pleasant surprise

having nothing to wear is a good problem to have in this case, but it's a problem nonetheless. most mornings, i put on a few items and then immediately move them to the pile of donations. it's annoying because i feel like i just assessed each item recently and decided to keep it, and then it's too big the next week. like i said, good problem to have, i realize, but it is annoying. i'm down to one pair of jeans (these, which i love) and a bunch of size 14/16 cotton tops which seem to be working okay. although i'm pretty solidly in a size 14/16 on top, the bottom remains a bit of a challenge because i generally carry a lot of weight in my middle area, and i have a lot of loose skin there making matters worse. 

so i was pleasantly surprised when i decided to just try a pair of size 16 pants i got who knows how long ago. they fit! and these are not a lane bryant 16 or an avenue 16, these are a dress barn 16, which means they're not as "generously cut" as true plus size pants. sidebar - dress barn? i think i shopped there exactly once and bought these pants, so go figure (do they have good stuff? should i go there?)

for a while, i've been feeling like no matter how much i lose, i might really need plus size pants for quite a while. i felt that way when i couldn't close the size 18 pants i had hanging, and i felt that way about these 16's too, but now i'm seeing it might not be as slow as i thought. not a bad way to be wrong.

i love new but old clothes, especially when the sizes are moving in the right direction.

skin deep

one of the most common discussions post-weight loss surgery is skin. while skin's ability to "bounce back" largely depends on age and skin elasticity, there are two commonly accepted truths: it's better if you exercise to at least tone what's there, and that if you lose more than 100 lbs, you're going to need the skin removed, or at least you'll want it removed in procedures commonly known in the WLS community as "plastics."

some people with large amounts of loose skin get infections and have health-related issues because of it, though sadly not very many, otherwise maybe insurance would be a better bet for coverage. since my insurance didn't even cover my gastric bypass (but of course they'll cover cancer, diabetes, heart disease and everything else that comes from obesity, but i digress...) i doubt they'll cover what actually IS more cosmetic (i'm sorry, but gastric bypass surgery is NOT cosmetic. okay i'm digressing again).

because i feel comfortable with you, my readers, i'll share what my arms look like right now. it's not pretty and you can even see the volume and looseness through thin shirts and sweaters when i move my arm quickly.

 

but the way i try to see it is that it's better than if there was fat filling the skin. my two biggest problem areas with skin are really my arms and my stomach, very common places. the procedures that would probably be done (once i'm totally done losing weight, have maintained the loss for at least a year and won the lottery) are an abdominoplasty (tummy tuck), a mastopexy (breast lift), and a brachipoplasty (arm lift).

in the picture, i can actually see the contour of a thinner arm on top, which is encouraging, like you could just lop off that whole bottom section and my arm would be great. no amount of toning at the gym (where this picture was taken) will fix what's on the bottom, but that's a worry for a later time.

leftovers

so you know how the moment where i have to stop eating is still hard for me sometimes? i had a little revelation this morning...i was having breakfast - turkey bacon, 2 egg whites and half a piece of american cheese on a slice of multi-grain bread. i ate the turkey bacon first (protein first, always) and then i had a bite or two left of the sandwich. i was full. not too full, just done. normally, i have that feeling where i weighed it, and the whole thing was 5 ounces, so why can't i have it? it's mine. 

this morning that wasn't really the feeling, and i felt like that was progress. i felt happy to feel done after a small, reasonable breakfast...the gift of early satiety that the surgery is best loved for. what i felt, though, was more just anxiety about how i'd account for the piece that was left over...if my breakfast was 248 calories and 23g of protein (which it was), then what do i do about the piece i was leaving over? on weight watchers, i would have just removed a point from the grand total number of points, and although i could figure that maybe 30 calories and 3 grams of protein could be shaved off, then how do i denote that in sparkpeople where i calculate my calories and protein? although the 30 or so saved calories doesn't matter much one way or the other, the protein is important to account for accurately. 

as i write this out, i realize this is probably one of two things, if not both: either a mind game because i'm finding a way to cling to that one other piece, or my own hangup on perfection for perfection's sake. as i finish writing this, i felt hungry again for that last piece. i put it in my mouth, and then i spit it out. i wanted to throw that last piece out...needed to. for principle, for progress, for peace of mind. it's in the garbage. 


just also realized a totally separate thought...i think in this instance, the bread acted as a stopper (which it can do, particularly when not toasted which this wasn't) and i actually think it falsely filled me. maybe bread shouldn't be a part of this meal, and i should just focus on the turkey bacon and egg whites.

changing my mind

part of my problem with food and eating has been scarcity mentality, which leads very obviously to binging. it's the feeling that "i might not always have access to this food so i better eat it now while i do." and that meant whether or not i was hungry, whether or not i wanted to be eating, whether or not i even liked what i was eating. i think in many ways it started as a kid because my mother was always concerned about my weight, so i felt watched...when she'd leave the house, it was time to eat! anything, everything, in large, sickening quantities, and fast because i never knew when she'd be back. sometimes, she'd be back much sooner than i expected to get something she forgot, and then the jig was up. i don't blame her...she was concerned, and with good reason. i know she often looks back and wonders what she did wrong, and although it's easy for everyone to play monday morning quarterback, she did what she thought was right, she did it out of love, and i don't blame her. (you hear that momma?)

but long after my mother was watching what i ate, it was the way i behaved. when i got my license, my main source of joy was not that i could cruise around with friends and be free (which i did, and i was), but that i'd have the shameless ability to get myself food - a lot of it. i could drive to a fast food restaurant and up to the drive-thru, not even having to get out of the car to order. i'd order so much that i'd pretend i was ordering it for a crew of people - pretending to the muffled voice on the other end of the speaker, pretending to myself. and then i'd go to another drive-thru and do the same. you don't get to be almost 400 lbs without habits like that...it's not just a sweet tooth that gets you there.

so even now, even when i can no longer physically binge because i've taken away that option, i have to be mindful of the behaviors that drove my binging, and the thought processes that were behind those behaviors - i had a gastric bypass, not a lobotomy. i have to watch the tendency to graze, which i've come to see as a long, slow binge. i have to watch my tendency to want to eat just for eating's sake, which i thought would fade away but hasn't yet...that moment when i know it's enough, but it's still hard to let go of that one ounce that i know could be mine...and i have to be mindful of my mind's ability to play tricks on me...that a whole bag of popcorn could be only 3 or 4 ounces, which i'm allowed to eat, volume-wise, but that that doesn't mean that i should eat the whole bag of popcorn, behavior-wise.

a lot of times, the old behavior comes from a good place, from wanting to do the right thing. it has always come from a good place - it was to make myself happy, comfortable and soothed. if we had a way to give that to ourselves or anyone else we loved, wouldn't we want to? it's the kind of love that hurts on the back-end.

here's an example of today's good intentions leading to yesterday's behavior... i want desperately to be off of artificial sweeteners, but i can't have sugar and i want to be able to eat sweet things once in a while. last week on my lovely farmers market outing, i discovered a fresh apple muffin that had no sugar ... it was sweetened only with apples and had oats and whole wheat flour, and was utterly delicious. upon realizing how much i liked it, and how it could totally replace junky snacks like this and this, my immediate thought was "so i should stock up on these every wednesday at the farmers market." 

as i thought through the plan, i realized quickly that part of what was so good about the muffin was that it was really soft and fresh, and that by the next day when i went to have the other half, it had already lost that, so two days or three days after buying it would be even less fresh...of course i explored that i could freeze them, refrigerate them, etc. but then it hit me - i should buy one on wednesday and have half of it and then save the other half in the fridge or freezer or give it to someone else to enjoy. and that's it. i don't have to eat it EVERY day. i don't have to STOCK UP. it can be something i have once in a while. and i can get to a place where my mind can change, and where that type of scarcity will be okay with me.

food for the soul

as i learn more and more about organic food and farming and our country's industrial food system, i become more and more impassioned about eating whole, healthy, natural foods, and so shopping at a farmers market, which was always appealing and feel-good to me, has become nourishing in a totally different and ever-evolving way. i feel like moving to the country and living and working in a way that honors the sun and the soil and the water and animals and plants and farm workers as well as the consumers and the society that supports it. but alas, there are billions of words written on those exact thoughts and feelings, and in some ways i take comfort in knowing there's a certain universality to those values and feelings. the best i can do is to live my non-country life in a way that honors those values, and so i've begun to do that in the very large majority of the way i shop and eat - farmers markets, whole foods, trader joe's, organic when possible, fresh and local almost always. see my ode to tomatoes from yesterday, which were in utter explosion mode at the farmers market today. of course there are a few straggling processed foods i still support - sweet and low (my main source of guilt and shame in life), sugar free foods, protein shakes and bars, etc. 

ANYWAY...i had an almost out-of-body happiness this morning at the farmers market near my office as i inhaled the sights, sounds and scents of a bustling market filled with gorgeous, fresh produce and dairy, the people who grow and pick and transport them, and a disparate collection of people who value the whole cycle. i was walking around smiling strangely, perusing all the items and deciding what i'd buy and from which stand. 

one of the things that's really lovely about having a very small stomach is that i don't need much food (sounds funny, doesn't it?), so i can buy really high quality foods in small quantities. this works out emotionally too, because i feel really good about buying the best food i can afford. one of the strange points made in one of the documentaries i've been watching (i think it was this one, though it could have been this one too, both of which should be on your queue immediately) is that americans spend much less on our food than other countries...which is sort of ridiculous since it's what we're putting in our bodies, and we only get one body. 

 

so i spent $12, and i got a real abundance of things to use over the next several days. i tried to buy some a little less ripe after confirming with the seller that they would ripen on the countertop...this way, i don't feel produce pressure immediately and can use them in waves, though all in the next couple days so i don't defeat the purpose of buying fresh and local. i got 2 beautiful green peppers and a white pepper (first time i've seen those!) which are supposed to be sweet, like red and yellow ones. i also got a bunch of radishes to dice up into salads, inspired by the healthy 8 from trader joe's. then i got a 1/4 pound of salad mix which i'm going to try adding to my lettuce-less shrimp and chicken salads, 2 teeny tiny plums, 2 donut peaches, an apple, a container of amazing looking cherry tomatoes in many colors, and a no sugar apple muffin...sweetened not with chemicals or sugar, but with apples and a touch of organic agave nectar. if it's good, and if i feel okay after eating a piece of it, it could be a great alternative to junky sugar free snacks that make me feel guilty (and sometimes gassy) because they're made of things that are not, or should not be, food.

the thing that made me smile the most was the sight of little babies, sleeping in strollers being walked around the farmers market. they're too young to make their own choices obviously, but the people making their choices for them seem to be doing it thoughtfully just by being at the market and not at the bodega or the grocery store around the corner, and they're doing something wonderful by bringing them there...even if they're sleeping, even if it's years before they know what arugula is or how to pronounce radicchio. it means something, even at their early age, to be there and be involved in the process. if you like this idea, read this inspiring interview. 


i'm hopeful that values about how and what we eat can sink in through a form of childhood osmosis, because it's something i really want to pass on to my own eventual children one day. the thing that leaves me wondering is why it didn't happen earlier on for me, someone who was lucky enough to have healthy-living parents with a sense of moderation and balance, who always worked hard at their own fitness and bodies...they did everything right in that regard. wow, that just became a downer. nah, not really a downer...it's all an evolution and i'm happy to be where i am, today.

bad medicine

the other day, a friend needed a recommendation for an orthopedist in the city and fast. i told him that i had one, but that he was a jerk on a personal level. he said he didn't care about that, and then he asked for the story and here it is:

about a year ago, i was having problems with my right hip which was just constantly hurting. as i often did, i assumed it was weight-related and figured it would get better when i lost weight so why seek medical attention? don't worry, this doesn't end badly, it really was weight related and nothing horrifying, but eventually the pain got bad enough that i figured i needed some relief and scheduled an appointment with an orthopedist i'd seen before. he took x-rays and determined that it was a little arthritis and prescribed an anti-inflammatory. because i was so used to doctors telling me i needed to lose weight, and because i was already scheduled for my surgery and armed with a plan, i felt the need to tell him right away that i knew it was probably weight-related and that i was going to be having the surgery, etc. i was so used to being on the defense in medical situations that i was happy to, for once, have a confident plan to lead the conversation with rather than “well i rejoined weight watchers and…” but in spite of my confident plan, this doctor managed to stun and shame me anyway. he was unmoved by my announcement of the surgery and my looking forward to it and instead pursued his own line of questioning.

doctor: so how long have you been this size?

me: well i've been in this general area for many years...since college i guess, but heavy in high school too.

doctor: wow.

me: yeah, so the surgery really feels like the right choice for me.

doctor: so what do you, just eat a lot?

me: um, yeah i guess. but its a little more complicated than that…
 

doctor: i mean, i can understand sometimes you just want to keep eating and (makes piggish noises and a shoveling motion with his hands to his mouth) but i mean, you have to just stop yourself.

me: (almost speechless) yeah i mean, like i said it's not as simple as what you're saying. i mean, i've done lots of reading and i'm in therapy and it’s a disorder even though many people don’t understand that, and --

doctor: okay well good seeing you. good luck, i'll see you again after you've finished the anti-inflammatory. take care.

when i told mitchell this story, he was infuriated and shocked, but i sadly wasn’t. i was used to this kind of treatment from doctors and other people alike, though admittedly, this time did seem particularly brutal. the truth is that many studies show that obese people receive the absolute worst medical care for two reasons – first, because doctors often blanketly assume that ailments are weight related (as do obese patients). though they often are, or certainly are exacerbated by weight, it sometimes causes patients and doctors alike to ignore symptoms that should be further explored because they’ve assumed the obvious, visible answer. and secondly, because some doctors, like some laypeople, are repulsed by obesity and see obese patients as lazy, lacking self-control and piggish. how can you care for someone in a respectful, responsible way when that’s what you think of them?

and the obvious other factor is that when people are treated this way and shamed by their doctors, it takes an awful lot to push through those feelings and drag yourself there when something hurts, especially when it’s something you know your weight affects. i didn't go back to the doctor after i finished my prescription. and my friend who didn't care that he was a jerk went and saw him and thought he was a jerk. shocker.