Re: 8 weeks today

August 3, 2005

Good morning, everyone. So, today marks the 8th week since my surgery on June 8th. I have 9 1/2 weeks (fitting, isn't it?) until is here.

I have lost 37.5 lbs. since the surgery, and 63.5 lbs. since orientation. My BMI has gone from 42.5 to 32. I went through the categories of Morbidly Obese, down to Severely Obese, and now I'm "Obese". I need to lose 13 lbs. and then I'll be in the "overweight" category.

I started out in size 18/20 and the other day I wore a 14 petite dress. My size 16 jeans are too big. (however, there are some 16s that still fit.)

When I went to Portland a week and a half ago, I fit in the center seat, between two large men...and I didn't have to touch them. There was extra room on both sides.

Men are now hurling themselves into harms' way to protect me (our capricious elevators, that are willing to snap you into two pieces should you dare cross through the doors at the wrong time), and are pole vaulting to get to doors to open them for me.

I was hit on by an adorable 22 year old at a dance club...and he wasn't even drunk. He was also the best dancer there. And hello? I'm 41 years old, for Pete's sake.

My best friend from Chicago was out here, and her tummy is bigger than mine. (Granted, she's 4 months pregnant, but hell...I'll take what I can get with that skinny little witch!!)

I am under 200 flipping lbs. for the first time in about 8 years. ANd I'm under 200 lbs, with this lovely, serene knowledge that I ain't nevah gonna go there, again! What a great thought!!

My scars are no longer raised...I've massaged away the keloids...and the look pretty darned good for only being 8 weeks out.

My inner thighs are a bit jiggly, but they are already showing signs of tightening since I've been back to Pilates and weight lifting.

My underarms are also a bit jiggly, but they are thinking about changing for me, I can tell.

I'm 5'6" and 198 lbs. That sounds a heck of a lot better than 5'6" and 261 lbs. My best friend was certain that I was at about 160. (Bless her.)

I have 53 more lbs. to go to reach goal. I'm hoping to get there by Christmas (which will be slightly more than 6 months from surgery...four and a half months from today. I'll need to average 12 lbs a month, and I think that's actually realistic. I'd like to go on and try to get to 135, if possible. So that I can get the Century Club (post surgery...I will reach the personal Century Club at 161.5).

For those of you out there, struggling to get off that 10 percent...lemme tell you. I struggled, too. I only had to lose 26 lbs, and the first 13 or so came off easily...but then I got distracted, and I couldn't seem to get myself properly motivated. There was some kind of psychological thing going on with me...and I just struggled. Finally...I just kicked myself in the patooty and took the Pam Marsh ninja "Just get this damned thing done, no deviations...take no prisoners" approach. Cheating wasn't an option. The gym was my best friend. Water ran from me in fear, due to my guzzling. No snacks. Three meals. Little ones. Sometimes protein shakes. And, in three short weeks, I was down where I needed to be.

You can do this. It is worth it. It is worth it. I mean, getting on the scale without fear of it jumping up several lbs. Think about it. I don't have fear of the scale anymore. Even on my period, if it goes up a lb, I KNOW it will come down again.

This is so worth it. And I'm worth it, darn it. And so are you. , Cecilia, Azin, Ron, Dean...all of you...you can do this. We are here for you...and I'm telling you...you will not be disappointed.

Robynn ...8 weeks out, and on my way.....Pamela A Marsh wrote:

Thanks for this information Robynn. I think this isgreat and will be very useful as I will be six monthpost op on Aguust 9th (yeah!!).Pam Marsh--- Robynn VanPatten wrote:> : I found this interesting article that might> offer some insight to you in your struggle....> > Robynn> > INTRODUCTION:> > > > A common misunderstanding of gastric bypass surgery> is that the pouch causes weight loss because it is> so small, the patient eats less. Although that is> true for the first six months, that is not how it> works. Some doctors have assumed that poor weight> loss in some patients is because they aren’t really> trying to lose weight. The truth is it may be> because they haven’t learned how to get

the> “satisfied” feeling of being full to last long> enough.> > > > HYPOTHESIS OF POUCH FUNCTION:> > > > We have four educated guesses as to how the pouch> works:> > > > 1) Weight loss occurs by actually “slightly> stretching” the pouch with food at each meal or;> > 2) Weight loss occurs by keeping the pouch tiny> through never ever overstuffing or;> > 3) Weight loss occurs until the pouch gets worn out> and regular eating begins or;> > 4) Weight loss occurs with education on the use of> the pouch.> > > > PUBLISHED DATA:> > > > How does the pouch make you feel full?> > > > The nerves tell the brain the pouch is distended and> that cuts off hunger with a feeling of fullness.> > > > What is the

fate of the pouch? Does it enlarge? If> it does, is it because the operation was bad, or the> patient is overstuffing themselves, or does the> pouch actually re-grow in a healing attempt to get> back to normal?> > > > For ten years, I had patients eat until full with> cottage cheese every three months, and report the> amount of cottage cheese they were able to eat> before feeling full. This gave me an idea of the> size of their pouch at three month intervals. I> found there was a regular growth in the amount of> intake of every single pouch. The average date the> pouch stopped growing was two years. After the> second year, all pouches stopped growing. Most> pouches ended at 6 oz., with some as large at 9-10> ozs.> > > > We then compared the weight loss of people with the> known pouch size of each person, to see if the

pouch> size made a difference. In comparing the large> pouches to the small pouches, THERE WAS NO> DIFFERENCE IN PERCENTAGE OF WEIGHT LOSS AMONG THE> PATIENTS. This important fact essentially shows that> it is NOT the size of the pouch but how it is used> that makes weight loss maintenance possible.> > > > OBSERVATIONAL BASED MEDICINE:> > > > The information here is taken from surgeon’s> “observations” as opposed to “blind” or “double> blind” studies, but it IS based on 33 years of> physician observation.> > > > Due to lack of insurance coverage for WLS, what> originally seemed like a serious lack of patients to> observe, turned into an advantage as I was able to> follow my patients closely. The following are what I> found to effect how the pouch works:> > > > 1. Getting a sense of

fullness is the basis of> successful WLS.> > 2. Success requires that a small pouch is created> with a small outlet.> > 3. Regular meals larger than 1 ½ cups will result in> eventual weight gain.> > 4. Using the thick, hard to stretch part of the> stomach in making the pouch is important.> > 5. By lightly stretching the pouch with each meal,> the pouch send signals to the brain that you need no> more food.> > 6. Maintaining that feeling of fullness requires> keeping the pouch stretched for awhile.> > 7. Almost all patients always feel full 24/7 for the> first months, then that feeling disappears.> > 8. Incredible hunger will develop if there is no> food or drink for eight hours.> > 9. After 1 year, heavier food makes the feeling of> fullness last longer.> > 10. By drinking water as much as

possible as fast as> possible (“water loading”), the patient will get a> feeling of fullness that lasts 15-25 minutes.> > 11. By eating “soft foods” patients will get hungry> too soon and be hungry before their next meal, which> can cause snacking, thus poor weight loss or weight> gain.> > 12. The patients that follow “the rules of the> pouch” lose their extra weight and keep it off.> > 13. The patients that lose too much weight can> maintain their weight by doing the reverse of the> “rules of the pouch.”> > > > HOW DO WE INTERPRET THESE OBSERVATIONS?> > > > POUCH SIZE:> > > > By following the “rules of the pouch”, it doesn’t> matter what size the pouch ends up. The feeling of> fullness with 1 ½ cups of food can be achieved.> > > > OUTLET SIZE:> >

> > Regardless of the outlet size, liquidy foods empty> faster than solid foods. High calorie liquids will> create weight gain.> > > > EARLY PROFOUND SATIETY:> > > > Before six months, patients much sip water> constantly to get in enough water each day, which> causes them to always feel full.> > > > After six months, about 2/3 of the pouch has grown> larger due to the natural healing process. At this> time, the patient can drink 1 cup of water at a> time.> > > > OPTIMUM MATURE POUCH:> > > > === message truncated ===__________________________________________________

August 3, 2005