Weight Loss Surgery

ttf_BMadsen
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Weight Loss Surgery

Post by ttf_BMadsen »

Hey All,

So, in my years on the forum, I've seen the topic of weight loss discussed regularly, and I've also seen surgery mentioned a few times, but, as far as I can tell from searches, nobody here has had it. I thought I would share my experience, being I'm now approaching 2 weeks post-op, with it, my current thoughts, etc. I'm happy to answer questions (I don't get on here every day, but I will check this semi-regularly).

First, a little background about myself. I've been heavy since late elementary school. I finally got serious about losing weight in college, and lost 50+ lbs halfway through my 2nd year. I managed to keep that weight off through a 4 month cruise contract (not easy when you consider the food and binge drinking that happens, and being I was an irresponsible 20/21 year old - I turned 21 on the ship - quite impressive). That weight took about 6 - 7 years to come back. I then lost about 15 lbs of that regain, and then, because of multiple injuries, dieting issues, etc, I ended up at my peak in Dec of 2015. Luckily, I was healthy through all of it - no blood pressure issues, no cholesterol issues. My doctor said to me, if I was 100+ lbs lighter, she'd not even worry as everything is "pristine."

I've learned A LOT about weight loss over the years. It's not about "dieting," but lifestyle changes. And, every time I've seen a nutritionist, and bring a food diary (with pictures of what I ate, because if you are going to be honest, you want them to know what you are eating and if you are estimating portions correctly, and pictures go a long way when you don't have a scale to measure with you), they have made suggestions, but they are minor suggestions of changes to my diet - except that I eat too much. Too much meat, too many veggies, cut back on carbs a bit more than the rest, etc. I don't eat a ton of chips, sweets, etc. My drinking is less than one drink a day (and often one or so a week), etc. I generally eat well. Just too much. So, "dieting" for me means cutting calories.

My main issue with cutting calories started about 3 years ago. I've always suffered from migraines to a degree, but not often. As a side note, I'm going to put this out there now - if you've never experienced a migraine, it's not just a headache - mine would render me useless for anywhere from 4-72 hours. Luckily, if I got 4 a year, it was a bad year for migraines for me. Now, for those who don't know about migraines, they have triggers. Some people need one, some need two or more to set them off. I'm a two+ person. The more you suffer them, the easier it is to avoid triggers, and manage them. Since I rarely got them, and need a combination, it's very hard for me to figure mine out. I know high-stress times can feed into them. And, 3 years ago, I found hunger was another trigger. During a time I was cutting calories, I had 3 migraines in one week. Luckily, they were short (longest was 8 hours), so I was still able to work, but it's not a way to live. I also was able to connect it to hunger, rather than weight loss, because 2 years ago I was able to lose about 10 lbs in 3 months by working out a lot (1-2 hours a day for 5 days a week). I didn't eat any more than usual, but didn't experience hunger, and lost the weight. But, my schedule doesn't permit that kind of time normally, so I couldn't keep dropping that way (I did keep it off, however).

So, I was getting stuck. My diet was good, I was working out at least 3 times a week, and couldn't cut calories without significantly harming my quality of life and ability to work. So I made the decision to explore weight loss surgery.

Now, every insurance company is different, but most have some sort of basic requirements to pass before you qualify. Mine required that I went to a center with specific qualifications (only 2 near me), had 6 months of nutrition counseling, and a psychiatric evaluation. My surgeon also required a cardiologist, pulmonologist, and gastroenterologist to sign off on the surgery. So, when I started, I had to wait until September before I could have my surgery because of the requirements (I then chose late October because I'm not typically busy late-october and November, so I knew I wouldn't miss too many gigs if recovery took longer than expected).

I'm not going to go into details about all of those visits, except to say that there are things you expect to hear there (eat more veggies, avoid sugar, etc), that I was already doing, and surprising things because of the way your body works post-op (no carbonated beverages, no straws, because of the possibility of severe gas pain).

I started the pre-op diet October 12th. My surgeon required, based on your BMI, either a one or two week liver shrinking diet to make the surgery safer. I feel into the one week range, thank goodness. I lost a lot of weight then, but it's not a long-term diet solution - you aren't allowed any fat or carbs, which isn't healthy long-term. I didn't get any migraines, thankfully, but I wasn't terribly hungry on it until about 3 days pre-op, so it was manageable at that point.

There are 4 primary types of weight loss surgery. Gastric Band (aka LAP Band), sleeve gastrectomy, gastric bypass, and BPD/DS. Most people have Gastric band or sleeve gastrectomy. I had a sleeve gastrectomy. This entails permanently removing about 80% of your stomach, leaving you with a very small stomach. It stretches a bit after the surgery during recovery, but it will always be significantly smaller than if you didn't remove it. It also removes almost all of the part that produces the hunger hormone.

After surgery, you spend a couple days in the hospital, and start on a liquid diet the day after surgery. After about a week, I was cleared to start eating purees. The first week, I was unable to lift anything more than 5 lbs (I could, but had to avoid it) - I was also told not to play. I was cleared to start playing a week after surgery, and am cleared to lift 15-20 lbs now.

All in all, I'm very happy I did it. I'm down 30 lbs already, and expect to lose at least 60 more over the next year. I am already back on gigs, and only lost a week of income, actually (and only had students and three gigs that I missed, so not a huge amount compared to what it could have been). If you need it, and have been on the fence, I highly recommend it - it's a life changer!
ttf_BGuttman
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Weight Loss Surgery

Post by ttf_BGuttman »

Brad, are you required to eat 6 small meals a day?  Someone else I know had Lap Band and that's what they told her.

As a fat old geezer, my doctor was toying with the idea of surgery, but given my heart problems (coupled with diabetes) we aren't sure it's that good an idea at this point.
ttf_BMadsen
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Weight Loss Surgery

Post by ttf_BMadsen »

Nope. Now that I can eat purees, I have 3 small meals and 3 protein shakes. Eventually, I'll eat "normally" - 3 small meals (bigger than what I'm eating right now - I literally only eat about 4-6 tablespoons of food), maybe a couple of snacks. Protein shakes will probably be in my rep for life, as they want me to consume 80-100 grams of protein a day, which is hard with such a limited diet.

I can't speak to your heart issues, but they find that many people (I think it was something like 75%) who have this surgery actually see their diabetes improve or go completely into remission. It didn't apply to me, as I never suffered from it, but it's worth knowing.
ttf_harrison.t.reed
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Weight Loss Surgery

Post by ttf_harrison.t.reed »

I am no expert on weight loss or this surgery, but I am decently fit and have pretty low body fat. First off, kudos for sharing the story. That takes a lot of guts to get that surgery and try to improve your life.

My thoughts probably mean nothing, but to me the big issue with weight gain comes down to sugar, refined carbs and other processed foods, and fake sugar, plain and simple.

Drinking a lot of juice, soda, diet soda, and beer/alcohol all but guarantees that someone will get fat, and it seems like the surgery wouldn't prevent these poisons from being consumed. Eating ANYTHING out of the frozen prepared foods section of the grocery, and nearly anything out of the main isles of the grocery store will make you fat. Adding sugar to any sauce or recipe will make you fat. The calorie in/out methodology is flawed. 100 calories of soda will always be more than 100 calories of banana or steak, because of what it takes to access those calories. 100 calories of white bread will never equal 100 calories of whole grain sourdough. I totally believe that the many health problems we face today would all but disappear if the central isles of the grocery were closed off and people could only buy raw food from the produce, butcher, staples (bulk rice, bean, flour, oil, spices, etc), and dairy sections (select items only). You could basically eat anything you wanted but you would have to cook or bake it yourself.

Hopefully this surgery does give you many extra decades of life playing the trombone and all is well. I'm kind of curious what limitations it puts on what you can eat. Any complications?
ttf_Doug Elliott
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Post by ttf_Doug Elliott »

Maybe if grocery stores were built like IKEA stores you'd burn it all off by the time you reached the checkout.
ttf_BMadsen
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Post by ttf_BMadsen »

Quote from: harrison.t.reed on Oct 31, 2016, 11:40AMI am no expert on weight loss or this surgery, but I am decently fit and have pretty low body fat. First off, kudos for sharing the story. That takes a lot of guts to get that surgery and try to improve your life.

My thoughts probably mean nothing, but to me the big issue with weight gain comes down to sugar, refined carbs and other processed foods, and fake sugar, plain and simple.

Drinking a lot of juice, soda, diet soda, and beer/alcohol all but guarantees that someone will get fat, and it seems like the surgery wouldn't prevent these poisons from being consumed. Eating ANYTHING out of the frozen prepared foods section of the grocery, and nearly anything out of the main isles of the grocery store will make you fat. Adding sugar to any sauce or recipe will make you fat. The calorie in/out methodology is flawed. 100 calories of soda will always be more than 100 calories of banana or steak, because of what it takes to access those calories. 100 calories of white bread will never equal 100 calories of whole grain sourdough. I totally believe that the many health problems we face today would all but disappear if the central isles of the grocery were closed off and people could only buy raw food from the produce, butcher, staples (bulk rice, bean, flour, oil, spices, etc), and dairy sections (select items only). You could basically eat anything you wanted but you would have to cook or bake it yourself.

Hopefully this surgery does give you many extra decades of life playing the trombone and all is well. I'm kind of curious what limitations it puts on what you can eat. Any complications?

I'll admit to past sins of poor eating - especially in childhood through my teen years. As an adult, I eliminated regular soda from my diet about 15 years ago, and diet about 6 years ago. Before the surgery, I rarely ate white bread - always opting for whole grains. I make a lot of my own sauces with no sugar, cook fresh a lot (or from frozen veggies - which have nothing added to them). I started eating this well in college, when I became a vegetarian (except for drinking WAY too much), and got better and better as I got older. Even after reintroducing meat and fish, I still eat very well. As I stated in my first post, nutritionists had very little advice for me except calorie cutting and eating a few less carbs - not a ton less, however. About 20% less or so. And, by doing that, I lost about 1 lb.

I have to run out to teach, but at some point I will try to link to some of the more recent research on weight loss - you are right that it's more than just calories in and out, but it's so much more than that than you realize. Our biology makes it incredibly difficult to lose and MAINTAIN weight loss. It can be done, but, when I can get that done, you'll see that it takes a level of work that most everyone would feel is extraordinarily difficult for any working adult to do.
ttf_timothy42b
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Post by ttf_timothy42b »

Thanks for sharing.

I lost 22 pounds this past year and got down to my goal weight(I've since crept up a bit, but I'm still maintaining a healthy weight.  So far.)

I did it on a wellness program we have at work, where they measure body composition and metabolism and give specific guidance. 

And like you, migraines that I'd pretty much got past, down to maybe one a year, came roaring back, daily.  They were milder and shorter, but still no fun, plus I get the optical part where I can't see to read or drive. 

They didn't last.  They were daily for a bit, then weekly, then tapered off. 

I read up on them again and some of the thinking has changed.  They are no longer thought to be vascular, but neurological.  And some of the triggers are not triggers, but symptoms - like that Hershey bar didn't cause it, you were already into prodromal and that included a craving for a Hershey bar.  (that's an example, I pretty much have a craving for a Hershey bar 24/7.)  My occasional extreme irritability is part of the migraine I'm going to get tomorrow.

Well, I've drifted off topic.  Congratulations on a healthier you. 
ttf_TromboneMonkey
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Post by ttf_TromboneMonkey »

I've actually found (60 lbs. down, eight years after losing it), that my life is much EASIER now that I spend, cook and eat less-- not harder.  I focus on food and fitness more than the average person, to be sure, but insofar as I believe that there is nothing more important on which to focus than maintaining one's quantity and quality of life, I don't consider it a hardship at all.  Quite the opposite actually.  PM me if you want some suggestions or a full program.  I have a half-dozen or so trombonist clients who have seen similar results to mine. No extreme dieting required. 
ttf_BMadsen
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Post by ttf_BMadsen »

Quote from: timothy42b on Oct 31, 2016, 12:48PMThanks for sharing.

I lost 22 pounds this past year and got down to my goal weight(I've since crept up a bit, but I'm still maintaining a healthy weight.  So far.)

I did it on a wellness program we have at work, where they measure body composition and metabolism and give specific guidance. 

And like you, migraines that I'd pretty much got past, down to maybe one a year, came roaring back, daily.  They were milder and shorter, but still no fun, plus I get the optical part where I can't see to read or drive. 

They didn't last.  They were daily for a bit, then weekly, then tapered off. 

I read up on them again and some of the thinking has changed.  They are no longer thought to be vascular, but neurological.  And some of the triggers are not triggers, but symptoms - like that Hershey bar didn't cause it, you were already into prodromal and that included a craving for a Hershey bar.  (that's an example, I pretty much have a craving for a Hershey bar 24/7.)  My occasional extreme irritability is part of the migraine I'm going to get tomorrow.

Well, I've drifted off topic.  Congratulations on a healthier you. 

I wish that the migraines had decreased - the longer I went, the worse I got. Over 3 weeks of calorie cutting, I had 2 migraines the first two weeks, and 3 the 3rd week. I stopped after that because it was clear it was getting worse, because none of my other suspected triggers were present.

I didn't have cravings leading up to my migraines either - beyond desiring to eat more. But I would have been thrilled to have steamed chicken and vegetables at that point, and that desire existed all day at that point, rather than specifically before the migraine.

Quote from: TromboneMonkey on Oct 31, 2016, 03:47PMI've actually found (60 lbs. down, eight years after losing it), that my life is much EASIER now that I spend, cook and eat less-- not harder.  I focus on food and fitness more than the average person, to be sure, but insofar as I believe that there is nothing more important on which to focus than maintaining one's quantity and quality of life, I don't consider it a hardship at all.  Quite the opposite actually.  PM me if you want some suggestions or a full program.  I have a half-dozen or so trombonist clients who have seen similar results to mine. No extreme dieting required. 

I'm glad that your program is working for you. When I get the chance, I'll post the research I mentioned earlier. It's not that you CAN'T lose weight, but it requires a certain level of focus on this stuff that is rather difficult for most people to manage with work and family obligations. It sounds like you are able. I would probably be able to as well, if my migraines weren't such an issue.

As for a program, I'm personally set with a program - I have a pretty scripted diet with my recovery (it won't be until about 12/14 that I can eat anything with little risk), but even after, my nutritionist has already approved my previous diet, just in much smaller amounts (with a few modifications - for instance, I used to make this great black bean filling that I would have on a whole wheat tortilla, and instead I'll add chicken and cut the tortilla because the carbs in the black beans is more than enough to cover my carb needs). But, I'm sure anyone looking to lose weight would be interested, knowing you've lost so much and kept it off for 8 years.

ttf_TromboneMonkey
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Post by ttf_TromboneMonkey »

I'll be interested to see that research. It's hard for me to ponder the idea that doing less would require additional focus in the long run.
ttf_BMadsen
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Post by ttf_BMadsen »

Here's a starter: http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html

Almost all of the research I've seen since this article has basically deepened the basic ideas that this magazine article talks about. I'll continue pulling up more things I've read in coming days.
ttf_robcat2075
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Post by ttf_robcat2075 »

Interesting to read your story. The only other online personality that i've followed who has had weight loss surgery is TV writer Mark Evanier who occasionally writes about it.


Best wishes for your continued weight loss and improved health!




ttf_BMadsen
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Post by ttf_BMadsen »

Here's a new story I just read that's exploring the link between poor memory and weight gain:

http://www.bbc.com/future/story/20161031-why-obesity-damages-your-mind-as-well-as-your-body

Nothing conclusive, yet - it's new - but it does raise interesting ideas and questions. One nutritionist I saw about 5 years ago told me to completely focus on my meal when I was eating, and I did for 2 weeks. I know I ate less, and lost 2 pounds, without changing what I was eating, but my wife wasn't happy that I was ignoring her during meals. When I tried to balance the need to focus on eating and on her, the weight loss stopped - and when I started focusing a lot more on her, I put those 2 lbs back on. Again - the kind of thing that seems to help, but for me, was unrealistic (and I doubt that my experience is unique).
ttf_BMadsen
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Post by ttf_BMadsen »

More articles citing reliable research into losing weight:

http://www.cbc.ca/news/health/obesity-research-confirms-long-term-weight-loss-almost-impossible-1.2663585

http://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss-drugs/art-20044832?pg=2

https://www.hsph.harvard.edu/nutritionsource/best-diet-quality-counts/

http://ajcn.nutrition.org/content/82/1/222S.long

I post these not to discourage trying (some are rather negative on long-term success), but to educate. My feeling is, if you know what you are up against, you can set realistic expectations, and decide if more extreme interventions (such as my surgery) are necessary, based on your health and goals.

The Mayo Clinic's page about weight loss drugs is interesting because my doctor and I considered them, but her concern was long-term dependance on them to keep the weight off. I wanted to not be on medicines long-term if I could avoid it, especially if they could have serious side-effects (because the longer you use them, the better the chance you can develop them).
ttf_Geezerhorn
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Post by ttf_Geezerhorn »

The very best weight-loss diet I ever saw advocated eating anything and everything you like - just smaller amounts. That is a whole lot more sustainable than crazy schemes. If it took 20 years to put the weight on, don't expect it to come off in weeks or months. Think long-term.

...Geezer
ttf_TromboneMonkey
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Post by ttf_TromboneMonkey »

Quote from: Geezerhorn on Nov 03, 2016, 06:29AMThe very best weight-loss diet I ever saw advocated eating anything and everything you like - just smaller amounts. That is a whole lot more sustainable than crazy schemes. If it took 20 years to put the weight on, don't expect it to come off in weeks or months. Think long-term.

...Geezer

 Image

Sustainability is everything.  It's science!

https://www.sciencedaily.com/releases/2005/01/050111122137.htm
ttf_slideorama
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Post by ttf_slideorama »

Bradley, thanks for sharing your journey. No doubt it may help someone reading to make positive changes to their own life. You were right when you said lifestyle changes, and doing what works for you, within job and family obligations. Some people are truly lucky if their healthy lifestyle gives them ample time to invest in their wellness. The rest of us just have to make time, the best we can.

I would like to mention that for me, I always feel better when I exercise daily, and eat a good balance of fruit, vegetables, beans, and nuts and seeds. Plant-based meals are the simplest and work the best for me (and the world 🙂).

Best of all, the ability to continue making music is a gift that some with health problems don't get to continue.

ttf_BMadsen
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Post by ttf_BMadsen »

Quote from: Geezerhorn on Nov 03, 2016, 06:29AMThat is a whole lot more sustainable than crazy schemes. If it took 20 years to put the weight on, don't expect it to come off in weeks or months. Think long-term.

...Geezer

Geezer, I'm not sure how to take this statement. If I take it at face value, then I have to assume you've completely ignored everything I've written and posted here, and believe that this choice I've made in consultation with my doctor over the course of years is a "crazy scheme." (To add to the background, my doctor started suggesting it for me in 2013, but I really didn't come around to the idea until Dec of 2015, and then by the time I got enrolled in the program and started working through the requirements, had to wait until October for everything to line up).

If I take it as a comment on weight loss in general, then you are also ignoring the articles posted. Even the article posted by TromboneMonkey admits to only modest losses, and doesn't look at regain issues. For long-term improvement in health, it's commonly accepted that (if you are overweight or obese) you need to lose at least 10% of your starting body weight and keep it off. Those diets, in the time frame indicated, actually had very few successfully losing at least 10% of the body weight in a year. There is also this caveat mentioned:

"… we found that a variety of popular diets can reduce weight and several cardiac risk factors under realistic clinical conditions, but only for the minority of individuals who can sustain a high dietary adherence level. Despite a substantial percentage of participants who could sustain meaningful adherence levels, no single diet produced satisfactory adherence rates and the progressively decreasing mean adherence scores were practically identical among the 4 diets. The higher discontinuation rates for the Atkins and Ornish diet groups suggest many individuals found these diets to be too extreme. To optimally manage a national epidemic of excess body weight and associated cardiac risk factors, practical techniques to increase dietary adherence rates are urgently needed," the authors write."

While the study admits that there may have been better long-term adherence if the participants got to choose their own diet, society is clear proof that long-term adherence is not actually possible with these diets, because outside of the study, we can all choose our way to weight loss, theoretically.  And, the transition back to regular eating, if you read the NY Times article, is particularly a problem, because our brains trick us into eating more without realizing it, and our bodies actually need significantly less than we realize because of the fact that a large amount of weight has been lost.

If these are wrong, please clarify. If one of these are correct, please take the time to read everything before commenting, so you add something to the discussion, rather than sounding like you are attacking what's being discussed. I intended this discussion to be a positive one, and educate the community on how having this surgery, should you deem it necessary, doesn't end your ability to play (as I remember was mentioned at one point in another thread).
ttf_Geezerhorn
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Post by ttf_Geezerhorn »

It was just a general comment on dieting, etc.

...Geezer
ttf_timothy42b
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Post by ttf_timothy42b »

On long car trips sometimes my wife listens to the radio talk show, Delilah.

Yeah this is a circuitous route but I might be able to connect it up.

The conversation is pretty much the same on every single call:
Caller:  I can't seem to stop nagging my husband, even though I know how much it bothers him.  I've been trying for years and failing, and I'm at my wits end.  I think my marriage is going to fail.  What shall I do?  (nb:  specific example chosen at random from multiple similar scenarios) 

Delilah:  Stop nagging him.

Caller:  Oh, thank you, thank you, you've saved my marriage and my life.  I'll always be grateful, and tell all my friends about you. 

The point is that some things are easy to know how, but hard or impossible to do.  Losing weight is one, quitting smoking is another.  The better studies say only about 5% of people actually succeed in quitting smoking.   
ttf_BGuttman
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Post by ttf_BGuttman »

Geezer, there are some of us (and Brad is one) who seem to gain weight even eating moderate meals and doing reasonable exercise.  There has been some talk of a bacterium in our gut, or a gene, or who knows what.

I know of several people (including myself and my spouse) who have battled obesity for all our lives.  We can diet and lose weight, but as soon as we let up it comes right back.

I applaud Brad for doing what he did.  I hope it works out for him.
ttf_Geezerhorn
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Post by ttf_Geezerhorn »

Quote from: BGuttman on Nov 03, 2016, 03:38PMGeezer, there are some of us (and Brad is one) who seem to gain weight even eating moderate meals and doing reasonable exercise.  There has been some talk of a bacterium in our gut, or a gene, or who knows what.

I know of several people (including myself and my spouse) who have battled obesity for all our lives.  We can diet and lose weight, but as soon as we let up it comes right back.

I applaud Brad for doing what he did.  I hope it works out for him.

I do too! Don't take my general comments any other way.

Which actually supports my assertion that adherence to a proper diet should be a life-long endeavor. I don't have a "weight problem", but it has been a life-long practice for me to weigh myself every day at the same time and under the same conditions. If I gain a pound, I do whatever I need to do to lose that pound - that day - unless I specifically wish to gain some weight. I always felt that was down-to-earth and something I could live with all of my life, which I have. If someone can not adhere to that, they may be a candidate for a doctor's intervention.

OBTW Bruce: I hope you are fully recovered from your horrific automobile accident!

...Geezer
ttf_robcat2075
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Post by ttf_robcat2075 »

Quote from: BGuttman on Nov 03, 2016, 03:38PMGeezer, there are some of us (and Brad is one) who seem to gain weight even eating moderate meals and doing reasonable exercise.  There has been some talk of a bacterium in our gut, or a gene, or who knows what.

I know of several people (including myself and my spouse) who have battled obesity for all our lives.  We can diet and lose weight, but as soon as we let up it comes right back.


I attribute it to prosperity and the bad food habits that enables.

There's a site called shorpy.com devoted to old photos from 1850 to 1950.

It is exceedingly rare to see an overweight person among those pictures. Most people are rail thin and not just the poor people. 

What happened? It's not like we are a different species than 100 years ago.

Food got cheaper. It got easier. It got mass produced. It got sweeter. And I suppose we have more time to eat now also.


Image


ttf_TromboneMonkey
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Post by ttf_TromboneMonkey »

Robcat is right.  Genetics and biochemistry alone are not sufficient to explain the weight shift in our society.  Also, regardless of how much one eats, if one eats less, weight loss will ensue.  I eat well below average for a male of my size to maintain my weight.  I find that it has the added benefit of saving me money and time.  However, the average person is eating well above what they need, almost double in fact.

http://static4.businessinsider.com/image/5232240a69bedded5396670c-960/markets_cotd-new.png



Quote from: Geezerhorn on Nov 03, 2016, 03:55PM

I always felt that was down-to-earth and something I could live with all of my life, which I have. If someone can not adhere to that, they may be a candidate for a doctor's intervention.

 

Indeed.
ttf_Ellrod
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Post by ttf_Ellrod »

There's just so much food around. When in the history of our species has there been such abundance? And, over our evolution, gorging ourselves  when food was available because tomorrow it might not be was probably a good strategy. Pretty strong innate drives.
ttf_TromboneMonkey
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Post by ttf_TromboneMonkey »

Quote from: Ellrod on Nov 05, 2016, 08:47AMThere's just so much food around. When in the history of our species has there been such abundance? And, over our evolution, gorging ourselves  when food was available because tomorrow it might not be was probably a good strategy. Pretty strong innate drives.

Agreed.  I think the ultimate solutions to the trends we're seeing will involve a massive environmental adjustment.  Right now we have government subsidizing the very things killing us.  That needs to stop.  We also need to create a social environment that encourages sustainable healthful habits.
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Post by ttf_Ellrod »

But, at the end of the day, those innate drives will compel us (as individuals) to gorge ourselves on good-tasting food, even though on a nutritional level, the quantity and quality are killing us.
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Post by ttf_Geezerhorn »

We're probably off on a tangent and the Tangent Cops will descend. However, until they do, if everyone would follow a vegan diet 90% of the time - as wife and I do - there would be enough food to go around for everyone on the planet with far fewer environmental consequences. At present world population levels, some scientists state that it is sustainable. Kinda uncommon - not unheard of - but kinda uncommon to see an overweight vegan.

...Geezer
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Post by ttf_harrison.t.reed »

You can eat all the french fries, cake, burgers, candy, mozzarella sticks, pizza, and nachos as you want, so long as you cook it yourself from ingredients that only have one ingredient listed on the packaging. Guess how often you'll be breading mozzarella to stick in your deep fryer.

This is why people were skinny in those old timey photos.
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Post by ttf_TromboneMonkey »

Quote from: Ellrod on Nov 05, 2016, 09:41AMBut, at the end of the day, those innate drives will compel us (as individuals) to gorge ourselves on good-tasting food, even though on a nutritional level, the quantity and quality are killing us.

Not necessarily. Choice DOES factor. I haven't eaten fast food in over five years, nor will I ever again.
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Post by ttf_robcat2075 »

None-the-less, I do want to wish BMadsen success with this new treatment.

When all the other tactics have been tried and have not succeeded then it is time to try something else.

I hope he will check in occasionally to let us know of his progress.
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Post by ttf_BillO »

I Agree with Mr. Reed.  Buy your food from the fresh meat counter and the produce section.  IF it comes in a sealed package with a list of ingredients longer than 1, it's probably best to leave it in the store.

I reached a peak or 294 lbs. the beginning of this last May.  My doctor was worried about type II diabetes, and my cholesterol levels were getting in the 'orange' zone.  I did not want to resort to drugs for the diabetes and cholesterol control and really felt awful physically.  My doctor gave me some literature about averting type II diabetes and the net of what that said was what I said in my opening remarks.  The kicker is I knew all this before too, so I only have myself to blame for my weight issue.

Since then I prepare all our food from fresh ingredients.  I've personally cut out all starch and sugar sources and stick with fish, lean meats, eggs, vegetables that grow above ground (plus some onions and turnips) and fruit low in sugar (peppers, cucumbers, tomatoes, etc...).  Of course the beer is gone.  Image

It's made a huge difference.  Right away my blood sugar settled down, my cholesterol dropped, my frequent indigestion stopped, my energy level went up and I started to loose weight.  The weight loss has been slow, but very, very welcome.  I'm now down to under 265 and it's been falling at about a pound+ a week since the start.

It's not been a huge change for me to handle either.  The variety of food around here has not diminished, just changed, and I really like the benefits.  Oh, and our grocery spend is less too now. Image  I've not yet felt the desire to quit this and go back to the old ways.  I don't think of it as a diet that will end some time.  This is now how I live.

I applaud anyone that takes some action to improve their lives.

Bruce bought up a god point, and it may be affecting most of us.  That is the bacteria theory.  There is more and more research coming out on this.  The point in time where obesity rates begin to climb correlates with the point in time when antibiotics came into use.  The latest research is not saying antibiotics should be avoided altogether, but they should not be unnecessarily prescribed and when they are prescribed, they need to be followed with a suitable pro-biotic therapy.

As to alcohol and weight loss, while alcohol itself cannot be turned into fat, it is more readily used by the body for energy than are sugars, triglycerides and ketones.  The net net of this is, if you wish to have a drink, it is best you don't drink anything with sugar in it, or beer, and do not drink within a couple of hours of eating.  Yeah, I know, nearly impossible, but it's better than giving it up altogether (at least for me).  Even then, drinking will slow your weight loss, so be moderate.

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Post by ttf_TromboneMonkey »

Quote from: robcat2075 on Nov 05, 2016, 12:20PMNone-the-less, I do want to wish BMadsen success with this new treatment.

When all the other tactics have been tried and have not succeeded then it is time to try something else.

I hope he will check in occasionally to let us know of his progress.

Yes!
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Post by ttf_Paul Martin »

Quote from: harrison.t.reed on Nov 05, 2016, 10:22AMYou can eat all the french fries, cake, burgers, candy, mozzarella sticks, pizza, and nachos as you want, so long as you cook it yourself from ingredients that only have one ingredient listed on the packaging. Guess how often you'll be breading mozzarella to stick in your deep fryer.

This is why people were skinny in those old timey photos.

That's a big part of it:  Cook things from scratch, and you know exactly what you are eating.
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Post by ttf_BMadsen »

Thanks all for the support!

All in all, recovery is going great. I'm digging into practicing more again (was doing very light sessions to keep the chops up enough for the gigs I had, but now I know I'm good to really push myself), and am continuing to drop.

When it comes to food choices, it's definitely better to prep all your own food with fresh produce (or frozen, which can be healthier than fresh because it's frozen at it's peak which preserves the nutrients) and meat. And, I applaud anyone who has that kind of time. My wife and I don't - between her full-time job, my gigging, rehearsals, teaching, chart prep, booking gigs, running multiple groups, and our 2-year old daughter, it's a wonder we have time to cook (which I make a priority). That being said, I don't use foods that are heavily prepared. I use canned tomatoes as a short cut for sauces (basically just tomatoes in there), canned beans (low-sodium variety), etc. I avoid "boxed meals" like the Hamburger Helper and other stuff that line the shelves, we rarely eat pasta (if it was once a month it was a lot, and very little in a serving, and always whole wheat), only bought whole grain breads, etc.

We are all right in the sense that we are not a different species than a 100 years ago, but we are in a different environment. It's only been in the past 50-60 years that we've really seen the level of prosperity where we have abundance, all the time. We are programed to gain weight easily because of the feast and famine cycles we used to endure - now it's all feast. And, because of that, we are starting to see biological changes - the bacterium theory, the way our brains can be rewired (in an article I posted), etc. In addition, our lives have become busier, and it's harder to fit everything in, so more and more of us are turning to convenience foods and restaurants to eat, which is not necessarily a source of healthy food. Until our society values good health, we aren't going to see a lot of changes to support this.
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Post by ttf_TromboneMonkey »

Quote from: BMadsen on Nov 06, 2016, 07:06AMThanks all for the support!

All in all, recovery is going great. I'm digging into practicing more again (was doing very light sessions to keep the chops up enough for the gigs I had, but now I know I'm good to really push myself), and am continuing to drop.

When it comes to food choices, it's definitely better to prep all your own food with fresh produce (or frozen, which can be healthier than fresh because it's frozen at it's peak which preserves the nutrients) and meat. And, I applaud anyone who has that kind of time. My wife and I don't - between her full-time job, my gigging, rehearsals, teaching, chart prep, booking gigs, running multiple groups, and our 2-year old daughter, it's a wonder we have time to cook (which I make a priority). That being said, I don't use foods that are heavily prepared. I use canned tomatoes as a short cut for sauces (basically just tomatoes in there), canned beans (low-sodium variety), etc. I avoid "boxed meals" like the Hamburger Helper and other stuff that line the shelves, we rarely eat pasta (if it was once a month it was a lot, and very little in a serving, and always whole wheat), only bought whole grain breads, etc.

We are all right in the sense that we are not a different species than a 100 years ago, but we are in a different environment. It's only been in the past 50-60 years that we've really seen the level of prosperity where we have abundance, all the time. We are programed to gain weight easily because of the feast and famine cycles we used to endure - now it's all feast. And, because of that, we are starting to see biological changes - the bacterium theory, the way our brains can be rewired (in an article I posted), etc. In addition, our lives have become busier, and it's harder to fit everything in, so more and more of us are turning to convenience foods and restaurants to eat, which is not necessarily a source of healthy food. Until our society values good health, we aren't going to see a lot of changes to support this.

Advertising is also a significant problem.  One study showed that food adverts increased consumption in children by 45% (!).
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Post by ttf_BMadsen »

Just an update. I'm now down 40 lbs ( Image ).

I can now eat a limited solid diet (no more purees, yea!!!!) Whole wheat crackers, veggies, and protein - protein is the primary focus, according to my nutritionist, with veggies and crackers being additional.

Feeling absolutely stellar - playing has been fine, can't wait to be able to play my tuba as well (I have a Wessex mini tuba in C that is under the weight limit, so that suffices, but I love playing my Sousa and my big tuba).

Still no real complications, other than needing to switch my multivitamin because it was making me ill. Very minor issue, new ones are great.
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Post by ttf_BGuttman »

Wow, Brad.  Good going.  Image  Keep us updated as major changes occur.
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Post by ttf_Geezerhorn »

I have to wonder if you will experience any loss of high range. I did after a hospital stay with significant weight loss (for my frame). It came back as I gained my body weight and strength back.

...Geezer.
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Post by ttf_BMadsen »

Haven't lost any high range yet.

Lost some endurance, but I didn't play much for over 2 weeks (started playing light, easy gigs after a week and a half, but waited until I started practicing with more intense sessions to determine how much I could push myself). It's coming back as I keep practicing and gigging.


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Post by ttf_Geezerhorn »

Quote from: BMadsen on Nov 17, 2016, 11:11AMHaven't lost any high range yet.

Lost some endurance, but I didn't play much for over 2 weeks (started playing light, easy gigs after a week and a half, but waited until I started practicing with more intense sessions to determine how much I could push myself). It's coming back as I keep practicing and gigging.


 Image  I believe that speaks well for your technique. It takes strength to hit higher notes, but some have the advantage of better technique that seems to require less strength than others who might have to belt it out with brute strength.

I believe if you continue to keep your protein, vitamin and mineral intake up - as well as a modest amount of carbs from complex sources - you will not experience loss of strength to any great degree. I think hydration is important as well.

Take care...

...Geezer
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Post by ttf_BMadsen »

Quote from: Geezerhorn on Nov 17, 2016, 11:31AM Image  I believe that speaks well for your technique. It takes strength to hit higher notes, but some have the advantage of better technique that seems to require less strength than others who might have to belt it out with brute strength.

I believe if you continue to keep your protein, vitamin and mineral intake up - as well as a modest amount of carbs from complex sources - you will not experience loss of strength to any great degree. I think hydration is important as well.

Take care...

...Geezer

This is certainly true - I'm taking in a MINIMUM of 60 grams of protein a day - most days 80+ - by order of the doctor. I also take a daily multivitamin, 2 doses of Calcium + Vit D (our bodies can't take in the amount I need daily in one does), and an iron+vitamin C supplement, all by order of the doctor.

I used to have bad technique - even after graduating from the New School. I chalk it up to being young and thick-headed - my teachers tried to set me on the right path, but I was hitting what I wanted to hit with enough consistency to be happy, so I didn't fix it. When I did some masters work and studied with Bruce Bonvissuto, that was the first thing he had me fix, and I was much more mature and open to doing the work. It's now something I pay careful attention to, because when my technique starts to falter, I IMMEDIATELY notice a problem.
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Post by ttf_Geezerhorn »

The following is my opinion. I'm not certified (though some may say I'm certifiable) and it's been a while since I studied this personally, so I may be off the mark.

I'm glad you are doing this per a doctor's instructions. I think it could otherwise be dangerous. When someone over-enthusiastically follows a diet to the point where it becomes a crash diet and the dieter reduces carbs down to below a minimal amount they truly need in a day - it can throw the body into ketosis or even acidosis; due to fat metabolism, if I remember my nutrition courses correctly. I'm not stating that is what I think you are doing; I'm stating that it is something to guard against.

I have heard of dieters reducing carbs down to below 35 grams a day. They can maybe get away with it for a day or two before trouble sets in. I would hope your Doc has counselled you to keep a little supply of crackers or a small piece of fresh fruit or maybe even hard candy (not sure about that) with you and if you feel any slight bit of dizziness or light-headedness, to ingest some. And since you are metabolizing fat from the body, I think hydration is necessary to flush everything out. Some dieters get extreme to the point where they do not want to even drink water, because it can temporarily fill the stomach up and make them feel "fat".

I would avoid all carbonated beverages - even diet ones. I find that when I consume them, my stomach gets a little distended from the CO2 released and when the gas gets burped out, I feel hungry from an enlarged and empty stomach. If I'm trying to lose weight, the last thing I want is to feel hungry.

But don't take my word on anything above. Continue to follow your Doc's advice, or if I've raised some points - seek their counsel.

Best of luck and keep us informed!

...Geezer
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Post by ttf_BMadsen »

Quote from: Geezerhorn on Nov 18, 2016, 01:20PMThe following is my opinion. I'm not certified (though some may say I'm certifiable) and it's been a while since I studied this personally, so I may be off the mark.

I'm glad you are doing this per a doctor's instructions. I think it could otherwise be dangerous. When someone over-enthusiastically follows a diet to the point where it becomes a crash diet and the dieter reduces carbs down to below a minimal amount they truly need in a day - it can throw the body into ketosis or even acidosis; due to fat metabolism, if I remember my nutrition courses correctly. I'm not stating that is what I think you are doing; I'm stating that it is something to guard against.

I have heard of dieters reducing carbs down to below 35 grams a day. They can maybe get away with it for a day or two before trouble sets in. I would hope your Doc has counselled you to keep a little supply of crackers or a small piece of fresh fruit or maybe even hard candy (not sure about that) with you and if you feel any slight bit of dizziness or light-headedness, to ingest some. And since you are metabolizing fat from the body, I think hydration is necessary to flush everything out. Some dieters get extreme to the point where they do not want to even drink water, because it can temporarily fill the stomach up and make them feel "fat".

I would avoid all carbonated beverages - even diet ones. I find that when I consume them, my stomach gets a little distended from the CO2 released and when the gas gets burped out, I feel hungry from an enlarged and empty stomach. If I'm trying to lose weight, the last thing I want is to feel hungry.

But don't take my word on anything above. Continue to follow your Doc's advice, or if I've raised some points - seek their counsel.

Best of luck and keep us informed!

...Geezer

Well, if someone wants to lose fat, some level of Ketosis is required - ketosis is how our bodies burn fat. But it needs to be controlled.

That being said, losing weight with surgery has very specific, unique circumstances that aren't true when you just diet and excercise.

For example, I have to be careful when I eat vs when I drink, otherwise the combination of liquids and solids in my stomach can cause issues. So, I stop drinking fluids 15 min before I eat, and start drinking again 30 minutes after I finish eating. No fluids during the meal, and I take 20 - 40 minutes to eat a meal. Stopping too often to eat would mean I risk dehydration, so I only eat 3 times a day.

I drink a minimum of 50 ounces of caffeine-free beverages a day. I can't drink anything carbonated anymore - the carbonation can stretch my stomach, and even if it doesn't do that, for the vast majority of people with this surgery, they find it gives them very, very severe gas pain.

There is a very specific diet you follow in recovery. Almost no raw fruit (skins and crunch are a problem, so ripe bananas are ok, for example), no candy, etc. Very, very low carbs (none at all for the first month beyond whatever is in your protein shakes and pureed veggies), mostly protein (to avoid muscle loss), etc. This has all been designed by nutritionists along with doctors, and perfected over a more than 10 years (I think more than 40, actually, since this is basically a modified gastric bypass without the bypass - so it almost eliminates the risk of nutritional deficiencies that can arise even when following doctors orders), so anyone doing this should follow their doctors advice, not anything anyone has posted here, including myself. Every doctor has adapted things for their patients so they know they work.

And, anyone doing this is going to eat very differently than what anyone else would expect, so it's even more important that you IGNORE the advice of anyone not tied directly to your healthcare team, especially those working with your surgeon, as not following the directions can last you in the hospital. I've already had a few people ask why I couldn't eat/drink something with them, and they tried to argue it would be fine, because it was "healthy" food (and, it was - bites of broccoli, a low-cal fruit smoothie, etc) - but, I know that what was in those foods would be problematic FOR ME because of the surgery, and had to be avoided, because of my situation.

The only people who tell me what I can and can't eat? My surgeon and the nutritionist working with them. They are the only people in the world who I trust to know what is going on with my body and offer advice. And, so far, they are right - I'm down 48 lbs now, with no issues beyond the multi-vitamin issue.
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Post by ttf_Geezerhorn »

Quote from: BMadsen on Nov 23, 2016, 07:10AMWell, if someone wants to lose fat, some level of Ketosis is required - ketosis is how our bodies burn fat. But it needs to be controlled.

That being said, losing weight with surgery has very specific, unique circumstances that aren't true when you just diet and excercise.

For example, I have to be careful when I eat vs when I drink, otherwise the combination of liquids and solids in my stomach can cause issues. So, I stop drinking fluids 15 min before I eat, and start drinking again 30 minutes after I finish eating. No fluids during the meal, and I take 20 - 40 minutes to eat a meal. Stopping too often to eat would mean I risk dehydration, so I only eat 3 times a day.

I drink a minimum of 50 ounces of caffeine-free beverages a day. I can't drink anything carbonated anymore - the carbonation can stretch my stomach, and even if it doesn't do that, for the vast majority of people with this surgery, they find it gives them very, very severe gas pain.

There is a very specific diet you follow in recovery. Almost no raw fruit (skins and crunch are a problem, so ripe bananas are ok, for example), no candy, etc. Very, very low carbs (none at all for the first month beyond whatever is in your protein shakes and pureed veggies), mostly protein (to avoid muscle loss), etc. This has all been designed by nutritionists along with doctors, and perfected over a more than 10 years (I think more than 40, actually, since this is basically a modified gastric bypass without the bypass - so it almost eliminates the risk of nutritional deficiencies that can arise even when following doctors orders), so anyone doing this should follow their doctors advice, not anything anyone has posted here, including myself. Every doctor has adapted things for their patients so they know they work.

And, anyone doing this is going to eat very differently than what anyone else would expect, so it's even more important that you IGNORE the advice of anyone not tied directly to your healthcare team, especially those working with your surgeon, as not following the directions can last you in the hospital. I've already had a few people ask why I couldn't eat/drink something with them, and they tried to argue it would be fine, because it was "healthy" food (and, it was - bites of broccoli, a low-cal fruit smoothie, etc) - but, I know that what was in those foods would be problematic FOR ME because of the surgery, and had to be avoided, because of my situation.

The only people who tell me what I can and can't eat? My surgeon and the nutritionist working with them. They are the only people in the world who I trust to know what is going on with my body and offer advice. And, so far, they are right - I'm down 48 lbs now, with no issues beyond the multi-vitamin issue.

You have gotten expert counsel and that's the way it should be. I imagine the toughest part of this past holiday week-end was saying "no" to all of the well-intentioned force-feeders you came in contact with. Everyone is a chef and a nutritionist.

But if you survived this past week-end, it's because of your determination!

One holiday down; one to go. You can do it!

...Geezer
ttf_BMadsen
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Post by ttf_BMadsen »

Holidays are a little easier than you'd think for me - we don't have family nearby, so this year it was just my wife, daughter and myself. But, even if we did have family over (or go to see family), everyone knows about this and has been extremely supportive, so I'm not terribly worried.

And, trust me - I already had problems with eating a little too much once (my doctor was surprised it was only once - apparently multiple instances is so common they expect it as part of the relearning how much you can eat process) - it's not an experience I want to repeat, so it becomes really easy to say "no" to the large amounts of food! Even last nights gig, with copious amounts of delicious hors d'oeuvres floating around, was easy to turn down more than 3 items, which was about all I could handle.

Thanks! I will continue to keep everyone updated with my progress!
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Post by ttf_BMadsen »

Another update.

Just got home from seeing my surgeon for a follow up.

I'm fully cleared to lift again - no weight restrictions, and can start going to the gym again.

I am also cleared to (slowly) introduce a more regular diet. Obviously, I still need to focus on protein, but at this point there are no restrictions on what I can eat. They recommend having one new food a day, to see how I tolerate it, and to avoid bread and rice for now because they can expand and fill the stomach very quickly, but I've been healing great.

On the healthfulness of my rapid loss, they say I'm doing fantastic. They project, for most patients, 10-12 lbs a month. I've lost 48 lbs in 7 weeks, if you include the pre-surgical period (38 lbs post-surgery, which is a 6 week period). They say as long as I'm feeling well (good energy levels, keeping food down, etc), the rapid loss is fine, and bodes well for long-term success at keeping it off, since it shows I'm willing to eat well long-term (which I already knew I was because I already had been).

Very happy I made this decision - the nutritionist expects I'll eventually make it down to 180-210 (hard to know exactly where in there I'll fall). I haven't been that weight since I was in middle school or early high school!
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Post by ttf_Geezerhorn »

Quote from: BMadsen on Dec 01, 2016, 09:02AMAnother update.

Just got home from seeing my surgeon for a follow up.

I'm fully cleared to lift again - no weight restrictions, and can start going to the gym again.

I am also cleared to (slowly) introduce a more regular diet. Obviously, I still need to focus on protein, but at this point there are no restrictions on what I can eat. They recommend having one new food a day, to see how I tolerate it, and to avoid bread and rice for now because they can expand and fill the stomach very quickly, but I've been healing great.

On the healthfulness of my rapid loss, they say I'm doing fantastic. They project, for most patients, 10-12 lbs a month. I've lost 48 lbs in 7 weeks, if you include the pre-surgical period (38 lbs post-surgery, which is a 6 week period). They say as long as I'm feeling well (good energy levels, keeping food down, etc), the rapid loss is fine, and bodes well for long-term success at keeping it off, since it shows I'm willing to eat well long-term (which I already knew I was because I already had been).

Very happy I made this decision - the nutritionist expects I'll eventually make it down to 180-210 (hard to know exactly where in there I'll fall). I haven't been that weight since I was in middle school or early high school!

That's excellent news!

I wouldn't be surprised if your team decided to take your weight down a little further than your target goal, to give you some bounce-back cushion room.

 Image

...Geezer
ttf_BMadsen
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Post by ttf_BMadsen »

An update...

I'm now down 69 pounds since 10/12. That's an average of 27.6 pounds a month.

My weight loss is slowing, but is still continuing. This is expected, but, after seeing the weight just drop, a little disappointing (I know it will continue, but there is something about seeing that scale move that quickly that is very motivating).

I tolerate most foods well. Bread and pasta are a big problem for me, but crackers are fine. I have lots of protein, and then veggies - carbs are not as important to me.

My tastes haven't changed a lot, but considering that I craved veggies and salads before the surgery, it's no surprise.

Haven't been able to start working out again - I've been way too busy gigging. And, most of those gigs involve playing my mini tuba (wessex mighty gnome) for 4+ hours a night walking around on my feet, so, that counts as a workout, right?

Interestingly, the NY Times just put out an article about Gastric Bypass. For those of you following this thread and interested, I found it very good.

http://www.nytimes.com/2016/12/27/health/bariatric-surgery.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region&region=top-news&WT.nav=top-news
ttf_Doug Elliott
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Post by ttf_Doug Elliott »

Wow, that is amazing progress!
I wonder how you can lose it that fast and still have stamina and chops to play lots of gigs.  I guess the simple fact that you're hauling less around gives you more energy.
Congratulations, it sounds like you're doing really well.
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