Lies my Mother Never Told Me

mags 18thI think it’s a well-known fact that the older we get the more we start to appreciate our parents.  I don’t believe I truly began to really appreciate my mothers’ love and the sacrifices she made (‘it’s ok honey…you have the last butter tart, really I’m STUFFED’…a dad never does that!) until I had my first child; it was only then that I truly knew what that all-consuming I would do anything for you’ love is all about.

Same goes for their wisdom.  And why I titled this blog ‘Lies my Mother Never Told Me’ is because she just never told lies.  Still doesn’t…ever.  I don’t even think she tells those little white ones.  Something that was always POUNDED into us as children (perhaps a bad choice of words no we weren’t physically abused!) was ‘thou shalt not lie’. We were always told ‘you will get into more trouble if you tell a lie than if you own up to what you did’.  And it was true!  When my sister broke the church window with a snowball trying to get me an icicle all she had to do was apologize to Father Harrison…go figure they were tellin’ the truth! :).

HOWEVER it seems as though a few…in fact maybe more than a handful…of my patients… lie to me.  One just fessed up yesterday.  Here’s the story:

‘Nora’ (that’s what my rotten children call me ever since I put on a pair of jeans they deemed to be ‘mom jeans’…the ultimate embarrassment apparently) forced me to come in on a long weekend to do a defill…FYI something us Lap-band nurses don’t take too kindly to.  Seems her band had been perfect but then suddenly something got caught and bam she couldn’t even get water down.  (Oh reeeeally?  As my Dad used to say ‘I may have been born at night but it wasn’t last night’).  Ok, so that can happen.  I know that you can be sailing along with no issues and the band can tighten and sometimes we can’t figure out why.  But in Nora’s case, and in most cases I knew that this wasn’t true.  She had  been denying any signs of being too tight, denied looking for ‘restriction’ from her band, and had been quite insistent on regular small adjustments, despite our worrying and warning that she may have been getting into the red zone.

And she had been lying to us about the symptoms and issues she had been having all along!

Nora however did not fess up right away. We ended up doing nearly a complete defill due to her inability to tolerate even sips of water.  As of yesterday it has been around 6 weeks of first waiting for the esophageal swelling to subside and now sloooowly starting to re-fill her band while she struggles with hunger without having the assistance of a properly adjusted band to help her.

So yesterday ‘Naughty Nora’ sheepishly came clean (I’m only trying to make you smile…I really like ‘Nora’ and of course have great respect for her despite her recalcitrant ways…I told her she is simply in her ‘teenage years’ and is pushing my limits ;)) Turns out:

  • yes she had been noticing more and more heartburn
  • yes she was having difficulty tolerating more and more of the solid foods she used to enjoy
  • yes she had been starting to go for the softer, easier, mushier food
  • and yes occasionally she did wake with fluid in her throat at night

So WHY DID SHE LIE TO ME???!!!  I’m feigning ignorance because I know exactly why.  Same reason we all lied to our parents (sorry mom!): Nora was afraid.  She was afraid to have fluid taken out of her band.  She was afraid ‘fluid removal’ spelled ‘weight gain’.  She was afraid of going backwards, losing the gains she had made in her weight loss journey and going back to the old days from which she had moved so far away.  She was afraid of failing at yet another weight loss attempt and that fear is HUGE and REAL I think for every banded individual.

But believe me, I have a fair bit of knowledge and experience here both as a parent and as a seasoned ‘Lap-band nurse’…YOU WILL GET INTO MORE TROUBLE IF YOU LIE ABOUT YOUR ISSUES THAN IF YOU TELL THE TRUTH. 

Being too tight, or on the cusp of being too tight may assist you to lose weight initially but eventually it always, always, always backfires, either in the manifestation of the unpleasant side effects of tightness that are listed above or in the more sinister form of pouch dilatation.  TOO TIGHT IS NOT RIGHT.  The best adjusted band is the one that has the least amount of fluid in it that is adequately controlling your hunger.  The best adjusted band is the one that has the least amount of fluid in it that is adequately controlling your hunger (no that wasn’t a mistake I meant to repeat that because I want y’all to listen).

Realize if you are with a good clinic that, like a loving parent,  your nurses only have your best interests at heart.  And we DO get p’o’ed when you lie to us because we KNOW that in the end you are only going to end up hurting yourself!

So for those of you who may have been tellin’ a few fibs…fess up.  You won’t get spanked or grounded or even yelled at instead you’ll get taken care of :).  Don’t be afraid.  You are NOT going to go back to the ‘old days’, you’ve got this wonderful tool for the rest of your life.

I hope everyone has been as fortunate as I have, to have been raised by a loving mom who did her best to instill good values, taught her kids the importance of telling the truth, and always forfeited the last butter tart.  Love  you mom 🙂

Yours in Health and Happiness,

Sue

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Extinction…not always such a bad thing

Image result for attercopus

Pop Quiz:  Attercopus, lime Skittles, Bruce Jenners man-bits and the lunch hour…What do all of these things have in common?  Come on think about it, don’t just say ‘I don’t know’…this is easy.  Omgosh, I’m dying here:  they have all gone the way of the dinosaur!  Gone, extinct, kaput!  (Some people are having a bit of an issue with the Bruce Jenner thing…”but he was an Olympic decathlete” they say!  “He still holds that title and maybe some altered parts” I say!).
Take the last one though, this idea of a ‘lunch hour’.  When was the last time you looked at the clock at work and thought ‘oh I’d better go take my lunch hour’.  Or turned to your co-worker at 12:00 and said ‘I’m going for lunch, see ya at 1!’.  CAN YOU IMAGINE?  She would likely choke on the PB&J that she is scarfing down at her desk!  It’s a shame but such luxuries are long gone.  (Granted an entire hour out of a work day for a meal might be a bit extreme but 30 min?  That’s not unreasonable).
I remember when growing up dinner was referred to as ‘dinner time’.  It was family time.  Dad got home at 5:30, dinner time was at 6 and we sat around and ate, talked and argued for the better part of an hour.  Now it seems we are always rushing, be it for a sport, a tutor, a class…dinner seems not so much an event but a function that has to get ‘done’.
The thing about being banded is that you CAN’T rush your meals.  You MUST eat mindfully.  This isn’t a luxury.  This isn’t something that ‘should be done most of the time’, but something that has to be done all of the time. Now and for the rest of your life.
I know I have written about this before but I truly think it is something that needs to be brought forward and addressed every once in a while…pouch dilatation (scary music in the background please).  Pouch dilatation sucks.  It means not only yucky symptoms (persistent heartburn, reflux, no sense of satiety, weight plateau or weight gain), but also most often a whopping big defill followed by a painfully slow refill to control hunger with the hopes that the symptoms don’t return.  IF the pouch dilation is excessive the band may need repositioning (i.e. surgery) so all in all a very bad path to go down, and one which for the most part can be avoided by:  taking small bites, chewing well and eating slowly.

I really hope that pouch dilatation is also starting to go the way of the dinosaur.  Maybe banking on its extinction is a bit optimistic, but I CAN say the incidence of pouch dilatation is decreasing dramatically at many clinics.  ‘Why is this??’  you curious readers ask 🙂 :)…well two reasons are  #1. the introduction of modest adjustments and #2. educating banded individuals on the importance of eating slowly (Dr. Paul O’Briens rule #3:  “Eat Slowly”).

So what does eating slowly mean?  It means taking at least 30-45 seconds between bites of food.  It means savoring your food, eating mindfully and it’s really how all of us, banded or not should be eating.
Eating slowly does three things:
  • It prevents food from getting caught
  • It allows that connection to occur between the stretch receptors in the stomach and the brain that signals satiety
  • And it prevents pouch dilatation
Back in ‘the old days’ when I first started in this business it was believed that a meal stayed in the pouch above the band and sloooowly trickled across.  We were militant about enforcing the ‘one cup of food’ rule because we thought going above that one cup lead to pouch dilatation.  We NOW know that it is a series of esophageal contractions that moves a bite of food down the esophagus and across the band in about 30-45 seconds, doing its work on the stretch receptors at that point.  If a person consistently eats too quickly, especially after they’ve had a few adjustment, then with time they risk developing pouch dilatation.
Now before you get scared, pouch dilatation rarely occurs before 12-18 months post banding and always presents with signs/symptoms of some sort.  So if you are new to the game and don’t have any symptoms you don’t have it.  That being said…be forewarned!  If you are having symptoms of any sort that seem out of the norm contact your clinic…that is what they are there for.
 Being well-educated on this wonderful tool that you own is one of the keys to success in life with the band.  Lets hope pouch dilatation becomes ENTIRELY extinct.  As for the other extinct items:  Given my rather severe spider phobia I am not the least bit sorry that ugly Attercopus is kaput…sayonara sucka.  The extinction of lime skittles was a GOOD thing as they were replaced with the far superior green apple flavour 🙂.  And as for Bruce, more power to him for having such courage and don’t we all wish him the very best?  Especially after having to deal with all those crazy Kardashians…
Yours in Health,  Happiness, and Living Mindfully,
Sue
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Setting the Bar

hot_cabana_boyI don’t like winter. I dread when the temperature starts to dip into the single digits let alone the minus range. I hate shovelling snow and I don’t like cold things unless they come in a frosted glass with a wedge of lime.

I am sitting in paradise this morning enjoying a delicious cup of the local coffee, listening to the birds chirp and the waves crash as I revel in the last day of a much needed and anticipated holiday. I don’t know about other fellow North Americans but I find that when I am in a tropical climate and answer the “where are you (unnaturally-pale-obviously not-from-around-here) folks from? ” I usually get the “Whoa! How much snow do you have?!” It could be September and someone will make the snow comment. If you are like me, in the early days of a vacation you take a small measure of evil glee in imagining loved ones donning heavy coats as you slip into your flip flops…however that glee starts to be replaced with a bit of humbleness and dread as departure day gets closer and closer. I really really don’t like winter.

To make matters worse I have been getting a daily email from a Canadian magazine to which I subscribe, counting down the number of days until both Christmas and New Years and listing the myriad of things to which one needs to attend in order to ‘be ready’. This has been going on now for several weeks and if I weren’t so afraid that I would miss out on some vital piece of information on how to best prepare for what they make out to be the upcoming Armageddon I would unsubscribe.

I’m not quite sure when the holidays started to create in me, not only a sense of joyful anticipation but a wee bit of dread and anxiety as well. There is just so much to DO and the daily reminders we get can make us feel slightly overwhelmed and panic-stricken. Not only that but I think many of us (women in particular) set unrealistic goals and expectations…we set that bar a little too high.

I remember hearing a motivational speaker talk about how to avoid getting frustrated and giving up when setting personal goals and expectations. She said instead of setting the bar so high that you can’t get over it and give up, set it a little lower so that you can’t possibly NOT get over it…and keep raising that bar. She was talking about exercise and weight-loss however I think that this is something that we can apply to many areas of life.

Sometimes when patients will express frustration over a lack of weight-loss or a lengthy plateau, it will be followed with a litany of excuses related to life events…birthdays, holidays, parties, vacations. There is often a sense of helplessness and an expressed feeling of not being in control. But let’s face it: these are some of the very things that make life worth living right? Where would we be without birthdays to celebrate (well…dead I guess ;)) without parties and holidays to enjoy and the odd vacation to help us get through the HARROWING winter (have I mentioned yet how much I truly don’t enjoy winter)?

We can use these events as an excuse for not eating well, for over indulging, for not staying active. But lets be honest where will that get us? To a frustrating (self-induced) lack of weight-loss or a lengthy plateau.

This Lap-band thing involves lifestyle change. For some it’s a minor alteration and for others a major overhaul. This can take time. So remember that bar when setting realistic goals and expectations: don’t set that bar so high that you can’t get over it, set it a little on the low side but BE SURE to keep raising it.

With holidays FAST (as my email keeps reminding me) approaching, I encourage you to write down some realistic goals. Put them somewhere that you will see them daily. Refer to them regularly.

Perhaps consider something along the lines of:

I will eat small amounts of good food mindfully
I will taste, savor and enjoy my food without guilt
I will serve myself small portions of food I like on a small plate
I won’t continue to eat something I am not truly enjoying
I will stop eating before I feel full
I will be active at minimum 30 minutes daily no matter how busy I get

These aren’t unrealistic goals that can’t be attained. This is ‘basic math’ so to speak…how all of us, banded or not should be living every day to be healthy.

This may not lead to weight LOSS over the holidays but it will help prevent weight gain and I think that is a realistic expectation to have of oneself.

Similarly for vacations, try not to view them as an opportunity to overindulge in excess, but do enjoy. (One of the many beautiful things about being banded is that it allows you to feel more satiated with smaller portions of well-chosen food, it allows you to feel more in charge). And while on vaca stay active! Walk the beach if you are somewhere warm (think of that snow!!) vow to take the stairs rather than the elevator (just pray you aren’t on the 20th floor), join in those water aerobics with the hot pool boy 😉 (NOW you get the point of the picture I chose for the blog…it was that or Snoopy in a Santa hat…tough decision :))

This morning at breakfast my husband commented that I was ‘really enjoying my food’ read: ‘eating more than usual’. Really? Day 6 without so much as a cross look betwixt us and he says THAT?! (Honestly no offence to you males…but sometimes you can be a bit clueless). Yes I AM ‘enjoying my food’ and perhaps I AM eating a little more than usual. But I am also walking, cycling and/or hitting the gym daily. And let’s face it it’s all over way too soon and then it’s back to regular routines.

So with the upcoming holiday season (and I mean ‘holiday’ in both sense of the word…that being Christmas and for some an escape from the HORRIBLE GAWD AWFUL North American winter…I really should move south) quickly approaching I wish you all of the joyful anticipation and happiness these events are meant to bring and none of the panic and fear we may impose upon ourselves by setting that bar too high (and say ‘NO’ to the friend who asks you to take part in the 40 dozen cookie exchange…seriously, I get that every year).

Yours in much Health and much much Happiness,

Sue

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The Happiness Factor

downloadThe other day I came home from work to the not uncommon sight of my two teen-aged sons zoned out in front of the TV.  This immediately triggered the universal cry known to all working mothers of: “ISYOURHOMEWORKDONE DIDYOUWALKTHEDOG WHYARETHEREDISHESINTHESINK”!!!!  Now usually this is met with stunned silence…not because they are surprised but just because the poor little dears seem genetically engineered not to hear the ‘mother call’.  This time however I got a major “SHHHHHHHH!!!!!”.  Not a good response at 6 pm.   But then I noticed what they were watching and sat down to join them.

If you haven’t watched the Netflix documentary called ‘Happy’ I highly encourage you to do so.  It explores what makes people happy and introduces you to the most incredible people along the way.  Turns out 50% of our happiness results from our genetics.  A mere 10% is the result of our circumstances, that being possessions, wealth, power, social standing.  40% is within our control, for example as a result of helping others, making and nurturing relationships, positive thinking.  40% !!!  Now that makes me…happy :).

Towards the end of the program a woman suggests that on a weekly basis you keep a ‘grateful diary’ and write down 5 things for which you are grateful.  I decided to do this today and made a point of doing it without thinking (hmmm that came out poorly) and the first thing I immediately wrote down was…no not my kids and that surprised me…my health.  Next came family which of course includes the brats, then came my kids again.  I continued on with home (not to be confused with ‘house’…my house could use a stick of dynamite), friends, neighbourhood, work and my dog Wally.  I’ve put these into my phone and plan to add to this weekly as the woman suggested.

Now I have to admit that I felt rather guilty that my first automatic entry was ‘health’ and not ‘kids’…what kind of a mother am I??? (a nagging one some might say…).  When I thought about it though I realized that without my health I wouldn’t be able to enjoy any of the other things on my list.  That brings me back to the 10% of our happiness for which material things are responsible.  A mere 10%.  Nowhere on my list was there a material item and I suspect that if any of you were to start a list, yours would not include ‘fancy car, shiny bling, tiger on a gold leash’ etc. (welllll a tiger would be cool…)

The unfortunate thing is that until we don’t have our health, most of us I think tend to take it for granted.  Think back to that whopping 40% of our potential for happiness that is within our control… that is a huge percentage when you think about it.  Getting ourselves and keeping ourselves healthy is a major way to contribute to that happiness potential.  And the best thing is it is within our control!!!  WE ARE THE MASTERS OF OUR OWN DOMAIN!!! 🙂

So whadda we gonna do about it right?  Most people reading this blog have a gastric band. The band is a really good tool, which when adjusted and used properly, controls the hunger one would normally feel after consuming a smaller portion of food.  So ask yourself:  is it doing that?  No?  Then get some help from your clinic and figure out why.  It always surprises me when patients are complacent about bands that are not functioning properly.  We sometimes will hear “well no one has contacted me”.   Now I’m not allowed to, but when I hear this I want to scream (politely of course) “are you kidding me?!”  If you had a car that wasn’t running properly would you wait for the car dealer who sold it to you to call you up?  Of course not!  You would be on the phone complaining!  Same goes for your band.  If it’s not working call your clinic and get some help.

The next step is choosing the right foods in the right portions.  We all know what our bodies need:  small amounts of good food eaten mindfully.  This applies to anyone, banded or not.  We need to choose food that will support and nourish our bodies and promote health.  If you are confused about food choices that’s ok, there is lots of help out there.  Most clinics offer the support of a registered dietitian so I encourage you to use them.  They are a wealth of knowledge and information.

Step three is moving that body.  Every day.  Consider this a gift and open it every single day for 30 minutes minimum.  Do something you enjoy:  walk, swim, ride, dance.  Just get those ‘happy hormones’, endorphins pumping!  Man you will be giddy!!!  The old saying ‘the less you do the less you want to do’ is true.  Once you get moving and making physical activity a part of your every day I PROMISE you it will become something you want to do and something that makes you happy…especially when you start to reap the benefits.

I firmly believe that the first step to happiness is health and we all have it within our control to improve our health.  Yes it takes work and effort and some sacrifices but the end result is worth more than anything we can buy!!!

I encourage you all to make a ‘grateful list’ as the woman on ‘Happy’ suggested.  Write down 5 things for which you are grateful and add to it weekly.  I’ve only just started today but  have looked at it countless times and have been mentally adding to it.  It really is all about the ‘little’ things.  I would be interested in hearing what everyone’s first 5 are…

Yours in health and happiness :),

Sue

 

 

 

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The Most Important Investment of All

downloadI still kind of shake my head when I realize that summer is actually over,  fall is well under way, and winter not that far off!!

I was SO meant to be born in SoCal (that’s ‘Southern California’ for all you folks who aren’t as hip as me… the fact that I still use the term ‘hip’ proves me otherwise) where the weather is permanently niiiice.  Once I get over my initial mourning period for the loss of summer however I do actually enjoy the fall season.  I love all the fresh produce, pulling out warm p.j.’s, long walks enjoying the fall colours.

So, of course this has to lead somewhere…the long walks.  Had one the other day with hubby.  Every 18 months or so I ask him what he does and I honestly make a very concerted effort to pay attention.  (I remember years ago when a girlfriend asked me what he did I chirped ‘he’s a portfolio manager’!  Case closed. Well doesn’t she go ask what that meant…WTFudge?  No one ever asked that?!  I looked at her blankly and said ‘go ask your dad’…).  But this time I was determined to show an interest.  I knuckled down and really focused as he started to talk about derivatives, hedge funds, price earnings ratios, long-term investments and blah blah blah…admit it you are just as bored.  You can see why this sets my mind to wanderin’…

So as he continued to thoroughly explain, I nodded my head every once in a while, said ‘mhmmm…’ and started to think about investments and the here-and-now.  When you get to a certain age, you start to think more and more about the long-term right?  So we hopefully have all worked hard, planned a little, saved a little.  I mean we all want to enjoy the better things in life:  a comfortable home, some nice vacations during the brutal winter months, three-ply TP.  But what are we doing about the short-term?   What are we doing for the here-and-now?  What are we doing to ensure that we will be around to enjoy the long-term investment?

We all know what it takes.  Its simple math even for a simple nurse :).  As Dr. O’Brien would say ‘eat a small amount of good food slowly’.  That 8 word mantra for healthy living applies to everyone banded or not.  It’s ‘eat less move more’banded or not that’s what we have to do.

We have been programmed to believe that we are not getting our fair share, not getting our money’s worth unless we are served massive portions of food off of mammoth platters disguised as dinner plates in restaurants.  Most of us were unfortunately pre-programmed as children that we had to clear our plates.  We have stopped recognizing the importance of getting active for 30 minutes a day.  This should not be considered a lifestyle option, it should be considered a lifestyle MUST.  Just like brushing our teeth, walking the dog and listening to our spouse ramble.  I honestly can’t understand why, if you have the ability to move your body you don’t take advantage of that gift.  There is absolutely NO EXCUSE.  NO ONE is that busy.  It is imperative to move our bodies (vigorously!) at minimum 30 minutes a day.  This improves heart health, lung function, psychological well-being, sexual well-being (that got your attention ;))…there is nothing bad about it.  It doesn’t have to be 30 minutes of hard cardio all at once.  10 minutes 3 x daily is just as effective.  Now tell me honestly you don’t have time for that!

In order to reap the benefits of long-term investments we have to focus on the here and now.  We can’t put our health on the back burner, we can’t wait until tomorrow because tomorrow may never come.  Not if we don’t take care of ourselves today.

If you are eating well and exercising daily then a HUGE high-five to you and KEEP UP THE AWESOME JOB!!  It’s not easy but when you look at is a gift rather than an obligation or punishment…it can actually become quite enjoyable!  If you are not, then it’s time to give your head a shake and start.  Anyone who has undergone bariatric surgery has made a very large investment:  a physical, psychological, emotional, not to mention financial investment.  If you are not benefiting from this investment ask yourself why.  Is it your band?  Is it properly adjusted?  Are you using it to its full potential?  Are you utilizing the support that your clinic offers?  Do you need further support, maybe from a counsellor?  Time does not wait and investments won’t grow and flourish unless they are cared for.

So as we came to the end of our walk I’m sure it was evident that I didn’t have a clue what he was talking about but that really didn’t matter.  What was more important was that we were outside, enjoying the fresh air, the fall colours and working on our short-term, long-term and here-and-now investments.  Next time someone asks me what my husband does I think I’ll just say ‘he’s a tax auditor’… that should prevent the conversation from going too much further :).

 

Yours in health, ‘wealth’ and happiness,

Sue

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Lessons From My Nephew

photo (1)Yesterday morning I awoke at 6 a.m. to the screams of a baby and had flashbacks to 14 years ago.  I live in a home with 3 large young adults and given that summer is here they rarely stir before 10 am (and thankfully they hardly ever scream when they wake).

My sister has arrived for a visit with her 15 month old son from Ethiopia and our house is slowly morphing back into a ‘baby home’. There are diapers and formula, baby books and toys, sweet wee overalls and the CUTEST little blue crocs (my kids could float a puppy in their own shoes if they so desired).

When we play music for Mackay he slowly starts to move his arms and before you know it his feet are stomping away and his head is bobbing (at 15 months he is sadly already a better dancer than myself).  Watching MacKay’s fascination and sheer happiness as my son played his guitar and then as my husband twirled maple keys in the air took me back all those years to when my own ‘little darlings’ were amazed by the smallest of wonders. It is absolutely beautiful and Mackay brings with him all the joy that a baby brings and even more cuz he ain’t mine :):).

One of the things that is glaringly apparent to both my sister (who is banded) and myself is how Mackay is a completely instinctive eater.   Mackay eats only when he is hungry, so like an instinctive eater his desire for food is driven by his need for fuel.  He eats until he is satisfied and then won’t touch another bite (in fact if you are successful in sneaking in ‘just one more little bite’  he opens his mouth and waits for you to take the offensive piece of whatever off his tongue).  If he doesn’t like or want something he won’t eat it…no amount of coercing or cajoling will convince him to open his little yap.  As my sister said, he has no emotional attachment to food.  He can’t see foods as ‘good’ or ‘bad’ and he doesn’t eat for any reason other than being hungry.  Food doesn’t fill any void aside from that of hunger.

What’s fascinating is that we ALL start out like this.  We ALL start out as instinctive eaters.  And somewhere along the way, for any number of widely varying reasons, many of us become over eaters or restrictive eaters or maybe a bit of both or maybe one or the other at various times in our lives.  I know I’ve blogged about this before but to actually witness my little nephew demonstrate pure unadulterated instinctive eating is quite an eye opener.

So the question lies in how do we get back there?  How do we become instinctive eaters again?  Can we turn back time and become the instinctive eaters that we were when we were children…or at least close to that?  I like to believe I am a  ‘glass half-full’ kind of gal and I believe the answer is a resounding “ABSOLUTELY“!!  I also am aware that this may take a lot of work and it is clearly not the sort of thing I feel qualified to fully counsel on, particularly in a blog.

 I believe that being a mindful eater is the best place to start.   How often do you sit down to a meal, maybe in front of the TV or computer, and all of a sudden look down at your empty plate and realize that you don’t remember eating the food let alone enjoying it?  It’s kind of like that scary feeling of arriving at a destination and not remembering driving there. 

I remember my sister telling me that when she made a point of setting her table and making her meal an occasion rather than just a function that she noticed three things happening: 

  • she was less likely to get food caught
  • she took greater enjoyment from her food
  • and she had greater satiety with smaller portions. 

This I think can be a first step towards getting back to being that instinctive eater we were way back when.  Always be mindful of WHAT we are putting in our mouths (is it healthy, at least most of the time?).  Always be mindful of HOW MUCH we are consuming (do I need this much fuel?).  Always be mindful of WHY we are eating (ask yourself those three very important words “AM I HUNGRY“?).  If you are not hungry…then comes the hard part.  Why are you eating?  What emotion or need are you looking to fill?  Recognizing triggers that make you eat is an essential part of becoming a mindful and instinctive eater.

This can all take time, effort, honesty with yourself, and sometimes the realization that maybe you need some outside help to assist you in getting to the root of a problem.  I always say that the band, or whatever bariatric surgery an individual has chosen to have will only assist that person so far.  If you don’t have your head ‘in the game’ eventually whatever weight loss/health strategy you have employed will backfire, and usually in the form of unpleasant symptoms such as heartburn, vomiting, or in weight regain and/or poor health.

Remember:  you are SO worth the investment in yourself that you have made…the physical, emotional, financial investment in your health.  We can have all the fancy ‘things’ in life but without our health we have nothing.

So here’s to getting back to our ‘inner child’ so to speak.  Mackay is teaching me a thing or two about eating, I’m just praying that he can do the same for my dance moves 🙂

Yours in Health and Happinesscrocs

Sue

P.S.  A book that many of you may have read, but if you haven’t I would highly recommend is Dr. Michelle May’s “Eat What You Love and Love What You Eat”.  It is a self professed ‘diet neutral’ book and gets behind fixing the problems that drive us to eat when we don’t need to eat…an AWESOME read 🙂

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“I Got a Fever”…..

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“I got a fever, and the only prescription is more cowbell”. (If you are a fan of SNL and Will Ferrell you will recognize that phrase and chuckle.  If not you probably just think me odd :)).

The fever I’ve been feeling for the last couple of weeks actually has more to do with cows in the field than the bells they wear.  Spring has FINALLY sprung after a most punishing winter.  As I sit writing this at a downtown Starbucks you can see the evidence of a Canadian spring everywhere…bustling sidewalk patios, urns bursting with spring flowers, the glare rebounding off alarmingly white legs (mine I noticed this morning have developed a decidedly orange hue…note to self:  ‘chuck the expired self tanner’.)

Spring to me is like the start of a new year. Everyone’s mood seems elevated as the days warm and lengthen and our ‘feel good hormones’ kick into action.  With the elevated mood usually comes a desire to get outside and move more.

Several weeks ago I dusted off my road bike, but it wasn’t until the past two weekends when I could finish my ride and still feel my fingers that I truly enjoyed the experience. Riding in the early morning past fields of horses, zipping down country roads, and leaving my ‘better half’ in my dust as I climb hills (HA! SUCKA!! Nothing like some healthy competition to keep a marriage alive) is exhilarating and I honestly  don’t understand why anyone who has the ability to move their body doesn’t. As I was riding last weekend I was sending up silent prayers of thanks for a body that can move, and a country that we can move safely and freely in. We are SO INCREDIBLY blessed here in Canada. We have no fear of bombs, snipers, terrorists, of our daughters being abducted for wanting to learn or gang raped and murdered simply for being XX instead of XY.

Getting active and moving more as you progress along your lapband journey is one of the many many perks of losing weight and feeling better in your body.  More and more patients are telling me that their reasons for weight loss are less about the number on the scale and more about health and longevity.  About kicking those comorbidities to the curb, saying ‘no thanks don’t need it now’ to the hip or knee replacement and ‘adios’ to the insulin.

There is an awesome clip on You Tube that I try to get all of my patients to watch.  It’s a brilliant little piece by Dr. Mike Evans, a Canadian doctor, called “23 1/2 Hours”.  If you haven’t already viewed it I strongly urge you to take the 9 minutes and watch it…it will change how you look at your day.

I’ve made a minor change in the way I talk to patients these days about ‘getting active’.  I’ve stopped asking “So how is the exercise going” and started saying “So are you enjoying getting more active”.  It’s amazing how that little change in semantics elicits a whole different response.  “Exercise” so often makes people (myself included) think ‘ugh…gym class’, or ‘gotta work off that dessert’.  Whereas ‘enjoying getting more active’ is interpreted as a bonus.  As doing something special for yourself, a right you have earned for working so hard at getting healthy.   It doesn’t have to mean treadmill, elliptical, stationary bike or any of the other various instruments of torture.  It can mean walking in the park with a friend, kicking the soccer ball around with your kids, powering through garage sales on a Saturday morning, getting dirty in your garden (or leaving your husband IN THE FREAKIN’ DUST MAN on a Sunday morning bike ride…SUCKA!)

But here is a suggestion:  make it a part of EVERY day.  Just like brushing your teeth, it’s not something you should do most days but something you want to do every day because of how it makes you feel (imagine if you only brushed your teeth every couple of days???  We’d all smell like Wally (pictured above) when he yawns 😦 ).

So take advantage of this glorious weather and this wonderful country that we live in and if you are able, get out and enjoy your body EVERY DAY.

Yours in health, wellness and gratitude,

Sue

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Embracing Change

CowsAs I stood on the train platform this morning in (yet again) this finger-freezing, mind and body numbing, -16 degree weather the term ‘polar vortex’ came to mind.  Before this wench of a winter descended upon us I had never come across that term.  And yet here we are throwing it around willy-nilly (there’s another good term…’willy nilly’…).  So I googled it to figure out just what the definition of a ‘polar vortex’ is.

I came across several definitions ranging from the laymen friendly:  “a persistent large-scale cyclone located near either of a planets geographical poles”, to ones that would likely even challenge Steven Hawkins let alone this lil’ ol’ lapband nurse!

My favorite however and the one that I feel most simply and succinctly describes it comes from the Urban Dictionary and is as follows:

“A weather system that results in record-breaking cold temperatures.  Can also be used as euphemism for “really f*cking cold or “f*cking freezing”.

(Now I didn’t write that so don’t blame me if you no longer find this to be a family-friendly blog…I apologize…but you have to admit there really is no better way to describe it).

But lets turn this blog around right now and stop the incessant whining.  Yes it is cold, yes it has been a punishing long and brutal winter but on the UP side…a CHANGE is in the air!!  The very good news is…only 15 measly days until spring!!!  I am getting pumped every day as I imagine that before long the snow will be melting and the dew drops and crocus’s will be poking their noses through the thawing ground.  This will be an extraordinarily good change!

I try very hard to take a ‘glass half full’ approach to life and to the changes that come with life.  And while it’s easy to look at the change from winter to spring in a positive light, it is not always easy to look at all change in a positive manner.

When I first started in the ‘band business’ things were quite different than they are now.  Based on the knowledge that was available to us about the band at that time our understanding of how the band worked, how and why it induced that feeling of satiety, was quite different from the knowledge we have today.  How we educated patients and how we adjusted the band was different as well.  We used to adjust more aggressively, and we followed a rather static ‘one size fits all’ algorhythm for band adjustments.  Then over the years research taught us a thing or two and we sat up and took notice and gradually changed our approach to band adjustments AND to how we educated patients.  Unfortunately however there is still a lot of misinformation out there and a lot of clinicians and educators who have either not had access to or not been listening to what the latest and most up-to-date research on the band is telling us.  That is that SLOWER AND MORE MODEST ADJUSTMENTS LEAD TO SAFER AND MORE WELL-ADJUSTED BANDS.  And the result is LESS COMPLICATIONS AND BETTER HEALTH AND WEIGHT LOSS.

Some people don’t like this change.  Sometimes when I share this information with individuals  they are not at all happy and are resistant to change (‘resistance is futile’ I want to say with an evil laugh hehehe…no I don’t really :)).  But this is a good change.  Properly understanding how your band works is imperative to living safely and effectively with your band.  If you don’t know how to use it properly it’s the equivalent of having that Ferrari in your driveway and not knowing how to drive it.  Yes it’s impressive and yes it cost you a lot of money but it’s not doing you one lick of good.

“When one door closes, another opens; but we often look so long and so regretfully upon the closed door that we do not see the one which has opened for us” ~ Alexander Graham Bell (who knew that?!  I thought he was ‘ just’ the dude who invented the telephone…).

If you are at a stalemate with your band and/or weight loss, maybe you have to change how you are expecting the band to work, and what you are expecting it to do for you.  Don’t resist the change that comes with increased knowledge because at the end of the day the band is a really wonderful tool, which when adjusted and used properly does a really wonderful job of controlling hunger.

So…here’s to the end of this long, miserable winter and to the possibility of any more stupid polar vortex’s coming  our way and to the  wonderful change of season that will soon be upon us!!

(It’s funny though a small part of me enjoys the cold weather…a very very infinitesimally small part because I feel a bit justified in misbehavin’ a wee bit:  cocooning a bit more, doing a bit less.   Who wants to go outside to warm the car let alone go for a walk?  And why not indulge in a bit of good old comfort food…as the Urban Dictionary puts it, its ‘really f*cking cold’!!)

Yours in health, wellness and the onset of spring 🙂

Sue

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“Do I Look Fat??”…and other stupid questions

images ikeaSO…Christmas has come and gone once again…thank goodness!  Don’t get me wrong I love the holidays…I love the decorations, the music, the happiness that people exude, the kindness displayed and the extra time spent with family and friends.  I love the promise of a New Year with all the possibilities and opportunities it holds (I do however HATE WITH A VENGEANCE this insanely cccccold weather!!).  I also enjoy though when the house is less chaotic, the tree is at the curb, the goodies have all been devoured and things start to settle back into a more normal routine.
I’d like to share with you an actual conversation had in my bathroom 4 days ago… this is not a fabrication:
Rob (my spouse): “Do I look like I’ve gained weight”?
Me: “You look great”! (I didn’t tell a lie and that’s what I would want to hear so why wouldn’t he?)
Rob:  “The scale says I’ve gained 7 lbs…but I don’t believe it” (hmmm…last time I checked it was telling the truth)
Me:  “You look good honey…maybe a little around the middle.”
Rob:  “I don’t think so…my clothes still fit the same.” (okaaay….)
Me:  “Well we all have been eating a fair bit of treats…” (diplomacy is the name of the game)
Rob:  “Nope I think its muscle, I’ve been working out more.” (you have not and I don’t think muscle jiggles like that)
What is it with men that  for the most part they have a so much healthier body image than we women do?  They can gain a few pounds or go off track and not implode with harrowing negative self-talk.  The world doesn’t come to an apocalyptic end if they whack back a few extra cookies over the holidays and they don’t sit down with their buddies over a bottle of chardonnay and bemoan that they are weak and fat and all the other horrible things women say about themselves because they happen to have indulged a bit or gained a pound or two.
In my stocking this year ‘Santa’ gave me the fitness magazine Oxygen (along with a cheese grater from Ikea and…wait for it…a cutlery tray, also from Ikea….but I digress…).  I have always enjoyed the magazine as I find it inspires me to consider trying new recipes and workouts.  No I don’t always go and do it but I do find it can be motivating.  This year my teen-aged daughter and I looked over the magazine together (yes whilst nibbling on shortbread) and our comments ran along:  “NO ONE looks like that unless they are on steroids”, “totally fake”, “she is completely botoxed”  “those abs/boobs are sooo airbrushed pass me another shortbread”.  No we weren’t being catty…I believe, thankfully, that Maggie and I both have healthy body images.  All of the comments we made I feel were based on truth (and lets face it a little bit of mother/daughter model bashing is good for the soul hehehe :)).
We women are the ones who for the most part buy those magazines (and I don’t just mean the fitness mags but all the fashion ones as well) and then set unrealistic goals and expectations for ourselves. And then what happens?  We berate ourselves because we don’t possess the super powers (and airbrushing skills) required to achieve them.   Healthy, normal, realistic males (and females) do NOT expect the women in their lives to look like the women (or 13-year-old girls posing as women) depicted in the media.
I think a really good New Years resolution for my female readers (and males if it applies…I’m not meaning to exclude anyone) is to either NOT buy those magazines, or if you can’t resist, to look at them with not just a grain of salt but the whole shaker. That and as I have said in other blogs, try setting small, realistic, attainable short-term goals.  For example NOT “I am going to lose xxx lbs this year”, but something more along the lines of:
 “I am going to focus on eating small amounts of good food slowly” (anyone recognize that??  Dr. O’Briens 8 word mantra).  Or…
“I am going to do something physical every day” (I don’t mean hit the gym every day but get moving…daily, your body needs it).  Or how about…
“I am going to stop ANY AND ALL negative self-talk.  Or…
“I am going to congratulate myself on every victory no matter how big or how small”.  Or what about….
“I am going to try to listen to my body more closely and eat when I am truly hungry”.  Or…
“I am going to re-connect with my clinic” (if your band or you, or you and your band are not working harmoniously together).
Above all we need to be healthy and happy and kind to ourselves because we are SO WORTH IT!  We can do anything and achieve anything we set our minds to but the things that are most worth having in life usually take a bit of work.  And there is nothing more valuable that we can give ourselves than good health.
I want to thank my readers for following and sending me your comments…they really make my day :).  I want to wish you all a 2014 that is full of happiness and laughter, of adventure when you seek it, and of peace and tranquility when you don’t, of goals and dreams that are worked for and met and most of all a 2014 that is packed with good health.  Personally I CAN’T FREAKIN’ WAIT until Valentines Day to see what treasures from Ikea might be in store for me.  (Actually I’m being cruel.  The cheese grater was the $$ fancy type that has a compartment to hold the cheese).
Yours in Health and Wellness,
Sue
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You Can Never Get Enough of a Good Thing…or Can You??

Anorexic DummyHave you ever wondered who comes up with the catchy phrases we throw around and why some stick and others don’t?  

Laughter is the best medicine“…”Rome wasn’t built in a day“….”A happy wife is a happy life” ( I hear that one muttered quite frequently).

How do you feel about “You can never get enough of a good thing“? Yes!  That sounds about right doesn’t it?? Who doesn’t want more of a good thing?  And then more and then some more!!!! 

Think of your 5 favorite “good things” (this sounding a bit ‘Martha-ish’…I bet she would say ‘staying out of prison’).  

It didn’t take me long to come up with mine: family, friends, warm weather (it’s the first of many…many…many cold days to come), good food, good health.  (And if I could sneak in a sixth it would most definitely be chocolate…and I mean rich expensive milk, not that healthy dark crap). Yup I admit it, a simple soul am I.   Then I thought ‘can I get too much of these things‘?  

Well…I suspect after the upcoming long holiday season I will answer loudly ‘YES’ to both numbers one and two.  (Don’t give me that shocked look…I love my little darlings and jovial friends as much as the next person but don’t we all crave some alone time by the beginning of January?!)  What about warm weather?  Well actually although I crave the sun and love the hot hazy days of summer…I would miss terribly the change of seasons and the anticipation we feel as the blossoming month of May sets in.  Good food…well again let’s reminisce back to that first week of January. I can already feel my pants getting snug.  I think the only one that I can admit that we can’t get too much of is good health.

So having said that, just as we all have different views of what is say, good politics so too do we all have slightly different versions of what constitutes ‘good health’.

Good health to the average Joe likely means a healthy heart, good blood work, healthy joints, optimal energy, minimal pain and healthy weight.

 Good health to the person going through another round of chemotherapy may mean a decent white blood cell count,  minimal pain, minimal nausea and vomiting and a bit more energy.

Good health to the person who suffers daily with COPD?  Perhaps being able to breathe comfortably, being able to walk up the stairs without oxygen or to carry out their activities of daily living.  It’s all relative isn’t it?

Good health to the person who suffers with obesity?
Number one answer I hear will nearly always be “weight loss“.

We all know that for most people who undergo bariatric surgery, weight loss is the primary goal. With weight loss comes a whole slew of other healthy benefits: lowered cholesterol, improved blood sugars, less pain, fertility (ok maybe for some not a ‘benefit’ :)), improved joints and mobility, improved self-esteem, the list goes on and on. But can we get TOO MUCH of this good thing known as ‘weight loss’. The answer is a resounding YES.

It is SO important to recognize what is ‘healthy’ weight loss and what is starting to become ‘dangerous’ weight loss.  I don’t profess in any way to be a psychologist or psychiatrist however with the number of patients I have counseled in my years as a lapband educator and as a Registered Nurse I can confidently say that I can recognize when someone has tipped the scale in the wrong direction.  That is the easy part. The hard part is convincing the patient of this.

Obesity and weight  loss are emotional issues. People who, after a lifetime of fighting this sh*tty disease finally start to win the battle, have told me that they would rather LOSE A LIMB than go back to being obese again. Doesn’t that speak volumes for how awful a disease this is??  

Sometimes people unfortunately  don’t recognize the signs that they are getting into the unhealthy range of weight loss.  Or they do but they just so don’t want to go ‘back there’.  Believe me however it is JUST as dangerous to be severely underweight as it is to be severely overweight.  I’ve had patients who have been too tight for years yet avoided coming into the clinic for a defill because they were afraid they would gain weight and go ‘back there’. This is an understandable fear.  And it scares me to think of how many people may be out there right now in just this situation.  

With weight loss there can without a doubt be ‘too much of a good thing’. Please take note of some of the indicators below that may show that you are getting into the danger zone.

First: BMI.  Don’t rely on the standard BMI scale as a measurement of a healthy weight for you.  I hate the BMI scale as there is no ‘one size fits all’. We all have unique body types, bone densities, muscle mass that will influence what a healthy weight for each of us will be. You can have a perfectly healthy person who is feeling great, has excellent health, looks wonderful but who by the BMI scale still falls into the ‘overweight’ category…it means nada.

Second:  look at your diet. Are you able to comfortably consume a wide variety of healthy solid foods…and are you consuming them?  Are you slipping into a maladaptive eating pattern, going for the softer/mushier foods because the solids aren’t going down?  Are you experiencing other symptoms of being in the red zone such as heartburn, reflux of fluid up your throat at night?  Are you skipping too many meals because of extreme lack of hunger?

Third:  how do you look?  How is you skin? Your hair? Your nails?  Are they flaky? Dry? Brittle?

Fourth:  how do you feel? Do you have lots of energy or are you finding yourself more and more lethargic?  How is your iron supply?  When did you last have blood work or a physical done?

Fifth:  what are people telling you?  Are you still getting the “Wow! You look awesome!”?  Or are loved ones starting to express concern?

Working in this field has been the most rewarding, incredible experience in my career as a RN. The people who have changed their lives for the better..because of their choice to have the lapband and to live well with the lapband, well it makes coming to work everyday worthwhile. But I say “living well” with the lapband. Yes there can definitely be too much of a good thing with weight loss.  Having the band is one thing and using it properly is an entirely different thing.  IF YOU SUSPECT YOU HAVE SLIPPED INTO THE UNHEALTHY WEIGHT LOSS CATEGORY PLEASE CONTACT YOUR CLINIC ASAP.  Remember, you have this band for the rest of your life.  Success is not all about the scale.  It’s about feeling good, enjoying good health and living life to the best of your potential.

Yours in Health and Wellness,

Sue

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