I've Had a Relapse (Expletives Deleted)

Since my RNY gastric bypass surgery a little over three years ago, for the first time in my adult life, "dieting" has not been part of my life. Don't get me wrong, I eat very carefully. I've spent the last three years retraining my eating and exercise habits. But as far as old-fashioned dieting goes, I don't do it any more and I never intend to do it again.

One of the most important lessons I have learned is that I am not fat; I have a chronic disease called obesity. And make no mistake about it, obesity is a disease as much as diabetes, cancer or heart disease. I had surgery for my obesity just like my husband had surgery to repair a deformed heart valve. And just like he had to change his habits after surgery, so did I.

Dealing with the disease of obesity requires a radical lifestyle change. I have completely changed many of my habits from where and how I shop to when and what I eat. Meals and snacks have to be planned ahead of time. This requires sitting down once every two weeks, actually writing down a plan, and making a shopping list. When I'm fully compliant, I enter the plan into a program that analyzes the nutritional and caloric content of everything I eat. Eating according to a plan takes away the "grazing" aspect.

Even three years later, it's way too easy to eat mindlessly. In an effort to learn to control my mindless eating I have some hard and fast rules that work for me.

1. I don't eat out of bags or boxes. Food must measured out into a single serving portion and put in or on a dish before I eat it. I eat my meals from a salad plate and snacks go in a four ounce bowl. Putting food in a dish makes me aware of how much I'm eating and it makes me feel like I get to eat "the whole thing."
2. I don't eat in the car. For the last 30 years I always ate breakfast in the car on the way to work. That includes, but is not limited to, such healthy and nutritious breakfast foods as pop tarts, Krispy Kreme donuts, cinnamon rolls, kolaches, sausage biscuits, Egg McMuffins, and Breakfast on a Bun. I can't even imagine eating any of those things today. Although I do occasionally fantasize about Cinnabons. But I digress. My "behind the wheel" cuisine was not limited to breakfast either. I often ate sandwiches or burgers in the car as I ran errands at lunch and it was not unusual for me to take along a bag of chips or cookies as a snack.
3. I never fail to take my vitamins and supplements. I take them every single day exactly as instructed by my surgeon.
4. I drink 60-80 ounces of water every day. I never drink carbonated beverages or high-calorie drinks. I don't drink any liquid with my meals or for 30 minutes after a meal. That 30 minutes gives my food time to digest more slowly and gives my brain time to receive the message that I have eaten.
5. I eat lean protein first, then if I have room, I eat vegetables and carbohydrates. I only eat one serving of fruit a day. I limit my sweets to one serving of dark chocolate every evening.
   
6. I do some kind of exercise for thirty minutes at least three times a week. This doesn't have to be strenuous exercise, usually it's just walking or bicycling.
   

Okay, those are the rules that work for me. But, truth be told, lately I've been non-compliant with my own rules. Nothing big, just a couple of extra pieces of chocolate after dinner or bringing the whole package of graham crackers to the sofa instead of just a serving which is two graham crackers. And, it's been to cold to exercise outside and, honestly, I just haven't done any exercise since Christmas.

I'm not what's known in post-op circles as a "scale ho." I rarely step on the scales at home. I'm just not obsessed with what the number says. I know when I've put on a few pounds because my jeans get tight. Then I know it's time to tighten up on compliance with the rules and get those few pounds off. Sometime around Thanksgiving I realized that my favorite jeans were too tight to be comfortable. But, hey, it was the holidays, so I just wore a bigger pair and kept on going. Imagine my surprise when I visited my surgeon's office on Saturday for my three year follow up, I weighed in at 197, up 22 pounds from my post-operative low of 175.

Before-300 pounds & After-175 pounds

What the heck?! How did a couple of pounds turn into 22 pounds. (Expletives are deleted here.) Honestly, my doctor was great. No fussing, no complaints, only encouragement from Dr. Patel. The only dietary change he told me to make is to add a daily protein shake to my routine. That should help me feel more satisfied which will make me eat less. Hopefully when I visit him again in April, I'll be wearing my favorite jeans, which are a size 12.

What all this amounts to is that I've had a relapse, just like with any other disease. It's just a relapse of obesity. And just like many other diseases, there is no cure. This is a chronic condition, but it can be controlled. I know what I have to do, I know how to do it and I know I can do it. I have the tool, I have the training, and I have the will.But I'm not going on a diet. I'm just getting back to basics with my plan for dealing with obesity. Just wait and see ... in a few months I'll be able to say "Grams Made It" back into her size 12 jeans.

Big Granite Dome or Milestone?

About eighteen miles north of Fredericksburg, Texas on Ranch Road 965 an enormous pink granite dome rises out of the Texas Hill Country.

Enchanted Rock is the 500 feet high centerpiece of Enchanted Rock State Natural Area. And, it's impressive. You can see it from miles away. It is designated as a National Natural Landmark and is among the oldest exposed rock in North America. Enchanted Rock received it's name from reports of spirit lights and night time noises emanating from the giant rock. The Native Americans had great respect for the huge natural monument, and some would not set foot upon it. Others used it for ceremony or observation and possibly human sacrifice.

I first saw it about 6 years ago when Grandad and Grams were weekending at a Sunday House in Fredericksburg. We had heard our daughter, Katy, and our soon-to-be son-in-law, Travis, talk about hiking at Enchanted Rock so we decided to take a drive out and see it.

As you wind through the hills it suddenly appears in the distance. From the day I first saw it, I wanted to stand on the top. At that time, I weighed in at 300 pounds, making such a climb impossible, or at least highly unlikely. But it became a dream that I tucked away in the back of my mind and my heart.

Three years later, when I was in a San Antonio hospital bed recovering from gastric bypass surgery, I still thought of standing on top of Enchanted Rock. When Katy and Travis visited, I told them of my dream to stand on the summit of Enchanted Rock. They enthusiastically agreed to take me to hike it when I was in good enough shape to make the climb. Thus my dream became a goal.

In the ensuing three years, I have walked many miles in my neighborhood and at the nearby nature trail. I have worked hard to retrain my eating habits and learn to live a healthy lifestyle. On September 27, 2009, I celebrated the three year anniversary of my surgery and the loss of 125 pounds. I knew it was time to tackle my long tucked away dream. We chose a date and I began training in earnest to hike up Enchanted Rock. On Sunday, October 18, we made the drive from San Antonio to Enchanted Rock.

We hiked the Loop Trail to the far side of the Summit, past Moss Lake to Echo Canyon where we began our climb to the Summit up the West side of the dome. The hike around the Loop Trail was beautiful. We saw all kinds of cacti and, even this time of year, there were wildflowers. We took a short side trail to an overlook that gave us a beautiful view out to the West. When we got to Echo Canyon, the hike became challenging. The approach is littered with huge boulders and loose rocks. Traversing this terrain is tough for a novice hiker and climber.

After hiking a few yards into the boulder field where I actually had to begin climbing over boulders and stepping across gaps, I looked at Katy and Travis and asked them a one-word question, "Seriously?!" They both were extremely encouraging and reassuring; they told me I could do it. In fact, not only could I do it, but they were going to make sure I would do it.

As I scrambled, sometimes on hands and knees up and across the boulder field, a family of four came walking along and passed us. Yes, they were just walking briskly along with poles in both hands, upright the entire time, and passing us right up. It occurred to me that perhaps I should follow them; and I did for a short way. But they were headed a different direction, so we made a turn toward the summit.

We cleared the boulder field and began climbing the smoother granite face of the dome. It was steep and challenging. Katy encouraged me to climb at an angle and track back and forth across the hill. I had to stop every 50 yards or so and catch my breath. This was truly challenging. I might have even quit, except I knew that the only way down was up and over. We climbed and climbed. Every time I thought I could see the Summit it turned out to be a lower outcropping. It seemed to take forever. My legs felt like lead and at times I couldn't catch my breath. Travis and Minnie, their Jack Russell Terrier, led the way. Katy stayed right by my side every step of the way.

As we neared the Summit and I realized I was actually going to make it to the top, I was overcome with emotion. I began sobbing aloud and could not catch my breath. I had to sit down. Travis and Minnie climbed back down and joined Katy and me as we took a break. As we shared a Granola bar and an orange, we talked about how far I have come. Just a few years ago, I could not walk through an air conditioned mall without sitting down to catch my breath. Now I was climbing the face of a huge granite dome. After a little rest, we resumed our quest.

When we finally stood on the Summit of Enchanted Rock it felt amazing. The 360 degree view is awe inspiring. Small pools of water are accumulated in the natural indentations on top of the dome. A lone tree grows there. There were also lots of people at the top. We had taken the path less traveled. Most visitors go up the South face of the dome, a much easier climb. We descended that way and were passed up by many, many kids. Apparently this climb is a piece of cake for the kids. They were often running up and down, not even out of breath.

With the help and encouragement of my wonderful daughter and son-in-law, I had reached a major milestone. It was so much more than I expected. Not only did I feel a sense of accomplishment and follow-through, I felt an opening up of possibilities. Dreams can come true if you're willing to put in the work.

Was it worth it? Absolutely! Would I do it again? Positively! I don't have to sit and watch other people any more. I am no longer an observer; now I am an active participant in life. I don't just dream of doing things, I actually do them!

So next time you're driving through the Texas Hill Country and see Enchanted Rock in the distance, don't just think of it as an enormous granite dome ... think of it as a milestone. It was hard ... but Grams made it ... because I can do hard things!

A Choice for Life

September 27 is a fairly uneventful day in history. In 1540, Saint Ignatius Loyola founded the Jesuits; in 1903, the wreck of the Old 97 occurred; in 1938, the Ocean Liner Queen Elizabeth was launched; in 1954, The Tonight Show debuted; in 1964, the Warren Commission released it's report on the assassination of JFK; in 1997, communications were lost with the Mars Pathfinder.

Famous people who celebrate their birthday on September 27 include Avril Lavigne, Wilford Brimley, Gwyneth Paltrow, Shaun Cassidy and Meat Loaf.

Grams celebrates September 27 as her re-birthday, known in the weight loss surgery world as my "surgiversary." On September 27, 2006 I had RNY gastric bypass surgery by Dr. Nilesh Patel at Innova Hospital in San Antonio. I am 3 years post-op, 115 pounds lighter and immeasurably healthier.

There were a number of things that led me to the decision to re-route my guts as a way to lose weight. I had recently been diagnosed with Type 2 Diabetes. I had been taking medication to control my blood pressure for more than 15 years. I was faced with looking for a job at 52 years old and 300 pounds. But most of all I was tired of failing. I had tried every diet known to mankind. Just to name a few of them I had been on 1,000 calories a day, diet pills, Weight Watchers, Atkins, South Beach, Cabbage Soup, liquid protein, low carb, high fiber, and so on and so forth. Now it wasn't that these diets didn't work, because they did. I lost weight on every single one of them. But I could never keep it off for more than a few weeks. Mentally, I was a failure and I couldn't take it any more. I had completely given up dieting and was gaining weight at an alarming rate. I could not let myself fail again.

After my father-in-law's funeral, I had the opportunity to visit with a friend who had already had RNY Gastric Bypass surgery. He looked great and seemed healthy for the first time since I had known him. I owe T.J. a debt of gratitude because he opened up to me and answered all my questions. He helped me overcome my fear.

Contrary to what anyone may think, weight loss surgery is not the "easy way out." There's nothing easy about it. It's a difficult decision that forces dietary and lifestyle changes. While it does "re-plumb" your digestive system, it doesn't "re-wire" your brain. Just because you shouldn't eat large amounts of sugary and fatty food doesn't mean you don't want to. It just means that when you do it's going to make you sick. That's right, WLS patients who don't learn to eat right are in for a lifetime of "dumping syndrome" which includes such fun things as sweating, nausea, vomiting, diarrhea, abdominal pain, cramping, fatigue, weakness, dizziness, shakiness, fainting and heart palpitations. Does that sound easy to you?

And trust me, there is a definite learning curve. About 8 weeks after surgery, I ate a meat pizza dish, which is an Atkins Diet recipe, and proceeded to vomit uncontrollably. I vomited so hard that I ruptured blood vessels in my face and got two black eyes. And, once, I absentmindedly ate a big piece of homemade carrot cake with cream cheese frosting and spent the next 2 hours laying on my neighbor's couch when I should have been playing bunco. There have been other occasions where I don't even know what made me sick. Something that's good today, might make me sick tomorrow. You just have to learn to know the signals that your body gives off.

Today, I weigh 184 pounds. My post-op low weight was 175. I regained about 15 pounds, which is totally normal. I have now lost 6 of those pounds and hope to get down to 150 pounds. I have not had any diabetes medications since surgery. The dosage of my blood pressure medication has been cut in half. I can walk more than 2 miles without any problem.

The reason I have been successful at this new lifestyle is the support I have received. My family has been amazing in their support. My husband, daughter and son have supported me unconditionally. They've been there for me through thick and thin. Pardon the pun.

For about 18 months I attended a monthly support group offered by my surgeon's office. My friends have been encouraging and supportive as well. Not one person has been disparaging about my decision to make this change. Even extended family has encouraged and supported me.

Shortly after surgery, my surgeon told me about an online support group at ObesityHelp.com. These women (and a few men) have made a huge difference in my life. Most of them are also post-ops. We have answered each other's questions, commiserated with each other, shared our stories, told of our failures and celebrated our victories. I turned to them for support when my husband was sick and my mother was dying. They are a great group of people from all walks of life who all share one thing in common. We were all morbidly obese, had weight loss surgery and found a new life. This past weekend I had the opportunity to meet many of them in person for the first time at an Obesity Help conference in Dallas. It was an exciting, educational, fun and renewing experience. This photo shows just a few of the OH Group who were in Dallas this weekend.


This picture will give you some idea of what I looked like pre-op. This is Grams and Grandad at a party celebrating our son's graduation from Texas A & M University. I weighed approximately 300 pounds.


This is a photo of Grams with her surgery twin, Terry, celebrating 3 years of post-op life. We had surgery on the same day in 2006; Terry in Alabama and me in Texas. We found each other at ObesityHelp.com on the Texas Message Board shortly after that.


These are my roommates from the 2009 Dallas OH Conference. From left to right: Grams, Dee, Sarah and Melanie. All post ops ranging from 10 days to 3 years. Dee and Melanie have only had surgery within the last few week.


Weight loss surgery isn't for everyone. It's hard work and you can never change your mind about the lifestyle changes. When you choose it, it's a choice for life, in every sense of the phrase. I would do it again in a heartbeat. Grams made it ... to a healthier and happier life.