Chris Stilson-Elmer

A Post-Op & A Doc (Cari De La Cruz and Connie Stapleton, Ph.D.) have officially designated 2015 as the Year of Recovery. There are just six, basic ingredients, which, if added to your life, can help you reach and manage your goals to lose weight and keep it off.
The good news is:
1) You already have everything you need to begin following the recipe.
2) It doesn’t involve shellfish, peanuts or milk, so you can’t possibly be allergic to it,
3) There is no baking, cooking, sautéing or mixing required, because the Recipe for Recovery doesn’t involve food, but does involve eating.


We like to say that obesity is “all about the food, but it isn’t about the food” (which makes you wonder why we’re talking about a recipe and ingredients). Well, let’s start here: Do you eat when you’re upset, stressed or worried? What are you eating to avoid? Are you eating to avoid a person? a situation? a feeling? By following the Recipe for Recovery, you can learn to deal directly with any upset, stress or worry related to any “what” or “who” so you don’t need to turn to food for a short-term “high” or “fix.” Here’s another one: Do you eat when you’re bored? What do you need when you’re bored? Are you in need of a hobby? Companionship? What are you doing to find a healthy hobby or seek healthy companionship so you don’t automatically turn to food? These are some of the important questions you’ll begin to ask yourself as you learn follow the Recipe for Recovery.
We know these are tough things to think about – especially when we’re busy plotting our next snack or obsessing about the box of donuts in the break room at work – fortunately, you don’t need to answer these questions BEFORE you can begin choosing to live in Recovery From Obesity. In other words, you don’t have to know what, where, or why in order to stop the destructive eating behaviors.
Basically, food is often a SYMPTOM of a problem – not THE PROBLEM. For example, you might have a problem with interpersonal relationships or issues at work, or perhaps a battle within yourself – like an “emotional storm” -- where you say really mean, negative, unpleasant things TO yourself ABOUT yourself. Rather than addressing the problem, you turn to food, so food becomes the focus rather than the actual problem! Unfortunately, food is a temporary (very temporary) reprieve from unpleasant feelings, memories, or thoughts and though it provides a chemically induced euphoria…it’s short-lived. What is true for the alcoholic is also true for people who abuse themselves with food, which means the problem will still be there when the food is gone…. and then you have the hangover to deal with -- usually in the form of self-brutality by way of horrendously abusive self-talk. Yikes!
We created the Recipe for Recovery from Obesity to help you learn to deal with the real issues (stress, worry, boredom, frustration, fear) in healthy ways (and to hopefully avoid the self-destructive eating and subsequent emotional hangovers).
Here are the six ingredients that make up the Recipe for Recovery:
1. AWARENESS: Awareness is always the first step in change, which is why we refer to it as the essential ingredient to weight loss and weight-management. It’s pretty hard to change something you’re not aware of. You might know that you’re obese, but are you aware of how you are contributing to the problem? Maybe you’re stuck in your weight loss journey, or you’re regaining, or you never made it to your “goal” – you’re aware that there’s a problem – but you don’t know what to do next. Becoming AWARE of your issues is the place to start.
2. ACCEPTANCE: This is often an overlooked ingredient in weight loss/management. If you don’t accept that weight and the associated issues are ongoing problems in your life, then it’ll be pretty difficult to make the necessary changes to lose that weight and keep it off! The truth is, there are many things we need to accept in our journeys of weight loss/management that you may not have ever considered, such as the fact that you’ll have to eat right and exercise regularly, and will probably have to forego (or greatly limit) some of the foods you really love. The process of acceptance may include having some anger, fear and even mourning. Accept it – and get on with the process!
3. ATTITUDE: We call this the flavorful ingredient (and for some of us, this one is pretty spicy!) We all have different “tastes” when it comes to food… and life, which means that we don’t all like the same things or do the same things in exactly the same ways! Variety is the spice of life? Well, we think attitude is the FLAVOR of recovery! Focusing on attitude and having a positive one can make all the difference in your Recovery results!
4. COMMITMENT: You’ll use this staple ingredient at least once (and sometimes several times) each day in your Recovery journey, especially when you inevitably develop a case of the “I-don’t-wannas” – you know, those moments when you just “don’t wanna…” workout…log your food…manage your portions, pass on the Cookies, etc. Adding a dash or a splash of commitment to your life helps you make the next wise choice. Every wise choice moves you toward your desired goals – a healthier self and a better quality of life.
5. ACCOUNTABILITY: Often quite underused, Accountability is an ingredient to help ensure the recipe is prepared as directed. We know it can be tempting to try to do things your own way, and we also know how that’s worked in the past! That’s where accountability really brings the Recipe for Recovery to life! Use accountability to do what you said you’d do when you began your weight loss journey. Whether you chose surgery, medically supervised weight loss, or another structured program, you agreed to do certain things, so this ingredient really matters. Hold yourself accountable for following through with doing the things you said you would do to get the weight off and keep the weight off.
6. EFFORT: The sixth (and key) ingredient in the Recipe for Recovery is Effort. Without ongoing, consistent, “use-it-whether-you-feel-like-it-or-not” – continual effort, the recipe will NOT turn out the way you want. Let us repeat: Your Recovery will NOT be successful if you do NOT use this key ingredient. When you put forth effort, you see results in the direction you are working toward. When you withhold efforts, you also see results – but not the ones you want! And, guess what? You can’t overuse this ingredient, so add it liberally and realize the fullness of a life in Recovery!
It may sound like a lot of work, but if you want what you say you want (a healthy life in Recovery From Obesity) -- these ingredients really add up to a winning result!

I am 41and was overweight my entire life unless WLS. I have excess skin and would love plastics but it is not in my immediate future. I am in shape now and while I do have excess skin from 39 years of obesity, it is livable and continues to improve. I highly recommend you weight train during this process. This was yesterday:

Hi @lynneanne. I'm also 56 and was not in shape either. I've lost 150 lbs. and I have alot of loose skin. Having said that, between body shapers, and certain clothing styles...no sleeveless, no shorts or dresses above the knee, I look just fine. As far as more intimate situations, I can only give you my experience and for me, my fella also has a band and is still about 40 lbs. from his goal weight so neither of us fixates on the things that are far from perfect. We simply enjoy the intimacy. Hope that helps you some. Oh and one more thing. The loose skin is worth the weight loss. I've never felt that being overweight was in any way advantageous over the skin issues.

Thank you for the replies. I am 3 months post op lost 60 pounds and probably have 40-50 more to go.

Thanks for your reply, I am 56. I am NOT in shape! I am currently 247 and pre-op I see my surgeon Wednesday. I have alot of stretch marks on my abdomen already so I'm worried about hanging skin there. I really want the surgery but I want to go in with my eyes open.

Lynne Anne,
It depends on how heavy you were, what shape you were in, and also on your age. I have lost 131 pounds, am 54 and not in very good shape! So it isn't very pretty. I can't afford plastics either, and I'm scared of the pain. As far as I go, the butt is my worst, sorry tmi! It's okay, unless you want to wear a bikini or revealing clothes. Short sleeves are kind of uncomfortable for my wings. But this is just me, and you might heal better, depends also on the condition of your skin. I was told working out helps.

Has anyone lost 100 pounds and not been able to afford the skin surgery? I won't and I want to know how bad it will look.

My surgeon said to wait 2 years post MGB to get plastic surgery.

My surgeon told me the earliest I should think about plastics is 18 months after surgery. That's the earliest point when weight is stable and you have a sense of how much your skin is going to bounce back. It was a 15-second exchange at most, so I don't know more than that. I'm just 3 weeks post-RNY so I filed it away for future reference.

I know the skin doesnt pop back into shape but I was curious if there was a time frame that you did notice firming. Trying to determine time frames to get plastics done after I hit goal.

I have been having this pain in the middle of my rib cafe directly in between my boobs for a couple days now. It only happens in the morning when i'm drinking my Protein Shake. I don't usually eat Breakfast, i do the shake instead and this pain comes and it knocks me over. I usually have to walk or rock back and forth until it disappears. Then i have to eat something to prevent it from coming back.
I just had a cat scan and everything done a few days ago and i don't have any issues with my gallbladder or leaking... it just this pain appears. I don't know if it is an air pocket or what it is but man it is painful.
Has anyone else experienced this?

Maybe a subject that is TMI but one that I def need to discuss.
I am 10 days post op, have had no problems having a BM on my own (without the daily milk of magnesia my MD recommends) just having liquid bowel movements (eww that sounds horrible), I am thinking that is because I am still on a liquid diet, but at what point is it considered diarrhea if every bowel movement you have is liquid? Maybe if it increases in frequency?
Also I feel like I have had a couple of episodes of dumping syndrome, I ate broccoli cheddar Soup (well blended -- also I know not the healthiest selection but it was Thanksgiving and I wanted a soup that was actually tasty -- and my favorite) and immediatley after was hit with the very painful need to go to poop (which I did -- and then my soup was gone out the other exit) any thoughts on avoiding dumping?
When do you resume normal poops!?! I need to know hahah

I'm worrying myself to death at the moment. I've followed everything I was told including no lifting over 10 lbs.
I noticed a few days after surgery that I had a small area that was some what swollen on the left side of my stomach, right below the ribs/breast on the left side.
Its not round and it doesn't hurt. There is no incision anywhere near this area. I'm wondering if this could be a hernia?
I'm planning to follow up with my doctor after Thanksgiving. Was just wondering if anyone else has had this?

I forced myself to burp (a lot) so I could get rid of the gas pains faster. That and drink warm broth, it'll get the gas moving the other way too. and of course, lots of walking. My biggest pain has been the muscle/tissue trauma from the laparascopic instruments (especially to the left of my navel). OMG, when I sneeze or hiccup, or bend the wrong way, YELP!! I discussed it with the surgeon, and this is normal since they have to ease those instruments inside your belly thru tissue, fat, and muscle areas. So just be careful not to overdo any exercise while you're healing. I'm 19 days post-op and this has been my biggest issue since returning home after surgery.

@@dashofsunshine Thank you so much for your reply. Oh my goodness it hurts so bad. I just talk to my surgeon's group and they said the same thing you did. I'll just be glad when this passes. And I'm walking all the time also. I ended up sitting up
for most of the night. Can't wait to be back in my bed.

I had surgery on Thursday and am experiencing the exact same, as well as lots of shoulder pain. My doctor says it is just gas (even though I've been walking my butt off) and that it will go away with time. But seriously, it is excruciating. I didn't sleep at all last night because these pains were ripping through my chest, shoulder, and upper back ????

Are you taking Prilosec?

I had surgery this past Friday and I've had this chest tightness especially under my diaphragm. Is this gas or fullness from drinking Protein Shakes? No shortness of breath. It only slightly pains to take a deep breath.

CAUTION! MEDIA HEADLINES MEAN TO SHOCK!
I was recently drawn into an online article with this tantalizing and provocative headline..



“Vitamin D Testing Not Recommended for Most People.”


This was the headline from the Harvard Health Blog. I HAD to read more, this surely couldn't be correct. Could it? Is all this ’vitamin D saves the world’ merely hype?
Not so fast. Remember, the media can’t sustain without an audience…even Harvard blog writers need readers. Flashy, conflict-building headlines do just that.
My beef here is that in today’s hurry-up world, there’s a good chance many people won’t read past the headline.
In fact, they may start thinking, “Hey, if Harvard says I don’t need Vitamin D, I probably don’t” and stop taking the supplements their surgical team has recommended.
Before anyone does that, here’s what I learned from reading the whole Harvard blog piece.
1. Many scientists don’t agree on what a ‘low’ level of Vitamin D is. 20 ng? 30 ng? 50ng?
2. Vitamin D research is at a crossroads because its not certain if there’s a solid relationship
between vitamin D levels and heart disease or cancer.
And……
3. Weight loss surgery patients are among the 3 groups of people that need to be
tested for vitamin D levels because of changes in fat absorption after surgery.
Will vitamin D prevent cancer, osteoporosis and heart disease? Not likely, on its own, but scientific research continues.
In fact, a clinical trial is underway involving 26,000 people that will provide some solid information on vitamin D’s role in our health. Look for the accompanying tabloid-type headlines in 2017.
Meantime, WLS patients, keep taking your prescribed supplements. You'll be glad you did.

Knowing your pain management plan post surgery will allow you to reduce complications and get out of the hospital soon. I have included some helpful tips from a hospital pharmacy insider... ME!


I often times get asked what is the biggest piece of advice I could give someone for surviving their hospital stay. For me the answer is a hands down no brainer. CONTROL YOUR PAIN MEDS! Nurses and hospital staff will be in and out to see you, but you need to realize that each nurse probably has four to six other patients all vying for attention. It is your responsibility to take your pain management into your own hands. You do not want to mess around when it comes to managing your pain! If you are in pain you will be unable to get up and walk. The longer you take to begin walking the greater your risk of complication and the longer your hospital stay. In this case DO NOT BE A TOUGH GUY! Wuss out and take the meds.




You will be constantly asked during you hospital stay what your pain level is. It will be on a scale of 1 to 10 with 1 being no pain at all and 10 being the worst pain you have ever felt in your life. Be sure to answer honestly. DO NOT TRY TO BE MACHO! 3 to 5 on this scale is considered pain, but tolerable. If you drop below a 3 many doctors will begin reducing pain medication. Above 5 and they may begin increasing. The doctors and nurses want you in the blissful middle zone of 4 to 5. It should feel as though you have a bad muscle pull in your stomach, but no sharp or stabbing pain on a continual basis.

Your pain post-surgery will most likely be controlled in one of a two ways. The first is with a gloriously blissful device known as a PCA pump. This is a machine in which a syringe of Morphine or Fentanyl (depending on what your doctor and a hospital pharmacist deem to be appropriate) is placed to be administered to you at the push of a button. The best part is that you have control of the button! The machine can be set to allow you to administer the dose yourself every so many minutes; usually half an hour. The other way your pain will be managed is with an injection of morphine or fentanyl? This is pretty straight forward and don’t worry if you are scared of needles. This pain candy is injected into your IV.



Once you get past the injections or PCA pumps, usually once they take out your IV, you will most likely be weaned onto an oral pain medication of some kind. Many surgeons prefer Percocet for this application, but you may also be given an oral morphine. There is really no major difference between these in terms of effectiveness though there are other consideration that your doctor and a hospital pharmacist will use in consideration of which to give you.




It will be your job in the hospital to stay on top of when you get your pain medications. Here is what you need to know from an insider. I work as a pharmacy technician in a hospital so I am familiar with the workarounds. Here is the rule of thumb. The PCA pump will be available to you at your discretion and will most likely be hooked up before you wake up from surgery or shortly after, but injectables last about two hours and the oral liquid lasts about four. That is a very short window and you need to be sure to talk with your nurses and find out how long each medication is good for.

I made it a point to let my nurse know half an hour before each medication was due. This will allow them plenty of time to get your medication to you before time runs out. If the medication is not stocked on the floor then it will be delivered from the pharmacy and will take time. You want to give your nurse plenty of time to make this happen. Your nurse will not always remember when your pain meds are due so it will be your job to remind them. Remember, they have five other six people all needed medicines and all needing extra special attention so it is possible that you could be forgotten if you do not speak up. I am positive some nurses found me annoying, but other said they really appreciated the fact I was trying to stay so consistent with things and remind them. They key here is to be very nice and just let them know you are trying to stay on top of things since you know how the pharmacy works. Nurse’s love blaming the pharmacy for delays and they will love you for not blaming them. Far too many people do.

Running out of pain medication is a lot like falling off a cliff. You go down fast and it takes a while to climb back on top of it. So do yourself a favor and make sure you understand how long your pain medication will last and what types you are on. Make it a point with one of your final doctors’ visits prior to surgery to discuss what their plan for pain management will be and specifically which drugs he likes to use and why. With this in particular and your weight loss journey in general, KNOWLEDGE IS POWER! The power to finally begin taking control of your life. That is what this amazing journey is all about. This will be a great way to practice in the hospital before you get home and the real work begins!

I quit Smoking and Caffeine, but Iove my coffee in the morning so I went to Decaf with sugar free hazelnut creamer...still has carbs..but for a teaspoon of it...falls within my required daily intake...although my surgery isn't until Monday 11/24...I am preparing.
On the 10 day pre-op diet right now...getting my Protein shakes, Water and good ole chicken broth..and of course my 1 cup of coffee...

It took me 6 months to break my caffeine addiction! I used to start out with several large cups of coffee, then drink diet coke like it was Water all day long. I managed to wean off completely starting with half-caf coffee and subbing LaCroix for some of the diet coke, but it was not easy! I had headaches off and on for months. I stayed completely off for the first several months post op, and have returned to a single k-cup of caffeinated coffee in the morning. If I want more coffee, it's Decaf. I don't do any kind of soda at all any more. Bubbles are banned and make me feel icky anyway. Do what you can to get off that stuff now! You don't want to be dealing with kicking that addiction post op.

@@MamaTo3inNH Willpower is a heck of a thing! Before my surgery I literally lived on coffee and maybe 16oz of Water for fluids...ridiculous! When I found out I couldn't have it anymore I just quit. No sense in chancing misery while trying to recover. On the plus side if you do get headaches now you can take medicine for it. I thought I would get headaches but I didn't. I don't even miss coffee anymore (unless I see a Starbucks then I kinda do but I just think of the SUGAR) So the choice is yours either way I wish you luck!

Hi everyone! I'm having GB on 1/19, and my surgeon said caffeine impedes healing and isn't allowed for 3-4 months after surgery. I drink 1-2 large mugs of coffee per day, and 1 or 2 servings of caffeinated crystal lite or diet coke (side note: diet coke is RARE - I kicked that addiction a few months ago! I would drink a 2 liter per day!)
Now, I have had days where I didn't get my usual caffeine intake and had horrid headaches. The dietician recommended I start weaning back about a month before surgery. My husband said since I will be on pain killers for about a week, my withdrawal headaches will go unnoticed, and I should enjoy my coffee as long as I can (up til midnight the night before surgery lol)....
Anyone have any insight into this? I have never had to break a habit like this. The diet coke quit was because I know many GB patients can't drink bubbly drinks so I wanted to nip that.
Thanks in advance

Protein is IMPERATIVE to bariatric patients. And the great thing is we have so many options!


Once upon a time it was nearly impossible for a bariatric patient to keep their protein counts up. We were taught to only eat certain foods and to avoid others. chicken breast, lean beef, and fish was the rule of thumb. The problem with these foods was that several people had problems eating, swallowing, and digesting them. And we were told that once we hit a certain point, to avoid Protein Drinks as we needed to be eating our protein rather than drinking it.
Isn't it nice to know that times have changed? New research and information has given the bariatric patient so many more options on foods we can eat now to keep our protein levels where they should be. We are no longer restricted to the leanest cuts of meat, but are encouraged to try other cuts such as dark meat chicken, 80/20 or 90/10 ground beef, and (a personal favorite) BACON. Additionally, we are encouraged to eat eggs and shrimp, salmon and pork. And protein drinks (when done RIGHT) are no longer a no-no!
How Much Protein Do We REALLY Need and Why Is It So Important?
According to most surgeons and nutritionists, we need about 65-70 grams of protein daily. That goes up a little bit if you're recovering from surgery or are sick or pregnant (to about 85-90 grams). Protein is an essential building block of our bodies. When we're losing weight, especially, protein is one of the hardest working macronutrients on the planet. Beyond muscle building, it also helps strengthen our immune system, rebuilds tissue, and can even improve brain function. Additionally, when we lose weight, our bodies burn protein. When we're not getting enough protein, our body takes it from wherever it can get it - typically our body muscle. What's more, it can actually take muscle from our cardiac system!
How Can I Get My Protein?
Focusing on protein is the #1 concern of many bariatric patients. Of course, eating your protein is the very best bet. Focusing on protein foods with a high protein to fat ratio is the very best bet. Some of the best protein foods are egg whites, chicken breast, and shrimp. Although other meats, poultry, and seafood are also good options. cheese is another great choice as are nuts and seeds. Beans do give some protein, but many bariatric patients have issues with digesting them.
Another good option is the Protein Drink. Once only encouraged in the early phases after surgery, now many nutritionists and dietitians are encouraging the bariatric patient to include protein supplements in their daily diets. Most contain high (35+ g) amounts of protein, and leave you free to consume other healthy (and needed) foods later on such as vital fruits and vegetables.
The #1 suggested protein drink that nutritionists suggest is whey protein. It is, by far, the most digestible and assimilated protein on the market (that means your body can use it a lot easier than other kinds). Sadly, many people can't tolerate whey or stomach it. If this is the case, there are other options available that are almost as easily digested such as egg white protein or vegan (brown rice, pea, and hemp) Proteins.
If I'm Focusing On Protein, I Don't Have Room For Other Foods, HELP!
VITAMINS! You remember those Vitamins and Fiber supplements the doctor sent you home with? TAKE THEM. It's true that we often have to forgo fruits, vegetables, and whole grains when we're focusing on protein. That's why these supplements are so important to our lifestyle.
Remember The Basics!
The basics of our lifestyle don't change with time. We still need to remain focused on protein, Water, and our Vitamin supplements. Keeping these three things at the forefront of your mind will help ensure you successful weight loss, successful maintenance, and a successful lifestyle overall!