Linda Federman's Blog

"The miracle isn't that I finished. The miracle is that I had the courage to start." – John Bingham

A Healthy Breakfast February 6, 2013

What’s on your breakfast table this morning?

For me it was a 1/3 of a an apple diced up with about 1/3 cup of Friendship 1 % whipped cottage cheese. (If you’re not a fan of cottage cheese, try this kind. Its smooth and fluffy, more like whipped cream cheese. I used to be a cottage cheese hater, but now I go to multiple stores looking for this when my local grocery is out. And it is PACKED with protein!) 1 cup is 180 cals and has 32 grams of protein! So for my serving I got 10 grams of protein for 60 cals. And some calcium too, with almost no fat.

I sprinkled it all with some good ceylon cinnamon. Yummy and satisfying.

Growing up I was not a breakfast eater. I would actually wake up with a sort of sick, sort of acidy stomach. No one ever really diagnosed it definitively; it was either because my body was already messed up and I was still digesting what I’d eaten the night before, or it was the physical manifestation of extreme stress, or both. Either way, it was enough of a struggle most days just to get out of the door to go to school, much less choke down any food.

The sad thing is if I had forced myself, and eaten the right things, I might have corrected some things that were broken, digestively and hormonally speaking.

Like most Americans, when I did eat breakfast, it was almost always a nightmarish volume of carbohydrates. Breakfast cereals (most of which were no better nutritionally than broken up cookies with milk poured over them. In fact I think one of them actually was called “Cookie Crisp” or something to that effect.) Donuts. Bagels. Toast. Waffles. My best friend’s family had the same breakfast every day, (and I slept over there often) a frozen english muffin with jelly and grape juice. These are all pretty easy to get, store, and eat while standing or commuting.

The problem is they are terrible foods. Packed with carbs, stripped of any kind of nutrition, and likely to cause the intricate system of digestion to run amok. There’s a bagel shop near me that has the BEST bagels; delicious, hot, fresh and huge – they are about 700 calories. And that’s before you smear them with butter or a slab of cream cheese; or add taylor ham, egg, and cheese.

So I felt full and happy and satisfied after breakfasts like that. Meanwhile my blood sugar is skyrocketing to Mars. An hour and a half later, its plummeting back down to earth. I would feel hungry again mid-morning, and that confounded me. But if my head said: “Hey stomach, we just ate an enormous high calorie breakfast. Chill!” a couple of times and I was able to avoid getting more food for a little while, eventually I would HAVE to eat again. It wasn’t me making a poor choice or being weak or gluttonous; it was the crashing blood sugar activating my body’s emergency alert system. Sometimes I would shake until I ate another portion of something, and then I felt better. Of course the “remedy food” was usually something else carby/starchy, so it would start the cycle all over again.

I will talk a lot more in my next post about Fat Chance, by Dr. Robert Lustig. But for now let me just share in a very casual way what the good doctor has to say about skipping breakfast: don’t.

Your body wakes up needing fuel, even if you’re not hungry (our signals for hunger and satiety are pretty much shot anyway.) After a little wakefulness, the body kicks in and says: “Hey wait a second, you’re running me on empty here.” And there’s evidence that it literally spends the rest of the day trying to compensate for the missed meal. So getting something at coffee break or having lunch and then dinner isn’t good enough. You are likely to not only consume more during a day without breakfast, but you are likely to store more of the calories consumed because you’re body is protecting you against further deprivation by “saving up” what you do give it.

Research even shows that while your endocrine system is busy trying to figure out how to run with no fuel, it is diminishing other functions to conserve the energy you’ve got stored. Like clear and focused thinking, for example. And it slows down the process of metabolizing fat stores for energy, leaving you foggy and sluggish. You’ve heard many analogies about running your car with no gas in it and there’s a reason for that. The human body is an intricate machine that in its healthiest state performs feats nothing short of miraculous. You are a miracle that is so complex – brilliant – ingenious.  “What a piece of work is man…” and all that.

And you need to give that machine the best quality of nutrition possible so it can do its thing.

Here are a few good breakfast ideas: they are not fancy – I’ll get into that more in another post. They are quick, high in protein, and low in carb.

1. 0% unflavored greek yogurt (my favorite) mixed with just about anything. I take a handful of fresh or frozen berries and half a sliced banana and mix it in to about 1/2 cup of yogurt for breakfast. This is my go-to breakfast and I wake up sometimes excited about getting to it. You can even mix this up the night before and have it ready to go (although banana does go brown. Save adding that til morning). Do not chose the flavored yogurts, they are loaded with sugar and that is unnecessary for flavor and satisfaction when it is so easy to add delicious things to it. Mango. Strawberries. Bananas. The options are limited only by imagination. You can also use it for savory meals, but we’ll talk more about that in another post.

2. Cottage cheese (see above); again if you don’t like cottage cheese, try the Friendship Whipped. It will make a believer out of you.

3. Eggs any way you like ’em. If you’re concerned about cholesterol, mix one whole egg with two whites. I eat a lot of eggs and without the “bad” fats and all the carbs in my diet, my cholesterol is beautiful and has been for years. (Also as a post-surg RNY patient, I find egg whites rubbery. The texture makes me gag and they are hard to digest. But that’s just ME.) My cholesterol is always under 130 and my HDL/LDL ratio is perfect.

There are some great recipes out there for crustless mini quiches that you can mix up in a second, cook, and freeze. This is one of my favorites: Crustless mini-quiche. They are a little bland for me so I pump them up with a lot of seasonings and spices. (I am a chipotle Tabasco devotee!) Freeze individually and then pop in the microwave for a few seconds or thaw on the counter.

Chop up anything and add to eggs. If you make steamed, roasted or stir-fried vegetables for dinner, save a 1/2 cup and chop up when you’re clearing at night. Then throw into your morning eggs.

I like adding salsa to eggs. (Just look for one made without sugar, or if you’re really inspired, make your own!) And cheese.

4. Cheese sticks made with 2% milk. Great grab-n-go snack!

A high protein breakfast will stabilize your blood sugar and keep you more even throughout the day.

Food that has its fiber stripped away causes your body to treat it as pure sugar. If you eat an orange, the fiber (cell walls) of the fruit help your body break it down and metabolize it. If you send it into the GI without the fiber (i.e. juice) it dumps directly into your system and is stored as fat before your digestive system can catch up and start processing it. Do you see where I’m going with this? Fruit – good; juice – bad!

 

Here we are again… February 5, 2013

Filed under: Uncategorized — lindafederman @ 9:31 am

Its been nearly a year to the date since I last posted with the intentions of reviving the blog. I’m nothing if not inconsistent. But as I like to say “Every day is Day 1”; and with my 5-year surgiversary coming up on February 15, I think this might be a good time to try again.

So I’m within 6 lbs of my goal weight, although some indeterminate issues with leg and knee pain have prevented me from exercising with vigor and regularity. (It doesn’t always hurt, but it ALWAYS makes for a good excuse.) I think I may be getting a handle on what’s going on, although I have to say I’m pretty disappointed that its even happening. I thought this would be the kind of thing one would expect when one carries around an extra 140 lbs., and that I would be impervious after having lost that. Au contraire…I guess now age is catching up with me, and who knows what damage was done all the years I carried that weight?

I’ve been doing the occasional Jazzercise class, which I kind of like but I prefer the “dancier” feel of Zumba. I go to the gym (sometimes a couple times a week; and sometimes a couple weeks pass with no visits at all). At this point I’m trying to experiment and figure out what I can do without flaring up my hip agony. So far the best thing seems to be the cross trainer, which is good because it is an excellent workout. With it being so cold (and me being so unable to tolerate the cold for a second) I can’t workout outside. But I hope in my deepest heart that once the weather turns warmer I will be able to run on my favorite trails and in my favorite parks and on my favorite boardwalks once again.

I still think its pretty amazing that I ever found any exercise “enjoyable.” I truly felt that it was a heinous chore, and that people who worked out with any commitment or regularity were at best way stronger than I; and at worst twisted masochists. It was not anything I thought I’d ever be able to force myself to do, because it stunk and it felt terrible. Maybe its good for you, but they said the same thing about castor oil.

Not only that, but it was something you had to do frequently and hard and there was precious little progress for all that work.

The first time I ran on a trail in a lovely park around a beautiful lake I realized I don’t hate running; I hate running on a treadmill. And I don’t hate exercise, I hate some kinds of exercise (the gym is up there because it is SO boring but my options are limited in the cold months.) I love Zumba because I love to dance and I love the beat and the music and before I know it class is over and I’m a little let down that its time to go home. (By the way, you can go to Zumba.com and put in the day you’d like a class and your zip and it will list all the classes in your area. Try it!)

I also have continued thinking about how to create a career helping others considering, undergoing, or living with weight loss surgery. If I acted on pursuing it as much as I think about it; I’d be actively doing that for dozens of clients by now. I feel so enthusiastic about my surgery, and so grateful for it that I want to help others experience it too. I also have strong opinions about the way obese people are treated, and the way the bariatric community handles patients, all of which have come from my experiences and the experiences of others. I firmly believe that the quality of care, the preparation for life with WLS, a good support infrastructure, and information are vital to the continued health, happiness and success of patients.

 

Reviving my Blog January 27, 2012

Filed under: mental attitude,running,surgery,Uncategorized — lindafederman @ 9:26 am

Its been a full year since I last posted to this blog. I’m sitting here in a completely silent house. With no one to talk to on facebook at the moment, no email to answer, no articles to read, no tv blaring in the background, my thoughts turn back here. I think its time. In the past year, many things have occurred to me about which I would have like to write, but something kept me from coming back here and doing it. I’m embarrassed and disappointed that I didn’t go to run at Disney, and that was the reason I abandoned the blog initially. But it doesn’t explain why I didn’t return to it.

I considered writing from the beach this summer. My happy place. More about that later.

I’m coming up on my fourth anniversary since having surgery. So many physical issues and emotional issues are converging at this point in my life, and I’m afraid my ability to deal with all of it is not always successful. I didn’t want to publish a diary in which I whine and complain and wallow in self pity. Maybe that is the main reason I didn’t write. Of course that doesn’t explain why I stayed away during the summer. There was nearly nothing to complain about then. Just observations about being completely happy and at peace. See, I’m just as unlikely to write about the good stuff.

Then of course as time went on, it seemed like there was an overwhelming amount of stuff to catch up on.

Now my thinking is this…just do it. Just start. Just do something. None of this is going away. The issues may morph and change order of priority, but there will always be issues. I think its good and right and cathartic to be writing about it. For no other goal or reason than … what? Maybe there is NO reason at all. And maybe the reasons will just become clear by doing it.

 

Pulling the Plug January 6, 2011

Filed under: Disney Half-Marathon,fitness,mental attitude,running,surgery,weight loss — lindafederman @ 8:35 am

Its January 6, 2011 and I woke up in my bed instead of a hotel room in Disney. I should have been there already, taking pictures with Mickey and getting ready to run on Saturday.

But after the surgery on Dec. 17, I had continued to feel the pain in the exact same spot. The same pain in the upper left side of my abdomen, neck, and in my shoulder. Part of me wondered if it’s the same pain for different reasons; could it just be that as it all heals it feels familiar? That the same nerves involved in the initial problem are now aggravated by the solution?

Conversations with my surgeon leave me feeling that I know so much less than when I began. I think I understand, but then I try to replay it in my mind and its sort of like trying to remember the details of a dream. The harder you chase after it, the dimmer the details become.

He said that he didn’t really fix a twist, but rather a place where part of the intestine “lopped” over itself, and secured it with a suture. He said there was a spiderweb of adhesions (I think?) that had secured themselves to the stomach wall, which he “peeled” off.

He said I may have an ulcer. I asked: “Isn’t that something you would have seen during the procedure?” and he said no because an ulcer would be inside the stomach, and they were examining the outside of the stomach and the intestine. Does this make sense? I may not even be remembering what he said correctly.

He prescribed Nexium every 24 hours for the next six months. At that point, it was about a week after the surgery. He asked if I’d been running and I told him I was barely upright. He said “Well you were skewered with several trocars. You should give it a week before you start to feel better.”

I do feel better, but my stomach still isn’t quite right. I have an appointment with a gastro-enterologist to investigate further.

When I got off the phone with him I realized that there was no way I’d be able to do the run. Even if I started to feel better immediately, I had lost quite a bit of training time during a crucial phase. I had to make a decision, and I knew that even if I felt well enough to run on January 8, I wouldn’t be prepared physically to finish it.

Team In Training assured me that all of the money I’ve raised (over $3,000!) will be applied to any future event I choose, and even if I never get to run, all of those contributions will still go to the crucial work of the Leukemia and Lymphoma Society. I was able to cancel my room reservations, and it looks like I’ll even get credit for most of the money I paid for my plane tickets.

I am terribly disappointed. But I think this turned out for the best and everything DOES happen for a reason.

I had set this experience up as a metaphor for my life. That I can do this physically (a real triumph for me). That I am stronger than my own self-doubt. That I can push myself to work hard and really accomplish something impressive. That I can be healthy and strong and fit. That I can enjoy something that I once found distasteful – even repulsive – because it brought me so many pleasures and benefits.

I haven’t lost the desire to achieve all of that. I still intend to run, and to attempt another event. I’ll likely pick one that takes place in the fall; if I’ve learned anything it’s that running in the cold is a real problem for me. (Temperature regulation seems to be an issue for a lot of weight loss surgery patients.) I guess that’s another benefit to postponing.

I really want to thank everyone for all their support – whether it was a note, a call, a word of encouragement, or a contribution. The groundswell from my cheerleaders, family, friends and acquaintances was a bonus I had not anticipated. It means the world to me that people were so enthusiastic, so proud, and had so much faith in me. Even people who don’t know me well, or only knew me through professional relationships, expressed their belief in me in big and small ways.

When things got rough, or I really didn’t feel like running further, or hitting the trail at all; when I felt tired, or achy, or like I just wanted to do something else – I thought about all those people who were counting on me to succeed.

I feel that I’ve let all those supporters down. But I am committed to trying again. I hope everyone that has been so kind will continue to be patient with me, and look toward the future with me.

 

GOAL and 30 Days To Go! December 8, 2010

With only 30 days to the starting horn, my Leukemia and Lymphoma Society fundraising page now reflects the passing of a major hurdle. I’ve achieved my financial commitment to collect $2,700 in exchange for the support of Team In Training to run the Disney half marathon.

From the smallest back pat and “Atta girl” to the largest check, the outpouring of support for this effort has left me speechless. Old friends, relatives, passing acquaintances, friends of friends, and total strangers have all made gestures. While everyone has their own motivations for pitching in, it all comes down to people perceiving some value in me or in what I’m trying to do. And that is awesome.

When I see the surgeon tomorrow, I’m going to tell him that unless he says I must have the procedure now or risk major consequences, I’m waiting until after the race.

This effort is a metaphor for me and my life.

I am no longer the person who folds when faced with a challenge.

I am no longer the person who lets life interfere with me doing something I think is important.

I am no longer the person who looks for easy excuses to abandon my commitments.

I am no longer the person who feels weak or incapable of working hard.

Seeing myself as inadequate, and punishing myself for it, got me in trouble in the first place.

I was watching the Biggest Loser last night. I know that there are a lot of people who object to that show, and I think a lot of the criticisms against it are legitimate. But I am addicted to it, because I can SO relate to the feelings of desperation that drive someone to participate in a circus like that.

Ada

I hope Ada (Termin-Ada) wins. She has struggled with a lot of pain in her life, mostly stemming from the drowning death of her brother when she was just a toddler, and the sense that her parents didn’t love, support, or approve of her. She has made amazing strides in coming to terms with her own self-acceptance and healing her wounds; she’s also the toughest physical machine I’ve ever seen and I admire her strength in all things. I think she deserves to win.

I relate to the struggle, the pain, and ultimately – the triumph. Last night’s episode was the last one before next week’s season finale. When the contestants joined the show, they taped a message to their “new” selves to be aired if/when they made it to this point in the competition. Each and every one of them said: “Don’t ever let yourself get back here.” And I totally get that!

I have a friend who calls anyone that hasn’t had weight loss surgery an “alien.” That’s a great way to describe it; you can tell someone who hasn’t been in these trenches what its like, but only another person who has been through it really, truly understands. All the good. All the bad. And that is one of the reasons why having a network of supporters and kindred spirits is so important. Besides feeling like you’re not alone in the world, you also share an amazing experience.

Thin people know what its like to be thin (and probably take it for granted). Fat people know what its like to be fat (whether they mind staying that way or not.) Even people who were fat and became thin by other means have a different perspective.

I feel that not only have I lost the weight, but I’ve completely transfigured myself, both figuratively AND literally. I did that. I chose that. I took control of a life that was uncontrollable. It wasn’t an easy decision, and it wasn’t an easy process. All of that – in addition to the physical modifications of my body – has implications for my whole lifetime.

 

Honesty – An Update December 3, 2010

I have been neglecting to blog.

At first it was subconscious, and then it became deliberate avoidance. I am well past the happy, shiny stage, and am firmly planted in the struggle and effort stage. It was easier to share when I was positive and upbeat and brimming over with enthusiasm. I also thought those evangelical messages would be more valuable to my readers.

But I’ve come to conclude that I owe it to myself, and everyone following my journey, to be honest.

So here is my honesty:

Things haven’t been going so well.


It seems some days like all kinds of things are conspiring to challenge me.

First there was the heel. The orthopedist said it was bursitis and sent me to the physical therapist. After a couple of treatments, the pain that only made itself known when I stretched too far or stepped a certain way started showing up more often, hurting more, and lasting longer. I decided I had been foolish to even address it; I should have left well enough alone. I think all the fussing with it, manipulating it, exercising it, whatever, just aggravated the situation. I cancelled my appointments, took a few days off and left it alone.

It’s still there, but in a minor, annoying and occasional way. I’m going to just ignore it.

Then there’s this other thing, and this has some deeper implications that I’d like to address here.

There’s a pain in my left side, just under the bottom of my bra. It is a twinge-y and nagging pain, about a level 4 on the discomfort scale. It radiates up into my neck and centers in my left shoulder, right at the joint. It comes and goes every now and then. It crops up a couple of times a month; usually starts when I’m in the car; and I know that when it starts it will be with me for a few days.

Every time it happens I think: “I should maybe get this checked.” And then it goes away and I forget about it.

Then one day it happened when I was sitting, but not in the car. So I stood up. And it vanished.

That day I called my surgeon, and he said it is something we need to look into. It could be a hernia or a twist in the intestine that happened as the result of the bypass, and its something that commonly shows up at this point (I’m about two months shy of my third “surgi-versary”) because there is a lot of extra room in the abdominal cavity and things can float, shift and twist.

Disclaimer: I am not a doctor. I don’t even swear to understand completely. I hope I’m explaining it properly.

I had a CT scan, but, as the surgeon predicted, it didn’t show anything. He said it probably wouldn’t unless they were able to look during the precise moment that the symptoms occurred.

The next step is a procedure. (See, I was just about to call it a laparoscopic laparotomy, but when I went to check the spelling, I see that these are two different things.) I get put under, they make a few holes, look around and fix what they find. It should be a one-day or outpatient event; unless they find something that can’t be done laparoscopically and bigger incisions are required.

The doctor felt confident that I could address this after the race in January.

Unless the symptoms changed.

Which of course they did. Over the weekend, I had a pain that started in the same spot, but radiated down instead of up. A level 7 or 8 on the pain meter. Unaffected by moving. Constant instead of intermittent.

Now I’ve got to see the doc again, and I suspect he’s going to recommend moving it sooner.

The wondering, the what-ifs, and the anxiety are draining me mentally and emotionally.

While I reserve the right to change my mind at any point, I say the following with the strongest conviction I can convey: Whatever happens, I’m not sorry I had the gastric bypass surgery. I still see only good things about being thin.

First of all, I took control of my life. That was a powerful step.

Second I have done things and felt things in these past three years that I either never had before, or hadn’t in a really long time and missed dearly.

Third, if I suffer complications from the surgery, at least I chose that over suffering the complications of obesity.

I never anticipated that problems would vanish and my whole life would be a delirious fantasy. What changed is me, from the inside out. The same people who do the same things that used to piss me off or depress me or wound me are still here and up to their old tricks. Life is still disappointing and frustrating and maddening at times.

But it doesn’t affect me the way it used to. And it is good to be free from some of the hurt and anger and resentment. It’s good to feel strong enough to face it all, and fight, and have some perspective about what is really important. It’s good to feel that when crap happens, it’s not because I am a crappy person who deserves it.


I gained all of that from losing the weight. How could I ever regret it?

How Can I Ever Regret Not Looking Like This Anymore? I Am Miserable Despite Being on a Lovely California Vacation With My Family, and I Can Barely Force A Smile!

Resume Whining…

Then there’s the weather.

And the “dreadmill” which I must default to because of the cold (that is a whole other post for another day).

And the newly installed crown in my mouth that started to hurt and needed to be adjusted.

And the ingrown eyelash that scratched my cornea. (Seriously??? An eyelash???)

And the scratchy sore throat.

Add all that to the fact that I am constantly plagued by a bone deep chill – (bypass patients will relate); suffering from a bad case of the winter blahs; and feeling very bah-humbuggish about the holidays: they start too early; go on for too long; bring out the worst in people; and have very, very little to do with me.

 

There was a time when I would have curled up into a ball and sat on the couch with a box or bag or bowl of something and waited until things turned brighter. But here’s an example of how the new me is coping:

On Tuesday, I rallied every fiber of my strength and energy and took a shower. I got dressed in nice clothes including makeup, jewelry and perfume. I went to my book group to discuss a book I started out hating and ended up thoroughly adoring (The Book Thief by Markus Zusak). I got on the dreadmill for almost two hours. I cooked a really nice dinner.

It did make me a feel a little better. They say that exercising raises your endorphin level, but my uplift-quotient is diminished by my level of hatred for running indoors on the dreadmill.

I think it had more to do with recognizing that I had (have?) the strength to stare that depression monster in the eye and fight my way past it. If I can’t slay it and throw it over the cliff, at least I can make it step aside and let me by for a little while.

That’s huge.

 

Previously Unknown Fact About Disney Half-Marathon November 20, 2010

The same day I got the diagnosis on the heel pain (see post below), I learned that the Disney half-marathon has a 3.5 hour time limit.

I did know that some of the races had limits, but I didn’t know Disney was one of them. Apparently, if you don’t hit certain mile posts along the course by a certain time, a Shuttle of Shame will come by and sweep you up, depositing you unceremoniously at the end of the course. In that moment, the Happiest Place on Earth must seem like the most Humiliating Place on Earth.

Good night nurse and thanks for playing!

The bad(est) news is that at the pace I ran in the two 5ks I’ve completed thus far, I ran about a 17-minute mile. In order to do the half-marathon in 3.5 hours, I have to do better than a 15-minute mile.

I don’t doubt I could work up to that, but the prescription to back off training looked like it would really hinder that progress.

I had to prove to myself that I could do it. So defying the Physical Therapist’s advice I ran 6 miles on the road in my neighborhood. I mapped out the distance from my house to the deli – 3 miles door-to-door. What I didn’t notice, in all my many years of driving that route multiple times each day, is how incredibly hilly it is.

It was tough, steep, windy and cold, but I managed to run it and get back home in 1.5 hours. That’s a 15-minute mile. But I was pushing hard, and I don’t know if I’ll be able to sustain that for the 13.1-mile course at Disney.

I guess its at this point that the initial enthusiasm and energy start to wane. Here is the place where the boys are separated from the men, so to speak. What happens when the going gets rough?

The old me would lie down, go shopping, eat. The new me will grouse, but do everything to keep going. I have to. I’m stronger than that. I have to be. Weakness and resignation were what got me in trouble in the first place.  I have to lift my head, straighten my back, and fix my gaze on the finish line.

I have so much to prove to myself. I have convinced myself that I can do anything if I work hard. I don’t want that to be an empty notion. I have said I want to do this til the voices in my head that say “I can” beat up the voices that say “I can’t.”

I must not give in. I must not give up. I just have to keep going.