Thursday, March 28, 2013

FitBit, how I love thee

If you keep up with my blog, you'll know that it is rare that I endorse anything.  The only thing I really try to endorse here is positive mental health and well-being.  On occasion, I will endorse another blogger who is doing it right.  I tend to leave product endorsements to those said bloggers too, but this time, it's personal.

For over two years, I heard about this great little device called a FitBit.  Everyone I knew who had one, loved theirs.  In January, I bought myself one because it sounded like a great thing. IT WAS THE BEST  investment I have made since weight loss surgery, though maybe I shouldn't say that since WLS caused me a lot of mental, emotional and health trauma, but I still don't regret the decision.

However, last week, I washed my FitBit.  I was completely devastated. One of my friends from high school posted on Facebook that they would replace it for free if you are an active user and you lose it, break it, wash it, etc.  So, two days after trying everything their help file would render, bag 'o rice, blow dryer (ok, that way my ingenuity,) my sweet FitBit did not turn on.  I had a super sad.  Like, Super Duber Grumpy Cat quality sad.

Imagine my delight when I received an email yesterday evening telling me all I had to do was this:

Write your Case # in a picture with your FitBit. 
And BINGO, they will send me a replacement. I am sad that I will not have it for the AllState Sugar Bowl Crescent City Classic this weekend. But I can live without it for just a little bit longer. Thank you, FitBit, for doing it right.

Wednesday, March 27, 2013

Obesity changes your brain

From a 2012 article in the journal, Nature Neuroscience, there are links to a high fat diet, neurogenesis and obesity in mice. The study put mice into two groups: those fed a normal diet and those who feasted regularly on high fat foods. After 1 month of chowing down, adult mice on high fat diets had quadruple the rate of new brain cell growth in the hypothalamus, a part of the brain responsible for regulating many metabolic processes. How does neurogenesis play a role in obesity?

To answer this question, researchers irradiated the newly created portions of rats’ brains. Not only did radiation inhibit 85% of neurogenesis, but irradiated mice gained significantly less weight and fat mass compared to the group that kept their new neural growth—even though all of them stayed on the same high fat diet. Furthermore, irradiated mice used more energy and were more active despite their unhealthy diet.

Our methods to treat obesity link, between diet and exercise, leave our the neural impacts on the brain. It's rather is thought-provoking, the connection has yet to be completely figured out in humans. There is still a mystery that lies within our genes, gene expression, hormones, stomach bacteria and how certain foods trigger desire for other foods.

Social scientists are pointing at the addiction to food in the brain and the link to chemical additives in what we eat. A 2012 study from the University of Amsterdam found that challenging cognitive training lowered addiction symptoms in individuals with a drinking problems. People who trained not only drank less—they actually improved memory capacity as well.

We must retrain our brains by diligently adhering to a plan. Set yourself up for success by planning for your week on Sunday; cut prep, plan your exercise and execute your plan. When you go off plan, make a mental note as to why, what prevented you from sticking to it, how you can do it better, and get right back on plan. Avoid idle time in front of the TV, if you are sitting in front of the TV, you could be exercising. In a recent study, LSUHealth Science Center found people ate 25% more when they had meals in front of the television, as oppose to those who sat down as a family to eat together at the table.

Change your lifestyle, change your life. You might still have genetics to fight, but you are one step closer to breaking bad habits and reprogramming the chemicals in your brain to like doing good things for yourself, like eating healthy foods and exercising. You may never love them, but doing them will help you do good for yourself.

Find Your Readiness

Find Your Readiness: Then push your readiness just a little bit further than you thought you could go. 

Let's talk about stress.  Exercise reduces stress (D'oh, you knew that!)  Walking for a minimum of 30-40 minutes a day improves your ability to cope with stressful situations in life, these are facts all facts.  As you build you endurance to exercise, you will find you can walk longer, faster, and have more energy throughout your workouts.  That's why you don’t need a supplement to “energize you” in order to get motivated for your workouts. Some products are being pushed on the bariatric community like a drugs or candy.  Just as drugs are bad, many supplements are bad, m'kay?  Be mindful of where you invest your money, all the nutrients you need can be gotten through food AND a good bariatric multi-vitamin. I won't plug any vitamins, I believe that several bariatric supplement companies make very good products, find what you like.

One of the reasons we should all hire a good personal trainer for at least 6 months is to learn how to push to  your bodies' limit.  The experience of having someone assess where your athletic ability is then push it further should help propel you to learn this skill too. If you can't, keep with a trainer until you learn to do it on your own. You want to push your body to its limit without overdoing it on a daily basis.  You should feel sore the next day, but it should continually be a mild to moderate soreness or muscle ache.  That’s the muscle breaking itself down and building back up again.  This is why protein is such an important element in our diets. Think of it like this, in order for your muscle to melt your fat, you must give it protein for fuel, (not sugar or non-complex carbohydrates.)  With that muscle burning like an engine, you’ll sleep better at night because your body (engine) must go to work on your day's fuel supply.   

I frequently use Walk and Talk therapy with my clients.  We will walk while we are in session because the distraction of walking often opens up the psyche to discussing what’s going on with them they might not otherwise talk about on the couch. We talk about their goals, beliefs, and action plans. Is there someone bullying them in school (or at work, home) and how do they handle that stress without getting angry but addressing it confidently? Are they self conscious about their body? Is there a voice inside saying, "What will people think when this 'fat girl' is working out?" Who cares, don't allow others to hurt you with words about the good you are doing for yourself. See how it will only holding back when we to invest other people's energy into our own potential?  Then can we move forward as necessary into doing for ourselves in day to day life.  If there is an internal dialogue of lies and negativity to one’s self, there will always be lies to others.  Stop caring what other people think in order to care for yourself.

What’s negative in your mind? How are you internally holding yourself back?  Are you pushing yourself to keep up with others because they tell you you should be a certain way?  There are many in this community that want to fit you into an unrealistic mold that isn’t you.  Their expression of what a post-op should be is their own, and they don’t really take into account where an individual is ready to commit. Individuality and self assessment is key, journaling is therapy. Blogging is therapy. Take a moment each day to envision yourself as successful.  What does that visual look like?  If it is merely a picture in your mind of a thinner you, you must go deeper.  What does your like look like as a healthier you?  

How do you define your successes up until this point?  Where have you found the most joy in being successful in life to this point?  When do you feel the most pride in your accomplishments?   
Now, the most important step… FIND YOUR FAILURES. SPEAK THEM. BE HONEST WITH SOMEONE YOU TRUST ABOUT WHAT YOU ARE OR ARE NOT DOING.  THEN, Realize that there are elements working for you and against you, hidden and known, that you must understand will always be there, whether you know about them or not.  The plan for you is what you make of it today, tomorrow and beyond.  There will be setbacks, there will be joys, there should be pain (physical, mental, emotional) in the growth experienced from losing weight. 

Do not be anxious to lose more than your body wants to lose at one time by stressing over weight loss.  Deal with implementing your health plan into your life with a positive attitude and a can do spirit! Try to not pass much judgment on others, they are dealing with their own story. Ultimately, do not lie to yourself about where you are in your journey.  The reflection we see of ourselves is the most important. 

As I lost the weight with my Lapband, my body became a deflated balloon. Before surgery, I had few body image issues, I really accepted my weight while trying to change it and embraced healthy living.  I never had a hard time meeting people or having friends around me that loved and supported me. I worked a lot and I bore emotional burdens on my sleeve.  I was often in stressful jobs, working very hard for little money as a mental health counselor in economically disparaged post-Katrina New Orleans.  Driving stresses me out, I was on the road in my car for 12 hours a day or more every weekday and worked at least 4-6 hours on the weekends, crisis dependent.  I was on call 24/7 and often had a patient that was overwhelmingly needy at 1am on a Saturday morning, or 4am on a Sunday.  Frequent trips downtown to University Hospital where psyche beds had been cut in half (twice while I was there.) Taking time for myself to do what I needed was exhaustive, but much of it was due to a lack of daily/weekly planning ahead on my part.

While my work life was very chaotic, my rock was my boyfriend, fiancĂ© and now husband.  He has continually been the encourager for my healthy eating habits, he also doesn't enable sweets.  This was a big problem for me before surgery.  Today, it is rare for sugar to be in our house. I keep raw cane sugar available for when he might want a brown-sugary oatmeal cereal but use it for nothing else.  He does, on occasion, want cupcakes and I will bake those for him, the request happens only once every other month and I don’t keep that stuff around.

Set up your living eco-system with positive reinforcements and know your nutritive necessities.  This means scheduling and keeping to a commitment to self care.  But this journey… it is all about you.  Who you are, is not who someone else is. Where you are and you are ready to commit varies from one person to the next... but find your change today.  Save the ones you're not ready to spend and work with those that you feel comfortable and are ready for. 

Monday, March 25, 2013

The breakdown between knowing and doing

We can be educated on what it is we need to do in order to be successful, but the gap between putting that information into practice is an emotional and mental battle for many of us.  It's a power struggle internally and externally.  I remember the offense I took when my mother would ask me, "Can you eat that?" after having had my lapband.  My curt and annoyed answer was always, "Yes, why yes I can eat that as long as it was within moderation."

It is hard to make the final decision to give up the really bad food.  "Libre albedrio," I wrote in my little leather bound journal in Rio De Janeiro, just weeks before having my lapband placed.  The freedom and determination of analyzing our plans to do something and implementing that plan.  This concept that needs to develop within our psyche to "never go back" or let ourselves get comfortable. Now, I must acknowledge my behavior has become owning my actions and words, being honest with myself when I do it wrong. There are repercussions to  poor decision-making, always, especially with food after surgery.  I had read and studied up on the LapBand as my only option on the basic principle that I did not want to cut into the natural state of my organs.  What I didn't know was the amount of anxiety that would arise from my sudden false truths I had about my diet.  What I ate.  Sure, I was confident that I could lose more weight with this assistance of a physical barrier to limit the amount of food I ate. Now, I realize I was on the cusp of the emergent new, innovative weight lost surgery, the vertical sleeve, but I didn't ever get told by my surgeon this was an option.  I went with what I felt was safe. 

I didn't realize that I would develop such severe food anxieties after weight loss surgery. I would have to deal with anxiety in a way I had never experienced before.  From the start, my band was picky.  Some days I could eat anything. I developed acid reflux, I couldn't sleep at night because I had insomnia from laying in bed face up all night trying to get to sleep. While I had experienced depression from my weight issues, I never acknowledged the anxiety that would come about from a sudden feeling of being cut off from something that provided me with comfort. My overall self confidence before surgery was solid.  I had done a lot in my career with I.T. in college and got a degree in clothing design from LSU. Heck, I even went to work for Liz Claiborne and Disney to realize that I wanted to counsel people for a living. I stood up and spoke when I saw something could be done better, but often was put down, cast out or reprimanded for thinking things could be done differently. I look back and think that much of it could have been weight bias and egotism.  I didn't pay attention to the looks because I had gotten them so much growing up that I was immune to it.

I made decent grades as I struggled through issues with learning disorder and cognitive dysfunction and passed with B's and C's to get through undergrad.  I was obsessed with working 40 hours a week, taking 15 hours worth of classes each semester at least, and branching out to discover me.  I successfully lost 75 pounds from my highest recorded weight in my life, 353 lbs. to 280 lbs. from 2002 to 2005, through graduate school.  Then, Katrina happened.  Another storm in my life in the means of a man came through earlier that year, which positively ignited my understanding of healthy living and exercise.

So, here I am now. 6 days away from the race that started it all in 2002.  The Crescent City Classic 10k.  Easter weekend, 2002, I did my first race.  A 10K. It took me 2 hours and 40 minutes to go 6.2 miles.  But I did it.  I had never intentionally set out to walk a mile when I did this race.  Sure, I had marched in parades growing up, I knew what it was like to wear my body down to exhaustion.  This was different.  This is different this year as well.  I'm on year number eleven and I'm still trying to figure some things out with fitness and health.

Yesterday, I started with a new personal trainer.  I posted it on YouTube last night and today. I don't normally do videos.  But I am going to try to get more into the blogging.  I hear you have to in order to get your voice out there to change the way things are done.

And so, I'll do that.  And yes, I will let you all watch me through the process.  Since I do intend on having revision surgery because I do believe that there is an issue with my ghrelin hormone and cortisol and gene expression, it is also what we eat, what we do, how we implement change, how we regain control over our selves and our own egos.  Connie Stapleton says it best, it's the mentally of the addict, "I want what I want, when I want it."  There is some cognitive dysfunction associated with obesity, excess hormones will effect your mood.

When you want what's good for you, you will do what's best for you.  Denial is an eternally sick place to be.

Saturday, March 9, 2013

Bothersome to me...

Over the years, there are things that have alerted me in getting to know many weight loss surgery patients.

There is often sense of anxiousness to have surgery.  Sure, I understand you have struggled with this for a long time and you have been pursuing the process for months or even years.  However, the process has many stages and each setback has it's own lesson for each individual.  I know, insurance companies are frustrating to deal with, financial issues are even more difficult to overcome, but embracing the knowledge that this path will not be the easy path, in my theory, is part of the lesson to be learned.

I have heard many patients with insurance complain about having to pay for anything out of pocket.  This is personal to me, but if you're going to complain about having to pay out of pocket for anything whatsoever while your insurance company will be putting up thousands of dollars to pay for your surgery, I think a step back needs to be taken here.  Count the blessing that you have insurance that is willing to pay for your surgery. Many other patients do not have this option.  Paying $300-500 for a trained psychologist or psychiatrist to do your mental health status is better than having to pay out of pocket for everything to the tune of thousands of dollars, right?

What I often find is that people don't really understand how insurance works.  While you are insured, others within your company and/or the organization as a whole, carrying the shared burden of your expenses.  Many often see their needs as their entitlement to services, but truly, others are in leveraging your cost of services.  Millions of Americans do not have access to the same level of care, through no fault of their own, their work situation and company size and benefit offerings differ.

Count your blessings.  When you hear, "Six month supervised diet and exercise program," and think to yourself, "I must start all of my work all over again?"  Try not to feel anxious, try not to feel discouraged, but rather, continue to approach this process as practice for post-surgery life.  These are the behaviors you will need to develop once the procedure is done anyway, so why not embrace the process?

Let's also get to the bottom of it.  It's not just (too much food) and (lack of movement) that caused the weight gain.  It could have been many other issues.  The complexity of hormonal imbalance due to related medical problems (i.e. having babies, thyroid issues, steroid treatment, etc., etc., etc.) None of these occurred overnight.  The weight will not leave your body overnight.  And you shouldn't want it to!  The goal is not super speedy weight loss, the goal is healthy weight loss. Anytime I hear someone say they are losing 5+ pounds a week, I worry.  It's not natural for the body to lose that much weight in a week.  Even post-op, 2-3 pounds a week is a healthy rate.  It's not uncommon for people to lose more, but the truth of the matter is that if you are losing more than that per week, you also need to be very careful your body has what it needs nutrient-wise to stay healthy.

And here's the counselor in me... Learning new behaviors is not easy.  After surgery, we are forced to live on liquids, so weight drops off fast.  As we develop appropriate changes back to solid foods, there is often a lack of guidance in surgical centers. If you haven't deal with the inner demons and are intimidated by going to counseling because you're afraid you'll have to talk about X, Y, or Z, well then, the changes to self-sabotage may be higher than you think. You may not realize that because your boss made a judgment toward you about how you're losing too fast made you go home and stuff yourself with chocolate, or because your mom said you looked sick that you choose to starve yourself because you didn't feel like eating.  This is where the head work comes in.

This is where talking to a trained professional gives you the opportunity to discuss exactly what's going on inside your head when people say things that are offense and you are, in turn, take it out on your body by not caring for yourself.  This is where working on building your self esteem comes in.  This is where looking deep inside your behaviors becomes so important to finding the new you.  This is where the real work lies.  It's not all about what you eat and how you move.  It's about how you respond to the stimuli in your environment that causes reactionary behaviors that might sabotage your success. It's learning new ways to cope with old problems and finding the best way to cope with new problems.

It's about self care.  It's about creating the new you and your new environment.  It's about redefining yourself and finding new things you like to do, eat, act and handle emotions. It's about self love. It's about realizing that you can not change the people around you, you can learn to be a good influence on them.  It's about dealing with your demons and working through the issues and resisting the temptation to transfer the problems to other addictions. Not all of that work can be done alone.  Your surgeon maybe amazing, but he can not get inside your head and change the way you think.  Neither can your therapist, but they can certainly help you find your best way.

So, when you complain about paying for services that can help you, realize that helping yourself is something that must be done anyway.  We often don't flinch at paying $80-120 at the salon or spa for self care, but then think that it's too much to pay that to see someone who has had much more education to prepare to help us with mental health matters. It's a double standard that many don't realize they have.

Though, plugging my own profession was not my intention of this blog, my intention was to put the message out there.  The process doesn't end with surgery.  The process ends with us becoming confident, healthy, and full of life to stand up for ourselves and understand how to be the best we can be.  If we find ourselves going down a path to self destruction or sabotage, then we need to realize that there is help.  Finding good help is priceless.

Wednesday, March 6, 2013

Don't be deceived, Weight Loss Surgery Community


There are people in the Weight Loss Surgery community that put themselves out there to "help others" when their true intentions are nothing more than self promotion. It's the kind of nepotism we associate with the "Good Ol' Boys" here in Louisiana.  The person or organization present as a "friend" or "ally" to support a cause, when the true objective is supporting their own agenda. It can be a struggle to have unbiased intentions.

Recently, I was encouraged to do some financial watchdog investigating of some 501 3 (C) organizations that support the weight loss surgery community.  I had always had a gut feeling that the true intentions of some people were not genuine in nature.  What I uncovered had me appalled but confirmed my suspicions.  I found IRS tax documents confirming that conference events were funding a big party for the elite members, more than $17k in Entertainment/Food/Beverage expenses. (Ref. Form 990-WLSFA-2012) Wow, what I read there is "Bar tab!"  What happens in Vegas, does not stay in Vegas.  I heard all about the excessive drinking, smoking and folly that follows when you get a bunch of people together to socialize. I thought we were advocating for awareness of the dangers of drinking after weight loss surgery?  I thought we were promoting healthy lifestyles... I thought... I thought.... Wrong.

I understand for many who spent their lives being an outcast or on the outskirts of the social scene due to self esteem issues, it can be uncomfortable, even anxiety provoking, to deal with large crowds of people or strangers or individuals who might ask you many questions about yourself OR talk endlessly about themselves without letting others get a word in edgewise. Instead of addressing these issue head on, drinking was encouraged and funded from the looks of these reports. When I offered to present at one of these conferences on my own dime, I got no reply.  I believed my education and expertise in mental health, anxiety, ADHD, depression and human ecology were useful to the community, and what I could offer was the cognitive restructuring instruction and expression that would make each individual in attendance assess their commitments, examine a self inventory, and work through their own integrity. I wasn't asking for money, I was offering a service at no charge, my expenses paid by me.  Nothing, not even an acknowledgement of my message was ever provided.

Let's go back to that $17k figure. That's nearly $50 per day a year for an organization that holds on one major event per year and maintains one full time employee, who does not take a salary.
(*applause here.*)
Now, I don't have a problem with people getting paid a salary. There are many people who work really hard for free (myself & many others in the WLS community) and don't care about making money because the intention of their actions is to do good for others by taking on the ethical responsibility to care for those in need.  I maintain my commitment to advocating for mental health issues in the weight loss community by offering ANYONE who contacts me, a referral to a local mental health professional (counselor, psychologist, social worker, psychiatrist, in-patient treatment, etc.) whom I have checked out.  That means, usually, that I will spend anywhere from 1-3 hours researching, through various resources, an appropriate provider for that individual's needs. I have only ever had three people take me up on that offer.

The disclosure of the grant recipient selection process has also been a mystery to me. It seems like the concentration of candidates for grants has come from a small pool of patients. It seems to help to be a friend of so-in-so and the requirements to be an Ambassador for a year after to the organization confuses me. Define how this is to be done... Help me understand what the entails. What happens when someone can't fulfill the obligation?  What happens when having gone through the process traumatizes the person to the point they are emotionally broken by the experience?

Please, beware of anyone asking for your money.  There are many people out there who tout themselves as "Coaches" or "Support Leaders" who have no true training in psycho-social group dynamics. Case in point:  I am supervised in a group weekly for my license. A group member, who had personal issues that effected her relationship toward me, verbally attacked me one day in group.  I retreated in defending myself because there was no right, wrong, rhyme or reason for her to target me in this manner. I let her air her grievances and returned them with silence. My supervisor did the same. Not everyone in the world can let such a matter go as we did. The next session, another group member confronted her and requested she apologize to me, without me saying a thing. This dynamic played out over 3 separate group meetings until I spoke up and asked her what made her so defensive with me.

It was simple: insecurity within herself. This person suffered from obesity, past addiction and drug use, and she choose to attack me, whether it be due to my success with weight loss or my lack of an alcohol or drug addiction. (That's a crowning achievement in this city, there are few people that you can count on to be sober 99% of the time, I am one of them.) My confidence in discussing my clients and my actions are always so precise. Her questions to me were always trying to pull apart what I did to find something wrong with my actions. She was trying to make me wrong by extracting details I always had an answer for, and she could never find much to criticize other than her excuse that, "I don't know what it's like." But I kept my bases covered. I always, always do my best to do the right thing, in the moment and in the end.

"There's no limit to the amount of good you can do if you don't care who gets the credit." 
I'd tell you who said that, but he wouldn't want to take the credit. 

Some people out there would have you believe that they themselves are living "Proof" that weight loss surgery works ALL the time.  They will tell you that you are to blame if you were not able to lose weight or you had complications. I'm here to tell you that it's more than just doing the right things.  It is finding the right mental framework, it is addressing ALL of your issues with emotional, psychological, and/or substance use and abuse, it is genetics, it is hormones, it is disease of the mind and body, and even the scars on the soul. It is everything that encompasses the complex disease that is obesity and goes straight down to the core of who you are.  Anyone who makes you feel inferior without listening to your story, understanding your struggles and assumes their prescription exactly what will work for you and is to have you pay them for support to tell you what they did/do, is not treating you as an individual but rather as a dollar sign.

What most people don't realize about counseling is that it is NOT advice giving.  It is NOT a quick fix.  It is a emotional journey, a personal excavation, and an opportunity to find genuineness of character within yourself.  Act out of integrity to yourself and others, admit that you are not without flaw or fault. Embrace the imperfectness, realize where your weaknesses lie. Be honest with yourself and others. If you have honest intentions, your results will always have positive outcomes.  Now, if someone were to call me for counseling services, yes, I do charge my clients for services. However, I will always consider financially challenged clients and work with them to find a rate that they can afford.

Dear reader, whomever you are, please refrain from the judgement that I am trying to start a riot in the WLS community or that I am targeting people. I am only pointing out observations and reporting facts.  I would hope that you take into consideration the charitable donations that could have gone to financially challenged patients out there who are struggling to regain their health but rather went to a bar tab and office supplies.  Advocacy starts with ethical action and unbiased intention. If the issues that I point out are resolved with action to correct the indiscretions of the past, the purpose of my tirade is served.  However, I completely expect people to criticize me and call me names and say mean things about me.  Because, ya know, bullying is so productive!

Friday, March 1, 2013

Forgive my absence...

I've made a few posts on the Facebook page, but not yet here.  I start entries and then go away from them because I get distracted.  Having my LapBand taken out has been traumatic, especially amidst Hurricane Isaac and getting married.

I feel so offline right now. I'm balancing a lot, seeing clients, starting an internship with LSUHSC working with the Trim Teens program, working with the lovely people over at Obesity PPM, and working on going back to school for my PhD! There is much goodness to come in the future. However, I have had to take a step back from blogging and will pick back up soon.

I hope everyone is having a wonderful New Year!