Friday, April 29, 2011

Head Hunger: Coping with Your Triggers for Overeating part 4

By Michelle May, M.D.
http://www.AmIHungry.com

Why am I hungry all the time?

If you find yourself thinking, "Why am I hungry all the time?" you may be confusing "head hunger" with "body hunger." If you're someone who's sensitive to food cues, weight management will be challenging until you are able to recognize the overeating triggers in your environment and break the associations that lead you to overeat simply out of habit.

Let's take a look at just a few of the common overeating triggers and strategies for coping more effectively with head hunger.

TEMPTING DISPLAYS: Seeing displays of food like candy or nuts in dishes and tempting foods when you open your cabinet or refrigerator can trigger you to want those foods.

Strategy: 
Out of sight, out of mind. Don't use food as decorations or leave appetizing foods laying in plain view. Try putting tempting foods behind other foods in your cabinets and refrigerator. If a co-worker keeps food out, ask them to put it in a drawer instead.

So if you've wondered, "Why am I hungry all the time?" it's time to develop new strategies. By learning to recognize and decrease your overeating triggers, distracting yourself and coping effectively with head hunger, you'll soon break free from old habits. You'll find yourself eating less, feeling more satisfied and more fulfilled. 

Discover what you need to know to change your destructive patterns for good in these nine "easy-to-read over a cup of coffee" e-book chapters from I'm NOT Hungry - What Now?
 


  
 

Thursday, April 28, 2011

Head Hunger: Coping with Your Triggers for Overeating part 3

By Michelle May, M.D.
http://www.AmIHungry.com

Why am I hungry all the time?

If you find yourself thinking, "Why am I hungry all the time?" you may be confusing "head hunger" with "body hunger." If you're someone who's sensitive to food cues, weight management will be challenging until you are able to recognize the overeating triggers in your environment and break the associations that lead you to overeat simply out of habit.

Let's take a look at just a few of the common overeating triggers and strategies for coping more effectively with head hunger.

'TIS THE SEASON:  Be aware of your seasonal and weather related cues for eating. Holidays can be especially difficult because of all of the social ties to certain foods and even certain people. Many of the foods you eat during this time may seem "special" and therefore, harder to eat in sensible quantities.

Strategy: 
These occasions repeat themselves year after year so you can anticipate what typically occurs and create a plan for dealing with your triggers. Make it a point to really listen to your body instead of the external cues when making your food choices. Also keep in mind that special foods will be even more special when you eat them mindfully when you're hungry, focusing on the appearance and flavors of the food, the ambiance, the other people and the reason you are all together.

So if you've wondered, "Why am I hungry all the time?" it's time to develop new strategies. By learning to recognize and decrease your overeating triggers, distracting yourself and coping effectively with head hunger, you'll soon break free from old habits. You'll find yourself eating less, feeling more satisfied and more fulfilled. 

Discover what you need to know to change your destructive patterns for good in these nine "easy-to-read over a cup of coffee" e-book chapters from I'm NOT Hungry - What Now?
 


  
 

Wednesday, April 27, 2011

Head Hunger: Coping with Your Triggers for Overeating part 2

By Michelle May, M.D.
http://www.AmIHungry.com

Why am I hungry all the time?

If you find yourself thinking, "Why am I hungry all the time?" you may be confusing "head hunger" with "body hunger." If you're someone who's sensitive to food cues, weight management will be challenging until you are able to recognize the overeating triggers in your environment and break the associations that lead you to overeat simply out of habit.

Let's take a look at just a few of the common overeating triggers and strategies for coping more effectively with head hunger.

HIGH RISK TIMES: Many people have times of the day that are high risk for overeating. For example, you may experience a late afternoon energy slump or a tendency to munch when you come home from work to transition into your evening.


Strategy:
  Know when you're most at risk and develop an alternate strategy. For example, create a Recharge Ritual or Transition Time that helps you relax or unwind. Save a favorite magazine or book to read, call a friend or walk your dog instead.

You can also print a one-page handout, "
101 Things To Do Besides Eat." Just highlight the activities that appeal to you and add some of your own. Keep your list (and any necessary supplies) handy and make a commitment to try one before eating simply out of habit.

So if you've wondered, "Why am I hungry all the time?" it's time to develop new strategies. By learning to recognize and decrease your overeating triggers, distracting yourself and coping effectively with head hunger, you'll soon break free from old habits. You'll find yourself eating less, feeling more satisfied and more fulfilled. 

Discover what you need to know to change your destructive patterns for good in these nine "easy-to-read over a cup of coffee" e-book chapters from I'm NOT Hungry - What Now?
 



  
 

Tuesday, April 26, 2011

Head Hunger: Coping with Your Triggers for Overeating part 1

By Michelle May, M.D.
http://www.AmIHungry.com

Why am I hungry all the time?

If you find yourself thinking, "Why am I hungry all the time?" you may be confusing "head hunger" with "body hunger." If you're someone who's sensitive to food cues, weight management will be challenging until you are able to recognize the overeating triggers in your environment and break the associations that lead you to overeat simply out of habit.

Let's take a look at just a few of the common overeating triggers and strategies for coping more effectively with head hunger.

BY THE CLOCK: Society programs us to follow a schedule, so like Pavlov's dog, you may have learned to salivate when the bell rings. The reality is that it's more convenient to eat at certain times than others so it takes effort to listen to your hunger cues.

Strategy:
Though it's challenging to change this routine, you can adapt it to fit your own needs. Learn to pace yourself by observing your natural hunger rhythms. You'll probably notice that you get hungry every 3-6 hours depending on what and how much you ate last. Keep a healthy snack handy to satisfy hunger that doesn't conform to mealtimes. If you're consistently tempted to snack right before a meal, move your mealtime up. And remember, if you're only a little bit hungry, you don't need to eat a whole plateful just because it is mealtime.

So if you've wondered, "Why am I hungry all the time?" it's time to develop new strategies. By learning to recognize and decrease your overeating triggers, distracting yourself and coping effectively with head hunger, you'll soon break free from old habits. You'll find yourself eating less, feeling more satisfied and more fulfilled. 

Discover what you need to know to change your destructive patterns for good in these nine "easy-to-read over a cup of coffee" e-book chapters from I'm NOT Hungry - What Now?
 


  
 

Monday, April 25, 2011

Motivational Monday

We do not plan to fail, we just fail to plan! Plan for your protein needs when you travel. ~Bariatriceating.com











    

Friday, April 22, 2011

The Hunger Scale

This tool will help you avoid eating mindlessly. The more in touch you are with your hunger, the less you need to count calories.

 
First, decide how you're feeling:

10: Stuffed. You are so full you feel nauseous.

9: Very uncomfortably full. You need to loosen your clothes.

8: Uncomfortably full. You feel bloated.

7: Full. A little bit uncomfortable.

6: Perfectly comfortable. You feel satisfied.

5: Comfortable. You're more or less satisfied, but could eat a little more.

4: Slightly uncomfortable. You're just beginning to feel signs of hunger.

3: Uncomfortably hungry. Your stomach is rumbling.

2: Very uncomfortable. You feel irritable and unable to concentrate.

1: Weak and light-headed. Your stomach acid is churning.

You should eat only when you're feeling 1, 2 or 3.

Put your fork down at 5 or 6 and wait until the next scheduled meal or snack.

If you're trying to lose weight, stop at 5, the point at which you're eating a little less than your body is burning.

Thursday, April 21, 2011

YOUR EXERCISE PERSONALITY QUIZ

By Michelle May, M.D.
www.AmIHungry.com A voice of reason for a society consumed by dieting, weight, food and eating. Vol. II Issue 2
We've all decided at one time or another that we needed to start an exercise program. Initially we feel enthusiastic – we join a gym, drag out a stationary bike or buy new walking shoes. But how often do you abandon your program because it gets boring, time-consuming or just doesn't feel right?
Sometimes the real problem underlying the excuses is that we simply haven't chosen the right activity for our personality so it seems awkward and uncomfortable. Frankly, if it's not fun and rewarding, we won't keep it up.
To identify your unique exercise personality traits, circle the answers below that best describe you. This information will help you decide what types of physical activity you're most likely to enjoy and stick with!


Why?



  1. My main motivation for exercising is to:
    a. look better

    b. feel better

    c. be healthier

    d. lose weight

    e. other:


  1. I am motivated by rewards like:
    a. visual graphs and numbers
    b. money or prizes
    c. intangibles, i.e. more energy or better sleep


Write your fitness goals using positive, powerful, measurable terms to keep yourself focused and inspired. Be specific about the results you want and the rewards you'll get when you achieve your goals.


How?



  1. Time for exercise:
    a. is not a problem
    b. is a challenge but can be arranged when I make it a priority
    d. is last on my list


  1. I'd exercise more if it wasn't for:
    a. the time it takes to get to the gym

    b. family commitments

    c. work

    d. the cost of a gym or equipment


  1. I stay on track best when:
    a. I set a goal to work out most days of the week but stay flexible about when
    b. I write my workout schedule in my appointment calendar
    c. I know someone else is expecting me to be there


  1. When I decide to do something:
    a. I have a hard time getting started

    b. I stick with it until it gets hard

    c. I make it happen no matter what


Making the commitment to invest your time, money and energy in becoming more active is never easy. When you anticipate possible challenges, you can plan to work around them. For example, if you're concerned about taking time away from your family you could involve them in your workouts, exercise during your workday, or decide that the time is worth it because you're healthier and less stressed.


When?



  1. I feel most energetic and alert in the:
a. morning

b. afternoon
c. evening


  1. In the past, exercise has worked best:
    a. when I do it early in the day before other things get in my way
    b. when I do it at work during my breaks or lunch hour
    c. when I stop in at the gym on my way home so I don't have to go out again
    d. when I do it after dinner to unwind or when I have help with the kids


Plan your workouts during your peak energy times and times that are most convenient.


Where?



9. I need:

a. to exercise at my own pace

b. the support of a friend or partner

c. the accountability of a class or lesson

d. to be pushed by a trainer or teacher



10. I love to be:

a. at home
b. outdoors
c. in an exercise environment


If you enjoy being at home or alone, use videos, a home gym, or try activities like walking or biking. If you enjoy being with another person, invite someone to walk, hike, play tennis or go to the gym with you. If you socialize while you exercise, consider joining a sports team, signing up for a class at church or work. If you're more of an outdoors-type, you'll enjoy walking, hiking, bike riding or sports. If you need a designated exercise space join a gym or studio. Hire a personal trainer (at home or the gym) for guidance or accountability.


What?



11. I really like:

a. technical gadgets and toys
b. a real physical workout so I don't have to think about anything
c. creative or artistic expression


12. When it comes to competition,

a. it makes me feel stressed

b. I like to challenge myself

c. a little is healthy and fun

d. I am very competitive



There are so many different forms of physical activity that the challenge is finding several that suit your preferences. For example, if you're a gadget guru, you might like a fancy pedometer, computer programs, or gyms equipped with high-tech monitors on all the machines. If you enjoy artistic expression, try yoga or dance.
If you thrive on competition, look for team sports and competitive races, or challenge competitive friends to play racquetball or tennis. If you enjoy challenging yourself, set goals and track your progress. If you don't like competition, but like to be with others, look for classes and gyms with a supportive environment.
Michelle May, M.D. is a recovered yoyo dieter and the award-winning author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle. Find additional articles and resources at http://AmIHungry.com/
Copyright 2010, Michelle May, M.D. All rights reserved. For permission to reprint, email enews@AmIHungry.com

Wednesday, April 20, 2011

Dieting is like cutting weeds with nail clippers...you'll never get to the roots

By Michelle May, M.D.

Original content found at http://www.eatwhatyoulovelovewhatyoueat.com/2011/02/dieting-is-like-cutting-weeds-with-nail-clippersyoull-never-get-to-the-roots.html

Why can't I stick to a stupid diet?

  • Why did I eat that candy? I wasn't even hungry.
  • Why did I order the burger and fries? I was going to order a salad.
  • Why did I eat that whole bucket of popcorn? The movie hasn't even started.
  • Why did I eat so much? Now I feel miserable!
  • Why did I hit my snooze alarm? I was going to get up early and go to the gym.
Sound familiar? These are the result of habits that keep you stuck in your eat-repent-repeat cycle. By definition, a habit is a recurrent, often unconscious pattern of behavior that is acquired through frequent repetition.

The problem with any habit is that it takes away your options. When you act out of habit, you continually recreate the past. No matter how motivated you are, new patterns cannot emerge from old, often unconscious, beliefs, thoughts, feelings, and behaviors.

You may already know that these are habits and you may have even tried various diets to try to break them. But that's a habit too! Dieting is like weeding your garden with nail clippers; it's a difficult, endless, futile chore that will never get to the root of the problem.

Until you know the real answer to why?, you're doomed to repeat those behaviors again and again (and again and again). Difficult. Endless. Futile.

The Missing Structure

What you're missing is the necessary structure for getting to the root of the problem. Once you know and understand the missing structure, you can make your ineffective beliefs, thoughts, feelings, and behaviors conscious. Once they are conscious, you are able to use specific processes to systematically replace them with effective beliefs, thoughts, feelings, and behaviors.

Without this structure, the whys? like those in the examples above are sources of recurring frustration. Try as you might, the solutions are out of reach. With structure however, the answers and solutions are clear and often quite simple.

For example, each of the questions above is addressed by the processes in each of the six stages of the Mindful Eating Cycle™ (in order):

  • Why do I eat?
  • When do I eat?
  • What do I eat?
  • How do I eat?
  • How much do I eat?
  • Where do I invest my energy?
The structure provides you with the flexibility and freedom for lasting change.



Monday, April 18, 2011

Motivational Monday

Feeling healthy and feeling good about yourself is not a luxury - it's an absolute necessity.

Friday, April 15, 2011

Gas, Bloating, Diarrhea: Sugar Alcohol

by Kaye Bailey

Original content: http://www.livingafterwls.com/Library/Gas%20Bloating%20Diarrhea.html#featured

Sugar intake is a real concern for people who've had gastric bypass, in fact most patients fear sugar. The foremost fear isn't weight gain, it's dumping. Foods containing sugar pass too quickly through the small pouch, they are rapidly absorbed and cause insulin levels to drop resulting in dumping.

Further reading: Sweets After Weight Loss Surgery

Very unpleasant. Instead of taking chances with sugar many of us reach for "sugar free" sweets or diabetic candy to satisfy our sweet tooth. Many of these products contain sugar alcohol, a natural sweetener derived from fruits and berries. Unlike artificial sweeteners that contain no calories, sugar alcohol has about half the calories of sugar. Diabetics are able to have food with sugar alcohol because it's converted more slowly to glucose and require very little insulin to be metabolized.

While sugar alcohols are low in calories and slow to convert to glucose, the down side is they can cause gas, bloating and diarrhea. I learned this the hard way. One day that devil we call temptation seduced me into buying a bag of sugar-free jelly beans. Jelly beans are dangerous because they are little bites of soft food which means a gastric bypass patient can eat too much volume. I ate the entire bag in about an hour (true confessions of the closet snacker). I soon became uncomfortable with a small tummy ache. The tummy ache turned to bloating, cramping and gas. Extreme cases of all three symptoms. Painful "take me to the hospital I think I'm gonna explode" symptoms. It took a couple of days for my body to return to normal, a couple of stressful and uncomfortable days.

The jelly beans I ate contained Mannitol, a common sugar alcohol extracted from seaweed. I know they contained Mannitol because I read the package mid-way through the crisis. The package contained this warning, "Warning: excessive consumption can cause a laxative effect" Fine time to be reading labels I told myself! Mannitol is found naturally in pineapples, olives, asparagus, sweet potatoes and carrots. It's about 60% as sweet as sugar, so more product is needed to replicate the sweetness of sugar. "Mannitol lingers in the intestines for a long time and therefore causes bloating and diarrhea." Yup! That's exactly what happens all right.

What other names are sugar alcohols called?

Sorbitol is found naturally in fruits and vegetables. It is manufactured from corn syrup. Sorbitol has only 50 percent of the relative sweetness of sugar which means twice as much must be used to deliver a similar amount of sweetness to a product. It has less of a tendency to cause diarrhea compared to mannitol. It is often an ingredient in sugar-free gums and candies.

Xylitol is also called "wood sugar" and occurs naturally in straw, corncobs, fruit, vegetables, cereals, mushrooms and some cereals. Xylitol has the same relative sweetness as sugar. It is found in chewing gums.

Lactitol has about 30-40 percent of sugar's sweetening power, but its taste and solubility profile resembles sugar so it is often found in sugar-free ice cream, chocolate, hard and soft candies, baked goods, sugar-reduced preserves and chewing gums.

Isomalt is 45 - 65 percent as sweet as sugar and does not tend to lose its sweetness or break down during the heating process. Isomalt absorbs little water, so it is often used in hard candies, toffee, cough drops and lollipops.

Maltitol is 75 percent as sweet as sugar. It is used in sugar-free hard candies, chewing gum, chocolate-flavored desserts, baked goods and ice cream because it gives a creamy texture to foods.

Hydrogenated starch hydrolysates (HSH) are produced by the partial hydrolysis of corn. HSH are nutritive sweeteners that provide 40 - 90 percent of the sweetness of sugar. HSH do not crystallize and are used extensively in confections, baked goods and mouthwashes.

Should Gastric Bypass Patients indulge their sweet tooth with sugar alcohol?

The American Diabetes Association claims that sugar alcohols are acceptable in a moderate amount but should not be eaten in excess. In addition, weight gain has been seen when these products are overeaten. Personally, I'm not dipping my sticky fingers into sugar-free candy again. For gastric bypass patients generally the key, as in all eating, must be moderation, not a full bag of jelly beans. And of course, we can always rely on the old advice of conventional dieters, "Hungry for something sweet? Reach for a piece of fruit

Thursday, April 14, 2011

Coffee, Tea, Caffeine, Soda

by Kaye Bailey

http://www.livingafterwls.com/Library/Coffee%20Tea%20Caffeine.html#featured

Dieters are often told – drink water. Drink a minimum of 64 ounces a day – eight glasses a day. Gastric-bypass patients don't have a choice: they must drink lots water. Other beverages including coffee, tea, milk, soft drinks and alcohol are forbidden. Water is the essential fluid for living. Water is one of the most important nutrients the body needs to stay healthy, vibrant and energetic. A tell-tell sign of a gastric bypass patient is the ever-present water bottle.

Rule # 2: Drink Lots of Water

The restrictive and malabsorptive nature of the gastric bypass causes several things to go wrong if a patient partakes of caffeine coffee or tea, high-caloric or alcoholic beverages. The caffeine assimilates into the blood stream very quickly causing jitters and nervousness more-so than a normal digestive system. The high-caloric beverages are easily absorbed through the shortened intestine causing a weight plateau or weight gain. And alcohol is absorbed with break-neck speed causing intoxication, vomiting or dumping.

Knowing this bariatric centers advise patients to drink water throughout the day to avoid dehydration. However, patients are told to avoid drinking water with meals as it will facilitate food movement through the small stomach pouch allowing a person to consume more food.

Nutritionists say a precise measure of the body's need for water is to divide body weight (pounds) in half and drink that many ounces every day. That number could well exceed 200 ounces a day for morbidly obese people actively engaged in weight loss. Most doctors advise gastric bypass patients to consume 64 to 72 ounces of water daily.

Wednesday, April 13, 2011

After Surgical Weight Loss: Resenting Normal Eaters

by Kaye Bailey

Original content: http://www.livingafterwls.com/Library/Resent%20Normal.html#featured

In the early weeks after having weight loss surgery almost all patients report resenting normal eaters. Some go as far to say the normal eaters flaunt their food consumption to make the WLS patient, who is eating meals the size of a chicken egg, feel inferior. In fact, this resentment has caused disputes among married couples and families.

What is odd is that normal eaters don't realize how resentful the WLS patient feels. The normal eater is doing what they have always done and it doesn't feel unnatural. Seldom will a normal eater admit to purposefully consuming normal amounts of food in front the WLS patient simply to cause resentment.

One successful method for WLS patients to cope with this resentment is to understand that what another person eats – any other person – has nothing to do with anyone else. Food intake is always a personal choice. This is the mantra I developed to cope with resenting the normal eaters:

It has nothing to do with me that they are eating copious amounts of nutritionally void high-caloric foods. They are making their food choices and I am making my food choices. I could try some chocolate cake or a chili-dog or lobster bisque. But I chose not to because I will get violently sick, I will gain weight and I will feel self-loathing. I chose not to eat those foods because I have the self-respect to serve my body, my nutrition and my mind well. When others chose differently it is not about me - it is their choice and their problem. They are not flaunting in my face, they simply don't know another way. I have chosen another way and I am living healthy and well because of my choice.

Tuesday, April 12, 2011

10 Actions for WLS Success

By Deb O

Original content: http://www.livingafterwls.com/forum/index.php?showtopic=7357

1. Vitamins are Vital: Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist. Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results. Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include: Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning. Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible.

2. Use the "Honeymoon" to Hone Your Habits: When you are feeling better than you have in years, and the weight is coming off easily, it's hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back. A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don't change what you've always done, you're going to keep getting what you've always gotten -- even after weight loss surgery.

3. Win with Water, Except with Meals: Yes, it's hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating.

4. Get Your Ounces In: Most WLS patients are at risk for dehydration, so drink a minimum of 64 oz. of water each day to help avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too.

5. Find Some Flavor for Those Fluids: Drinking diet soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we do know is that it keeps you from getting the hydration your body requires after WLS -- because when you're drinking soda, you're not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there.

6. Caution Ahead: Handle Alcohol with Care: If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it. Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious. Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations. If you think you have a drinking problem, get help right away.

7. Eat with Excellence: Eat all your meals according to your plan. Keep your favorite protein handy, make your meals ahead of time to help when time is tight and try some new dishes every so often to keep your menu fresh and fun. Keep unhealthy food out of sight -- even out of the house if you can convince the adult(s) in your home to do so. Feed yourself at regular intervals so that temptations for poor choices are reduced. And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your "absolutes" based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you.

8. Eat Enough; If You Need More, Plan Protein: Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It's one thing to eat the three to five small meals you and your doctor agree you need. It's something else altogether when you start to graze, eating any number of unplanned snacks. Grazing can easily make your weight creep up. Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing. Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement.

9. Carbs Can be Friends, If You Like Complex Relationships: Let's face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, and these have beneficial vitamins and help keep things flowing through your system. For example, if you can handle pastas, try whole grain Kamut pasta--in moderation, of course. (Kamut pasta doesn't have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as "condiments," rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies.

10. Move to the Groove, Put Your Pedal to the Metal, Run for Fun and Shake that Booty: Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest!


"Action" version re-rewritten by Deb O., member of LAWLS
"Dummies" version rewritten by Sally Perez
Original article written by:
Mason. EE, Personal Communication, 1980. Barber. W, Diet al, Brain Stem
Response To Phasic Gastric Distention.
Am J. Physical 1983: 245(2): G242-8 Flanagan, L. Measurement of Functional


Monday, April 11, 2011

Friday, April 8, 2011

Quit Smoking—Smoking Cessation

Free Patches...No Classes

The WHMC Tobacco Quit Line Research Study is available to Active Duty Members, Reservists, Guard, Retirees, and Dependents.  The study aims to assess the effectiveness of a tobacco quit line in the military.  The research project will include telephone counseling sessions and nicotine patches at no cost to the participant.  For more information, please call 1-877-726-6211.



**** All patients must be smoke free for 6 months before they will be given a surgery date

Wednesday, April 6, 2011

Liquid Protein

Original content at http://www.5daypouchtest.com/recipes/days1_2.html

Mocha Smoothie by Andie Jamari
Page 6 - Neighborhood Cookbook
Ingredients:
1/2 cup decaffeinated coffee
1/2 cup skim milk
2 Tablespoons vanilla or unflavored protein powder
1 Tablespoon cocoa
4 teaspoons Splenda (or sweetener of your choice)
5 ice cubes

Directions: Place all ingredients in blender container, cover and blend until smooth. Serve immediately.
**Serves one. Per serving: 110 calories, 15 grams protein, 11 grams carbohydrate and a trace of fat.

Ingredients:
1 cup water
2 packets Splenda
2 scoops vanilla protein powder
8 ice cubes
1 teaspoon pineapple extract
1/2 teaspoon coconut extract

Mix all ingredients in a blender until smooth and creamy.
**Recipe Note: protein count will vary depending upon the brand of protein powder used. Please consult product label for nutritional information.
Ingredients:
1 cup skim milk
1/4 teaspoon ground allspice
1/4 cup Splenda
1/3 cup unflavored or vanilla protein powder
3 teaspoons instant tea mix, unsweetened
3/4 teaspoons vanilla extract
3/4 teaspoons cinnamon
8 ice cubes

Directions:
Place all ingredients into blender container; cover and mix until smooth. Pour into glasses and serve immediately.
**Serve 2. Per serving: 110 calories, 16 grams protein, 11 grams carbohydrate and no fat.
Ingredients:
1 (4 servings per package) package Jell-O sugar-free instant pudding, any flavor
2 cups fat free milk
2 scoops Unjury unflavored protein powder

Directions:
Measure 2 cups of cold fat free milk and add two scoops of unflavored Unjury. Shake or stir until Unjury is completely dissolved into milk. Place the sugar free pudding mix in a medium bowl and slowly whisk in milk mixture. Whisk until smooth. Cover and chill.
**Serves 4. Each 1/4 cup serving has 14 grams protein.

Tuesday, April 5, 2011

Frequently encountered post operative problems

Nausea/Vomiting: This is the most common problem after GBP, and is almost an expected outcome in the first few weeks. In this early post-operative period the new stomach pouch and the attached small bowel don't function very well, and this causes symptoms of poor function. In some patients this occurs because they are trying to eat too much at once, and the resulting "stuffing" of the gastric pouch causes pain and nausea.

On days when patients have N/V, they should be instructed to "fall back" to clear liquids only, and the problem will usually pass in 12-36 hours. If the N/V persist to an extent that the patient is becoming dehydrated, arrangements should be made to be evaluated.

Keeping a food diary will help you figure out if vomiting is caused by food.

Bowel Changes: Liquid stools for the first 3 weeks after surgery. If they become too frequent, you may take the anti-diarrheal products that are liquid or chewable, such as Imodium AD.

Pain: Incisional pain is usually nearly resolved by the time the patient is discharged from the hospital. Patients commonly have persistent discomfort at the left rib margin, secondary to intra-operative retraction- this is benign but can require 1-3 months to resolve.

Ventral Hernia : Approximately 20% of patients will develop an incisional hernia after open GBP, and is much more rare after laparoscopic GBP. This is usually manifested three months or more after the surgery, with patient complaints of midline abdominal pain and a bulge under the incision.



Hair Loss: Many patients report that in the 2-4 month time period their hair brush begins to fill up with huge clumps of hair. This hair loss is very common, and is due to a relative protein deficiency. As long as you maintain your protein intake the hair loss will resolve-no patients have yet gone bald due to GBP.



Flabby Skin: Unfortunately, skin does not always shrink as fast as you lose weight. This frequently results in bothersome and unsightly folds of skin on the abdomen, thighs, and upper arms. This extra skin can be removed by plastic surgical procedures. Arranging to have this done by military plastic surgeons is only sometimes possible. The copayment for this surgery at BAMC or WHMC is approximately $3,800.00 for the abdominoplasty alone.

Lactose Intolerance: Dairy products frequently cause cramping and diarrhea after GBP, because the surgery has bypassed the part of the bowel that has most of the enzyme (lactase) necessary for digestion of mild sugar. On the other hand, dairy products are desirable because of their protein content. Patients generally appreciate a substantial improvement in their ability to consume dairy products with the addition of Lactaid, which can be purchased over the counter in drug stores and supermarkets. Patients can also anticipate improvement in milk tolerance over a period of months following surgery, as the bowel adapts to the new nutritional flow. This may be short or long term. Only time will tell.



Dehydration: Watch your urine for a dark color or strong odor, or watch for bad taste in your mouth, with nausea. These are signs of dehydration that tell you to drink more. As a gastric bypass patient, you can become easily dehydrated. Your goal the first day home is to drink a minimum of 42 ounces of fluids. Then increase your fluid intake you intake daily until you are drinking closer to 72 ounces of fluids.



Constipation: In the long term you may have difficulty with constipation. This is usually due to relative dehydration and the patient should remember frequent small volume fluid intake. Another option is to purchase over-the-counter products such as Milk of Magnesia, Colace, or Dulcolax, taken as directed. You may also opt for a stool bulking agent such as Metamucil or Benefiber daily.



Metabolic Changes: Two to four weeks after surgery, your body reacts to the smaller amount of food. You feel tired, lethargic, and often depressed. Your body wants to slow down until the old food supplies returns. The best way to deal with this is to recognize the symptoms and know they are normal. Start exercising so your body gets used to using body fat as source of energy. As your body adjusts, the hibernation syndrome will end.



Hypoglycemia: You may feel lightheaded, shaky, faint, or have a headache. This could be caused by hypoglycemia

(low blood sugar) and can be helped by drinking milk or orange juice, or by eating a graham cracker, a granola bar or a piece of hard candy. It is a good idea to carry one of these products with you at all times. You may experience this if you have skipped a meal, or did not eat before exercising. You can also suffer from what is called rebound hypoglycemia, if your diet is high in carbohydrates. If this condition continues contact your bariatric surgeon.

(To prevent hypoglycemia eat a well balanced meal that includes proteins, whole grains, fruits and vegetables).



Dumping Syndrome: This is the result of an intolerance to foods that are high in sugar (sweets), fats or grease. When you eat these foods, they now enter your intestines without being partially digested by the gastric juices of your old stomach. You may then become lightheaded or dizzy and have cramps, diarrhea, flushing, or sweating. Some patients may even suffer from nausea and vomiting. This reaction can last for 30 minutes or a day. Once a patient experiences this very unpleasant reaction, they will want to avoid foods that caused the dumping syndrome.



Possible complications of lesser frequency

Gastroenterostomy stenosis:
The anastomosis of the stomach to the bowel is made a certain size to restrict the rapid emptying of your new stomach. In some patients, excessive scarring can occur at this site and will shrink this opening further. The patient usually complains of inability to tolerate solid foods and may have retching or vomiting. This complication is managed by performing an endoscopic dilation (enlarging the opening via an upper GI endoscopy). It may require multiple dilatations at different times to manage the problem.

Marginal ulcers:
Erosion occurring at the anastomosis between the small intestine and stomach pouch. Patients usually complain of pain, nausea and occasional vomiting of blood. Treatment is usually consists of antacid medications, however, refractory cases may require re-operation and reconstruction of the connection between the stomach and small intestine.


 

Monday, April 4, 2011

Medical ID Tags


MEDICAL ID TAGS
What should I engrave on my Medical ID Tag?Select the most important medical information, in case you cannot speak for yourself. Having your medical condition(s) listed is important to alert Medical Emergency responders!

You will be limited by the number of characters per line on the tag you have selected. Many choose to have their first name or full name and an "ICE" (In case of emergency) telephone number, rather than the medication taken, as that can change. You should also carry an Emergency Wallet Card that has the medicines you take, doctor's phone numbers & more listed.

This is a general guide, and these are only suggestions. Please consult your physician for the most critical information to put on your medical identification tag.
Information to list:
FIRST & LAST NAME                                               Example: JOHN DOEMEDICAL CONDITION &/or PROCEDURE             ROUX-EN-Y or LAP BAND or GASTRIC SLEEVE, etc.ALLERGIES &/or OTHER INSTRUCTIONS             DM / ASTHMA / PCN ALLERGYICE #1 or MILITARY FACILITY                                MILITARY FACILITY    ICE #2                                                                       ICE 123-456-7890    
Google: "medical alert bracelets"
American Medical IDhttp://www.americanmedical-id.com/
Titanium, Stretch, Sports Bands, Sterling Silver, 10K gold, Lynx, and more.
Creative Medical IDhttp://www.creativemedicalid.com/
Stainless Steel, Beads, Italian Charms, Stretch, Leather, Allergy Free, Crystals, Designer, and more.
Lauren's Hope – http://www.medicalert.org/www.laurenshope.com (largest assortment of styles/colors)
Men's: Stainless Steel, Sterling Silver, Leather, Black Tube, Dog Tags, Guitar Picks, Waterproof Bands, Combo Sets, and more.
Women's: Sterling Silver, 14K Gold, Pearl, Natural Stones, Crystal Beads, Leather, Black Dress, Custom, Watches, Seasonal, Combo Sets, (bracelets are interchangeable with tag) and more.
MedicAlert -
Sports Bands (assorted color/pattern bands), Stainless Steel, Stretch Bands, Sterling Silver, 14K Gold, and more.

Disclosure: This is for informational use only. Department of the Air Force and the Department of the Army do not support or disclaim the views and products of the websites provided within. The use of these websites, products, items, materials and information within those sites is at the patient's discretion.