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I realized before I made the decision to have weight loss surgery, that there had to be more to success than just the surgery itself. I realized there was more that needed to be "fixed" than a tiny tummy, a healthier diet and more exercise. There is more to the issue of obesity than what you eat. I found that it's also about what was eating me. I just didn't know what that "something" was. But it didn't take long before I figured it out.

It was only a few weeks as a matter of fact, that I came face to face with this "missing link" and I began to experience the impact it would have on my success.  

The problem, however, is our appetite. BUT, Not just the appetite for food. I began to recognize the fact that we are created with different appetites. These appetites have a value and purpose.

We are made with an appetite and desire for food, sex, authority and power, pleasure, work, gaining wisdom, companionship, love, acceptance, to be wanted, needed, understood, cared for, appreciated, trusted, and to fellowship with God. That's a lot of appetites, no wonder we are still hungry.

To satisfy an appetite, you must use the actual thing being desired to fill it. This is where we get off track.  We begin to use the wrong thing to fill the appetite desire.  We begin to substitute by trying to fill our needs with something else.  ou may have discovered already, that our appetites don't like to be ignored. That is when they begin to "rage" out of control.   

I encourage you to consider your appetites. Do you recognize your body's different desires? What are you really hungry for?  Are you filling every desire with food instead of what you really want or need? 

You can read more about appetites and how I worked through "what was eating me in my book, Out of Obesity and into the Promised Land. Click on title to purchase.

Yes, you can. You have many more miles to go!

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Before surgery, most everyone is asked or required to go on some kind of "diet."  Whether it's a grueling fast, a traditional diet that requires measuring and calculating or just a casual lean and green. Dropping pounds is the whole point behind losing weight before surgery.

It may sound crazy, but it does have a purpose—and the purpose of losing weight before surgery is to help shrink your liver. And it is extremely important for the safety of you and your surgery team. A fatty liver not only slows down your metabolism, but is gets in the way of the operating procedure. 

Before my weight loss surgery in April of 2006, I started losing weight on my own, a month or two before my first Dr. visits. I know it sounds crazy, I viewed surgery as the light at the end of the tunnel. But my biggest motivation—I had two upcoming weddings that year. I couldn't waste any time getting into mother-of-the bride dresses, I had to get going fast.

Once I began my series of visits with my surgeon, I had lost some weight. Those few pounds made a big difference in reducing my liver. I was told at that point to keep going by eating "lean and green". What does that mean exactly. Just what it sounds like...to make green vegetables and lean meats the majority of my eating plan. It helped to keep the weight off while I waited for my surgery date. 

There was one consolation. I love veggies. My pick of the crop is the long, thin, french variety of green beans.   We are talking fresh or frozen here, not canned.   

These extra fine variety of beans are my favs! They are called "French" not to be confused with "french style" which refers to the cut. French beans are the long thin variety of bean. I was introduced to these beans years ago when my neighbors grew some in their garden, they were the real thing —  from France. 

With careful attention to detail, you can find them in the frozen section of our grocery store. I usually sauté them in the skillet with a little water, olive oil, salt and pepper. Sometimes I add a little garlic or herbs, such as thyme or even a little squeeze of lemon. Cook until they are as tender as you like. 

My favorite way to serve them is to chop them up and add a little vinegar and cucumbers on top!

I usually fix a huge skillet early in the day and store them in the fridge for those "hungry" moments when I have to grab something quick. Yes, I love them that much! 

My second favorite veggie is collards, which you can also sauté or steam in the skillet in a much shorter time that boiling for hours in a pot of water. If you don't like collards then maybe you'll prefer my third runner up in the green vegetable dept—broccoli. My favorite way to eat broccoli is steamed in a Ziplock steaming bag. Three to 4 minutes tops and you're on your way to healthy, lean and green.

So if you're looking to make those scales go down even before surgery, consider going lean and green. 

Yes, you can. You have many more miles to go!

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Do you ever think about how slow a sloth moves. They move slower than a turtle. I get tired just thinking about it.

We all want things in our lives to happen fast, instantly, right now, no waiting — especially weight loss...even after weight loss surgery.

I remember once, before surgery, being so frustrated with constant dieting and little lose weight, I threw myself across my bed in a moment of self pity and announced to my husband that I was not going to get up until I had lost 50 pounds. He jokingly remarked, "Well then, you will , because I'm not bring you anything to eat."  He always has a way of snapping me back into reality with his humor. 

You know the routine, you hear it all the time from dieters, I'm sure you have experienced it yourself. You commit to a strict diet, allowing yourself no carbs, fat, fries or sugar, hoping that all the sacrifice will result in massive weight loss in a hurry.  

But let's face it, life is just not like that, weight just doesn't fall off in an instant. The reality is: it wasn't that way before weight loss surgery and it isn't that way after surgery. Will we lose weight after surgery? Yes, if we follow a healthy eating plan and get moving...weight loss will happen—but not always as fast as we would like. 

Even now, after 12 years after RNY, losing a few pounds takes effort. And the older I get the longer it takes to drop those unwanted pounds. Weight loss surgery is a tool that can make it happen. There are, however, other factors involved in weight loss. A healthy diet, increased activity and a willingness to make lifestyle changes are things we can change, but often there are things that affect weight loss that we just have to accept such as medication and (as much as we don't want to admit it) —our age!

I was reminded of a scripture in Exodus that has inspired me through a great deal of transitions in my life. Exodus 23:30 reads, "Little by little I will drive them (your enemies) out before you, until you have increased enough to take possession of the land."

A few years ago, I lost a few pounds. Then I became discouraged because my weight loss stalled. Eventually, I let a few bad habits slip back in and before I knew it, little by little, I had gained those 15 pounds back. If only I had stayed the course. If only my derailment had been short lived, I wouldn't be facing having to lose those pounds again.

I've had to learn the same lesson again...the hard way...that taking possession of the land, involves dwelling in the land — on a full time basis. It means a commitment to longevity, even if it requires us to get back on track when we get derailed. 

More than not, enemies such as old habits, require a reversal and an increase of positive behaviors before long term change is realized. So hang in there. It will happen, little by little, we increase enough, and take the land.

Yes you can...you have many more miles to go! 

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We hear and speak words all the time, but most of us seldom take the time to consider how words alter our perception of who we are.

I love to study words, but not just uncommon words we have never heard before, but everyday words we think we know the meaning of. Most of the time, I may think I know the meaning of a certain word, but when I actually look it up in the dictionary, I often find a deeper meaning, a whole new sense of wonder and a renewed sense of understanding about its meaning.   

The spoken word is actually not just a lifeless word; words are vibrations that cause movement. They change the atmosphere around us. When that movement is realized on our hearing ear, we are suddenly awakened into a different reality. 

We don't just hear words. Words are alive and active. They cause change. They cause us to think, feel, imagine, communicate, change, and heal. Words carry meaning. They matter. Words are powerful. They make a difference. They change us and the world around us. They hold the power to inspire, strengthen and empower.  They impute wisdom, provide understanding, reveal truth, give direction and create awareness.

I want to inspire you to take a look at the words you hear. Awaken your awareness to how you respond to the words you speak and the words you hear. How can you use the words you hear to change yourself, the way you feel about yourself and the world around you? I challenge you to examine the words around you to change your environment and your self-image for the positive. Make the healing, make the count for the good.

Words are not just words. Yes, you can. You have many more miles to go!

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There is a kind of sabotage that's more serious than the kind that others do to us. It's how we sabotage ourselves. It's called transfer addiction. If you have never heard of transfer addiction, you need to keep reading.

According to Dr. Lance Dodes, assistant clinical professor of psychiatry at Harvard Medical School and the author of Breaking Addiction, it is not unusual for recovering addicts to transfer one obsession to another. 

“It’s been well known for a very long time that A.A. meetings used to be filled with smoke because people shifted their focus from drinking to cigarettes. Alcoholism isn’t about alcohol any more than compulsive gambling is about playing roulette—or winning money. Addiction is a solution to an emotional need. If you deprive someone of one solution to their emotional problems, it’s not surprising that they’ll find another one instead.”

It is true that some of us became overweight for reasons other than food. But for most of us, myself included,   the fact that we turn to food for comfort sets us up for food addition. And it doesn't help that most of us are or were in denial.

For some of us - food is an addiction. We use it to cover up a lifetime of pain and disappointments. Weight-loss surgery might restrict our food intake, but it can not fix the real issue. We need a real remedy. We need to get to the root cause of what is eating us. We need to discover our emotional need and fill it with what we're really hungry for. Food isn't it...and it will never be enough to satisfy our hungry hearts. Easy - no. But we can, and we must. 

It begins with realizing we may be in denial. Admitting we may not be able to solve our dilemma with weight-loss surgery alone—or any other addiction, for that matter. We live and act out of how we feel. We feel what we believe. We solve root issues by getting to the bottom of our core beliefs and changing them. 

  • I started by asking myself what I was feeling when I found myself looking for food when I wasn't hungry. 
  • Then I asked myself when the feeling started. It's like following a trail of smoke to the source of the fire. 
  • Once I found the answers, I asked myself what I believed about myself and if the beliefs were true or false. 

There is a way of escape. It's based on finding truth. It may take time and effort, or even professional help, but we can be free. 

Then you will know the truth, and the truth will set you free. John 8:32

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In 2006, I made the decision to have weight loss surgery. It was not a decision I took lightly, but after much research, thought and prayer.

I am often asked about making such a life-changing decision. How do we make the right choice?

While considering whether or not to have weight loss surgery, I researched. I prayed, a lot. I waited, and listened for guidance in making the right choice. But, even so, I didn’t have a clear and certain answer that gastric bypass was the “right path” for me. But one thing was certain: I did believe that whatever my choice, I had expressed to God my faith in His promise to bring restoration to my life. So, I stepped out in faith that God would see me though to success.

It reminds me of a story in the Bible. As a child, it was my favorite—and still is. It’s the story of Jairus and his daughter. The story tells us that Jairus’ daughter has just died. As Jairus stands face to face with Jesus, he expresses his faith with an invitation—an invitation to “come.” His invitation expresses his certainty that if Jesus “comes,” life will return.

As Jarius starts his journey home, what happens next is something unexpected. Matthew 9:19 says, “And Jesus arose, and followed him….” 

Making the decision to have surgery is difficult, and from our current view our outcome is uncertain. In prayer, we can extend to God an invitation to “come.” We then, step out on the certainty that He has our best interest at heart. His heart is to bring healing and restoration. Then, whatever decision we choose, we can put our faith in the fact that He not only leads, guides, and prepares the path ahead of us, but He also follows on the heels of our faith. 

Jesus did arise and "come." And with him came resurrection of life to Jairus’ daughter—and for me, too! On Easter Monday, April 17, 2006, God redeemed my circumstances, I received my health and my life back. It was my personal resurrection day. This year, I celebrate 12 years of weight loss surgery success. 

you can read the full story in Matthew 9:18-34

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M.O. that's short for Modus Operandi.

That's Latin for "method of operating" meaning: normal operating procedures. But as weight loss surgery recipients you may know by now that our parts don't "operate by the normal method" anymore—and neither does our medical care. 

With that in mind, let's review some medical "methods of operation" that change as well as information you should share with emergency, hospital or other health care professionals. 

If you have had weight loss surgery, you should inform medical personel that you have had it and what kind of procedure you had. It is always of the utmost importance. 

It could save your life...

MO = time is of the essence

An informed medical staff helps insure that you get proper approach or medical treatment and executions without unnecessary delays. Saving time, could save your life.  

Knowing that you are a weight loss patient lets them know certain medical conditions to look for that they might not check on a non-weight loss surgery patient. Depending on your symptoms they could look for things such as vitamin and mineral deficiencies, ulcers, bowel obstruction, and blood sugar levels. 

Bowel Obstructions. Any abdominal pain should never be overlooked. Notify your surgeon or get medical attention immediately if you experience any abdominal pain.    

Any and every doctor that is treating you needs to know that you have had weight loss surgery.  

If you ever have any upper GI done, your health care professionals should be notified of your altered anatomy. 

MO = procedures and techniques

Protocol is different from other patients. After a gastric bypass or weight loss surgery, there are certain medical procedures that should be altered, such as smaller diameter instruments used. 

One example, gastric bypass patients should not have a"blind" NG tube. An NG tube is a nasogastric tube, a slender tube that is inserted in the nose, down the back of the throat, and into the stomach. An NG tube might be placed if a patient needs his stomach suctioned out. Patients can also be tube fed through an NG tube.

Normally, a doctor or nurse puts the tube up the nose and pushes. For a normal anatomy, it generally ends up in the right place. They check before pouring anything into the tube to make sure it's in the stomach, not a lung. When this procedure is done "blind," they can't see where the tube is going.

Get the idea, you don't have a normal size tummy! After a gastric bypass, you should NOT have a blind NG tube. Your stomach is shaped differently after a gastric bypass, and the walls of your little pouch can easily be damaged by the NG tube if it's not inserted carefully. A doctor should insert the tube using a scope, a tiny camera, that allows him or her to see where the tube is going.

MO = medications offered 

There are certain medications that gastric bypass patients shouldn't take, including NSAIDS. NSAIDS are non-steroidal anti-inflammatory drugs, and include things like ibuprofen, Motrin, and Aleve. Also steroids should not be taken without additional medications to protect the pouch. These medications are commonly given for pain inflammation. Gastric bypass patients shouldn't take them because they are at a higher risk for ulcers, and NSAIDS increase the risk of ulcers significantly. Your surgeon should provide you with a list of medication to avoid. (there is also a list provided on miles to go site)

MO = medical identification

As you can see, there are several reasons why you should inform those in charge of your medical care that you are a weight loss surgery patient. Another way to insure that a proper plan is carried out in an emergency is to wear a medical identification bracelet after having weight loss surgery. 

After surgery,  I got a medical ID bracelet. Not only am I a RNY patient, I have hypoglycemia and sleep apnea. I am also allergic to medications that need to be realized, even if I am unable to communicate these needs.

Hypoglycemic episodes are not uncommon for gastric bypass patients and symptoms may sometimes surface unexpected. Symptoms include, weakness and fainting. 

There are lots of choices on-line, including American Medical ID, that are attractive and affordable. 

MO ID = What information you could put on the id...

Here are some ideas you might want to list on your bracelet.

  • Your Name 
  • Type of Surgery Procedure*
  • Medical Conditions 
  • Medications
  • Emergency Contact 
  • Doctor's Name
  • Drug allergies, No NSAIDS
  • No Blind NG tube
  • Blood Type
  • Sleep Apnea

*Wearing an identification for Gastric Bypass or Weight Loss Surgery is important. 

MO = local 

Locally at New Hanover Regional Medical Center,  emergency medical and hospital care for weight loss surgery patients have expanded. 

No one "plans" to have an emergency, but you can have a "plan" for the unexpected—helping insure that incase of an emergency or if you are unable to relay information that you receive the appropriate medical care for your specific needs as a weight loss surgery patient.

Just make it your M.O. = "standard method of operation". 

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The first and most important ingredient in our pre and post op food plan as weight loss surgery patients is protein. 

Whether whey, egg, or soy, find one or more that you can at least tolerate and hopefully enjoy. 

Although taste is extremely important, the ingredients are what make the protein beneficial. So if you're going to drink it for health, lets choose the best.

Protein offers a plethora of important benefits, but simply stated, protein is what helps us lose fat without losing muscle mass.  

There are so many protein supplement options on the market today and the list just keeps growing and growing. Options are a good thing, but with so many options how are we suppose to choose which one is the best?

In my opinion, the best protein shake is the one you will drink. So, let's take a look at some important componets to consider when making your choice.

I also recommend finding several varieties that you like. 

Pricing

I once heard that choosing a protein supplement is like choosing a car seat for your infant...would you go for cheapest of safest? 

It may seem that protein supplements are expensive, mostly because you're buying them in bulk. Remember your health is your priority. Consider the servings per container and remember protein shakes and powders are your meals for as long as your in the weight loss phase. You're not eating a lot of "real" food. Protein shakes are essential for health during this weight loss phase. Compromises are not going to be in your best interest.

Protein shakes will phase out of your routine after you're on maintenance.

Not all proteins are created equal. Start with a high quality protein that you enjoy and then you can look around for other products you like, such as additional flavors, bars or puddings. 

Reading Labels

Label reading is important, but it can be confusing, but not when you know what to look for...

The top five things to consider are all listed on the nutritional label.

  1. calories
  2. fat
  3. sugar
  4. carbs
  5. protein
  • Check ingredients and grams. First look for high quality protein. The protein content should be as high as possible.  High quality protein is imperative, not the lest expensive. It should be listed first on the ingredient label. Protein supplements should offer a complete source of protein (more on this later).  Protein content is most important.   
  • WHICH WHEY: Whey protein isolate or hydrolyzed whey is best, but whey concentrate will do in a pinch. *These proteins digest very quickly and are the ones most often chosen workouts or exercise. Casein or milk protein isolate will digest much slower. Other drinks may contain protein blends, including egg protein, soy and/or added amino acids such as branch chain aminos or L-glutamine. 
  • Twenty / 20 grams per scoop is considered high. 
  • Next: check the label for: low carbs, low sugar, and low fat with the least calories as possible. (see below). Usually if the carbohydrates and fat are low the calories will be also. 

Taste

Select a protein drink that taste good. You will be on protein supplements during your weight loss phase. It's important to find a protein drink that you enjoy. Don't expect it to taste like the best milkshake you've ever had, but can you tolerate it? What flavors do you like best?

You might prefer to find one you can add your own flavor to and get creative. Find several that you like and try not to get burned out on just one flavor or product brand. I chose one staple brand that I liked with high quality medical protein and made shakes of different flavors. Then I had more than a dozen that I liked, both powder an pre-made, ready to use varieties. This really helps take the frustration and stress off. You need to make it work into your lifestyle, travel, work and schedule as well as taste. 

Fats

Contrary to popular belief, zero-fat products are not necessarily the best. Fat limits should be around 5 grams per serving (or single digits). Some fats are healthy, such as CLA, or conjugated linoleic acid, sesame see oil and medium-chain triglycerides (saturated fat from coconuts) help to fill you up, stabilize blood sugar and burn body fat. Avoid other high saturated fats.  

Sugar

Many protein drinks are sweetened with the artificial sugar substitute sucralose, also known as Splenda. Anything over 10 grams of sugar per serving is considered high. Keeping the sugar as low as possible or around 10 grams, will ensure that you don't have dumping. Lactose, which is milk sugar, causes dumping. Loctose-free proteins are available if you have a problem.

Fiber

Pick a product with some dietary fiber. Enlightened protein drink manufacturers recognize the link between fiber intake and reducing the risk of heart disease and obesity. Several products offer 5 or 6g of dietary fiber per serving, which can also help to suppress hunger between whole-food meals. If the product you select doesn't have fiber you can add your own by adding wheat germ. It's better to select a good product that meets the fat, sugar, carb and protein criteria and add your own fiber. 

Where to find protein supplements

Protein supplements are everywhere from health food stores, vitamin store, grocery and specially stores, the internet and many bariatric sites. 

It's a good idea to start by researching on the internet. Some places offer samples. Once you found one you like, high quality protein that fits the nutritional requirements and taste you prefer, then shop for price comparison.   

My staple protein duirng the weight loss phase was Unjury Medical Quality Protein, however, I had dozens of other brands I enjoyed. I was always on the lookout for new products. Unjury is sold in large containers and also smaller packets which made easier travel.

Although I never really did a lot of the high protein "shots" or "viles", they are good for traveling, especially when traveling by air.  I always made sure that when traveling that there was at least one variety of protein that I could find at a local grocery store. I did this by researching different brands and knowing my protein inside and out. Do this ahead of time, not to get caught without.

Finding several proteins I liked really paid off in the end. I actually learned to enjoy protein shakes!

Choosing proteins are essential for good health and weight loss...so enjoy the journey, get creative and most importantly, know your protein! Look for other protein favorites and information in the protein section.

Yes, we can, we have many more miles to go!

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I love to cook in my slow cooker. It's so easy and over the years I've found lots of fast and delicious recipes that I can make ahead. Easy to cook, easy to clean. Thats my motto! But fish in a slow cooker? Who ever thought that would work? But it does!

In fact, it's fast, simple and it's delicious and best of all it's loaded with healthy protein. It suddenly became a family favorite—they raved about it for days!

The serving size for this recipe is 4ounces of sea bass fish fillets—which has 22grams of protein. However, I have used tilapia and salmon, and the cooking time is approximately the same.  

Pecan-crusted Fish Packets

  • 4  4ounce fresh skinless sea bass or salmon fillets, about an inch think. (talipia is thinner, but it works well).
  • 1/3 cup finely chopped toasted pecans
  • 1 TBsp ghee (clarified butter or coconut oil)
  • 1 tsp snipped fresh basil
  • 1/4 tsp salt
  • dash of cayenne pepper
  • 4 cups fresh baby spinach
  • 4 lemon wedges

1. Rinse fish, pat dry.

2. In a small bowl combine the next five ingredients. 

3. Cut four 12-inch squares of parchment paper. For each packet, place 1 cup of spinach in the center of the square.

4. Top with a fish fillet, spread fish with 1/4 of the pecan mixture. 

5. Bring up the opposite sides of the parchment paper and fold several times over the fish. Fold remaining ends and tuck underneath packet. 

6. Place packets in a 4 to 5 qt. slow cooker. Cover and cook on high for 1 1/2 to 1/3/4 hours or until fish flakes easily. 

7. Serve with lemon wedges.

Makes 4 servings. For sea bass: 216 calories, 13g fat. 3g carbs, 2g fiber, 1g sugar, 22g protein. (revised from Better Homes and Gardens recipe)

Look for more recipes on Miles to Go in the recipe section.

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Studies show that folks who keep a food diary lose more weight. What have you got to lose?

Does keeping track of foods, exercise, weight, and goals seem too complicated? Wouldn't it be great if you could just click a button and it would be done for you?

What if there was an app on your iphone that would keep track of it all for you?  What if you could see exactly how much more protein you needed before the end of the day. Wouldn't you like to know how many carbs a certain food item has and how much you can have, before you eat it, or better yet before you purchase it at the store, or order it from a restaurant menu?

Now you can…. It’s fast and easy.  

One app that I have used for years is "LOSE IT" but there are many others - just choose one that fits your needs. 

I like LOSE IT because, you plug in your food item and adjust the portion size and it will figure your totals. This online food tracker will give you the current count of protein, fats and carbs for each day, as well as percentages and it allows you to scan in your own food nutritional labels. That takes the guess work out of making selections at the grocery store. 

Set up your nutritional goals including measurements. You can enter your own guidelines and track your personal boundaries for calorie counts, fat, carbs, fiber, protein, and water for each day. Then you can see at a glance how your progressing.

When you enter your weight under the “weight” section, then your target weight and the deadline, it breaks down your weight to tell you how long it will take and how many pounds you have to lose to accomplish your goal. That way you can tell if your goal is realistic. It makes it easy and fun to record your progress and see your accomplishments.

The app even calculates your daily “activities”, has an online community and challenges if you want to connect with others that are on the same journey to success. 

One of the other advantages to LOSE IT is that it instantly syncs to your computer from your iphone. The computer version allows you a little more in-depth information about your weight, health and progress.

Keeping a food diary is more than just a daily help for keeping track of what you eat, having a food diary allows me to see forward in meal planning. I plan my meals on the app and they set them on a clock -it's as easy as touching a button. It already calculates the food in waiting into my daily counts, and allows me to see them, as they wait for me to include them in my menu.  Keeping a food diary was really helpful when I first began to struggle with low blood sugar. I could go back and review my menus and foods eaten to figure out what was causing the most problems and what foods were helpful in helping me remain stable. 

So Check it out and — Lose it! 

Yes you can, you have many more miles to go !

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