Sugar's revenge

I am feeling somewhat the worse for wear this evening/really early morning (swing shift and all). The temperatures were in the low 90s here today, and I'm not sure I believe in hell--but if there is one, I know why it's purported to be hot. High temperatures are nowhere near as miserable as they were 91-give-or-take pounds ago, but summer will never, ever be my favorite season. I'm as pale as it gets, generally light-sensitive, and far too much shaving of the body is required for everyday societal acceptance. A season where you can drink hot tea and put more clothes on, with overcast skies that never exacerbate a headache--that's a season I can get behind. But I digress.

As I've noted here before--somewhat ruefully--I have had much more adverse reactions to fried and fatty foods since surgery than I have to foods containing sugar, and the latter foods are much more my bugaboo. ("I can take or leave sweets," some people say. I don't envy many people, but I envy those people. A lot.)

I believe the culprit for tonight's stomachache was, ironically, sugarless gummy bears--I must have eaten too many of them. I believe they are sweetened with maltitol and most anyone who's ever eaten sugar free candy knows better than to overindulge, weight-loss surgery folks or otherwise, because the end result is unpleasant. (It could have also been the fact that there was some sugar in my Jamba Juice, some in my protein bar, some in my protein shake, and it all swirled together to become a miniature cyclone of gastrointestinal discomfort.)

As the kids say, I've been schooled.

In about a month, I will be a year out and I'm feeling somewhat discouraged. My weight has been in the 208-210 range lately and that number is going the wrong way. Clothes are still getting smaller, so maybe the weight is still being redistributed, but I've got to get out of this rut.

Deep cleansing breaths....

Ahhhhhhhhhhh. It's been an exhausting couple of weeks. I've worked every hour my employer would approve; I've also had a lot of other things to take care of outside of work. The nature of Mr. Salted's job is such that he is a missing person during the holidays, so I pick up the slack out of necessity. It's always a relief to have it just be over.

Food has been a challenge this last month or so, as one would expect. It is everywhere, in large quantities, and damn near impossible to avoid. At work, whatever chocolate-coated pile of toxicity is to be had resides right next to the fax machine, which I use frequently. I tried to stick to sugar-free things whenever possible, but I did have a cookie or piece of chocolate (or two) here and there. I definitely felt ooky once or twice, but I have still never had sugar cause full-blown dumping syndrome. This is both good and bad, as I now know my system will tolerate at least a small portion of foods that contain sugar. Feeling ooky and the looming possibility of dumping syndrome keeps me from truly bingeing on sugar. The maltitol and sorbitol in sugar-free sweets has actually caused more discomfort for me than sugar itself has (though I have to admit I eat a larger portion of the sugar-free stuff--whatever the package says a serving is).

I also seem to feel hungrier more often than I did initially--not just for sugar, but in general. Dry meat, bread and grease are my worst enemies, so I avoid them. I used to love almonds and cashews, but nuts have lost their luster. I'm still getting most of my protein from beans, peanut butter, or supplements. I have noticed an increased lactose intolerance when it comes to milk, though cheese, cottage cheese and sour cream have not been a problem. I have also been drinking diet soda--though not a great deal, and not every day. Lately I've been drinking several cups of hot tea with Stevia every day, which I enjoy and which makes me feel full. I used to hate hot tea, but I've found some really good flavors lately. I think my favorites are Celestial Seasonings Bengal Spice, and Gypsy Tea Gingerbread Chai.

I haven't gained any weight, but I am a little worried. It is coming off so slowly now, and I still haven't been cleared to work out yet. I feel a little panicky that I'm more hungry and that I know I can eat some sugar. I'm also a bit freaked out by the way my body is changing. Mr. Salted observed that I probably haven't been through anything remotely like this since puberty. He has a point--and no wonder I get neurotic, because my puberty was H-E-L-L. (Don't get me wrong--I don't think anyone's adolescence is any picnic--but I was one of those unfortunate little girls that was visibly developing in the second grade. It was extremely scary at the time, not just because I couldn't control what my body did, but because of the way the world seemed to react--what felt like the whole world seemed not only all too aware of what was happening, but just as uncomfortable with it as I was.)

As I type and articulate this, it begins to make total sense that my world feels full of triggers at the moment. Once again, I am in a transitional period where I can't control what my body does--it loses weight, but only from where it damn well wants to. I've lost 62 pounds, but I'm not proportionate. I can see the loose skin thing happening in the near future, as certain regions are feeling a bit deflated as of late.

There are also the things people say. "Even your head looks smaller," one friend told me. (???) People will say "hey, skinny," which, of course, was a taunt I heard many times growing up. I know the people I know now mean well, but it feels weird--not only am I far from skinny, but I seriously doubt that even my skeleton is skinny. "You're really a petite woman," I've heard more than once since surgery, or "I never knew how tiny you were." I saw some friends on Christmas Day that I hadn't seen since before I had surgery. "You look fantastic," one of them said. Later, when I was walking to the restroom, I heard him repeat to Mr. Salted, "she looks fantastic." Even when it is positive, it is still so, so hard for me to hear my looks being discussed like I can't hear what is being said. I have to remind myself constantly: I'm not thirteen years old, and it's not malicious. Being steeped in dissociation from my body since I can remember, I myself have also been heard to remark, "I don't know what is under there." (Read: I don't know what the body under the fat is like.)

And I don't.

Nutritionist appointment, 5 months in

This picture is from my girls' night out last weekend, not the nutritionist...these were Derby Punches, in honor of the Kentucky Derby--bourbon and lemonade from someone's grandma's recipe. The cool glasses had all the Derby stuff on them and you could buy them for a buck and keep 'em, so I bought mine. I have always wanted to go to the Kentucky Derby just so I could wear the big picture hat, but in reality, I think I just want the hat.

***

I saw my nutritionist Monday. She was very encouraging and told me what a great job I was doing, which felt really good...I just feel like I'm treading water so much of the time. I had lost a couple of pounds, which surprised me because I haven't been exercising (my ankle is still popping and sore--my regular doc is sending me a written referral to have it looked at; one of my tasks for today is to find an orthopedist my insurance covers and to make the appointment). I've stayed within five pounds of what I was when I first went in to see her, but I still weigh less than I did at the beginning.

She praised me for using my time well by joining this group and really trying to get to the bottom of everything within me so I can succeed in the long run, and also complimented me on my food journal--its detail and follow-through. All of this just felt really good; too often, I am caught up in feeling guilty for being unemployed/not productive enough, not to mention overwhelmed by all the emotional stuff I'm working through. She kept saying things like how I was "on it" and "ahead of the game". This was my five-month appointment with her, meaning the six-month one is next month (June 12!) and the pre-op stuff can really begin then, if not before. (Another task for today is to contact the surgical center and see if I need to anything to start the ball rolling, as I know there are some pre-op procedures that need to happen--an abdominal ultrasound, bloodwork, etc.)

We talked about what I would be eating as surgery gets closer. I do not have to do a liquid diet prior to surgery as I had previously thought, but I do have to go to a very low-carb diet two to three weeks prior in order to shrink the liver. Low-carb in this case means a total of 40 total grams of carbohydrates per day. Fiber content can be subtracted against the carbohydrate amount. She gave me a couple of sample menus. The daily fiber goal is 25g, and the daily protein goal is 50g prior to surgery, but 60-80g after.

Thirty days prior to surgery, I will need bloodwork done. I also need to make sure my medications can either be crushed or will be available in a liquid form, and that I have vitamin supplements on tap for after--she recommends Bariatric Advantage.

I thought about getting a book on making baby food for afterward, but she referred me to a pureed diet on the Web through University of Pittsburgh Medical Center under "info for patients". She also said netwellness.org was a good resource for pureed foods information, and lent me Susan Maria Leach's book, "Before and After: Living and Eating Well After Weight Loss Surgery". Apparently this book is like the Bible of weight loss surgery, and the author also has a very comprehensive-looking website--I believe it is bariatriceating.com.

We talked a bit about sugar. I have been fairly successful in giving it up and just using artificial sweeteners. While a lot of programs suggest giving those up as well, I don't think it's realistic for me for any number of reasons. My diet is restrictive enough (and going to be even more so)--I don't want to set myself up to fail. I am not keeping it in the house, which seems to be a key point. Times like this weekend, I am always aware that this could be my last piece of pie or my last whole martini, and I have been enjoying those things in moderation and feeling fairly serene about it.

(Apparently the magic amount of sugar that usually causes dumping syndrome is just over 5g, though she cautioned me that this is not an absolute--some people take one bite of cake and that's it.)

I am going to have to discover all the natural stores in the area, which is previously uncharted territory (except for Trader Joe's). I need to start stocking up on healthy protein drinks, for one. Muscle Milk is one she likes, and Pure Protein drinks is another.

I have been using nutritiondata.com for a lot of my nutritional information for the food journal, but my nutritionist also recommends calorieking.com.