Thursday, August 30, 2007

Interesting Finds on the Web

Here are some more interesting articles and blog posts from the far reaches of cyberspace.

The Psychology of Real Happiness
More Fun With Brain Chemistry
ZIP Codes And Property Values Predict Obesity Rates
Thermography Detects Breast Cancer "Too Early"
Diet Foods Make You Fat
You're Likely To Order More Calories At A 'Healthy' Restaurant
Household Mold Linked To Depression
Wanna Cut Plaque In Your Arteries? Slash Your Carbohydrates!
Why do people get fatter by not eating much rather than by eating more?
For those of us who are on unhealthily low-calorie diets...

Monday, August 27, 2007

The Protein Dilemma

As any WLSer knows you have to get in your protein. Each bariatric center has a different requirement. It usually ranges somewhere around 60-70 gms per day. When you are in the fast weight loss phase the protein intake is crucial. You want to be losing the fat not your muscles.

In looking for some good protein shake recipes, I stumbled upon this fascinating tool from Unjury. It is a protein calculator. It is simple to use. It will also calculate some basic protein foods for you. The only problem I found with it was the exclusion of higher fat foods, like full fat milk and cottage cheese for example.

In playing around with it I found that when I first had my surgery I should have been getting in 90gms+/day of protein---my forced 60-70 was well below what my body needed. Now I should only be getting in 50gms---I'm quite sure I get in way more than that now.

Here's another way to calculate your protein needs: How to Calculate How Much Protein You Need for Optimum Weight Loss on a Low Carb Diet. It is a time consuming effort but is more scientific than the previous way. It also takes into account the amount of protein you need for the brain.

Getting back to the "newbies"---new post-WLSers. Getting in your protein is very difficult when your pouch wants to revolt on you every time you turn around. Most rely on protein shakes in the beginning. Some even use them long term, although it is not necessary. As your weight drops so does your protein requirement.

I received an email recently from someone wanting some recipes for protein shakes. I'm going to post some of my favorite ones. Let me add this bit of info too. The best protein powder you can ever invest in is Unjury UNFLAVORED. Being unflavored you can add it to anything. As a newbie myself, I added it to creamed soups, SF jell-o, refried beans, my morning coffee, just about everything. Unjuy's website even has some good recipes. Even recommending to add it to Crystal Light. I never did that, but it sounds good to me.

Here are some good shake recipes I found online. These are the one's I have used myself. You will find most are low carb---which means they will be higher fat---which is a good thing. Some of these recipes call for soy protein powder---NEVER use the soy---always go for the whey protein powder. Soy is not a good thing for anyone. Here again Unjury is my favorite brand of protein powder. It is smoother in texture and no aftertaste. Which was a good thing for me as a newbie---too many things just made me gag.

DI'S BASIC SHAKE AND VARIATIONS you'll love the many variations for this one

I hope you all do well with your protein needs. It is vital you get in all your nutrients. Protein, vitamins, water, and don't ever forget your fat intake too. You have had a major surgery to make your life healthier, do not let yourself get too comfortable in your eating where you actually suffer from undernourishment, and you gain weight to boot.

Sunday, August 26, 2007

WLS--the whole truth....

If you mention the words gastric bypass surgery in passing to anyone---you get opinions from across the board. Some tell of horror stories surrounding the surgery. Others say the surgery saved their life. Still others tell you anyone having it are just a bunch of lazy slobs. Then there is the old taking the easy way out argument.

Let's settle this once and for all. WLS IS NOT EASY!!!

It has to be the hardest thing I've ever had to do in my life. Remembering to take a truckload of pills 6 times a day, monitoring every morsel I put into my mouth for possible hidden sugars, making myself get to the doc for follow-ups routinely, planning ahead every day to make sure I have food, vitamins, etc with me "just in case". Keeping up with the research coming out for the long term effects. As well as a whole bunch of other day to day crap.

You can talk with anyone and they know someone or know some who knows someone who regained their weight after having the surgery. Yeah it happens. Too many people want to return to what they deem is "normal" eating again. Hello--you have been "gut whacked" you will never, ever be normal again. PERIOD. Get used to it. I know that may sound kinda harsh. But hello reality check here folks---undergoing major surgery is nothing to be taken lightly.

There has been news this week of the study done that is suppose to sing the praises of how good WLS can be. You can read it here: Weight Loss Surgery Extends Lifespan.

I feel the only way to be able to make this major of a decision about your health. You have to have all sides of the story. Which is what I attempt to do with my blog. I believe in making an INFORMED decision, before you ever contemplate WLS. When they wheel you in that operating room, you have signed a paper stating that you have given them INFORMED consent. Well, how the hell can it be informed, if you don't know all the facts.

In the interest of giving you another view of this study, read this blog post: Junkfood Science: Was this really proof that bariatric surgeries save lives? I believe you may be in for a surprise. I certainly was after reading it.

When I talk with my fellow WLSers, everyone usually tells you they had the surgery for health reasons. I'll be perfectly honest with you. My health was bad when I started researching the surgery. That's not why I chose to have it. I wanted to be thin, bottom line. I thought being thin and svelte would be the answer to all life's problems. Did I have on rose colored glasses or what.

So before you leap on the WLS bandwagon. Do your research. Know what changes you MUST make to be successful. Understand the risks over the long haul. Last but not least, surgery is a last, final option. After trying everything else---my suggestion is give a high fat carb restricted diet a chance---then check into having the surgery. You have to be willing to NEVER EVER be "normal" again.

If you can't give up your carbs, diet sodas, take your vitamins, exercise daily,.....yada yada, yada.....If you still want to be able to scarf down a piece of chocolate cake, bag of chips, french fries, and sit around on you duff all the time and still drop monds of weight---hoping to keep it off---which you won't mind you.....Then by all means---DO NOT HAVE WLS. This surgery is just a tool. You have to do the work. It is not a magic cure all. Contrary to some people's views the surgery can not fail---short of certain complications. YOU are the thing that has failed in the equation.

Ok rant is over now.....

Seriously folks--do your research before undergoing the knife....

Friday, August 24, 2007

Dietary Fat ---Can it be part of a WLS diet?

This is my 100th post---not too shabby for an old country girl. I wanted to make it a good one, although highly controversial.

No where on this earth is the low fat dogma stronger than among my fellow WLSers. The bariatric centers tell you to follow what boils down to a low carb diet, but without fat. You will hear shouted by everyone---lean clean protein. Many are finally coming around to the idea of leaving off the carbs, although they are still stuck in the old whole grain mentality. When telling them to increase their fat intake---I hit a huge stone wall.

Most of my fellow WLSers are professional dieters. We have tried everything under the sun to lose weight over the years. Only finding ourselves that much fatter and our metabolism completely screwed up. So as a final resort, we have WLS. But most are still in that diet mode mentality. Which has always been, eat less, exercise more and cut the fat.

Science does not support this theory. Dietary fat, especially saturated fat, is crucial to the body functioning. Being that all WLSers are deficient in fat soluble vitamins, you would think they would "get it", and start upping their dietary fat intake. It just boggles my mind to see how deeply this behavior is imprinted on each of them.

Dr Mike Eades had a very moving post about the phenomenon of meme as it applies to the idea of weight loss.

To lose weight you need to eat less and exercise more » Michael R. Eades, M.D.: "that it is an element of culture or a system of behavior that passes from one person to the next non-genetically, but more like a virus. Some ideas become memes; some don’t. The ones that do can become extremely powerful. In fact they can become so powerful that, like a deadly virus, they can kill their host."

Eat less and exercise more

Did you ever wonder where that idiotic advice came from? You hear it everywhere. From your own doctor, from your next door neighbor, from the health writers in all the major papers, from just about anyone you ask. How’s the best way to lose weight? Eat less and exercise more.

Would it surprise you to learn that there is no scientific evidence that people can lose weight by eating less and exercising more? Sure, there are studies showing that it works for the short term, but who wants to put the effort into losing weight for the short term. We all want long-term, i.e., permanent, weight loss. There are no studies showing that eating less brings about permanent weight loss and no group of studies demonstrating that increasing exercise promotes weight loss. So, how does one achieve permanent weight loss? It’s easy. Ask anyone. Eat less and exercise more.

Since there is no evidence that the eat-less-exercise-more strategy works other than for the very short term, how did it become so entrenched in the minds of so many? It did it by the same means that the idea that a low-fat diet is optimal for health (another unproven hypothesis, that if anything has been shown to be just the opposite) got traction. It is a meme.

This is all just stuff that has been passed around so long---without proof mind you---that everyone believes it. As Dr Mike said---it is the same with the idea of low fat being good for you---or that saturated fat is bad for you. It is simply not the case. Dietary fat should be a part of everyone's eating plan. I want to focus on the WLSers though.

Dumping Syndrome is a big worry post-WLS. Most run into this as it applies to sugar or higher glycemic foods. I have a serious problem with it. Also many have problems with dumping after a fatty meal. My question to them---what else have you eaten that day? How many are on some form of fiber daily or fiber supplement's? How many use SF processed foods or artificial sweeteners? These two things alone can cause the symptoms most describe they suffer after a higher fat meal. This being typically gas , bloating and nausea. What makes you sure it is the rib eye steak you just ate and not the bowl of Fiber One you had for breakfast or that fiber and artificial sweetener loaded protein bar you had or that bowl of oatmeal you had for breakfast? My theory is---you are so entrenched in the old fat is evil mindset it has to be the fat causing it.

Then you have those post-ops who get nauseated just by the smell of frying foods. I'm one of them. Fried foods are no where near being in the same ball park as a nice juicy fatty steak. Fried foods are a big NO NO for ANYONE---all that trans fat is just wrong. That being said---a good old baked chicken thigh, with the skin, is better nutritionally than a boneless, skinless, broiled chicken breast. The chicken breast is a staple for most WLSers. They wouldn't dream of eating a thigh with the skin and only have steak on very rare occasions. Which only leads to more anemia. They even take great recipes for meatloaves and substitute ground turkey for the ground beef. All this in the name of lowering the fat content. They are also lowering their iron intake at the same time. Then they take perfectly good recipes and tweak them to lower the fat content--like homemade salad dressings. Apparently loading up on the carb laden low fat versions of sour cream, yogurt, and mayo is ok.

Saturated dietary fat is GOOD for the body. It does not cause heart disease---carbs do that. It does not cause obesity---carbs do that. It does not cause diabetes---carbs do that. Here are some great benefits of saturated dietary fat:
  • Saturated fatty acids constitute at least 50% of the cell membranes. They are what gives our cells necessary stiffness and integrity.

  • They play a vital role in the health of our bones. For calcium to be effectively incorporated into the skeletal structure, at least 50% of the dietary fats should be saturated.

  • They lower Lp(a), a substance in the blood that indicates proneness to heart disease. They protect the liver from alcohol and other toxins, such as Tylenol.

  • They enhance the immune system.

  • They are needed for the proper utilization of essential fatty acids.
    Elongated omega-3 fatty acids are better retained in the tissues when the diet is rich in saturated fats.

  • Saturated 18-carbon stearic acid and 16-carbon palmitic acid are the preferred foods for the heart, which is why the fat around the heart muscle is highly saturated. The heart draws on this reserve of fat in times of stress.

  • Short- and medium-chain saturated fatty acids have important antimicrobial properties. They protect us against harmful microorganisms in the digestive tract.
Calcium problems are big after WLS as we discussed in a previous post. According to this 50% of your fat intake needs to be saturated for calcium to work properly. A strong argument to up your dietary fat for post WLS for sure. Also the benefits on the immune system is critical too for post WLS. Many of us have a suppressed immune system due to our poor nutritional status caused by the malabsorption. Ask many of my fellow WLSers how many colds they get each year.

The biggest argument against dietary fat has always been that it increases your chances of heart disease. WRONG!!!

The cause of heart disease is not animal fats and cholesterol but rather a number of factors inherent in modern diets, including excess consumption of vegetables oils and hydrogenated fats; excess consumption of refined carbohydrates in the form of sugar and white flour; mineral deficiencies, particularly low levels of protective magnesium and iodine; deficiencies of vitamins, particularly of vitamin C, needed for the integrity of the blood vessel walls, and of antioxidants like selenium and vitamin E, which protect us from free radicals; and, finally, the disappearance of antimicrobial fats from the food supply, namely, animal fats and tropical oils. These once protected us against the kinds of viruses and bacteria that have been associated with the onset of pathogenic plaque leading to heart disease.

While serum cholesterol levels provide an inaccurate indication of future heart disease, a high level of a substance called homocysteine in the blood has been positively correlated with pathological buildup of plaque in the arteries and the tendency to form clots—a deadly combination. Folic acid, vitamin B6, vitamin B12 and choline are nutrients that lower serum homocysteine levels. These nutrients are found mostly in animal foods.

The best way to treat heart disease, then, is not to focus on lowering cholesterol—either by drugs or diet—but to consume a diet that provides animal foods rich in vitamins B6 and B12; to bolster thyroid function by daily use of natural sea salt, a good source of usable iodine; to avoid vitamin and mineral deficiencies that make the artery walls more prone to ruptures and the buildup of plaque; to include the antimicrobial fats in the diet; and to eliminate processed foods containing refined carbohydrates, oxidized cholesterol and free-radical-containing vegetable oils that cause the body to need constant repair.

I am most definitely in the minority in the WLS community with my views on dietary fat. I hope those of you reading this blog will check out some of the following links to learn of the science behind what is really a healthy diet---and low fat is definitely not a part of it.

Minds set in concrete
This one is really enlightening about why it is so hard to change people's way of thinking.

The Skinny on Fats

Framingham follies.

The Oiling of America

The Importance of Saturated Fats for Biological Functions

Know Your Fats: An Example of Junk Science

Effects of a carbohydrate-restricted diet on emerging plasma markers for cardiovascular disease

Comparison of isocaloric very low carbohydrate/high saturated fat and high carbohydrate/low saturated fat diets on body composition and cardiovascular risk

The effects of a low-carbohydrate, ketogenic diet (high fat)on the polycystic ovary syndrome: A pilot study

Eat Fat And Grow Slim

Top Ten Nutritional Myths, Distortions and Lies That Will Destroy Your Health.

I'll leave you with those but will also give you some book recommendations.

The Great Cholesterol Con

The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It

Natural Health & Weight Loss

The Brain Trust Program: A Scientifically Based Three-Part Plan to Improve Memory, Elevate Mood, EnhanceAttention, Alleviate Migraine and Menopausal Symptoms, and Boost Mental

Good Calories, Bad Calories

Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats

Take your time and really do the research, don't get bogged down in low fat dogma. A higher fat diet CAN be a way of life after WLS---and it should be.

Monday, August 20, 2007

Away For Awhile

I will be away for awhile from blogging and other online activities. My father's family has had several illnesses as of late. I am stepping in to assist my cousins at this time. They came to me recently and asked for my assistance in dealing with doctors and such. My father wanted me to help but would not ask me. I could not tell him no. He wanted it to be my decision alone. So in case I did not feel I was up to it, I could say no without guilt. Thank goodness for that. I agreed to help where ever I could.

The main one is my oldest and favorite cousin. He was just diagnosed with liver cancer. It has metastasized already so the prognosis is not good. I will be helping the family set up things in the home and getting hospice involved. His health has not been the best for a number of years. Which only makes this that much harder on the family. Having worked hospice before in my 20 year nursing career, I'm familiar with all the ins and outs. This will help make his final days that much easier. Also it will help the family cope with everything to come.

My father's oldest brother living brother is another I will be assisting. He has been diagnosed with the mid-stages of Alzheimer's. My cousins refuse to place him in a facility, so I will be assisting them in finding good qualified people to help out in their home on an around the clock basis. I will probably be taking some shifts myself in the beginning. Giving us added time to get just the right people.

I personally am doing very well. So do not be concerned about me. I just felt the need to not add too much by worrying about my blogging at this time. So take care everyone and I will return when I can.

Friday, August 17, 2007

Who We Leave Behind

I spent a very stressful day Tuesday. Huddled under an umbrella in the scorching heat. Watching the faces of family members. Seeing their tears. Telling myself, just a few short years ago, that could have been my mom sitting there instead of my aunt. What was I doing? Where was I at? I was in a cemetery. Attending my cousins funeral.

He committed suicide.

I have written several posts about suicide and my own attempt. So why did I not talk about this sooner? What prompted me to speak up now?

First it hit way too close to home. I had to sort through alot of my own emotions. I needed to get my self in a comfortable place. For someone who has a history of suicidal ideations, the death of someone close, by suicide, can trigger their mind. Send them back to that deep dark place. Even someone who has become much stronger can be pulled under.

From outward appearances only, my cousin was very happy man. He had his own business. He owned his own home. He was intelligent. He had four wonderful kids and four gorgeous grand kids. He was surrounded by many friends. He was active in his community. He had dealt with and beaten drug and alcohol addiction. He had much to live for. So why did he give up?

Inside he was in turmoil. He had battled mental illness since his early teens. He was bombarded from his own mind with thoughts and voices telling him others were out to get him and to take his own life for nearly forty years. Schizo-effective disorder was only one of his diagnoses, Bipolar was another. He had spent considerable time in and out of hospitals. Had tried numerous medications. According to the note left---he was just tired.

At his funeral they played a Vince Gill song---Go Rest High On That Mountain:

I know your life
On earth was troubled
And only you could know the pain
You weren't afraid to face the devil
You were no stranger to the rain

Go rest high on that mountain
Son, you work on earth is done
Go to heaven a shoutin'
Love for the Father and Son

Oh, how we cried the day you left us
We gathered round your grave to grieve
I wish I could see the angels faces
When they hear your sweet voice sing

Go rest high on that mountain
Son, you work on earth is done
Go to heaven a shoutin'
Love for the Father and Son

It brought so many feelings flooding back. I remembered that deep dark despair. I could feel his pain. When you reach that point---you are thinking of no one but yourself. Your mind can not comprehend the effect your passing will have on those around you. Jon at Living With a Purple Dog, had a link to a very powerful article that made me take a step back. To try and shake free of those awful bleak thoughts. Read it here:

Life Sentence

If I would ever find myself back in that "place". I will remember the look on my aunt's face and think of my own mom. I will remember his children breaking down and think of my own son. I will remember his sister having to be taken away and sedated and think of my own siblings. And I will remember the words written from this mother to her daughter.

For you see, it's not all about us. Although we are in pain at the time and just want the hurting to stop. It MUST be about--- who we leave behind......

Thursday, August 16, 2007

Lemon-Tarragon Chicken Salad

I have this thing about tarragon---so when I was looking through my Southern Living magazine--trying to get some light summer foods for all this heat---I found this recipe. It was fabulous!!! For those of you who have never tried tarragon---it really adds a punch of a flavor.

Lemon-Tarragon Chicken Salad

Prep: 20 min.
Bake: 7 min.
Cool: 15 min.

When fresh tarragon isn't available, substitute 1 1/2 tsp. dried crushed tarragon.

1/2 cup chopped pecans
3/4 cup mayonnaise
1 tablespoon chopped fresh tarragon
1 teaspoon grated lemon rind
1 tablespoon fresh lemon juice
1 teaspoon salt
1/2 teaspoon freshly ground pepper
3 cups chopped cooked chicken---I used leftovers
2 celery stalks, finely chopped---mine were super fine
1/2 small sweet onion, finely chopped---Vidalia if you can find them
2 cups seedless red grapes, cut in half (optional)
Garnish: halved lemon slices

1. Arrange pecans in a single layer on a baking sheet.

2. Bake at 350° for 5 to 7 minutes or until lightly toasted. Cool pecans on a wire rack 15 minutes or until completely cool.

3. Whisk together mayonnaise and next 5 ingredients in a large bowl; stir in pecans, chicken, celery, and onion just until blended. Stir in grape halves, if desired. Garnish, if desired. Yield: Makes 4 to 6 servings

Southern Living, JUNE 2007

This made for a great salad--easy to prepare--no heating up the house either. If you want to cook some chicken especially for this salad--marinate the pieces in some tarragon vinegar, olive oil, lemon peel, and chopped tarragon. Then grill them quickly. It will only round out the flavors even more.

Wednesday, August 15, 2007

Does My Pouch Still Work??

I've seen many post WLSers go through the dreaded regains. Some even go so far as to say that their pouch doesn't work any more. Some even look into getting a revision done. This is ludicrous. As everyone is told before they ever go under the knife. The pouch is just a tool. You have to be willing to change all the eating habits you had that made you fat in the first place.

You just need to be willing to go back to the basics. When I stray too far from my normal eating course of low carb. Yeah I have those days just like everyone else. I fall prey to old behaviors and old comfort foods. Even though they make me sick as a dog. I go on a meat or fat fast. Dr Atkins has a fat fast and I found the meat fast on low carb luxury. Neither one of these should be done long term. It is just to get myself back into ketosis. Especially after I have been on a self loathing causing carb binge. Another thing I add is MCT Oil. It is suppose to get you into ketosis super quick. I first discovered it when doing some research about the ketogenic diet and the effects on the brain.

My good friend, Kaye Bailey, recently did a couple of posts about her special way of getting back to the basics. Here are the links:

Fat Burn: Catching the Regained Weight

Five Day Pouch Test

Recipe Suggestions: 5 Day Pouch Test

If you are struggling as many of us do. Remember you are the one in control. You work your pouch not the other way around. Remember why you had the surgery in the first place. You must be willing to change your lifestyle. You can't do what you've always done and expect different results.

Walk From Obesity

Since obesity was a very big---pardon the pun---part of my life for so many years, I would like to bring this to your attention.

In September and October in cities all across America, obesity sufferers and survivors alike join forces and walk to raise money for research, education, prevention and treatment of the life-threatening disease of obesity.

Since its inception, the Walk from Obesity has raised more than $1.6 million to support research and educational programs on behalf of all of those affected by this disease.

Many participants walk on behalf of those unable to do so, because obesity has stolen their mobility, dignity, hope or life.

The ASBS Foundation and Obesity Action Coalition's Walk from Obesity was established to give hope to those needing it most.

Walkers raise money by asking friends, family and co-workers to sponsor them. In addition to walker income, funds are raised through sponsorship, matching gifts, corporate contributions and other fundraising activities.

The funds raised through this event support the ASBS Foundation and the Obesity Action Coalition's independent educational missions and fund programs focused on research, education and advocacy for all those affected by obesity.

There are quite a few WLSers who participate in this even each year. Since the closest one to me happens to be in Atlanta--I get involved by donating to varied walkers. If you happen to be involved in this just email me your donation page link and I will post here on my blog. For those who would like to participate---check this list to see if there's one near you---Join The Walk

Melting Mama blog Her Sponsorship Page

As more come in I'll be happy to add their link to the list.

If you do not have a walk in your area---they will be starting application s for next years walk in November 2007. Check out there website here---Walk from Obesity.

Obesity is a serious, chronic disease affecting more than 32 percent of American adults and 17 percent of American children (an increase of 75 percent over the last 20 years). Every day hundreds of people in the United States will die from obesity and its related health conditions. Obesity is a complex, multi-faceted disease that has been misunderstood by medical professionals, governmental agencies and the general public.

It is a common misunderstanding that an obese individual has directly caused their condition by overeating and/or a lack of willpower. Negative stereotypes have contributed to the lack of adequate support, education, research and treatment for this disease. Obesity is a complex disease with many factors contributing including behavior, environment and genetics.
So take the time to visit the site---get out and walk too. They have a wonderful Training Program on the site. It lists a 10 week walking program that would be great for those having had WLS. So check it out.

Tuesday, August 14, 2007

I've Been Tagged!!!

I see these things happening on other blogs all the time. I have so wanted to get involved. It takes me back to childhood---waiting to be chosen to be on someone's team on the playground. I'm so happy to FINALLY get picked.....

CindySue---a fellow RN and LC blogger from Cindy's Low Carb Life tagged me to list 8 random facts about myself.

First, the Rules:
1) Post these rules before you give your facts
2) List 8 random facts about yourself
3) At the end of your post, choose (tag) 8 people and list their names, linking to them
4) Leave a comment on their blog, letting them know they’ve been tagged

Here are my 8 facts:
1. I'm mother to a 1 son, 24 who lives way off in Connecticut.
2. I have 1 sister and 2 brothers.
3. I come from a very large extended family, my dad is one of nine children. There were seven generations of us until last summer when my grandmother passed away at 107 yrs old.
4. I love to sing. Have been doing it all my life. My first solo was at the tender age of two. Even performed with a country band for awhile, locally.
5. I used to be able to play a wide assortment of musical instruments--but baritone and saxophone were my specialty. Haven't picked up any in 20 yrs.
6. I'm an RN and have worked in all specialties, except pediatrics and labor and delivery. Even worked for a time as a traveling nurse all over the south east. I now work in the mental health field and making plans to return to school to further my degree. Hey, you're never too old to learn.
7. I learned to water ski at the age of 6 and spent many a summer day on the river with family. Haven't done that in years either.
8. I used to suffer from agoraphobia and did not leave my house for over 3 years.

Now let me see---who do I want to tag??? This tag has been going around the LC community--so I think I will branch out to my WLS and Bipolar friends.

LivingAfterWLS Blog
Blog home of my lovely long time friend Kaye Bailey

Living With A Purple Dog
A fasinating blog by a very powerful voice in the online mental health community

The Low Carb Band-it
This is a great blog that deals with following a LC eating plan and having had the lap band WLS. Great recipes too.

Melting Mama
A great blog by a fellow WLSer, funny as hell too.

The Weigh We Were
A super site that supports people making the change to a healthier lifestyle.

Mental Health Notes
A very open and frank account of the mental health community.

Bipolar Wellness Writer
A fabulous writer who sheds a very positive light on Bipolar Disorder and recovery. She's a published author too.

Bipolar Works
A great place to gather strength to return to the work force while dealing with the problems of a mental illness.

I look forward to see what each of you have to say about yourselves.

Sunday, August 12, 2007

Calcium Needs After WLS

Calcium is one of the main supplements all bariatric centers require for their post-ops. But just how important is it? If you haven't already read the previous post I did on Vitamins, Medications, and Malabsorption After WLS, take the time to read it now.

Calcium plays a very important role in the human body. Being a woman, I pay particular attention to my calcium intake. Being a WLSer I really pay attention.

The partitioning of the stomach during bariatric surgery results in a dramatic decrease in the production of hydrochloric acid, affecting the absorption of calcium and iron. However, absorption can be increased by using different salt forms or manipulating gastric pH. Calcium carbonate depends on acid for its absorption; calcium citrate does not. One study comparing the bioavailability of both products in achlorhydric patients found the bioavailability of calcium carbonate and calcium citrate to be 4% and 45%, respectively. While calcium citrate is more expensive than calcium carbonate, it is logical to specifically recommend calcium supplementation with the citrate salt in this patient population. Decreased calcium absorption can increase the risk of osteoporosis. While specific guidelines to monitor bone density do not exist for these patients, early bone densiometry testing would be prudent.(I highly recommend this test)
Calcium citrate is the recommended form. Most of the calcium supplements found in stores are the calcium carbonate form. It doesn't work so don't waste your money. That includes those candy type chews many WLSers love. Viactive for example,which happens to be loaded with trans fats and high fructose corn syrup. Who wants that in your body anyway. Also do not waste your money on the ones that have vitamin D in them. Besides being the WRONG type of vitamin D---check out the earlier series. It is also not in an oil based form so it won't be absorbed, PERIOD. You need to read the labels on vitamins just as closely as all the food labels out there.

Since we are at a risk of calcium deficiency---this can lead to osteoporosis. Which I already have a problem with, but I'm working to correct it. Anyhoo, since osteoporosis is a problem many PCPs automatically want to put you on some of the meds to combat it. This is not a good idea.
The oral bisphosphonates (drugs for osteoporosis) are another class of medications that could present problems due to a reduced pouch size, which may increase the risk of gastrointestinal ulceration. Since these patients can be at risk for osteoporosis because of decreased calcium absorption, other treatment options (e.g., calcitonin salmon nasal spray, synthetic parathyroid hormone [teriparatide], raloxifene [for women]) should be considered.
These drugs are caustic to our pouch just like NSAIDS. We've all heard the horror stories about bleeding ulcers, ER trips, etc after taking NSAIDS. So the best thing to do is prevent the deficiency of calcium in the first place. The research is out there to prove it. Here are a few examples:
Metabolic bone disease after gastric bypass surgery for obesity.

BACKGROUND: The popularity of gastric bypass surgery for treatment of morbid obesity has been increasing in recent years. Osteomalacia and osteoporosis are commonly observed in patients who have had partial gastric resections for treatment of peptic ulcer disease. Recently, we encountered four patients with previous gastric bypass surgery who had metabolic bone disease similar to that reported in the older literature in patients who had partial gastrectomies.
METHODS: Review of clinical data of four patients who developed osteomalacia and osteoporosis 9 to 12 years after gastric bypass surgery for morbid obesity.
RESULTS: All subjects were women, 43 to 58 years old. Three had Roux-en-Y gastric bypass, and the other had a biliopancreatic diversion 9 to 12 years prior to presentation. Weight loss averaged 41.8 kg. Patients reported fatigue, myalgias, and arthralgias. They had symptoms for many months or years before the correct diagnosis was established. All were osteopenic or osteoporotic with hypocalcemia, very low or undetectable 25-hydroxyvitamin D levels, secondary hyperparathyroidism, increased 1,25-dihydroxyvitamin D levels, and increased serum alkaline phosphatase.
CONCLUSIONS: Relatively little has been published in the general medical literature about this postoperative complication of bariatric surgery. Yet, nearly all patients after bariatric surgery will receive their long-term follow-up from a primary care physician. Physicians and patients need to be aware of this complication and take measures to identify and prevent it.
Bone and gastric bypass surgery: effects of dietary calcium and vitamin D.

OBJECTIVE: To examine bone mass and metabolism in women who had previously undergone Roux-en-Y gastric bypass (RYGB) and determine the effect of supplementation with calcium (Ca) and vitamin D.
RESEARCH METHODS AND PROCEDURES: Bone mineral density and bone mineral content (BMC) were examined in 44 RYGB women (> or = 3 years post-surgery; 31% weight loss; BMI, 34 kg/m(2)) and compared with age- and weight-matched control (CNT) women (n = 65). In a separate analysis, RYGB women who presented with low bone mass (n = 13) were supplemented to a total 1.2 g Ca/d and 8 microg vitamin D/d over 6 months and compared with an unsupplemented CNT group (n = 13). Bone mass and turnover and serum parathyroid hormone (PTH) and 25-hydroxyvitamin D were measured.
RESULTS: Bone mass did not differ between premenopausal RYGB and CNT women (42 +/- 5 years), whereas postmenopausal RYGB women (55 +/- 7 years) had higher bone mineral density and BMC at the lumbar spine and lower BMC at the femoral neck. Before and after dietary supplementation, bone mass was similar, and serum PTH and markers of bone resorption were higher (p <>
DISCUSSION: Postmenopausal RYGB women show evidence of secondary hyperparathyroidism, elevated bone resorption, and patterns of bone loss (reduced femoral neck and higher lumbar spine) similar to other subjects with hyperparathyroidism. Although a modest increase in Ca or vitamin D does not suppress PTH or bone resorption, it is possible that greater dietary supplementation may be beneficial.
Now that we know what a problem it can be after WLS. Let's get a little background on calcium. I'll reference one of my favorite sites for vitamins and minerals--Linus Pauling Institute.
Calcium is the most common mineral in the human body. About 99% of the calcium in the body is found in bones and teeth, while the other 1% is found in the blood and soft tissue. Calcium levels in the blood and fluid surrounding the cells (extracellular fluid) must be maintained within a very narrow concentration range for normal physiological functioning. The physiological functions of calcium are so vital to survival that the body will demineralize bone to maintain normal blood calcium levels when calcium intake is inadequate. Thus, adequate dietary calcium is a critical factor in maintaining a healthy skeleton.
Calcium is a major structural element in bones and teeth. Bone is a dynamic tissue that is remodeled throughout life. Bone cells called osteoclasts begin the process of remodeling by dissolving or resorbing bone. Bone-forming cells called osteoblasts then synthesize new bone to replace the bone that was resorbed. During normal growth, bone formation exceeds bone resorption. Osteoporosis may result when bone resorption exceeds formation.
Calcium plays a major role in bone formation, this everyone knows. But calcium is so much more than that. The human body is a complex being. There are many checks and balances on the cellular level. One little thing gets out of whack, the whole system is messed up. Here are some functions of calcium:
Calcium plays a role in mediating the constriction and relaxation of blood vessels (vasoconstriction and vasodilation), nerve impulse transmission, muscle contraction, and the secretion of hormones like insulin. Excitable cells, such as skeletal muscle and nerve cells, contain voltage-dependent calcium channels in their cell membranes that allow for rapid changes in calcium concentrations. For example, when a muscle fiber receives a nerve impulse that stimulates it to contract, calcium channels in the cell membrane open to allow a few calcium ions into the muscle cell. These calcium ions bind to activator proteins within the cell, which release a flood of calcium ions from storage vesicles inside the cell. The binding of calcium to the protein, troponin-c, initiates a series of steps that lead to muscle contraction. The binding of calcium to the protein, calmodulin, activates enzymes that breakdown muscle glycogen to provide energy for muscle contraction.
So it controls cell membranes, muscles, enzymes and hormones too. But it also plays a role in blood clotting.
Calcium is necessary to stabilize a number of proteins and enzymes, optimizing their activities. The binding of calcium ions is required for the activation of the seven "vitamin K-dependent" clotting factors in the coagulation cascade (see vitamin K). The term, "coagulation cascade," refers to a series of events, each dependent on the other that stops bleeding through clot formation.
Regulation of calcium in the body is tightly controlled, through a vast series of checks and balances.
Calcium concentrations in the blood and fluid that surrounds cells are tightly controlled in order to preserve normal physiological function. When blood calcium decreases (e.g., in the case of inadequate calcium intake), calcium-sensing proteins in the parathyroid glands send signals that result in the secretion of parathyroid hormone (PTH). PTH stimulates the conversion of vitamin D to its active form, calcitriol, in the kidneys. Calcitriol increases the absorption of calcium from the small intestine. Together with PTH, calcitriol stimulates the release of calcium from bone by activating osteoclasts (bone resorbing cells) and decreases the urinary excretion of calcium by increasing its reabsorption in the kidneys. When blood calcium rises to normal levels, the parathyroid glands stop secreting PTH and the kidneys begin to excrete any excess calcium in the urine. Although this complex system allows for rapid and tight control of blood calcium levels, it does so at the expense of the skeleton.
The parathyroid glands sense the serum calcium level, and secrete parathyroid hormone (PTH) if it becomes too low, for example, when dietary calcium intake is inadequate. PTH stimulates the activity of the 1-hydroxylase enzyme in the kidney, resulting in increased production of calcitriol, the biologically active form of vitamin D3. Increased calcitriol production restores normal serum calcium levels in three different ways: 1) by activating the vitamin D-dependent transport system in the small intestine, increasing the absorption of dietary calcium, 2) by increasing the mobilization of calcium from bone into the circulation, and 3) increasing the reabsorption of calcium by the kidneys. PTH is also required to increase bone calcium mobilization and calcium reabsorption by the kidneys. However, PTH is not required for the effect of calcitriol on the intestinal absorption of calcium.
Now we see that calcium is strictly regulated. As WLSers, we become deficient simple because we don't absorb enough. Or is something else the cause???
A low blood calcium level usually implies abnormal parathyroid function and is rarely due to low dietary calcium intake since the skeleton provides a large reserve of calcium for maintaining normal blood levels. Other causes of abnormally low blood calcium levels include chronic kidney failure, vitamin D deficiency, and low blood magnesium levels that occur mainly in cases of severe alcoholism. Magnesium deficiency results in a decrease in the responsiveness of osteoclasts to PTH. A chronically low calcium intake in growing individuals may prevent the attainment of optimal peak bone mass. Once peak bone mass is achieved, inadequate calcium intake may contribute to accelerated bone loss and ultimately to the development of osteoporosis.
So once again things fall back on vitamin D deficiency. Now you see why I devoted 4 blog posts to vitamin D alone. It is THAT important. Also, I'm sorry to say, one that is frequently overlooked. Magnesium plays a role here too, so make sure to add that to your arsenal of supplements.

Several things can also play a part in the utilization of calcium by the body, sodium, protein, phosphorus, and caffeine.
High sodium intake results in increased loss of calcium in the urine, possibly due to competition between sodium and calcium for reabsorption in the kidney or by an effect of sodium on parathyroid hormone (PTH) secretion. Each 2.3-gram increment of sodium (6 grams of salt; NaCl salt) excreted by the kidney has been found to draw about 24-40 milligrams (mg) of calcium into the urine. Because urinary losses account for about half of the difference in calcium retention among individuals, dietary sodium has a large potential to influence bone loss. In adult women, each extra gram of sodium consumed per day is projected to produce an additional rate of bone loss of 1% per year if all of the calcium loss comes from the skeleton. Although animal studies have shown bone loss to be greater with high salt intakes, no controlled clinical trials have been conducted to confirm the relationship between salt intake and bone loss in humans. However, a 2-year study of postmenopausal women found increased urinary sodium excretion (an indicator of increased sodium intake) to be associated with decreased bone mineral density (BMD) at the hip. Additionally, a longitudinal study in 40 postmenopausal women found that adherence to a low sodium diet (2 grams/day) for six months was associated with significant reductions in sodium excretion, calcium excretion, and aminoterminal propeptide of type I collagen, a biomarker of bone resorption. However, these associations were only observed in women with baseline urinary sodium excretions equal to or greater than 3.4 grams/day (i.e., the mean sodium intake for the U.S. adult population).

As dietary protein intake increases, the urinary excretion of calcium also increases. Recommended calcium intakes for the U.S. population are higher than those for populations of less industrialized nations because protein intake in the U.S. is generally higher. The RDA for protein is 46 grams/day for adult women and 56 grams/day for adult men; however, the average intake of protein in the U.S. tends to be higher (65-70 grams/day in adult women and 90-110 grams per day in adult men). Weaver and colleagues have calculated that each additional gram of protein results in an additional loss of 1.75 mg of calcium/day. Because only 30% of dietary calcium is generally absorbed, each one-gram increase in protein intake/day would require an additional 5.8 mg of calcium/day to offset the calcium loss. At the other end of the spectrum of protein intake, the effect of dietary protein insufficiency on bone health has received much less attention. Inadequate protein intakes have been associated with poor recovery from osteoporotic fractures and serum albumin values (an indicator of protein nutritional status) have been found to be inversely related to hip fracture risk.

Phosphorus, which is typically found in protein-rich foods, tends to decrease the excretion of calcium in the urine. However, phosphorus-rich foods also tend to increase the calcium content of digestive secretions, resulting in increased calcium loss in the feces. Thus, phosphorus does not offset the net loss of calcium associated with increased protein intake. Increasing intakes of phosphates from soft drinks and food additives have caused concern among some researchers regarding the implications for bone health. Diets high in phosphorus and low in calcium have been found to increase parathyroid hormone (PTH) secretion, as have diets low in calcium. While the effect of high phosphorus intakes on calcium balance and bone health is presently unclear, the substitution of large quantities of soft drinks for milk or other sources of dietary calcium is cause for concern with respect to bone health in adolescents and adults.

Caffeine in large amounts increases urinary calcium content for a short time. However, caffeine intakes of 400 mg/day did not significantly change urinary calcium excretion over 24 hours in premenopausal women when compared to a placebo. Although one observational study found accelerated bone loss in postmenopausal women who consumed less than 744 mg of calcium/day and reported that they drank 2-3 cups of coffee/day, a more recent study that measured caffeine intake found no association between caffeine intake and bone loss in postmenopausal women. On average, one 8-ounce cup of coffee decreases calcium retention by only 2-3 mg.
Sodium is not a problem for me. I don't use very many processed foods. I even make my own ketchup and tomato based products, as well as my own soups. Canned veggies, soups, and prepackaged meals are loaded with sodium. So are deli meats. These are things everyone needs to avoid.

Protein, now that is problem being on a low carb eating plan. Also most WLSers are told to get in at least 70gm of protein a day. So what really is my proper protein requirement? The easiest way to calculate protein intake is use the formula a fellow low carber posted. You don't have to be doing low carb to utilize this formula---although I recommend it---low carb is really the only way to eat after WLS. Especially if you want to be successful.

How to Calculate How Much Protein You Need

Phosphorus, I think it's funny that the main sources people use for there daily calcium intake also contain phosphorus which inhibits calcium. I'm talking about dairy products, milk, yogurt, and cheese. Now ain't that a kicker. I want to emphasize the bit about the sodas. Every bariatric center tells their clients--NO MORE SODAS--but very few listen. Most are addicted to them. If you havent't given yours up, maybe this will convince you to do it. Me included. I don't drink them but maybe one or two a month. But that stopped when I began doing this series.

Caffeine, here is my achilles heel, I'm a coffee hound. I don't drink just one or two cups. It's more like one or two pots. I also live on tea---hey this is the south. So this is an area I sorely need to work on. But I dread the headache I'm sure to have. But I will be better off without it.

Alrighty now y'all, that's it for this post. Remember to take your own health into your own hands. Make sure your doc is doing the proper labs. Get a print out of it to make sure. As for the calcium, most all of us take it post-op. But we don't take the vitamin D and that is the crucial part. So keep a running list of the labs you need to have done as we continue on with this series.

Also this research just came in---Skeleton Is An Endocrine Organ, Crucial To Regulating Energy Metabolism.

Bones are typically thought of as calcified, inert structures, but researchers at Columbia University Medical Center have now identified a surprising and critically important novel function of the skeleton. They've shown for the first time that the skeleton is an endocrine organ that helps control our sugar metabolism and weight and, as such, is a major determinant of the development of type 2 diabetes.
So there you have it---if we take proper care of our skeleton, we can effect our weight too. Need any more reason to make sure your take your vitamins???

Friday, August 10, 2007


I feel honored. Jimmy Moore, a true powerful voice in the low carb online community, has posted a list, 50 Sizzling Hot New Low-Carb Blogs For 2007. Imagine my surprise when I saw my blog listed:

- Scale Mistress
- Short Girls Low-Carb Support Group
- Permanent Low-Carber
- Sara Ost's Healthbolt
- Mother/Daughter Meltdown
- Back Across The Line SEE!!!
- Burning The Scale
I feel honored. Y'all need to check out the full post for the rest of the lists. It includes recipe sites, fitness sites---doing low carb mind you, as well as host of others.

Another great site you need to check out is Jimmy's brand spankin' new forum, Low Carb Discussion. I ran into many of my fellow bloggers there. Most are powerhouses in the online community. I'm astounded at the wealth of knowledge they all have. So if you are looking for a wealth of knowledge concerning a low carb lifestyle, as well as a super support network, check it out today.

Low carb is really the only way for us to live. Science tells us so. There is no evidence supporting a low fat low calorie approach to health and weight loss. On the contrary, there are mounds and mounds of evidence that clearly report the opposite. So check out the sites and the low carb links. Your health and well being is at stake.

Monday, August 6, 2007

Vitamin B---B1---Thiamine

I'm going to take a break from the Fat Soluble Vitamins series to discuss Thiamine. This is serious deficiency noted after WLS. It has some dire consequences if not addressed quickly.

Thiamine Deficiency May Complicate Gastric Bypass

Thiamine deficiency with a nonclassic presentation may follow gastric bypass for obesity, according to a case report in the December 27 issue of Neurology.

"The neurological complications following gastric bypass surgery are diverse," coauthor Raul N. Mandler, MD, from George Washington University in Washington, DC, said in a news release. "Vitamin B1 deficiency and Wernicke encephalopathy should be carefully considered in surgically treated obese patients."

Bariatric surgery is an effective treatment for many patients with morbid obesity, but this procedure has attendant risks. Neurologic complications are particularly serious potential complications of bariatric surgery, including myelopathy and ataxia associated with deficiencies in vitamin B12, vitamin E, and copper. Patients might also experience neuropathies related to other deprivation of essential vitamins and micronutrients.

The classic presentation of Wernicke encephalopathy includes oculomotor abnormalities, mental status changes, and ataxia. Unfortunately, this classic presentation occurs in only 20% of cases of Wernicke encephalopathy. Examining risk factors for thiamine deficiency, including bariatric surgery, can help physicians diagnose this disorder.

Obesity Surgery Linked to Atypical Encephalopathy

Bariatric surgery appears to increase the risk for atypical Wernicke encephalopathy, a serious neurologic condition caused by thiamine deficiency that is typically associated with alcoholism.

In the first study to characterize the syndrome in this patient group, researchers at Wake Forest University School of Medicine in Winston-Salem, North Carolina, conducted a systematic literature review in an attempt to describe the clinical features, risk factors, radiographic findings, and prognosis of Wernicke encephalopathy.

"What we found in our paper, which is clinically useful, is that this syndrome is most commonly reported in young women who present with vomiting 1 to 3 months — although it can range from 2 weeks to 18 months — following obesity surgery," principal investigator Sonal Singh, MD, told Medscape.

Currently, said Dr. Singh, there is no standardized pre- or postoperative protocol aimed at preventing Wernicke encephalopathy; it is left up to the individual providers to determine treatment.

Although some research suggests preoperative thiamine supplementation provides effective prophylaxis, more research is required to confirm that this is the case.

The good news is that if caught in the early stages, the syndrome is very responsive to thiamine treatment given intravenously or by injection. The study showed that 13 of the 32 patients made a full recovery; others had some residual neurological deficits.

In the meantime, said Dr. Singh, clinicians should have a high index of suspicion for Wernicke encephalopathy in patients who present with any type of neurological symptoms after bariatric surgery.

"It is important that doctors and patients are aware that the outcome is wholly dependent on early diagnosis. Patients should be advised to immediately report any neurological symptoms," he said.

In the meantime, a prospective long-term study to determine the incidence of the syndrome is needed to help guide preventive, as well as treatment, protocols.

As you can clearly see, this can be very dangerous. We're talking about your brain here people. The scariest part about this to me is the fact that those having WLS do not have the typical types of symptoms associated with encephalopathy. Also it is pretty scary too that not everyone is aware of the nutritional deficits that are so common after WLS. I don't mean just US either. Many docs aren't aware either.

That's why I preach proactive health care. You must take an active part in your own care. You must seek out knowledge to make you a better health consumer. If there is one thing I've found out over the years, you can not blindly listen to your doc. Quite a few just do not keep up to date on the research available. If they did, tons more people would be on a low carb eating plan by now. (Hey had to throw that in there too.)

So okay, now we see what the potential problems may be. Let's cover some basics about Thiamine now.

Thiamine is a water-soluble B vitamin, previously known as vitamin B1 or aneurine. Isolated and characterized in the 1930s, thiamin was one of the first organic compounds to be recognized as a vitamin. Thiamine occurs in the human body as free thiamin and as various phosphorylated forms: thiamin monophosphate (TMP), thiamin triphosphate (TTP), and thiamin pyrophosphate (TPP), which is also known as thiamin diphosphate.

So being water soluble means as post WLS patients, we are able to absorb it more readily. So that brings to the equation, if we absorb it better, then why do we suffer with a deficiency? Let's first look at what the RDA of thiamine is. Then we'll see what foods are high in it.

Recommended Dietary Allowance (RDA) for Thiamin
Life Stage Age Males (mg/day) Females (mg/day)
Infants 0-6 months 0.2 (AI) 0.2 (AI)
Infants 7-12 months 0.3 (AI) 0.3 (AI)
Children 1-3 years 0.5 0.5
Children 4-8 years 0.6 0.6
Children 9-13 years 0.9 0.9
Adolescents 14-18 years 1.2 1.0
Adults 19 years and older 1.2 1.1
Pregnancy all ages - 1.4
Breastfeeding all ages - 1.4

So for me that means I need only have 1.1 mg of thiamine daily. But look at this chart to see where we can get thiamine from our diet alone.

Food Serving Thiamin (mg)
Lentils (cooked) 1/2 cup 0.17
Peas (cooked) 1/2 cup 0.21
Long grain brown rice (cooked) 1 cup 0.19
Long grain white rice, enriched (cooked) 1 cup 0.26
Long grain white rice, unenriched (cooked) 1 cup 0.04
Whole wheat bread 1 slice 0.10
White bread, enriched 1 slice 0.11
Fortified breakfast cereal 1 cup 0.5-2.0
Wheat germ breakfast cereal 1 cup 4.47
Pork, lean (cooked) 3 ounces* 0.72
Brazil nuts 1 ounce 0.18
Pecans 1 ounce 0.19
Spinach (cooked) 1/2 cup 0.09
Orange 1 fruit 0.10
Cantaloupe 1/2 fruit 0.11
Milk 1 cup 0.10
Egg (cooked) 1 large 0.03

*3 ounces of meat is a serving about the size of a deck of cards

For me and my low carb lifestyle---this list has pretty slim pickin's. Since the deficiency really shows up in the early stages after WLS---you can plainly see how you can become deficient. Throw in the problem most new preops experience of not eating very much period and the problem only gets worse. The only food on that list that I ate as a newbie was eggs. It would take you eating 36 eggs a day to get the recommended amount of thiamine. I eat alot of eggs, but I would take nearly a month to eat 36.

So the answer is simple---take a good B Complex---making sure it has thiamine in it---not all of them do I've found. Poof. No more deficiency.

Thiamine is a great vitamin for the brain as you can well see, but it plays a role in other diseases also, Cataracts, Alzheimer's disease, Congestive heart failure (CHF), and Cancer. So rather than turn to big pharma, take care of your health from a nutritional standpoint. It just makes common sense.

Update: 8/9/07

This news story just came out concerning diabetes and thiamine deficiency.

Vitamin B1 deficiency found in diabetics

British researchers have discovered that deficiency of Vitamin B1 may be key to a range of vascular problems for people with diabetes.

Paul Thornalley, of the University of Warwick Medical School, said he has showed conclusively that diabetic patients are Vitamin B1, or thiamine, deficient in blood plasma.

The study, published in Diabetologia, found that thiamine concentration in blood plasma was decreased 76 percent in type 1 diabetic patients and 75 percent in type 2 diabetic patients.

The researchers found that the decreased plasma thiamine concentration was not due to a deficiency of dietary input of thiamine, but due to a profound increased rate of removal of thiamine from the blood into the urine.

The researchers also found that the decreased availability of thiamine in vascular cells in diabetes was linked diabetic complications such as damage to the kidney, retina and nerves in arms and legs. It likely reflects problems in endothelial cells -- cells that line the body's entire circulatory system -- and increased risk of atherosclerosis -- chronic inflammation in the artery walls.

WOW!! A whopping 75% deficiency in type 2 diabetes alone. Since many people who undergo WLS have a history of diabetes, I felt compelled to add this in. For those of you who are still diabetic, even after WLS, please take heed and increase you B1 supplementation. Also, do not forget to make sure your doc is checking your thiamine levels.

Thursday, August 2, 2007

Star Jones-Reynolds WLS Controversy

I've had about enough of this. Who gives a rip. So what if she had WLS. My dear friend Kaye Bailey, from LivingAfterWLS, wrote an outstanding essay about this very thing. I am putting it up in it's entirety , with her permission for all to see.

In Praise of Star Jones Reynolds

by Kaye Bailey
August 1, 2007

Star Jones Reynolds has been taking a media and blog-lynching for years. First because she was fat, next because she did something to gain control of her weight and health, next for refusing to share her private medical information with the public. And now for publicly disclosing a very personal and private matter: she had gastric bypass surgery.

If you are looking for Star-Bashing then move along, you won’t find it here.

Star Jones Reynolds is more representative of the weight loss surgery community than one might think. Her predicament vs. the average desk-jockey-Jane is that of full public exposure. Granted, she elected a career in the public spotlight, but she is a person and deserves to protect her private life as much as you or me. When an average-Jane such as myself had gastric bypass and chose not to disclose it to my co-workers I did not have to see my big butt splashed on the tabloids with speculation and accusation. Oh sure, there were whispers behind my back as my ever-shrinking body told the tale of rapid weight loss. But I ignored it and stuck with my story, “changed my diet and I am exercising regularly.” Which actually is the truth – to this day – 8 years post-op.

You see, medical history is nobody’s damn business but your own. As far as I’m concerned there is too much disclosure of medical history. I don’t want to know about polyps in the president’s colon or kidney stones being passed by my co-worker down the hall. Details about Aunt Madge’s diverticulitis qualify as to much information.

Now, what would be the reason that Star or me would keep our little surgical solution secret? I don’t know about her but I felt ashamed that I needed help, drastic help to take control of my health. Plenty of times I heard the chants, “Eat less, move more.” No kidding, easy to say those words little miss skinny-minnie-eat-anything-you-want-and-don’t-gain weight. How about we strap a hundred pounds or so on your almighty back and see how much you move and how friggin’ hungry you get! I felt enough shame on my own and didn’t need anyone else to serve me a super-size portion of guilt. And that shame haunts me.

And another thing, talk about stomach stapling, gastric bypass or gastric banding to just about anyone and I guarantee they know “a friend of a friend who got that done and things went bad.” It’s tough enough to make the decision to have surgery, why add to the mental torment with stories of a friend of a friend?

People on the outside looking in say weight loss surgery (gastric bypass or gastric banding) patients take “the easy way out” of obesity. The obese are viewed as slothful, dumb and weak. Ms. Jones-Reynolds proves that theory wrong. She is an educated and ambitious black woman who created a perfect storm of stardom and success in a world where the odds were against her. Really, how many morbidly obese black (or white for that matter) women rise to the level of success she achieved? And so what if along the way she neglected her health, as so many of us do? And so what if she chose the best medically available option for her long-term success? Losing weight by any means is tough work. The easy way is staying fat.

Weight Loss Surgery Video Link Weight-Loss Surgery Myths Dispelled

As a celebrity she no-doubt observed the way other celebrity weight loss surgery patients shed their weight in the public fishbowl. Any public figure paying attention to that would think twice before “coming out” with the humiliating information, “I have an illness for which I am being medically treated for the sake of my health.” If her illness were something with a cause ribbon such as heart disease or cancer she would have been applauded and praised for taking advantage of state of the art medical science. But obesity, no, that’s a disease of shame and disgrace.

Weight Loss Surgery Video LinkObesity and Your Health: How WLS Can Help

And what if down the road she regains a few pounds? Most of us do, including the celebrities whose worth is measured by the scale. She will then face another public lynching as the bloggers and the press guesstimate her tragic rebound to the land of the binge-eating bulge. What is so skewed about this, a relapse with a “real” disease is cause of public empathy and humaneness. Regained weight, on the other hand, is a feather in the cap of those “I told you so” critiques who think someone else’s weight is their business.

It is no wonder Star Jones Reynolds, me, my brother and thousands of the weight loss surgery patients living amongst us keep (kept) our dirty little secret to ourselves for so long.

Kudos to you Ms.Jones-Reynolds. I wish you the best of health and happiness. You’ve earned it the hard way.

Well said, Kaye!!! I have nothing to add---you said it all.

Kaye is a fabulous writer. You can find more essays by her here. She also has over 100 articles here.


It is the first of the month an time for a weigh-in. I am up 5lbs. I knew I would be. Actually I'm surprised it is not more. This past month has been extremely trying. Which in turn leads me to eat. The only thing to do is acknowledge it and move on. It's not the end of the world. I'll just need to keep a tighter hold on myself.

I started to fore go this post at all. No one really wants to admit when they screw up. It comes back to accountability and personal responsibility. It does no good for me to ignore it and only report the good days.

I write frequently about the LivingAfterWLS website I belong to. The founder, Kaye Bailey, developed an Empowerment Philosophy for them members. I have it printed out an posted on my wall to remind me how important taking responsibility for my own health is, the good as well as the bad.

The first step to personal empowerment is personal responsibility. LivingAfterWLS holds individuals accountable for making their weight loss surgery successful. When individuals take responsibility they feel liberated and motivated to invest personal equity in their success.
Personal empowerment is not borne of the statement "I am empowered." It is a state of mind cultivated with education, thought and validation.

I take this philosophy and attempt to apply it to my everyday life. You all are faced with choices on a day to day basis. We make those choices. No one makes them for us. So we must live with the consequences and take responsibility for them. We can not lay blame at someone else's feet.

As far as my weight loss or gain---there can be no excuses. No one has a gun at my head forcing me to put foods into my mouth that I know will lead to a weight gain. Shoot in my case---what the sam hill is that food even doing in my house. I live alone. I do the grocery shopping. Even those who share a household with someone else, have a choice. Just because it is there doesn't mean you have to eat it.

I do not see myself as a failure. That is what got me in trouble so many years of yo-yo dieting. I would cheat, then feel like a failure, then eat more because of my despair. Which is stupid in the first place.

So now--what is my plan for this month. One is not to buy stuff I know not to eat in the first place, no matter what the reason is. Second is to find something to relieve the anxiety leading me to eat in the beginning. Third is to choose a different food all together if #2 doesn't work. Something that is low carb but will satisfy my "head hunger" without adding pounds.

Are you taking responsibility for your health, your weight loss??? We have a saying in the Neighborhood.


Each person is the master of their own destiny. So hold yourself accountable for your Bad choices as well as the good.