Jean McMillan

I was banded on 9/19/07. A red-letter day. Since then I've had ups and downs on the scale and in medical issues, but I've never regretted having WLS. It turned my life - and my head - around. Except that... After about a year of stable weight, I've been alarmed at gaining 5 pounds in the past month. That is such a puny number compared to my weight gains in the past that I'm embarrassed to admit it, but just 5 pounds freaks me out. It makes me want to smash my scale with a sledge hammer, if only I could find one. And perhaps that lack is a good thing. Knowing me, I'd smash my scale, my foot, and the porcelain tile in the bathroom, at a high cost all 'round. I've logged my food to test my calorie intake, and can't find an explanation there. It's possible that high sodium intake contributes to this, but I'm here to tell ya: my XS-capacity bladder gives me frequent and vivid messages quite soon after sodium indiscretion. So of course, with the weight gain/loss/gain/loss history I bear, I'm in a panic. Until today, when my XS bladder sent me to the loo for the 40th time in 4 hours (perhaps a small exaggeration) and I suddenly realized that (sorry if this is TMI) I'd pulled down my size 4 pants without unzipping them. Again. I raced into my closet to check the size tags on the pants hanging there, and they were size 4's. Yes, this has happened before. I report it now because (of course) I want your sympathy but also because the public declaration reminds me that this is, as I've said so, so many times, a lifetime journey. Jean

FIT AND WELL-NOURISHED. Can't get much better than that! At the end of the visit the last time I saw my internist (routine checkup), he said, "You're doing a wonderful job of taking care of yourself." That short sentence is solid gold to me.

I did something similar. I bought a beautiful skirt that was about 2 sizes too small, hoping that one day I could wear it. Sort of a motivation garment. Every time I saw it in my closet I was reminded of the future's "maybe". When I could finally wear it, I felt like a million bucks every time I put it on. The sad part is that eventually it became too big for me...or should I say I became too small for it...

Amen to that! One of the nicest compliments I got when I'd lost 30-40 lbs was, "I the outfit you have on. It fits!" The American Cancer Society has long understood the relationship between looking good and feeling good. They have a program called "Look Good, Feel Better" that partners with Cosmetologists and provides spa days and other services for women with cancer. I know I definitely feel much better about myself when I take the time to do my hair and makeup and accessorize on weekends and days I work from home. It's a challenge during weight loss, but I'm determined to wear clothes that fit now. I've been lost in shapeless knits and elastic waistbands for too long, and I'm ready to look as good on the outside as I know I'm going to feel on the inside. I know constantly buying clothes can get expensive, but this is a peeve of mine. As people lose weight, I feel it's SO IMPORTANT to wear clothes that fit your ever shrinking body! Not only does it just make you look more put together, it makes you FEEL more put together, thus encouraging continuing positive behaviors that got you there! Even if it's just a few nicer pieces you can mix and match until you have to buy the next size down. We lived our lives being frumpy and wearing over sized, ill fitting clothes to hide our bodies. Why continue to do that as we get smaller? We need to flaunt our confidence and success to the world!

If the key to weight loss success is self-esteem, and you’ve got none stashed in the pantry where you used to keep cookies and potato chips, where do you go to find some? HOW WE GOT HERE In Part 1 of this article, I introduced the idea that positive self-esteem is the key to weight loss success. In Part 2, I’ll talk about why so many obese people have a negative self-esteem Now let’s have a quick look at how we came to be such sorry specimens. Any psychologist or sociologist will tell you that some of the most troubling factors contributing to low or negative self-esteem (on the levels of individual people as well as the aggregate of citizens called American society) are a person’s physical appearance, weight, intelligence and peer pressure. Very often all four of those factors are tightly intertwined. In an elementary school cafeteria, Jane, an obese girl with a tray piled high with food winces at her classmates’ teasing. Unable to find a friendly place to eat her lunch, she sits down alone and cries at the sound of other kids’ voices: “Fatso!” One of the school bullies shoves Jane’s lunch onto the floor and laughs, “You didn’t need that food, Fatty!” Jane heads to the lavatory to cry in private. She hides in a stall and hears the popular girls chanting, “Fatty Fatty, two by four, can’t fit through the bathroom door!” I’m sure you’ve guessed by now that Jane’s name is actually spelled Jean, and that the school cafeteria scene above lives in my distant memory. Even when I don’t consciously think about that unhappy incident, it and many others like it formed my beliefs and feelings about myself a long, long time ago. Sometimes I feel that I’ll never get them all weeded out of me. In my case, that ancient stew of negative self-esteem flavored my life with some miserable symptoms: hypersensitivity to criticism, perfectionism, guilt, shame, irritability, a defensive attitude, a sense of defeat and insignificance, and a persistent, low-grade “fever” of dissatisfaction with myself, my life, and everybody else. And yet, despite all that, at age 62 I can call myself a success, not just at weight management but at a host of other things. No, car repair is not one of those things, but on the whole I’m doing pretty well. I have my husband, my friends, and my own determination to thank for that. If I can turn myself around, you can do the same for you. Low self-esteem is not something that gets fixed overnight, and having bariatric surgery is not the cure. Choosing surgery is a wonderful first step, but it’s not the end of the journey. So please, be kind to yourself! I’m not talking kind in the sense of indulgence but in the sense of a loving caretaker who understands that you’re weak and believes that one day you’ll be strong. WHERE ARE WE GOING NEXT? Psychologists say that self-esteem is linked to a sense of competence – the awareness that you have the knowledge, skills, and resources needed to accomplish a task. It’s unlikely that you’re going to start your weight loss journey with a strong sense of competence regarding weight loss. In fact, it’s quite likely that your self-esteem in that area is torn down and tattered from all the diet and weight battles you’ve fought and lost in the past. No matter how much information you’ve gained from your pre-op education, you don’t yet have a history of weight loss success to buoy you along. So how do you even begin to feel good about your ability to make the lifestyle changes required for weight loss - make good food choices, control portions, take tiny bites, avoid grazing and so on? I’ll adapt the take tiny bites strategy to this effort. You tackle the weight loss project one tiny bite at a time. You repeat the effective actions of making good food choices, controlling portions, taking tiny bites and avoiding grazing over and over again until you’ve learned how to do it with less effort and more enjoyment. You seek and acquire the knowledge, skills and resources to help you succeed. You seek assistance from your surgeon, your support group, your family and friends. All this work may never become fun for you, but in my case, weight loss made it all worthwhile. TODAY’S WEIGHT LOSS SUCCESS FORECAST IS… Does the importance of positive self-esteem mean that you’re doomed to failure if your self-esteem isn’t already strong on the day of your bariatric surgery? Certainly not. If you take on the challenge of a weight loss winner’s lifestyle one tiny bite at a time, your WLS journey can actually help you increase your overall self-esteem while decreasing your weight. Each step you take, each new behavior, each pound you lose, will prove to you how capable and worthy you truly are. From time to time, you may have to ignore or silence the voice of self-doubt. I like the way my friend Lisa counsels self-doubters. She says, simply and firmly, “You can do this.” So when your inner Doubting Thomas (or Thomasina) whispers (or shouts), “Forget it! No way! Lost cause!” take a deep breath and tell her “I can do this. I will do this.” Eventually you’ll turn your eating behavior around, reach your weight loss goal, and finally feel proud of what you’ve accomplished.

The self-image of obese (or any other) people is complicated, isn't it? I've been contemplating that for years. On one hand, you have obese people who don't see themselves as obese, and apparently don't recognize the health risk that poses. On the other hand, we're living in a society that holds up "skinny" as divine, is extremely critical of the obese, and yet goes on super-sizing every meal we eat. In that setting, it's hard to keep your balance.

Perspective is a highly under-rated thing, isn't it? When I look out the window at my worktable, I can see a neighbor's barn (we live way out in the boondocks, where barns and cows are more populous than shopping malls and poodles). From here, it looks tiny, but in fact it's huge. It's just one of his barns (we're in the agri-business heartland) and he can fit several pieces of modern farm equipment in it, things that look like they just landed from Mars and are getting ready to take over the world. That's why I have to constantly supervise my own thoughts and make sure I'm reacting to real things in the appropriate degree to achieve the end I so very much desire.

I took 2 weeks off and was bored and restless by day 3. I worked from home then (nothing physically strenuous) but if I'd been working outside my home, I probably would've longed to go home and rest after a few hours of work. And, I wasn't allowed to drive for 2 weeks - both to protect those new incisions and because I was taking a painkiller. Some very simple, basic things were a challenge for the first month or so post-op. Like getting up out of a chair, reaching to get something out of a kitchen cupboard, lifting my little pug. The other thing was that sleeping when I had all those new incisions was a challenge. I used pillows to support and/or take the weight off anything tender or sore, but I can't say I got a good night's rest until a month or so post-op.

One of the things that (usually) keeps me sane in the kitchen is the Clean Up As You Go Rule. When I was single, it was easy to enforce. Then I married, and my kitchen sanity took a beating. I love to cook, and that’s been a big help at every stage of my weight loss journey. Finding WLS-friendly food at restaurants or in vending machines has rarely been an issue for me, because I’d rather cook and eat at home. Eating my way around the world during business travels was fun at the time, but the weight I gained through the years was not in the least fun. I realize not everyone shares my love of cooking (in fact, some of you hate it), so when I wrote Bandwagon Cookery, I took pains to make the book entertaining. This is an excerpt from the book. If reading it doesn’t change your thinking about cooking, I hope that at least it amuses you. KITCHEN SANITY: CLEAN UP AS YOU GO aka The Beef Broth Story One of my mom's cardinal kitchen rules was: clean up as you go. It's possible to take this to ridiculous extremes. My Aunt Jeanne (for whom I was named) was not a great cook but she was a dedicated dishwasher. If you were cooking anything in Jeanne's kitchen and let go of it for a minute (let's say you were stirring the sauce and put the spoon down while you spent 30 seconds searching for the dried basil), she would wash it. You'd reach out your hand for that spoon and it'd be gone...over to the dish drainer. And then there's my husband, Mr. P., who is (in more ways than one) cut from the same piece of cloth as Jeanne. In the small kitchen of our first home, the food prep area was to the left of the sink. We stacked anything that needed to be washed to the right side of the sink. After years of cleaning up after myself, I certainly appreciated it when Mr. P., would automatically, without being begged, coaxed, or bribed, wash anything that was sitting on the right side of the sink. But one Sunday I spent something like 49 hours (yes, I do know there are only 24 hours in one day, but it felt like 49 hours) making my own beef stock. I roasted a cow's worth of beef bones, then I boiled them in huge vats (lobster pots, actually) of water with onions, carrots, celery, and herbs. Then I drained the stock, put it back in the vats, and added crushed eggshells to help "clarify" the broth. (By now you're thinking, "You are a very sick lady, Jean", and I agree, and you haven't even heard yet all the gory details about the time I boned and stuffed a game hen into a chicken into a turkey before adding gourmet stuffing and roasting the whole thing one Thanksgiving). Then I poured the broth into large bowls and left them to cool for about 10 minutes while I washed my hands, visited the bathroom, and had a hit of wine. Refreshed, I returned to the kitchen ready to pour this fabulous stock into freezer containers and… it was gone! Mr. P. had discarded every last drop, carefully washed all the bowls, and was sitting virtuously at the kitchen table reading the Sunday newspaper. The kitchen counters were clean and tidy...and the stock and everything I'd used to make it had disappeared. "Where is the stock?" I screamed. Mr. P. looked up from the financial pages and said, "What stock?" (OK, I just added the financial pages for fun. He would only read the financial pages if there were ads in there for guns and knives - hey, not a bad idea!). "The stock I left on the counter!" "You mean that brown stuff in the bowls?" "Yes, the brown stuff in the bowls! Where is it?" "I threw it out and washed the bowls. Why?" For a moment I was speechless (hard to imagine, I know). I looked at the gleaming, empty kitchen counters and thought of all the work I had put into that stock. What was more important, a loving husband or 20 quarts of beef stock? And always having sensible priorities, I said, "What the f***ing f***?! That was the f***ing beef stock I've been working on all day, and you threw it out? Why would you do that?!" He carefully set the newspaper on the table and said (slowly, and with equal care, as any sensible man must do when dealing with a loved one's psychotic break), "It was on the right side of the sink. That's where we put everything that needs to be cleaned, right? On the right hand side of the sink?" Silence again. How could he think that those bowls brimming with fragrant, glorious, homemade beef stock were something that needed to be discarded? Was he totally witless? Or was I? Because he was right: I had put them in the Goodbye Zone. I shook my head at him ("You got me!"), wearily refilled my wine glass and retired to the living-room with two dogs who were probably thinking, "That beef stock sure would've tasted good poured over my kibble."

I love to cook, and that’s been a big help at every stage of my weight loss journey. Finding WLS-friendly food at restaurants or in vending machines has rarely been an issue for me, because I’d rather cook and eat at home. Eating my way around the world during business travels was fun at the time, but the weight I gained through the years was not in the least fun. I realize not everyone shares my love of cooking (in fact, some of you hate it), so when I wrote Bandwagon Cookery, I took pains to make the book entertaining. This is an excerpt from the book. If reading it doesn’t change your thinking about cooking, I hope that at least it amuses you. KITCHEN SANITY: CLEAN UP AS YOU GO aka The Beef Broth Story One of my mom's cardinal kitchen rules was: clean up as you go. It's possible to take this to ridiculous extremes. My Aunt Jeanne (for whom I was named) was not a great cook but she was a dedicated dishwasher. If you were cooking anything in Jeanne's kitchen and let go of it for a minute (let's say you were stirring the sauce and put the spoon down while you spent 30 seconds searching for the dried basil), she would wash it. You'd reach out your hand for that spoon and it'd be gone...over to the dish drainer. And then there's my husband, Mr. P., who is (in more ways than one) cut from the same piece of cloth as Jeanne. In the small kitchen of our first home, the food prep area was to the left of the sink. We stacked anything that needed to be washed to the right side of the sink. After years of cleaning up after myself, I certainly appreciated it when Mr. P., would automatically, without being begged, coaxed, or bribed, wash anything that was sitting on the right side of the sink. But one Sunday I spent something like 49 hours (yes, I do know there are only 24 hours in one day, but it felt like 49 hours) making my own beef stock. I roasted a cow's worth of beef bones, then I boiled them in huge vats (lobster pots, actually) of water with onions, carrots, celery, and herbs. Then I drained the stock, put it back in the vats, and added crushed eggshells to help "clarify" the broth. (By now you're thinking, "You are a very sick lady, Jean", and I agree, and you haven't even heard yet all the gory details about the time I boned and stuffed a game hen into a chicken into a turkey before adding gourmet stuffing and roasting the whole thing one Thanksgiving). Then I poured the broth into large bowls and left them to cool for about 10 minutes while I washed my hands, visited the bathroom, and had a hit of wine. Refreshed, I returned to the kitchen ready to pour this fabulous stock into freezer containers and… it was gone! Mr. P. had discarded every last drop, carefully washed all the bowls, and was sitting virtuously at the kitchen table reading the Sunday newspaper. The kitchen counters were clean and tidy...and the stock and everything I'd used to make it had disappeared. "Where is the stock?" I screamed. Mr. P. looked up from the financial pages and said, "What stock?" (OK, I just added the financial pages for fun. He would only read the financial pages if there were ads in there for guns and knives - hey, not a bad idea!). "The stock I left on the counter!" "You mean that brown stuff in the bowls?" "Yes, the brown stuff in the bowls! Where is it?" "I threw it out and washed the bowls. Why?" For a moment I was speechless (hard to imagine, I know). I looked at the gleaming, empty kitchen counters and thought of all the work I had put into that stock. What was more important, a loving husband or 20 quarts of beef stock? And always having sensible priorities, I said, "What the f***ing f***?! That was the f***ing beef stock I've been working on all day, and you threw it out? Why would you do that?!" He carefully set the newspaper on the table and said (slowly, and with equal care, as any sensible man must do when dealing with a loved one's psychotic break), "It was on the right side of the sink. That's where we put everything that needs to be cleaned, right? On the right hand side of the sink?" Silence again. How could he think that those bowls brimming with fragrant, glorious, homemade beef stock were something that needed to be discarded? Was he totally witless? Or was I? Because he was right: I had put them in the Goodbye Zone. I shook my head at him ("You got me!"), wearily refilled my wine glass and retired to the living-room with two dogs who were probably thinking, "That beef stock sure would've tasted good poured over my kibble."

Eight years ago, I weighed twice what I weigh today. Thanks to bariatric surgery, I’ve lost 116 pounds. Sometimes I look in the mirror and still see Fat Jean. And sometimes I look in the mirror and see Slim Jean, and I think “What the heck happened?” What happened is that, as an acquaintance once said, I’ve lost an entire person. And what also happened is that I’ve gained an entire person. One who likes to dress in nice clothes that show off her nice parts. One who longer wishes she were invisible, is willing to chat with complete strangers, and can drive past McDonald’s and not feel French fries pulling her into the drive-through line. And this is a person who’s willing to try new things, even as my hair grows silver and my mind and body grow slower and my energy diminishes…but so far, it hasn’t diminished to my pre-op activity level: sitting for hour after hour in a big, soft armchair with a mystery novel and 2 small dogs on her lap and a bag of potato chips within easy reach. Please God, don’t ever let me return to that! But it’s not God’s job to prevent that. It’s my job. Forever and ever, amen. Because this journey never ends. And that’s OK. Because the day I take this weight loss and my new, energized, interesting life for granted is the day my Bandwagon veers off the road and into a deep, deep ditch. I’m determined to stay on the WLS path. I marvel almost every day not just at my size 4 wardrobe but at my mostly wonderful quality of life. So please don’t be discouraged if, despite WLS, you find yourself plodding down the road hand in hand with your old food devils or trapped on a weight loss plateau. Sometimes we need to revisit old places, if only to help us remember how far we’ve come and motivate us to climb the next hill.

Oh, dear, I've worked at dozens of behaviors and still do and probably always do. As time goes on, the focus of my work changes. I'm changing, my world is changing, and just when I think I've got it all figured out, I go around a corner only to find an old ghost waiting for me. I had to work very, very hard at mindful eating in my first few years post-op. No more shoveling in the food so fast I hardly tasted it. Nowadays I'm working more on believing I'm thin. When I look in the mirror, one day I see Fat Jean, and the next day I see a skinny girl and think, "Who i s that girl? She looks familiar?"

Self-pity is a popular commodity in the WLS community. I often say things like, “You want my pity? Sorry, you can’t have it. I’m saving all of mine for a truly deserving person – like me.” Let’s see how Jema and her dog deal with self-pity in today’s Jema & Alice cartoon, Come to My Pity Party! * * * Admit it. You know what self-pity is, at least well enough to know it at a glance as you trudge on and on towards your weight goal. So take a look at this cartoon and see if you recognize anything about it. In today’s episode of the WLS adventures of Jema and her faithful dog, dark clouds hang over their heads and rain a deluge of self-pity onto Jema’s life. What climate condition started that rain? The cause is an emotional meteorological phenomenon commonly known as envy. Jema has been comparing her WLS journey to everyone else’s and comes out crying because they’re all so successful that she’s a failure in comparison. Or so she believes…. I understand how Jema feels because if I let them, envy and self-pity walk hand in hand through my life. They trample right over the good stuff and cultivate the bad stuff. The kind of stuff that gets me nowhere near my goals. Jema’s problem today is that she attended a support group meeting and left it thinking evil thoughts about another bandster who’d reported a 50-pound weight loss already. Jema had "only" lost 35 pounds. What was wrong with her? Why was Debbie Doolittle but not Jema blessed with superior band success? Jema’s been a good girl too, in fact, a very hard-working and deserving girl. As our heroine wails in today’s cartoon, “It just isn't fair!” So she throws herself a pity party while Alice plays the violin. And then? And then, she dries her eyes and moves on. She decides to use her rival’s weight loss success as inspiration instead of punishment, Debbie Doolittle might even have some tips to share at the next support group meeting. Somehow, some way, Jema’s going to find the silver lining in her dark cloud. OK, party’s over. Back to work! Click here to see today's cartoon: https://www.blogger.com/blogger.g?blogID=1554342973151004146#editor/target=post;postID=8785291681792807452

I haven’t seen a report card for 35 years, but I clearly remember the looming importance of each semester’s report card. In elementary school, we were graded on effort as well as achievement. Tell us honestly: what’s your bariatric effort grade today? When thinking about your report card, please grade yourself for both achievement and effort. Anybody who thinks having weight loss surgery is "taking the easy way out" is sadly mistake. Of course it's easier than weight loss without surgery - that's the whole idea! But easier doesn't mean automatic, either. I’ve seen 2 different effort and achievement trends in fellow post-ops’ WLS journeys: Weight loss is relatively easy in the beginning, when you’re at your heaviest and also most gung-ho, but eventually it gets harder as you get smaller (and burn fewer calories), the novelty of your surgery wears off, and your underlying eating issues (like stress eating, emotional eating, etc.) aren’t addressed. For band patients, weight loss can be hard in the beginning, when you don’t yet have enough fill in your band, but eventually you and your band click and the weight loss gets easier. Both situations #1 & 2 require extra effort on your part sooner or later. Neither situation is better or worse, but your awareness and understanding of your situation can help you deal with it with less “poor me” and more “go me!” I’ll illustrate this with an example from the frivolous but always fascinating aspect of life: hair. I have straight, thin hair, and not a lot of it. I wish it were thicker, curlier, shinier, but it’s not. With the help of my hairdresser, I can make my hair look better, but agonizing about it does not do a single thing to make my hair curl. Similarly, I have an inborn intolerance for idleness and am easily bored, especially when it comes to food and exercise. I wish that weren’t so, but it is. With the help of my nutritionist, food magazines, and cookbooks, I manage to plan and prepare healthy, delicious, interesting meals. With the help of my fitness instructor, I manage to participate in a wide variety of fitness classes that are never boring. In the “go me!” department, I’m pleased to report that I’m so accustomed now to eating small meals off small plates, I don’t even think about it anymore, except when I’m dining out and my meal arrives on a dinner plate. That is quite an accomplishment for a girl who once ate a 5-pound lobster all by herself, and followed up with half a gallon of ice cream, spooned directly from the container into my mouth!

When thinking about your report card, please grade yourself for both achievement and effort. Anybody who thinks having weight loss surgery is "taking the easy way out" is sadly mistake. Of course it's easier than weight loss without surgery - that's the whole idea! But easier doesn't mean automatic, either. I’ve seen 2 different effort and achievement trends in fellow post-ops’ WLS journeys: Weight loss is relatively easy in the beginning, when you’re at your heaviest and also most gung-ho, but eventually it gets harder as you get smaller (and burn fewer calories), the novelty of your surgery wears off, and your underlying eating issues (like stress eating, emotional eating, etc.) aren’t addressed. For band patients, weight loss can be hard in the beginning, when you don’t yet have enough fill in your band, but eventually you and your band click and the weight loss gets easier. Both situations #1 & 2 require extra effort on your part sooner or later. Neither situation is better or worse, but your awareness and understanding of your situation can help you deal with it with less “poor me” and more “go me!” I’ll illustrate this with an example from the frivolous but always fascinating aspect of life: hair. I have straight, thin hair, and not a lot of it. I wish it were thicker, curlier, shinier, but it’s not. With the help of my hairdresser, I can make my hair look better, but agonizing about it does not do a single thing to make my hair curl. Similarly, I have an inborn intolerance for idleness and am easily bored, especially when it comes to food and exercise. I wish that weren’t so, but it is. With the help of my nutritionist, food magazines, and cookbooks, I manage to plan and prepare healthy, delicious, interesting meals. With the help of my fitness instructor, I manage to participate in a wide variety of fitness classes that are never boring. In the “go me!” department, I’m pleased to report that I’m so accustomed now to eating small meals off small plates, I don’t even think about it anymore, except when I’m dining out and my meal arrives on a dinner plate. That is quite an accomplishment for a girl who once ate a 5-pound lobster all by herself, and followed up with half a gallon of ice cream, spooned directly from the container into my mouth!

A skewed body image is fairly common in obese or formerly-obese people. Back in bad old days, I couldn’t see or comprehend how fat I was. I could see it in photographs, but not in the mirror. Seven years later and 115 pounds lighter, I’m beginning to see and believe how small I am now. I still struggle with my dislike of a particular body part. Although the dislike is somewhat balanced by my like for other body parts and the sized XS clothes I wear, that awful body part bugs me. I can see the size labels on my clothes and the numbers on my scale, but the mirror tells a different story. Just like poor Jema in this article’s cartoon, I still have fat days. So, what’s going on in that teeny organ I laughingly call my brain? Let’s pick up that rock and take a look at the creepy crawlies underneath it. Call it shock therapy, aversion therapy, or unflinching honesty. It must be done sooner or later, so let’s do it now. My big bugaboo is my belly, and its reign of terror has gone on for 50+ years. Even when I was just overweight, not yet obese, my belly caused a business associate who hadn’t seen me in a while to ask, “Jean, when’s your baby due?” And when I said curtly, “I’m not pregnant,” this jerk said, “Hmmm. Are you sure about that?” Now, I often say that I have no desire to ever wear a bikini again, not in public and not in private. That’s not due to modesty or age-appropriate dressing. It’s because I don’t think the world is ready to see my belly. According to the body fat quiz at http://www.healthcentral.com/cholesterol/home-body-fat-test-2774-143.html?ic=4004 ), my body fat percent is now 21.5% - ideal for a woman of my height and age. That 21.5% fat includes both subcutaneous (under the skin) and visceral (surrounding my internal organs), and it amounts to 25 lbs. of fat. In my mind, every ounce of that is located on and in my belly. So, what can I do about my belly? I’m sometimes tempted to click on one of those omnipresent internet ads that proclaim, “Trim belly fat with this one weird old trick,” but I don’t because I suspect the trick is just too weird for a sensible senior citizen like me. I exercise 5 days a week, doing aerobic/cardio training, strength training, flexibility and stretching. I’m working on better posture and firming up my abdominal muscles. A tummy tuck would probably help, but it’s not going to happen unless I win the lottery (after buying a ticket for the first time, of course), so I dress carefully to hide my “too fat” mid-section, in clothing that’s not clingy and doesn’t smack of maternity-wear. I’m hiding my trouble zone not just from other people but from myself when I dress like that. In introspective moments of reflection, I ask myself if I’m continuing my old can’t-see-the-fat trick. Shouldn’t I finally face that demon? Maybe, maybe not. Obsessive thinking has rarely helped me deal with life’s challenges. A very honest friend confirms that fat belly is real. Rather than allow it to run my life, I’m going to try changing the way I react to it. I think that’s a strategy that will help me in lots of different ways, some of them unrelated to my faulty body image. I also suspect that lots of different people underestimate the power of their own thoughts. If negative thinking about your own body troubles you too, why don’t you join me in the effort to put the negative stuff in its place and cultivate positive thinking? And dare I suggest a laugh or two? Check out the Jema & Alice cartoon you’ll find here: http://jean-onthebandwagon.blogspot.com/2014/07/does-this-make-my-butt-look-bio.html

If I didn’t have a sense of humor, I could never have survived 60 years of living, including 2+ decades of morbid obesity and the 6+ years of my WLS journey. Don’t get me wrong – I took my band (and later, my sleeve) surgery very seriously because I felt that this was my very last chance to get healthy – but laughter is part of what makes my life happy, and makes it much easier to bear my ridiculous fear of starving to death. Today’s episode is: I’M GONNA STARVE! That title is exactly what I thought in the beginning about my post-op life – Deprivation! Suffering! Starvation! I know I’m not alone in this because through the years I’ve seen so many posts on the “When will this get easier?” theme. To reach the easier part of my WLS journey, I had to do some mental, emotional and spiritual fine-tuning. The idea of a middle-class woman living in a rich and obese country like the USA actually starving to death was and is absurd. Absurdity is ideal material for a comic strip. I hope you’ll get a laugh or two from I’M GONNA STARVE.

I think a lot of people experience at least some of the craziness you describe, not just in the context of WLS but a lot of other life changes. And some of those people (like me) apply our inborn analytic urges to every single thing we do, worsening and prolonging the craziness. But...I agree with Socrates, who said, "the unexamined life is not worth living." I want to live, to understand, to know myself and my world. Sometimes the learning process is very uncomfortable, but on the whole it's worthwhile (for me) and eventually it does get easier. And when I stop learning, I figure it's time for me to go home forever.

I'll keep my fingers crossed for you on that lottery prize!

Being Superwoman isn't all it's knocked up to be, is it? About 10 years ago, I abandoned an interesting but stressful and time-consuming career. Having more free time felt strange for a while, but now it's precious to me.

Believe it or not, I actually love the fruits and veggies my doctor tells me will keep me healthy. When I was growing up, no one had to tell me that, like Popeye, I needed to eat my spinach. I’d rather not eat greens out of a can, but decades later, they appear on our dinner table often. At home here in rural Tennessee, we enjoy many months of harvest from our big garden and small orchard. We are truly blessed in the produce department. The problem is that the harvest is too big for a big man and a small woman to eat. We give a lot to friends, coworkers, and the local food pantry, but my husband continues to overestimate how much I can eat nowadays, and I continue to work on strategies to make produce easier for my altered upper GI tract to handle. During my pre- and post-op nutrition classes, my dietitian warned us that fruits and vegetables are a challenge for most gastric band patients to eat, and repeated the “take tiny bites and chew each bite 100 times” mantra many, many times. It took several months and band fills for me to truly understand why Susan had repeated her warning so often, and what was true for me as a bandster is still true for me as a sleevester. If you’re in the same situation, I offer you a delicious mixed salad of produce prep ideas. But first, let me address the juicing of fruits and vegetables. It's true that juice is easy to get down. It’s true that you can get vitamins, minerals, and flavor from juiced fresh vegetables and fruits. It’s true that you can add protein powder to juice to amp up its nutritional benefits. But even the freshest juice won't give you the fiber and satiety of the solid versions. One of the things I like best about raw produce is its CRUNCH. Just the act of crunching a carrot makes eating it so satisfying to me. And no one can convince me that juicing is convenient. I used the fancy juicer my helpful husband gave me at the time of my surgery exactly twice. I love to cook and love kitchen toys, but assembling, cleaning, and reassembling a juicer takes far more time than I’m willing to give a glass of juice that takes me all of a minute to drink. I stuck to my pre- and post-op liquid diets like a good girl, but if I’d believed I could lose my excess weight and maintain a healthy weight by consuming liquids for the rest of my life, I wouldn’t have had bariatric surgery in the first place! Here are some suggestions that might make it easier to eat your fruits and veggies, both raw and cooked. Peel and seed everything within reason, except perhaps grapes (unless you can find yourself a cute slave boy to peel your grapes for you - and if you find one, ask him if he has a brother or sister who would like to move to Tennessee - MUST LOVE DOGS). It's easy enough to peel fruits like tomatoes, peaches and plums by dunking them in a boiling water bath for a minute. The skins of bell peppers can be a problem for me, but if you grill or broil the peppers until they're charred, the skins slip right off (you'll have to rinse off the stubborn bits) and the roasted flavor is wonderful. If eating fruits or vegetables "out of hand" (such as two of my favorites - carrot sticks dipped in hummus and apple slices smeared with with peanut butter) is a problem for you, cut them into small pieces and eat them with a fork. When I eat with utensils instead of my fingers, I automatically eat more slowly and carefully. Try shredding the food in a food processor. At times I haven't been able to eat broccoli, Brussels sprouts, cabbage, carrots, apples, spinach, kale and other things whole or even chopped, but they worked if I shredded them before I cooked or ate them. Try alternating bites of a challenging fruit or vegetable with a less challenging food. For example, instead of just eating a banana, cut it up and mix it with other cut fruits and berries in a salad. Then (slowly) eat a bite of banana, a bite of melon, a raspberry, and so on. Or eat a bite of strawberry, then a bite of cottage cheese. “Lubricate” fresh blueberries by mixing them into thick, yummy, protein-rich Greek yogurt (a sprinkle of chopped nuts in that makes it even better). Although I prefer fruits and most veggies raw, sometimes I have to do what my grandmother called "blanching". Bring a pot of water to boil. While it's heating, cut up the fruits or veggies into small pieces. When the water is boiling, throw the produce in, turn off the heat, and let it sit for one or two minutes. Then drain it and run cold water over it (or put it in an ice bath) to stop the cooking. The produce should still have its bright color and it hasn't lost a lot of nutrients, crunch, or flavor this way, but the parboiling takes some of the meanness out of the fibers. Just before serving, mix the raw or cooked produce with a sauce, yogurt, light sour cream, hummus, dip or low-fat dressing. Sometimes all any food (including meat) needs is a lubricant to help it go down. Just don't overdo the sauce so that it covers up the flavor of the food and sends a flood of saturated fat into your circulatory system. Corn kernels can be a challenge for us to eat (cooked or popped) because of the fibrous hulls. That doesn’t mean you can never eat corn again. It just means: eat it carefully, and in moderation. It’s mighty hard to eat corn-on-the-cob carefully, so I slice the kernels off the cob (which also reduces the annoyance of corn stuck in the teeth. I’ve also had good luck with fresh corn if I cut the kernels off the cob before cooking the kernels. Hold the corn cob so it stands with its stem end on a plate or bowl. Run a sharp knife from the tip of the ear straight down to the stem end, leaving 1/8 to ¼” of pulp behind on the cob. Then cook the cut corn with a little bit of water or broth, or proceed with your recipe. Use caution when eating generic brands of frozen and canned corn, which in my experience contain more tricky and/or indigestible stuff (like bits of cob) than the more expensive name brands. If you love fresh fruits and veggies too, y’all are welcome to pick all you can eat from our garden and orchard this year. To find us, get yourself to Memphis and drive north until you hear barking. I must warn you, though, that our dogs love produce too, so you may have to negotiate your share of the apple harvest with them. But they also love company, so come on down!

Be sure to drink LOTS of Water when you're eating high-fiber foods and/or supplements. If you don't, the constipation is like to get worse instead of better. Water helps the body assimilate the fiber. Infrequent bowel movements are not considered a medical problem, but when that goes on and on, it can be very uncomfortable (for me, anyway). A colonic would probably help (I had one before my last colonoscopy), but having to do that on a regular basis for the rest of your life could get expensive and a colonic is not risk-free because there's an area in the neighborhood of the anus that can cause heart problems if it's stimulated the wrong way (if that's confusing, remember that I'm not a doctor!). Another approach would be to swallow an 8-ounce bottle of magnesium citrate (immediately followed by an 8-ounce glass of water when the situation gets to the very uncomfortable stage. It makes me gag but it does work (I think that other forms, like liquid gel pills, don't have the laxative effect). But...using it (or any other laxative for that matter) on a regular basis can make your bowels too lazy to function properly, which is a worse problem than constipation. Another thing I've used in the past is Laci Le Beau Super Dieter's Tea. I get it in the tea & coffee section at Walmart. It comes in a few flavor choices; I prefer the cinnamon. You make the tea with one teabag and 12 oz of water; that has 1.9 g of senna in it. You can also find senna in tablet form. But...it's not a good idea to use senna on a regular basis (see above). Do you have a gastroenterologist whose advice you could seek?

The fact that the band procedure is re-operable, whereas other WLS procedures are not, may factor in to the higher rate. RNY and the band can be reversed (not necessarily with ease, but it can be done). The sleeve, and the sleeve portion of DS (duodenal switch) cannot be reversed because 75-80% of the stomach is removed and discarded.

Officially, average weight loss with the band is 1-2 lbs/week, so you're doing fine. But...I do feel your pain and frustration over your rate of weight loss. In our heart of hearts, don't we all wish we could wake up in the recovery room after surgery at our goal weight? Unfortunately, only limb amputation could accomplish that. Generally speaking, men tend to lose weight faster than women because of their greater muscle mass. People who start out at a higher weight usually lose weight more quickly at the start because their basal metabolic rate is higher (they need more calories just to stay alive). I've encountered post-ops of all surgery types who lost weight at a stupendous rate for a month or 3 months or longer, and eventually they (and their very confused bodies) slammed into the brick wall of a plateau. The calorie restriction that comes along with almost any kind of weight loss effort (with or without surgery) is a big challenge for the human body. We're programmed to eat to stay alive, and when we eat less day after day, week after week, month after month, eventually our bodies ratchet down our metabolism just to deal with that perceived starvation threat. Then you throw in other health problems, exercise, medications, hydration, hormones, etc. etc..... Of course, nothing I said in the paragraph above is going to make patience any easier for you to practice. It's certainly not one of my strong points. So my final words (for now) are as follows: HANG IN THERE!