Jean McMillan

Excellent insight and advice!

Do you know when to stop eating? To learn the when, you must pay attention to your “stop eating” signals. How do you know when to stop eating? Do you eat until you're full? No, you don't. You should never again try to eat until you feel full, not just because that’s how you became obese enough to qualify for bariatric surgery but because if you’re like me, your stomach (or soul) is an endless void that no amount of food will ever fill. You’re going to have to figure out a new stopping point. As mentioned in Satiated vs Stuffed, satiety is not quite the same as being full. Full means your upper stomach has reached its maximum capacity: that you have overeaten again – an old habit that made you obese enough to qualify for weight loss surgery. Satiety happens on your way to being full. With a properly adjusted band, you will be comfortable if you stop eating when you're satiated, but you’ll experience discomfort if you eat until you're full. This third article in the Satiety 101 series discusses the signals your body gives to tell you you’re satiated, but that’s only half the battle. The other half involves heeding instead of ignoring those signals. That subject could fill a book (which that I might write some day). Today we’ll focus on recognizing your own unique Stop Eating Signals. Because of its anatomical position (near your diaphragm, and pressing on the vagus nerve at the top of your stomach), the band’s presence (but not your band itself – which we must remember is an inert piece of plastic without any magic at all inside) can give you quick feedback about your eating behavior. The feedback is written in a language issued and understood by your brain, with assistance from your endocrine and digestive systems. Even if you were lousy in your high school French class, you will have to learn how to get directions in that language, so you won’t end up on Weight Gain Road instead op Weight Loss Avenue. Those directions come in the form of what I call Soft Stop and Hard Stop signals. To understand those directions, you’ll need to slow down and pay attention while you eat. It takes 15 to 20 minutes for satiety signals to reach your brain and to be broadcast to the rest of you. If you usually eat with a crowd (family, friends, coworkers), you might need to try eating by yourself for a few meals so you won't be distracted. Stop signals can be subtle and they can come from unexpected parts of your body. It's better to heed a gentle reminder than wait for a hammer to hit you on the head. SOFT STOPS are your early warning system, gentle reminders from your body that it's time to stop eating. Because they don't hurt much, they're easy to ignore. They include: · Mild queasiness (an icky, but not about-to-vomit, feeling) · Fullness or pressure in the back of the throat · Pressure in the chest or just below the breastbone · Throat clearing · Some difficulty swallowing · Burping (or the urge to burp) · Taking a deep breath · Mild coughing · A sigh · Hiccups · Watering eyes · Runny nose · Left shoulder pain · A sneeze · More saliva in the mouth than usual · A sudden distaste for the food you were enjoying a moment before As soon as you notice one of these signs, stop eating! I don't care if your stubborn mind is insisting that it's okay to continue (because it thinks you have room for just one more bite, or the food tastes good, or you haven't cleaned your plate, or you deserve the food, or whatever's going on in there). If you go on eating past this point, you won't be changing your eating behavior and you're likely to get into trouble…that is, a hard stop. HARD STOPS are the equivalent of running into a brick wall. They can happen without any apparent warning, but usually you have sped heedlessly past a soft stop before you hit the wall. Hard stops are the painful and sometimes embarrassing reminders that you have eaten too much, too fast, in bites that were too big, without chewing enough. They include: · Chest pain and/or painful pressure or tightness in the chest · Feeling like you have a rock in the back of your throat · A burning sensation in the throat · A “stuck” feeling, as if the food you’ve eaten has nowhere to go · Productive burps (PB's) – regurgitation of food, kind of like the way a baby erps up milk · Sliming (excess saliva and mucus that's so profuse, you have to spit it out) When you experience a hard stop, STOP EATING! It's not at all a good idea to keep eating after you experience a hard stop, even if the discomfort goes away and your plate of food still looks appealing. You may feel fine and may in fact be able to eat some more, but you should not eat more. The hard stop has irritated your upper gastrointestinal system. Continuing to eat will just perpetuate the problem, getting you into a never-ending cycle of eat-hard stop-pain-eat-hard stop-pain. Cycles like that tend to turn into complications like band slips and esophageal and stomach dilation. That’s the reason for my next piece of advice: follow a liquid diet for 24 hours after a hard stop episode, then transition carefully back to pureed then soft then solid food. If you’re like me, you did not have WLS in order to live on liquids for the rest of your life. That’s yet another reason to learn how to prevent hard stops in the first place, so that you can eat and enjoy real food at every meal. Now here’s one last chunk of information before the bell rings and today’s class ends. You may not experience any or all of these stop signals any or all of the time. At breakfast you might get one signal and at lunch, an entirely different one. At dinner, you may notice no stop signal at all. As time goes on and you lose weight and the amount of saline in your band changes, your stop signals may change as well. All that can be frustrating, but it will force you to go on eating slowly and carefully for the rest of your life, and that’s actually a good practice for anyone, banded or not. That plate of food before you is a blessing that some people in this world can only dream of. Those small portions may look puny to you, but would be a feast to someone else. So treat your food, and your body, with the care they deserve. Learning to recognize satiety over and over again is an ongoing process because our bodies are not statues made of marble. We are all marvelous, unique, and complex creatures who change by the minute, every day of our lives. Click here to read about how those changes can affect soft and hard stop signals. http://www.bariatricpal.com/page/articles.html/_/support/post-op-support/restriction-riddles-r93 This is the third and final article in the Satiety 101 series of articles.

Are you still searching for the feeling we call “full”? Not once in my life before my band surgery did I ever feel I had eaten enough food. Day after day, meal after meal, I searched for the feeling of “full”. I had no idea what it felt like, for many reasons. Some were emotional, some spiritual, some physical. Researchers now theorize that the internal message system in obese people doesn’t function properly, so that we don’t receive or comprehend “full” messages. Whatever the reason(s), I ate as if I was shoveling food into a bottomless pit that no amount of food could ever fill. As a new bandster, it took me a long while to even begin to pay attention to my eating, never mind figure out when to stop eating. And no wonder. For over 50 years, I had eaten mindlessly, greedily, endlessly. Every single day, every meal, every moment, I ate and ate to reach what I call Thanksgiving Dinner Full. I loved to cook (and still do). I loved to eat (and still do). My business travels took me all over the world, so that in each country I was able to enjoy a huge variety of different and delicious food. Occasionally the food was very strange – I can’t recommend eating the lightly grilled, still wriggling sea slug I sampled in Taiwan – but I was always game for a culinary adventure. It’s very ironic that during those overseas travels, I witnessed true hunger, deprivation, and near-starvation firsthand. What I ate in one day then could probably feed a whole family for a week. In Southeast Asia I once met a new business associate for the first time. We talked business for a while. Then he said something startling, seemingly out of the blue: “Your family must be very wealthy.” I said, “Uh, not especially.” He smiled at my modesty, gestured at my size 24 body and said, “But it is true, because I can see that you eat very well.” That encounter was mortifying on several levels, as I’m sure you can imagine. When I left that business career and coincidentally began dealing with my weight and eating issues, I also began to feel shame for my eating behavior, for the waste of all the food I’d gobbled up in my perpetual quest for TDF (Thanksgiving Dinner Full). But how on earth could I end that quest? How could I ever learn to stop eating before I reached the TDF level? I was extremely fortunate to start my weight loss surgery journey a short while later, and even more fortunate that my Lap-Band® eventually became such an effective tool in helping me eat less and lose weight. Although I felt I’d done a lot of research as a pre-op, I have to smile every time I think of a bandster friend who told me, “I had no idea how much work this was going to be.” I had no idea either. Every bite of food, every sensation in my body before, during, and after I ate, became a big project. If you’re a new post-op, or even a further-out post-op, are you too discovering how much work is involved in living with and succeeding with your band? Perhaps wondering, “What have I gotten myself into?” If so, that’s OK. Remember that you’re not alone, and that you can succeed even if feels like getting there is taking forever and a day. So, c’mon, Jean. Get to the point. Tell us: how do you know when to stop eating? Do you eat until you're full? What is “full” supposed to feel like now? My answer to the first question is no. As a WLS patient, you don't eat until you’re full. You should never again eat that way, not just because that’s how you became obese enough to qualify for bariatric surgery but because eating that way will hinder your weight loss and can cause some nasty side effects and complications. So you’re going to have to figure out a new stopping point. And that stopping point is the satiety point. Satiety is not quite the same as being full. For a bandster, full means that you have overeaten again and will soon be so uncomfortable you’ll have to take a few breaths before you go on to clean that plate like a good kid. (Which, by the way, is another practice you’ll have to give up sooner or later). Full means your upper stomach has reached its maximum capacity and that at any moment, that food is going to back up into your throat and make an ungraceful exit all over you, the table, and your dining companions. Full means that you sped right past your satiety point. Full means that it’s time to start paying much closer attention to how you feel as you eat. Satiety happens on your way to being full. With a properly adjusted band, you will be comfortable if you stop eating when you're satiated, but will experience discomfort if you eat until you're full. If you eat to the TDF point, you won’t have that old faithful full-belly sensation that made you loosen your belt while waiting for Mom to bring you a big piece of pumpkin pie. Instead, you’ll probably feel pressure, even pain, in your upper abdomen and chest. You’ll produce enough excess saliva to make you drool. You’ll think you’re about to power barf. You’ll be very sorry you overate. You’ll promise God and your bariatric surgeon (who are not actually the same person, by the way) that if you can feel relief right now, you’ll never overeat again. You’ll need to learn some strategies to prevent another episode of overeating. In article #3 of the Satiety 101 series, “Recognizing Satiety,” we’ll take a look at some common signals our bodies give us when we’re closing in on the satiety point.

My band was removed because of esophageal damage from several decades of "silent" reflux whose symptoms I managed to ignore because I was never aware of any acid. My symptom was a persistent cough, and I didn't believe the ENT doc I saw for the cough when he suggested my problem was reflux. My band probably aggravated the problem. And to illustrate what a contrary person I am, I later revised to the sleeve despite knowing that reflux is extremely common in sleeve patients. So it looks like I'll be taking omeprazole for the rest of my life, and I hope that PPI (omeprazole is a proton pump inhibitor) use doesn't cause me the problems it causes other folks.

I'm so glad that this article spoke to you. And I completely, utterly, 1000% believe that tighter isn't always better. So much so that I wrote an article about it, which you can find here: http://www.bariatricpal.com/page/articles.html/_/support/post-op-support/tighter-isnt-always-better-r95

I had yet another thought earlier today. Port infections are often a sign of band erosion (that is, the band eats through the stomach wall, from the outside to the inside of the stomach) because infection at the erosion site travels along the tubing to the port. Band erosion isn't usually fatal, but it demands urgent treatment, at least with antibiotics. Please let us know how you're doing!

Once again, I must apologize for tardiness in posting about satiety signals. I'm usually a get-there-15-minutes-in-advance person, but nowadays, I move more slowly (I'm almost elderly) and life tends to intervene (I'm way too busy). Anyway...the whole topic of satiety signals kept me stewing for several hours this afternoon, and I finally decided to divvy up the topic into 3 articles. The first one is here: http://www.bariatricpal.com/topic/293230-satiety-101-satiety-the-restriction-myth/#entry3308624. I hope it helps to at least begin to clarify things. Stay tuned for #2 in the series, which I will post as soon as I've had some sleep. Jean

Hang in there! You're not crazy, and you just need to keep on keeping on. If you'd like to read more about the infamous Green Zone, click this link: http://www.bariatricpal.com/page/articles.html/_/support/post-op-support/get-into-the-green-zone-r97

Oh, I know so well the feeling that I must eat plenty now in anticipation of future famine. In one sense, it's ridiculous. I'm a middle-aged, middle-class, well-fed woman living in an over-fed nation. On the other hand, every living creature is hard-wired to fear famine. If we don't eat, eventually we die. It's a very tough nut to crack, but if we don't try, we die anyway, sooner or later.

If and when you decide to get another fill, make it a small one. Nothing wrong with taking it slow and easy!

Restriction is a myth, and it’s time to stop believing in it. The adjustable gastric band isn’t all about restriction after all. It’s all about satiety. I tend to talk about satiety a lot. Why? Because recognizing satiety is absolutely crucial to our weight loss success and good health, no matter what bariatric surgery we have. Satiety is the sensation of having eaten enough food. Understanding satiety is so important to weight loss success that I’m dividing up what I have to say into three Satiety 101 articles. This is the first of the three. Let’s start by asking an important question: do you think that your properly-adjusted band will restrict how much you can eat, so you take in fewer calories and lose weight? I realize that someone – perhaps more than one person (perhaps even your very own bariatric surgeon) may have told you that the adjustable gastric band works by creating a small stomach pouch that restricts how much you can eat. But I’m here to tell you, it’s a lot more complicated than that, and to go on thinking of the band as a “restrictive” method does bariatric patients a disservice. The notion of restriction is a myth, a holdover from earlier times, before the band’s function and effects were fully understood. Now, after nearly 30 years of clinical use and studies, band manufacturers and bariatric surgeons are beginning to see that the old idea of the band’s “restrictive” mechanism is not only incorrect, but can cause a host of unpleasant and sometimes dangerous side effects and complications (such as band slips, esophageal dilation and achalasia, pouch dilation, and disappointing weight loss), and some of those complications can cause permanent damage. If you swallow a few bites of barium-coated food (doesn’t that sound yummy?), fluoroscopy will show that food passes through the upper stomach pouch, right past the band, and into the lower stomach pouch within in minutes of each swallow you take, so that you can go on eating just like you did as a pre-op: fast and furious (when food doesn’t make that trip a quick one, it may mean that the band is too tight and needs fluid removed from it). That quick trip also means that you can eat far more food than you need, just like you did as a pre-op. Finally, the bariatric medical community is beginning to see that instead of being restrictive, the band works by reducing physical hunger (the need to eat) and appetite (the desire to eat), and by creating early and prolonged satiety, so that the patient, not the band, can reduce her/his food intake. Now, let me re-state that from the point of view of someone who lived with a Lap-Band® for five wonderful years. It’s up to you, not your band, to make the band work for you. Your band is an inert, expensive piece of plastic that doesn’t limit how much you eat. It doesn’t know your name or that you hate broccoli. It’s not going to leap out of your mouth and throw your forkful of food on the floor when it’s time for you to stop eating. It’s not going to sound an alarm or start flashing red lights. It’s not going to shout, “Jean McMillan! Stop eating right this minute!” (Yeesh! In that last scenario, the band sounded an awful lot like my mom!) Seriously, though. One of your jobs as a successful bandster is to learn when and how to stop eating, all by yourself. The “how” to stop is a big topic, not just for WLS patients but for every human trying to lose weight and avoid wasting precious resources like food, and far beyond the scope of this article. So for now, let’s concentrate on the “when” to stop eating part. We’ll do that in the second article in the Satiety 101 series: Satiated vs Stuffed, so stay tuned! This is the first in the Satiety 101 series of articles.

Well, I know I promised earlier to post a list of satiety signals this afternoon or evening, but I don't think I'll be able to do that along with everything else I've got going on today (it's amazing how losing weight can fill your days up with fun and interesting things that have nothing to do with food!). So I will do my best to get that list out tomorrow.

Yes. In a sense, it's all in your head. Or most of it. But a lot of it is autonomic (like breathing, heart beating, blood circulating, etc.) and not within your conscious control. The (extremely simplified) way the band works is to press against the walls of the stomach fundus (the curved upper part), thereby activating the vagus nerve that passes through that area. The vagus nerve carries satiety messages (as well as a lot of other messages) to the brain. Your physical hunger ceases and your brain broadcasts that it's time to stop eating, via various stop signals. Your conscious job is to pay attention, notice those signals, and stop eating when they happen. That can be tricky because some of those signals seem to have nothing to do with hunger or eating. My nose used to run when it was time for me to stop eating. Weird, huh? And yes, your sense of "restriction" can vary from one day to the next. Or when the weather changes. For example, I used to feel a lot tighter in the morning than in the evening. I have to run now but will post a separate thread about satiety signals later today. Jean Edited to Add: also, the band's proximity to the diaphragm can trigger satiety signals, like a hiccup.

I just had another thought, about something that might help you find your very own Green Zone. One of the biggest jobs for any WLS patient, no matter what surgical procedure they have, is learning how to recognize satiety. That's something I managed to completely ignore for 54 years before my band surgery, mainly because I was eating for a lot of reasons that had nothing to do with physical hunger, good nutrition, health, or any of that good stuff. Satiety is the feeling of having eaten enough food for now. For someone like me who had a gaping void inside that no amount of food could ever fill, learning to recognize satiety wasn't just hard - it was scary. Deprivation was one of my worst fears. I think that fear exists to some extent in every living creature. If we don't eat, we eventually die - every single one of us. A morbidly obese, middle-class, middle-aged woman with a job and a home and loving friends and family is not likely to starve to death, but that fear haunted me for a long time. Fortunately, I made lots of friends on online WLS sites like Bariatricpal who helped me by sharing their own satiety signals. The work of paying attention to and heeding those signals was all up to me. I got better at it as time went on. My conscious behavior and the effect of more saline in my band helped a great deal. Now that my beloved band is gone, that work is much harder, but like it or not, it's my job for life. Other members have shared some of their "stop eating" signals on this thread, but please don't kick yourself (or blame your band) if all those signals don't happen to you on the magical, mythical day that your band is filled to an optimal level. Even if and when that day arrives, those signals and that optimal fill level are probably going to change. One of the best - and hardest to handle - consequences of my WLS has been learning to pay attention to and take good care of my body. It's the only one I have, and I plan to make it last a long, long time. Jean P.S. - I wrote an article about recognizing satiety here: http://www.bariatricpal.com/page/articles.html/_/support/post-op-support/how-much-food-is-enough-r96

The "real" Green Zone signs vary from one person to the next, and vary in one person from one day to the next. Every creature on earth, even of the same species (such as human), is unique - in anatomy, genetic inheritance, environmental influences, you name it. We're all influenced by weather; hydration; illness; stress; time of day; time of month; medications; food choices; a host of internal, autonomic processes; and more. I wrote an article about the Green Zone here: http://www.bariatricpal.com/page/articles.html/_/support/post-op-support/get-into-the-green-zone-r97 Keep in mind that average weight loss with the band is 1-2 pounds a week. In 6 years, I haven't met a single WLS patient who lost a steady 1 or 2 or 1.5 or whatever pounds a week, for many of the reasons mentioned above. My own weight loss was very uneven - something like: - 1, -.5, + 1.5, -2, -.25, -1, + .5, and so on. As long as the overall trend is downward, that counts as success in my book (speaking of which, I highly recommend the bandster's Bible, Bandwagon). Many of us lose more quickly at the beginning of our WLS journey and more slowly as we approach our goal weight. Men tend to lose more quickly than women because they have greater muscle mass. Even when you get to your goal weight, you're not likely to see that exact same weight on the scale every day for the rest of your life.For example: a few days ago, I gained 2.5 lbs overnight. Why? Because I'd been eating high-sodium stuff for a few days. That's a red flag, not a cause for panic. After a few days of making better food choices, I know that 2.5 lbs will go away. Jean

It interests me when a member posts something potentially controversial or inflammatory and then states that he/she "won't be reading the negatives anyway." This is like setting a pot of Soup on a stove burner on a high setting, then leaving the pot to boil over and burn someone, while announcing that "It's too hot in the kitchen so I'm getting out of it." Although the OP (original poster) states that this thread is directed at "many who seek accurate information", 99.9% of the thread appears to be directed at a single, unnamed individual. If the OP has a problem with that individual, I believe it should be dealt with in a private conversation with that individual. In my own not-so-humble opinion, making a personal problem the topic of a public discussion that invites the victim to defend him/herself, and others to join the mob mentality the thread fosters, is the passive-aggressive antithesis of the "best wishes" the OP expresses at the close of the thread. I will now close the kitchen door and depart this thread with the hope that the fire burns itself out so we can all go back to helping and supporting other. Jean

This exchange is an excellent illustration of why combining different WLS forums into a single site was not a good idea...IMHO. Sojourner, I don't disagree with what you've said here, but I do want to comment on the above statement, which I do understand is your personal opinion. For 6.5 years, I've belonged to another WLS site that includes forums for different WLS procedures, where heated exchanges like the one on this thread happen from time to time, but I don't think combining all the various forums on Bariatricpal will significantly increase the frequency of online arguments, because I've also observed quite a few people who hop from one site to another, and one forum to another and back again, waving whatever banner is important to the at the moment. Tis the nature of the beast. I'm almost a techno-phobe, so if it's easy for me to navigate the Internet, surely it's even easier for the rest of the online world?

If nothing else on this thread is certain, it's clear that you didn't intend to start a bonfire. Unfortunately, that kind of thing happens in online forums from time to time - not just on bariatric sites, but on sites devoted to topics as varied as books, cooking, and exercise. You've gotten some useful, supportive replies to this thread, so it was worth posting it. I hope your future bariatricpal conversations are less contentious!

It sure sounds like your body is trying to get rid of your port, and if it also goes to work on your band, your complications will get even worse. Like Carolinagirl, my life is more important than my weight loss surgery, and I'd go to the emergency room and call my bariatric surgeon immediately. Please don't think that your only choices are to live skinny with open abdominal wounds or live fat without your port and/or band. Once the port complications are dealt with, you may be able to revise to a different bariatric surgery procedure that doesn't involve implants. Good luck! Jean

It is confusing, isn't it? And very hard to study and analyze in a scientific manner, so we may never have an answer to the eternal question of: is it me or my WLS? Your ability to eat less even of "bad" foods is probably due to a combination of your band's effects on your appetite and satiety and new eating habits developed over time following your band surgery. I think some of the eating habits I acquired in 5 years with my band did survive, but since my sleeve surgery, my conscious behavior while eating seems to have changed. For example, with my band, I would suddenly lose interest in finishing whatever food I'd been eating (even a "bad" one). In fact, that food would often seem repulsive when I'd been enjoying it just moments before. And on the whole, food was less appealing to me, so I thought about it, anticipated, and enjoyed it less. That's all history for me now. WLS of various types has been done for decades now, but even the best bariatric medical professionals are still learning how each procedure works. The human body is very complicated and as I understand it, nothing in the body works entirely independently. Conscious and/or exterior actions affect unconscious, interior, autonomic functions, and vice versa. The nervous system, immune system, digestive system, circulatory system, endocrine system and so on may be able to function independently in some ways, but that doesn't mean each system receives no messages, input or effects at all from the other systems. Then a surgeon opens up that complicated human body, fiddles with the innards, closes up it up (perhaps even leaving a "foreign object" like a gastric band behind), and as a result, all of the bodily processes we take for granted are thrown into a tizzy. Some of the tizzy is beneficial, some is not, some is neutral. And since every human being is unique, it's impossible to predict how that surgery (be it dental, bariatric, cardiac, etc.) will affect the patient in the short or long term. I don't think it's a bad thing to have both WLS and conscious behavior helping to manage our weight, and after 5+ years on WLS forums, it's my opinion that believing that WLS can and will do all the work in weight loss and management is all too likely to lead to frustration and failure.

I've had 2 WLS procedures (the band and the sleeve) and neither of them have cured my obesity or any of the emotional stuff that contributed to my obesity. I'm 18 pounds below my goal weight thanks to WLS, but I still experience stress and temptation during the holidays - in fact, all year 'round - because unlike B52, I'm a human being.

While it's true that the sleeve is easier for some because it doesn't require adjustments (fills and unfills, I don't agree that it provides a better quality of life post-op. I revised from band to sleeve in August 2012 and in the 16 months since then have experienced complications that required more tests, procedures, treatments, time off work, and general misery than I ever experienced in 5 years with my band or even for decades before that. I'm happy with my weight loss, of course, but nothing else about my sleeve is easy to live with on a daily basis. I wrote in some detail about my band-sleeve experience in a blog post here: http://jean-onthebandwagon.blogspot.com/2013/03/a-lot-of-people-especially-those.html One of the unexpected (to me) aspects of sleeve gastrectomy is that, contrary to popular opinion, it does indeed cause the micro- and macro-nutrient malabsorption that made me decide against RNY. So I'm dealing with a variety of Vitamin and mineral deficiencies, supplements to compensate for all that, and unintentional weight loss. I'm 18 pounds below my goal weight and still losing. I don't dwell on my dissatisfaction with my sleeve because there's really nothing I can do about it. Most of my stomach is gone forever, so all I can do for the rest of my life is make the best of the situation. Quality of life is a very individual thing, hard to quantify, and unless the members of whatever committee you met with have had weight loss surgery, I doubt they're able to give you any accurate reasoning, data or scientific evidence to back up their claim that the sleeve offers a better quality of life. If you want anecdotal evidence about that, I suggest that you visit the sleeve forum. And keep in mind that band-to-sleeve revision members who post there may be delighted with their improved quality of life because their band side effects and complications were so awful that just removing their bands was a relief, not because the sleeve is superior to the band. The bottom line is that there is no such thing as a perfect, risk-free, easy success weight loss surgery. All you can do is do your research, pick the procedure that feels right to you, and move on. I'll close this message now because I'm tired, don't feel well, and have too much to do today, including picking up a prescription for injectable B12 and syringes and making an appointment with my gastro-enterologist about starting Iron infusions to deal with my post-sleeve anemia. Jean

You’re tired of your old body – the fat one that’s caused you so many problems – but are you ready to move into a new one? The idea for this article came to me in a dream. It was what I call an anxiety dream, in which I’m trying to accomplish something important but encounter obstacles everywhere I turn. That’s kind of a parable of life itself, isn’t it? When I wake from a dream like that, I feel frustrated because I didn’t get to finish my dream task, but at the same time I’m relieved to be released from the endless struggle. So in this particular dream, I was moving into a new, multi-story house, kind of like the old tenement buildings you see in dying New England mill towns. It was essential that I quickly locate and organize all my belongings so that I could use them to start an urgent and important project. Every time I carried something into another room to put it away, I would find other people there, already moving my stuff, wreaking havoc on my carefully ordered household. When I went back outside for another load of stuff, more people would be poking through it as if it was so much garbage left out to be collected and buried at the dump. These interfering people ignored my pleas to leave my things alone. For every armful I took into the house, they carried out ten. Then my husband started a load of wash in the laundry room a few feet away from the bedroom, and the sound of the washer’s spin cycle woke me up. Thank God. I trudged off to the bathroom, pondering the meaning of the dream. I haven’t moved into a house for 14 years, so why was I having a dream about moving house? As I made the bed and thought more about the dream (which didn’t want to leave my head just then), I suddenly knew what it was about. My big moving project for the past 6 years hasn’t involved moving into a new house. It’s involved moving into a new body. Like any move into the unknown, it’s been both exciting and scary. I no longer have a jumbo, custom-built pantry to hold 50+ years’ worth of bad habits and warped beliefs about myself. I keep forgetting where I’ve put things, and have sabotaged my own efforts numerous times. At times, circumstances beyond my control have put my new “home” into disarray, but I’ve kept working at it, carrying things in, bringing things out, rearranging things…a seemingly endless task. I think I’m pretty much settled now. I watch elderly people who have to work so hard to accomplish the simplest tasks – sit down, get up, button a shirt, open a jar – and remember my mom talking about the way her body had betrayed her as she aged. I suppose that could happen to me sooner or later. But for right now, I’m in a good place: my new body - the home I carry with me everywhere. As you continue on your weight loss journey, please take good care of your body. You may not like it much now, but it’s your home. Your very own home. As it changes, you will have to learn its new floor plan. When you go to a closet to fetch a size 16 dress and find only size 18’s, you may feel so disoriented that you forget the size 20, 22 & 24’s you took to the Goodwill Store last week. As you pass through the front hallway of this new home and see yourself in the mirror, the person you see might look like a complete stranger. What’s she doing there? She’s fat, I’m not, so why is her reflection all I can see? Where did this mirror come from, anyway, the funhouse at a circus? Don’t give up. One day you’ll have all the curtains hung, the walls painted, the furniture arranged, a fire burning in the fireplace, and you’ll think, “I’m so glad to be home.”

A WLS friend of mine, Tom B., posted a great article on his blog yesterday: 10 Cold Hard Facts about Weight Loss Surgery. I highly recommend reading the article no matter where you are in your WLS journey. Tom states those 10 facts quite plainly, but not in an accusatory manner - more like a good friend who's answering you honestly when you've asked, "What's it really like?" Here's a link to the article: http://beariatric.com/2013/12/16/10-cold-hard-facts-about-weight-loss-surgery/ Jean

Kiwiladydee, I have fibro also. When researching the Obesity-Fibro article, I spoke to a doctor who told me (in exact terms that I don't remember now) that weight loss releases toxins into your system - plus goodness knows what other toxins we're exposed to every single day in the modern world. Is the rash on your face bilateral (both sides) and shaped something like a large butterfly? That could be a sign of lupus erythematosus, along with your fatigue, pain, etc. Since lupus is an autoimmune disorder, it seems like it could be a first cousin to fibro. I was diagnosed with discoid lupus some 20 years ago. It rarely bothers me now, but I have to wonder if and how my obesity, fibro, and lupus are interconnected. Jean