know I had it! WOW!)
Come walk with us!
If you haven’t already heard, "Walk the Talk" is a support group and team that is open to any Clarian Bariatric patient, family member or visitor. We meet every Friday from 11:30 a.m. - 12:30 p.m. at the Clarian Bariatrics outpatient clinic. We walk the local trails for one mile (30 minutes) and then have lunch together while we chat, ask questions and discuss strategies and successes.
We are also a team that chooses to “Walk the Talk” around the community. We sign up for active charity events and join them as a team together. Feel free to join us at support group and the charity events anytime. You do not need to attend support groups to participate in the "Walk the Talk" charity events. You can find out about these events on our blog, in the Bari Bites Newsletter or by calling Erin Light at the Clarian Bariatrics at 317-275-7010.
Clarian Bariatrics in the news!
Check out this great profile of Carla Belle, one of our recent success stories. The Indianapolis Star will be tracking her progress and fitness routine with Erin Light.
Bypass surgery and work are getting her back in shape | IndyStar.com | The Indianapolis Star
Source: www.indystar.com
Click the link below to checkout the first exercise article, where Erin and Carla demonstrate some chair exercises that are great for all patients.
Superwoman | IndyStar.com | The Indianapolis Star
Source: www.indystar.com
Finally, Erin Light was recently interviewed by the Indianapolis Recorder about smart water choices. Check it out below!
The Indianapolis Recorder > Health > Tap or bottle it?
Source: www.indianapolisrecorder.com
Enjoying the State Fair Experience, and Still Eating Healthy, Part I
"I was fortunate enough to enjoy an entire day at the Indiana State Fair last Saturday, meeting my personal goal of seeing absolutely everything there was to see, visiting every corner of the fair, and doing it all in just one day.
I started out by joining the our First Lady, Cheri Daniels, Erin Light and the rest of our Clarian Bariatrics team in the two-mile Heartland for Health Walk. It was a very pleasant walk at that time of the morning and I talked to a lot of other folks who are interested in getting themselves fit. Thanks to Mrs. Daniels and Clarian Cardiovascular for sponsoring the walk, and to Erin and the rest of Clarian Bariatrics for organizing the team.
But, I thought I’d share some reviews of ways to enjoy the fair WITHOUT drowning yourself in fried foods and sugar. As you know, being a post-bariatric patient, I don’t think my body would enjoy that deep-fried Snickers bar too much anymore! In fact, you would be happy to know that just the smell of an elephant ear made me queasy! What a change from a year ago!
Of course, my recommendations here depend on where you are in your post-surgery journey, and what foods you can personally tolerate. Don’t take chances. Talk to one of the dieticians if you have questions. I am almost 18 months post-surgery so I’m in a pretty good place.
Veggies!
- I know we’re all supposed to be getting our protein. But, there are some pretty good veggies at the fair! Just WALK PAST that Deep Fried Veggie booth on the main street!
- Ya Ya’s Tomato Balls - They’ve gotten a lot of press this year. Sounded tasty to me, so I checked them out. Breaded and deep-fried! DEFINITELY A PASS!
- Just past the deep-fried veggie booth you’ll find a sign for “Tomato Bob’s”. They serve very crisp and tasty veggie kabobs. But, at $3 a pop, a little expensive.
- However, that same booth has real nice salads, too. Look into it. Low fat and sugar-free dressings available.
Staff qualifications when searching for a bariatric surgery clinic, Part II
What are the staff qualifications?
Because Clarian Bariatrics is a surgical weight loss program, this is not as big an issue as it would be in a weight loss clinic. You can be sure here that you are followed by qualified, board certified medical doctors and nurses who are well trained and have a great deal of experience in surgical weigh loss.
Who supervises the program?
Terri Hohlt, MSN, RN, is the Program Administrator. Terri has 30 years of nursing experience with Clarian Health. Her role is to keep an overview of the whole program. She hires the staff, keeps the program on budget, makes sure the physicians and staff have what they need provide top of the line care to our Indiana bariatric patients. Terri continually monitors all aspects of the program to assure we provide the quality care each person deserves.
The medical director of the program is Samer Mattar, MD, who is board certified surgeon. Dr. Mattar has received special training in advanced laparoscopy surgery at Emory University Hospital. He is also a member of the American College of Surgeons, the American Society of Bariatric Surgeons, and several other professional organizations. The medical director's role is to ensure that all patients receive the highest quality medical care available.
In addition to the above, the Clarian Bariatrics surgery program provides a “complete package” program with weight loss support provided by a full staff of highly trained, licensed, board certified Dietitians who specialize in weight loss and the health problems caused by obesity. We also have a Bariatrics Behavioral Medicine department headed up by Clinical Psychologist William Hilgendorf, PhD, HSPP. His staff helps to support your surgical weight loss effort with a variety of group sessions geared specifically to bariatric patients.
What type of weight-management training, experience, education, and certifications does the staff have?
You can see from the list above that this program is serious about providing you top of the line quality care. In addition to the above highly trained staff, other members of the team are patients of this bariatric surgery center with the deepest understanding of the program, and patients concerns, and struggles. They have insights that only someone who has been there can provide, that adds to their qualifications for the position they have at this Indianapolis Weight loss clinic.
Want to learn more? Then join us at a FREE informational seminar. Dates can be found by clicking on the image at the right of this post.
Hair Loss in the Bariatric Patient, Part II
- Hair loss continued more than one year after surgery
- Hair loss started more than six months after surgery
- Patient has had difficulty eating and/or has not complied with supplementation
- Patient has shown low values of ferritin, zinc or protein on lab results
- Patient has had more rapid then expected weight loss
Zinc: Zinc deficiency has been tied to hair loss in both animal studies and human cases. Based on studies done and their results, it can not be definitely said that zinc would prevent hair loss after weight loss surgery and further studies would be needed to make this connection. A note on zinc: The tolerable upper intake level for zinc is 40 mg in adults. These levels can cause gastrointestinal distress. Chronic toxicity can start at intakes of 60 mg/day. Some patients have heard on chat rooms and list serv forums that “high dose zinc will prevent hair loss after weight loss surgery.” Patients should be advised that high dose zinc therapy is unproven and should only be done under supervision due to the risks associated with toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this.
Protein: Low protein intake is associated with hair loss. Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk. Pancreatic enzymes that would help aid in protein digestion are redirected to a lower part of the small intestine. Based on this, it is likely that maldigestion, rather than malabsorption, is responsible for many hair loss cases.
Biotin: To date, there is no science that would support supplementing with, or topically applying biotin will prevent hair loss or improve hair regrowth. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.
Hair loss can be distressing to bariatric surgery patients and many will try to nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is most likely caused by surgery and rapid weight loss. However, later hair loss can be indicative of a nutritional problem.
Reference: Bariatric Times. “The Latest on Nutrition and Hair Loss in the Bariatric Patient” by Jacqueline Jacques, ND. 9/08
Hair Loss in the Bariatric Patient, Part I
Hair loss has many causes. The most common type of hair loss after weight loss surgery is a loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes.
For most of our life, we are always in the process of growing and losing hair. Human hair follicles have two states: a growth state and a dormant state. All hairs begin in the growth state and then shift to the dormant state, which lasts 100-120 days. After this many days, the hair will fall out. At any given time, about 90 percent of hairs are in growth state and 10 percent are in a dormant state.
Specific types of stress can result in a shift of a higher percentage to the dormant state. These stresses include: high fever, severe infection, major surgery, acute physical trauma, chronic debilitating illness (such as cancer or end stage liver disease), acute weight loss, crash dieting, hormonal disruption, anorexia, low protein intake, iron or zinc deficiency, heavy metal toxicity and some medications.
Bariatric surgery patients have two major risks for hair loss: major surgery and rapid weight loss. These two are likely to account for much of the hair loss after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that shifted into the dormant phase have fallen out. Hair loss will rarely last for more than 6 months in the absence of a dietary cause. Patients can be reassured that with time, patience and keeping up good nutritional intake, hair will grow back.
Total Body Fitness Class
All Clarian Bariatrics patients are welcome to join the class and attend support group afterwards. The classes will be education-based and will focus on teaching proper form. You will learn how the exercises we perform can play a role in your personal workout program, and you will leave with a new understanding about the exercises that are good for your body. All fitness levels and abilities are welcome too! If you have any questions, please contact me at elight@clariannorth.com. I hope to see you there!
Are you supported?
If you have surgery in a weight loss surgery center that does not have an adequate support system in place, and you do not have an abundance of supporting people around you, do not stop looking. The Indianapolis Clarian Bariatric Center is supportive on more than the level. The search for a proper fit is so important; do not settle for just any old place to change the rest of your life.
Yes, we stand behind our beliefs, we believe what we say and we walk what we talk. Those are very important items when considering weight loss surgery. No person can do this alone, the education aspect alone could be overpowering. Whether your support system is family, friends or loved ones we are always here to lend a hand, loan an ear or offer a word of encouragement.
The people who work at Clarian Bariatrics believe in our passion. We want all of you to succeed and the only way to do that is support! Support does not mean, contribute to lifestyles that will harm a Bariatric patient, and often it is given to our patients in an honest straight forward manner, but it is given in love. Support groups. walking groups, copings skills classes, cooking classes are all ways to build a stronger foundation for a successful outcome. Come and visit us at our education seminars (we have one this week) and take the steps to changing the rest of your life.
Step away from the cheeseburger!
STOP! Put that cheeseburger down and step away from the counter. I know there are healthier options at local fast food chains, but as a Indiana weight loss surgery patient I have paid the price for a trip to the Arches, a ride with the King or a swim with Long John. We need to stay away from those places. If you are tempted to try just one fry, who is to say you will not slip down that slope to a value meal (the fries are cheaper in that)?
If you must stop somewhere, go for a salad (no dressing), hold the cheese and croutons. Add lemon juice and salt and pepper and tons of veggies. The cheese is never 1% or 2% and you add tons of unnecessary calories to our day. I will run over to Subway and get a salad with grilled chicken and loads of veggies on these harried days. The kids love it and it is a better option than the burger joint.
Sometimes these places are a huge trigger for us and I admit I have tried. That doesn’t make me a failure. It does make me very cranky; the stomach cramps are not pleasant. Take it from one who has sailed with the arches, the king and Long John. Do not go there. Think ahead, keep your plans on a calendar so that you know the commitments for the day and can prepare ahead of time. Preparation is the key. If you have specific dietary questions feel free to call one of Clarian Bariatrics Registered Dieticians at 317-275-6067.
Considering Weight Loss Surgery? Read This First!
I will not discuss those in this blog, but I do want to talk about two things that should NOT be a factor in the consideration for bariatric surgery. From the July 2009, issue of Obesity Action Coalition:
Loose Skin: Loose skin is a reflection of significant weight loss and it does not seem to matter if the weight-loss is slow or fast. If a gastric band patient, a sleeve patient and a gastric bypass patient all lose 150 pounds, they will ALL have some degree of loose skin.
Cost: In most markets, gastric bypass and sleeve gastrectomy are more expensive than adjustable gastric banding. While this is not important if insurance is paying for your surgery, it is important to those that have to pay for their surgery themselves. “Cash pay”
Patients should choose their operation FIRST and THEN figure out how they are going to pay for it. The decision of which type of surgery to have needs to be discussed with your surgeon as the two of you should make that choice together.
Want to learn more about Indianapolis weight loss surgery? Then join us at a FREE informational seminar, where you can hear Indiana bariatric surgeons and staff discuss the many aspects of sustainable weight loss. Click the image of the right of this page to get started.
Need some extra support?
The group is for greater than one year post-op bariatric patients and it meets the second, third and fourth Tuesday's of the month from 6 p.m. - 7 p.m. at the Clarian Bariatrics. Remember: the first Tuesday of each month from 6 p.m. - 7 p.m. is always the large group support session.
See you then!
Cooking Class Recap and Recipes
During the next few weeks, I will be posting the recipes Anessa developed for the class, (they all tasted so good). Remember the recipes can be tweaked to your tastes, experiment and ejoy.
Caramel Drizzle Protein Shake
Most of us will use a protein supplement for the first year after weight loss surgery. Therefore, we better find food we like! After the first year, most bariatric patients can get the protein needed through food. However, if you need a shake...use it!
8 ounces skim milk or 1% soy milk
1 scoop vanilla protein powder
1 tablespoon toasted wheat germ
1 tablespoon sugar free instant pudding mix, butterscotch flavor
1 teaspoon sugar free caramel syrup (such as Starbucks sugar free caramel latte syrup)
A handful of ice
In a blender, combine all the ingredients, blending until smooth. Add more ice if desired.
Enjoy your cold and frothy shake!
When Life Happens
My initial thoughts are how do I numb this pain and make it disappear? Life happened and I have no desire to face it head on. I would simply prefer to dull the pain by indulging myself in a huge foot long chili cheese dog followed by a Reese’s peanut butter cup blizzard. Once I finished I would embrace the euphoric feeling of my sugar high laughing at the grim reaper screaming take that! Would I eventually crash from the euphoric feeling and be miserable? Yes… Would the pain still be there? Yes…
As a bariatric patient the above mentioned option would not be a wise choice for me. Life is going to happen and we need a backup plan. Personally, I know if I’m not careful emotional eating will undermine my weight loss surgery success. I’m taking this minute by minute, hour by hour and day by day. The day it happened I chose to take my son on a long bike ride, feel the sun on my face, the wind in my hair and take deep breaths. The following evening I chose to continually keep myself busy by re arranging my bedroom, hanging curtains, dusting and vacuuming. Whenever I slowed down I physically had to take a step back, let myself cry, take a few deep breaths and start another task. Today my choice is to blog about my personal struggles with you! Tomorrow is a new day and I again will have to make a choice!
Do you find yourself struggling with life situations and emotional eating? When was the last time you attended support group? Please visit our website for any upcoming support groups or feel free to contact me confidentially and directly at bariatric.clarian.org or 317-275-7010/877275-2555.
Comfort Food, Part II
Extremely! Did I make some poor choices these past few weeks? Yes! Did it make my pain disappear? No. Did I feel better? In that moment for a few minutes I told myself I felt better. 20 minutes later did I feel miserable? YES. If it wasn’t for my support system of family, friends, colleagues, dietitians and other bariatric patients I would not make it through times like these. LIFE IS HARD AND FOOD IS EASY. That is the honest truth. I live with a food addiction everyday and some days I have to tell myself to go minute by minute and hour by hour. When that day is over I have to remind myself how much I accomplished.
Life is full of stressors, emotions and celebrations. A typical day can be filled with the emotion of balancing work and home lives. Some of us are facing the anxiety of looking for a new job due to today’s economic times and layoffs. Each new day is a fresh start and full of opportunities and choices.
What will my choices be today? What will your choices be today?
Recipe: Lisa's Tomato Sauce
Pasta sauce is one of those, if you make it ahead and freeze, pulling it out and adding some protein just takes a second. Here is the pasta sauce I keep on hand and an exaple of one of our favorite “Friday” meals as we call them. This is one the kids are okay eating any day of the week. Add a salad of your favorite veggies with a new kick on dressing.
As a bariatric patient I chose to not eat dressings, but plain lettuce is not for me, so I take a quarter to a half of a lemon squeezing juice directly to the salad with salt and pepper and you have a very refreshing summer salad.
LISA’S TOMATOE SAUCE (Pasta or Pizza)
4 c tomato sauce ( you can use can if you do not have fresh)
2 cloves garlic
one can green chilis ( this gives it a little kick)
1 yellow pepper diced
1 orange pepper diced
1 red pepper diced
1 med Vidalia onion diced
oregano
basil (I use all of these to my taste, do not be afraid to try it)
salt and pepper
Add all to a soup pot or something you can cover let simmer until all veggies are soft.
You can puree the veggies if you do not like a chunky sauce ( I like it with some texture)
Cravings
A recent article in the Wall Street Journal stated, “Certain foods seem to fuel the appetite like pouring gasoline on a fire.” I like that quote. What the author of the Wall Street Journal article was talking about, after her review of recent research, was that foods high in unhealthy fat and high in refined carbohydrates sets up a kind of “fullness resistance.”
A dietician can explain why these foods tend to satisfy us for only a short time and promote further eating. A dietician can also recommend alternatives to these types of foods. Take a moment to list several ways you can fight your cravings. Each time you withstand a craving, the easier it will be for you to withstand the next craving.
Small WOW Moments
This past Sunday was one of those days when I realize how amazing it is to be a gastric
bypass patient. I started planting a flower bed last year and had decided this year I would like to add even more. My husband and I love the look and smell of fresh mulch around plants, flowers and trees. Sunday we purchased two yards of fresh mulch, which filled up the entire eight foot bed of our truck. In the past when any physical labor was required I would sit on the side lines feeling guilty as my husband worked for hours. This year when we arrived at home with our two yards of mulch he grabbed the shovel and wheel barrel while I grabbed the mulch fork and we went to town! I was right there with him unloading the mulch into the wheel barrel walking to our destination, with the wheel barrel in tow, then spreading the mulch throughout our flower beds.
My husband was so use to doing all the work I had to ask him several times to stop and let me take over. Not only were we both astounded by me saying “Hey let me do that” I think we were both in shock that I never once complained. There was no back ache, no huffing and puffing from shoveling and no stopping to sit because I felt like I was going to pass out from exhaustion. I just kept going back for more.
I did it! I accomplished something that two years ago I would have sat by and watched my husband do alone. I had this overwhelming since of excitement and freedom. I was no longer bound by the restrictions of the excess weight I use to carry. I was working in my yard and it felt GREAT. Having weight loss surgery was a very personal choice for me and this is one of those small WOW moments I will always cherish.
Cookbook Recommendations for Bariatric Patients
Earlier in the week I discussed the request from many patients for cookbooks that could be used by weight loss surgery patients. Even though there is not specific cookbook for bariatric surgery, these include some great recipes.
The Art of Simple Food: Notes, Lessons, and Recipes from a Delicious Revolution. (ISBN-10: 0307336794 ISBN-13: 978-0307336798)
The author, Alice Waters, is credited with the organic food movement. This doesn’t mean you have to use 100 percent organic foods but her description and simplistic approach to cooking is the best attribute of this cookbook.
Martha Stewart's Cooking School: Lessons and Recipes for the Home Cook (ISBN-10: 0307396444 ISBN-13: 978-0307396440)
We all know Martha Stewart. This cookbook is visually one of the best books I have seen. The use of photographs to demonstrate technique is fantastic. In addition her explanation of basic kitchen tools – pots, pans, spices, herbs, etc is for anyone with no or very little culinary knowledge.
I'm Just Here for the Food: Version 2.0
(ISBN-10: 158479559X, ISBN-13: 978-1584795599)
Alton Brown, host of “Good Eats” on the Food Network has put into writing his special brand in the explanation of basic cooking techniques.
Don't forget to check out the recipes on this blog either!