editors note: This is geared towards RNY types, and since I recently had my 2 year anniversary of having quit drinking soda, I thought this was a good one to share.

Let me start off by saying:
I’m not a Doctor or Nut these are my opinions based on my research etc, blah blah………

Cliff notes version:
Drinking carbonated beverages of any kind can sabotage your weight loss and cause you possible severe health problems as a surgically altered Freak such as osteoporosis.

Long boring version:
Carbonated drinks include most soft drinks, champagne, beer, and seltzer water. If you consume a soft drink or other carbonated beverage while eating, the carbonation forces food through the pouch, reducing the time food remains in the pouch. The less time food remains in your pouch, the less satiety you experience, enabling you to eat more with increased risk for weight gain.

The gas released from a carbonated beverage may “stretch” your pouch over time. Food forced through the pouch by the carbonation could also significantly enlarge the size of your stoma (the opening between the pouch and intestines).

An enlarged pouch or stoma would allow you to eat larger amounts of food at any one setting. In this way, consuming carbonated beverages, even if the drinks are diet or calorie free, may cause weight gain or interfere with your weight loss success.

Weight Gain:
Soft drinks also cause weight gain by reducing the absorption of dietary calcium. Dietary calcium helps to stimulate fat breakdown and reduce its uptake into adipose tissue. Epidemiological and clinical studies have found a close association between obesity and low dietary calcium intake. Recent studies have found that maintaining sufficient amounts of dietary calcium helps to induce weight loss or prevent weight gain following diet.

The high caffeine in carbonated sodas is one way that drinking carbonated soft drinks may reduce the absorption of calcium into the body. Studies have found that caffeine increases urinary calcium content, meaning that high caffeine may interfere with the uptake of dietary calcium into the body. Keep in mind that one 12 oz. can of Mountain Dew has 50 mg of caffeine, and Pepsi and Coke (diet or those with sugar) contain 37 mg of caffeine each.

Colas, such as Pepsi and Coke (diet or with sugar), may also cause calcium deficiencies from the high amounts of phosphoric acid that they contain. Phosphate binds to calcium and the bound calcium cannot be absorbed into the body. Both animal and human studies have found that phosphoric acid is associated with altered calcium homeostasis and low calcium.

Carbonated beverages, then, may reduce dietary calcium because of their high caffeine or phosphoric acid content or because drinking such beverages tends to reduce the consumption of calcium-containing foods and beverages. Such deficiencies in dietary calcium intake may be even more pronounced in Freaks.

Calcium deficiencies with Bariatric surgery are well documented due to malabsorbtion because we bypass of the portion of the gut where active absorption of calcium normally occurs. Drinking carbonated beverages may further increase the risk for dietary calcium deficiencies and, in this way, hinder maximal weight loss success.

For all the reasons described above, including calcium deficits, reduced satiety, enlargement of pouch or stoma, drinking carbonated beverages, even those that are sugar-free, could lead to weight gain.

Dump City Arizona:
Carbonated beverages that contain sugar, however, pose a substantially greater threat to the Bariatric patient in terms of weight loss and weight loss maintenance with surgery.

Sugar-containing soft drinks have a relatively high glycemic index, meaning that blood sugar levels readily increase with their consumption. The rapid rise in blood sugar, in turn, increases the production of the hormone, insulin. , that acts to drive sugar into tissues where it is metabolized or processed for storage. High insulin levels, however, also contribute to fat accumulation, driving fat into the fat storage depots and inhibiting the breakdown of fat.

Soft drinks with sugar are also high in calories. An average 12 oz. soft drink contains 10 teaspoons of refined sugar (40g). The typical 12-oz. can of soda contains 150 calories (Coke = 140 calories; Pepsi = 150; Dr. Pepper = 160; orange soda = 180; 7-up = 140; etc.). Soft drinks are the fifth largest source of calories for adults, accounting for 5.6% of all calories that Americans consume. Among adolescents, soft drinks provide 8%- to 9% of calories. An extra 150 calories per day from a soft drink over the course of a year, is equivalent to nearly 16 pounds and that weight gain multiplied by a few years could equate to “morbid obesity”.

Health Problems From Soda:
In addition to the adverse effects that carbonated drinks have on weight loss or weight loss maintenance, carbonated beverages may also have adverse effects on health. Soda beverages and other carbonated drinks are acidic with a pH of 3.0 or less.

Drinking these acidic beverages on an empty stomach in the absence of food, as Bariatric patients are required to do, can upset the fragile acid-alkaline balance of the gastric pouch and intestines and increase the risk for ulcers or even the risk for gastrointestinal adenomas (cancer).

In an attempt to keep your body’s blood pH from becoming too acidic, it uses its stored supplies of iodine to neutralize that acid.

This iodine is no longer able to be used by your thyroid which in turn slows down your metabolism and thus causes you to put on extra weight.

Soft drink usage has also been found to be associated with various other health problems. These include an increased risk for diabetes, cardiovascular disease, kidney stones, bone fractures and reduced bone density/osteoporosis, allergies, cancer, acid-peptic disease, dental carries, gingivitis, and more.

Soft drinks may, in addition, increase the risk for oxidative stress. This condition is believed to contribute significantly to aging and to diseases associated with aging and obesity, i.e. diabetes, cancer, cardiovascular disease, liver disease, reduced immune function, hypertension, and more.

Although it’s tough to quit soda, there are good reasons why weight loss surgery and soft drinks don’t mix. The first is related to your new, smaller stomach size. For example, if you’ve had Lap-Band® surgery, the inflation of your stomach pouch caused by drinking even a sip of carbonated beverage can cause your pouch to strain uncomfortably against the band. Gastric bypass patients and sleeve gastrectomy also report feeling uncomfortable from the gas produced by even a mouthful of soda.

In short: The gas in the drink comes out and expands your stomach like a balloon. Your new pouch can be stretched out over time if you drink carbonated beverages after your surgery.

I was talking with a WLS surgeon about soda’s and he told me the following:
“Many patients find it hard to give them up, however. I had one lovely lady who underwent the RNY and quickly lost weight, but then she stopped losing for a while. She came back to see me, after having stretched her pouch to over 20 ounces, and wanted a revision. She admitted to drinking about 40 ounces of Coke® a day. I told her once she stopped drinking the cola we would reverse the surgery for her. She never returned………”

Body Chemistry – Very informative video:

Hope you managed to stay awake!

I’m really not sure what sort of adjectives to use to describe it.

Overall, I’m still fine with where I’m at, though my scale is dead right now, so I don’t know where I am at number-wise. But I’m not feeling any tightness in my clothes or anything…. so despite my continuing battle with some junk here and there, I think I’m doing good.

Spent a wonderful fall day with the girlfriend in Stillwater, a nearby river town. We walked through antique shops and other little stores on main street, sat by the river for awhile and just enjoyed the unseasonable warm weather. Oh, and the kitchen store – I could spend a day there checking things out, adding them to my wish-list.

Then we had dinner at a lil bbq place, split and appetizer and an entree and came home with some of each left over. Then I did something I haven’t done in nearly two years. I had ice cream.

For better or worse, I don’t dump very easily. When I do, it’s typically not too bad, some sweats, maybe a bit of a “foggy” feeling. Not sure if it’s a hypo or hyper-glycemic reaction or what… but if I catch it and get some protein in me like a cheese stick or some jerky or something, I can get it under control with minimal fuss.

Anyways, I had peppermint bon-bon. It was good. I didn’t dump, but I was still too full from dinner I think, so a lil discomfort there. Which is good and bad.

It’s another item I am going to have to .. avoid. It’s going to be work to make sure it’s not something I’ll over-indulge on. Plain and simple. Although, I did find a frozen yogurt in the store that has no added sugar, just 5g of sugar per 1/2 cup serving. I have some in the freezer now. The trick will be limiting my portions. It’s tucked way back in the freezer. Actually, I think tonight I’ll have a lil and put the rest in the deep freeze down in the basement.

Then Sunday had dinner with G and the girls, brought stuff for us to each make our own pizzas using some whole-wheat pitas I found at the store for the crust. That’s when I found the frozen yogurt.

So yea, last weekend was great. Earlier this week I started working on my mummy costume for halloween, and things were good.

Then Tuesday happened.

There’s a fairly decent chance I’ll be laid off for a bit sometime in the very near future. Maybe.

My boss gave me a heads up on it. I do some of our basic books, so I know where we’re at. I know what jobs we have… or rather don’t have going on. I wouldn’t be as stressed about this if I had the money they owe me for back-pay. But they don’t, so I don’t.. and… yea… that whole thing is just hovering there right now.

Then Wednesday… Tanner got.. sick. I dunno… Tuesday night he was chewing on threads coming off the ripped up sheets I’m using for my costume. Wednesday morning he wouldn’t eat his breakfast. Usually he’s meowing like a banshee to wake me up to feed him. Not today.

My hope was that he just swallowed some of the threads and they needed to pass and he’d be fine.

I got home late Wednesday evening… he wasn’t fine. Took him to the vet yesterday morning and well… I ended up saying good bye.

Last night, I turned to food.

Fortunately, not in the way I would have in the past. I still have most of that frozen yogurt in the freezer. No, instead of pigging out, I cooked. I made a mushroom lasagna using eggplant slices instead of pasta. It was my first attempt, and I’m happy with how it turned out, but as G and I were eating I was already coming up with some tweeks in my head. Not only that, but was trying to think of other uses for the eggplant that I could do to sub for pasta…

So are my emotional eating, binging days over? No. Are my days of turning to food for comfort over? No. But I think I’ve progressed.

Food is still a joy for me. I will never be one of those “food is just a fuel” types. Never. I don’t want to be.

And while I’ve always loved cooking, my cooking has evolved. I take as much (maybe more) joy in the process, in the creation as I do in the eating. I had a great stroganoff I used to make using condensed soup and sour cream. Now I’m trying to come up with a from scratch recipe that I really like.. and I’m close. Very close.

It’s things like this that keep the pleasure of food in my life, finding better, healthier ways to fuel my body and my … well, my soul. It’s part of living my life instead of watching it go by. And it’s part of , well, finding a better, healthier way of dealing with the joys and pains that come along with living that life.

Originally published November 29, 2008

I don’t know the last time I tried cottage cheese, before yesterday. But, it’s on the list of foods that is good to have both as part of my pre-op weight loss, and one of the first foods I can have post-op.

My aversion to it has been mostly phychological. When I was a kid, maybe 4th grade or so… we took a weekend trip down to see my mom’s friend in Albert Lea area… “Aunt Betty & Uncle Jim”. When we got back we discovered a bowl of mostly eaten cerel had been left out… and what was now left in the bowl looked like cottage cheese. After that, I couldn’t look at the stuff without that memory coming back to me.

Yesterday I had some cottage cheese with breakfast, mixed in a spoon full of lingonberry preserves I had picked up at Ikea. Afterwards, I couldn’t help but think of the deer hunting scene from the movie Red Dawn – “It wasn’t so bad.”

Even though it was Black Friday, I braved the stores a bit. At Target I bought some new dishes. Not that I don’t already have dishes.. actually have a nice set that I’ve had for over 15 years that I’ve supplemented with a few things like cereal bowls, pasta bowls and such in the ensuing years. Problem is, everything is HUGE. The cereal bowls hold about two and a half cups of food. And just the regular plates… well, 3 oz of meat and a half-cup of cooked veggies get kinda lost on there. Even my small wood bowls hold over a cup… looking at a quarter-cup of cottage cheese in there, well would get rather… disheartening.

So I bought some salad plates, they are a bit bigger than the side plates from my main set, but square, so I dunno… they’ll be ok. I think my other plates would have been almost too small for an entree. But the bigger deal is the bowls. Some matching “dipping bowls”. They hold just over a half-cup, so they’ll hopefully make it easy to maintain some portion control.

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I’m going to have to cut out the Gatorade mix. While I drink it fairly dilluted, it has sugar. Post-op, not sure how that will go down, might cause dumping. Dumping is bad. If you haven’t heard of it yet, dumping basically occurs after WLS if you eat food that is sugary or has too much fat, not with lap-band, but with RNY. That’s because these sugars and fats are usually absorbed in your stomach, now they go right to the intestines. The effects of which can vary, but none are pleasant – abdominal pain, cramps, gas, bloating, and diareah.

There are lots of sugar-free options, but I got the Gatorade powder cause it’s cheaper. Buy in bulk, right? And while the directions call for one scoop (bout a tablespoon) for 12 ounces of water, I do that for about 32. Just enough to give the water some flavor. I actually use old Gatorade bottles, they hold up well. While shopping yesterday I bought a bottle of G2 (the lower-sugar/carb version) and stright from the bottle, it tasted too sweet. That’s a good sign, no?

The big thing is these individual packets, Propel fitness water, Crystal Light, even sugar-free Kool-Aid. They’re nice, but spendy, around $3 for 6 or so. Still cheaper than a bottle of pop I suppose. And I’m fine drinking tap water, so it’s not like I’m spending a ton on bottled water. I picked up a couple of Lipton green tea and white tea ones yesterday at Target, and then at the Dollar Store found some Hawiian Punch ones. May have to go back there and stock up.

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I found a site yesterday that could be pretty handy – SparkPeople. It’s a social networking site geared towards fitness, diet, and general health. I found it while trying to find a way to figure out the nutritional value of the bread I made for Thanksgiving. They have a meal planner/diary feature that will figure out how much you are getting in calories and other stuff, let you keep track of how much water you’ve been drinking, a weight tracker and stuff I haven’t even played with yet. They also have various “groups” you can join based on various interests/topics. It’s going to take awhile to get through everything here… but I am going to use it to help track my meals. I can make notes in my phone throughout the day, then transfer them there to get my daily calorie count, etc. One problem, the site refreshes a LOT as you do different things. They need to incorporate AJAX in to the site, speed it up a bit.

Originally published November 12, 2008

Tonight was my first meeting in awhile regarding the WLS. It was a group intro session… they had a staff person from Unity talk… and she is 7 years post-op herself. BTW, I realize these posts are getting long and maybe boring… but what do you want me to do? I’ll try to start finding some sort of inspirational or maybe at least humorous images to go along with these posts in the future.

I got there just in time for the meeting. I don’t think all the people there were possible patients… folks are encouraged to bring a support person with them. There were maybe 9-10 guys out of the over 50 there… including myself. The presenter mentioned knowing what it was like to be “here”, to be sitting in this room, all nervous. I’m not though.

I think I’ve learned a lot about this whole deal, but I started getting more details I haven’t found elsewhere… gonna run through them here… now, if you are reading this cause you are looking in to this, one thing I should mention that I discovered tonight – different hospitals will do things slightly different. What I list here may not be how the hospital you check out does certain things.

At the beginning, after by-pass surgery, the “pouch” or your “new stomach” holds bout 1/2oz. It will stretch a bit, slowly, until after a year or so you’ll be eating about 3/4-1 cup of food per meal.

A difference here than with the lap-band, with lap-band you start out fairly normal after surgery recovery and work your way down to smaller and smaller meals as they tighten, or fill the band.

After the surgery, you’ll be downing nothing but clear liquids for a period of one to three weeks, then you start on puree’d foods, and by about week five you should be back to eating “real food”. Just a heck of a lot less. But even then, avoid bread, rice, and pasta for the first few months until you can see how your body will handle them. Soft breads especially, as they are hard to chew. Oh, and ground meats too. After WLS you need to chew and chew and chew your food until it’s the consistency of apple sauce. You need to do this because the opening from your esapaugus to your new stomach is only about the size of a drinking straw… if you don’t chew… well… ever had a banana shake and had a chunk of banana clog the straw? You don’t want that to happen.

And the big thing – no drinking while eating, or bout 30 min after. WLS as a tool works because it’s about getting your body to feel full, and stay full. If you drink, you’ll empty out your stomach too fast, get hungry again, and eat more. Think of it this way… pour some actual apple sauce into a funnel and let it drip through. It should sorta dribble through. Now add a couple tablespoons of water to that sauce… it runs through a lot faster, right?

And of course besides sticking to the 3-meal-a-day deal, getting 30min of exercise a day is huge. Even right away… even if you have to break it up in to five or ten minute blocks. Beside burning calories it can help with your skin and energy levels and other stuff.

Things aren’t gonna be all sunshine and roses even after you lose the weight, there are some general changes that it seems just about everyone goes through…. like they become much more cold-sensitive. Now as a guy that sweats when it gets above 35, right now that don’t sound too bad. But I suppose, like I joke about when I play paintball in 40 degree weather in a t-shirt, I am well insulated. Who knows how I’ll feel once I lose that insulation.

Course there’s the risk of loose skin. Keeping hydrated, making sure you get enough protein, not smoking and exercising can all help minimize the problem as you lose weight, but the risk is there. Sure, if you can afford it, cosmetic surgery will take care of that. But even if you can’t… what’s worse? a bit of loose skin, or an extra 150 pounds?

The hair loss thing I’ve mentioned before – no biggie for me. The presenter and a couple other women that have had lap-band all said they lost hair, but also most of it did come back. Heck maybe I’ll get lucky and end up with more than I’m starting out with now?

Then there’s “dumping”. I’d heard it talked about a lot… but never in much detail. Basically, it is mostly for those who go through by-pass. Since you are by-passing the bulk of your stomach, certain foods that are normally broken down there end up right in the intestines… and when it comes to sugary or greasy foods… that’s not usually a good thing. With a lot of people, ya eat too much and it’s gonna cause all sorts of issues… usually not serious, but likely rather uncomfortable or maybe a bit embarrassing if you’re in public. They suggest being at home when you try reintroducing such foods back in to your diet.

Also, there is “psychological maladjustments”. This covers a rather broad area, that I’m not sure I can touch on just yet. But they did go into common emotional changes. You may end up asking yourself “did I make the right decision?”, or mourning loss of food in general. Relationships can, and likely will change… but on the plus side you may also end up more outgoing, getting more socially involved.

Now when you compare bypass to lap-band (I’m leaning toward bypass at this point), the advantages it has are a more rapid weight loss and the total weight loss tends to be higher. And like lap-band, there is a minimally invasive option available. Lap-band work by restricting the amount of food you can eat, but after that everything that happens to the food is like normal. Bypass on the other hand is a “mal-absorptive” procedure. Basically means since you’re skipping over the bulk of the stomach, you skip absorbing some some of the “bad” stuff like fat and sugar.

And there are other things that pretty much become a non-factor after surgery. I can eliminate acid reflux, type 2 diabetes, and in some cases high blood pressure almost immediately. Others are gonna be helped by the fact your losing weight, light the blood pressure, cholesterol, sleep apnoea. And if they’re not eliminated, they can be severely reduced. I’ve got three of those issue and at risk for the other two… so… this just about seems like a no-brainer for me.

Oh, along with the skipping of sugars and such, you also end up skipping the absorption of some of the good stuff, so you need to take supplements the REST OF YOUR LIFE. I emphasized that because this is … forever. Lap-band, worst case, can be removed. Bypass, you can’t undo. So from then on, yer doing vitamins, calcium and b12… at the least.

And other than the supplements, you’ll need to watch over what other meds you take. Make sure they’re not too bid… or that they can at least be dissolved in water, or crushed or chewed, or maybe they come in a liquid form.

Generally, pre-op, you are going to need to lose about 10% of excess weight. Probably looking at 15+ pounds in my case. I’ve read on other sites that this is mostly done right before surgery when they put you on a liquid diet for 2-3 weeks. Unity doesn’t do that. You still need to lose the weight though, it help clean up the liver and make it easier for the surgeon to get in there and do what they need to do.

Speaking of which, the operation will likely take anywhere from 45min to four hours. Most insurance companies require an overnight stay, and they get you up and walking around hours afterwards. Never too early to start exercising. They said here you wake up with an IV, but no other tubes. And depending the the kind of work you do, you’ll likely be out for one to six weeks… mostly depends on if you need to be able to do any lifting and such that might effect your incisions.

Speaking of incisions… this is surgery. Pretty major surgery at that. There can be complications… from bleeding, infections, blood clots to leakage. They said if that happens, you will get sick very quickly and to notify the surgeon ASAP. At Unity, you end up with the pager number of your surgeon, and they (or someone working for them I figure?) is available to you 24/7/365. Period.

Now worst case, yea… you can die from this surgery… or bout any other. National average is 1 in 200. Unity though, their average is about 1 in 3000. That’s kinda nice to know. After the bypass surgery, there are a number of follow ups. 1 week, 5week, 3month, 6month, 12month, and every year after that. But Unity balances it out and seems to offer a number of free services as well, such as support groups and fitness/diet consultation and such.

I’ve already taken the next few steps… I have my nurce clinician appointment next week as well as my psyc evaluation. Week after that I meet with a dietician. I’ve been checking with my insurance company and think I’m pretty well covered there. Which I hope so, because if I were to have to pay.. I’d be looking at $15-20,000.

So that’s where I’m at right now. By the way… PLEASE realize that none of the above is actual medical advice. I don’t guarantee any of it to be accurate. This is what I took away from the meetings… don’t be stupid and take my word for it. If you have questions, talk to YOUR doctor. K? K.

Oh, and if you want to see a lap-band surgery, the surgeon at Unity did one a couple weeks back and they broadcast it live. You can still catch it at or-live.com

The folks over at Zen Habits recently posted a pretty good article on The Simple Fitness Rules, and I thought I would make some observations on them from a WLS dude perspective.

They start out with two simple rules…

1. Get your body moving on a regular basis; and
2. Eat a moderate amount of real, whole foods (with occasional indulgences).

Number 1 is something as a WLS patient we’ve been hammered about since that first informational session. Just moving (something beyond our normal routine) is important. And the moderate amount of food thing, well… we’ve got a tool to help us out in that department.  So it’s the expanded version of this I want to look at more.

1. Get Moving
2. Enjoy Yourself
3. Slowly Add Intensity
4. Minimal Equipment
5. Just a Few Exercises
6. Eat Real Foods
7. Eat Less
8. Give it Time

Get Moving – like #1 on the short list, just get and move. In the beginning right after surgery… doing dishes by hand instead of stuffing them in the dishwasher could be enough. How about vacuuming the house an extra time or two this week? Walk to the corner store to get a bottle of water once in awhile. the point is to just start doing it.

Enjoy Yourself – Ok, vacuuming may not fall in to this category. How about some gardening? Invite the neighbors over for some badminton? Find something you enjoy doing. Exercise does not have to be a pain. And while some of these things won’t get you your daily exercise, by mixing it up throughout the week it can help you from getting bored.

Slowly Add Intensity – The first time I walked around my block after surgery, about a 3/4 mile trip, it took me over half an hour, and I had to stop and rest once. Now I could do that same block in less than 15 minutes. What ever exercise you find that you enjoy, build on it. If you walk the same route or distance each day, time it and try to do just a bit better today than you did yesterday.

Minimal Equipment – The Zen Habits author said it right… keep it simple. I have a gym membership, but I’ve only been once post-op. It’s too nice out to be in a stuffy, smelly gym. I’ll keep the membership so I have a place to go walk come winter (I am in Minnesota after all), but for now I get by with walking, my bike, and a resistance band for some upper body strength training. The home fitness market is big, and you can get things like resistance bands, balance balls, and more at very reasonable prices. Another way to keep it simple, if you have kids… take them to the local playground and play with them. And while they’re playing on the swings, try a few chin-ups on the monkey-bars, or if the slides not being used, try climbing it a few times. These little things can add up quick.

Just a Few Exercises – The Zen Habits author talks about just doing a few different types of exercises… and I agree to an extent. Muscles have great memory, and if you do the same couple of exercises over an extended period of time they will remember the motions and you’ll get less results from them. So yea, maybe do just a few for a few weeks, then mix in some new new ones for a few weeks then go back to the original ones for awhile, etc. Keep those muscles guessing!

Eat Real Foods and Eat Less – Ok, for the most part as a WLS patient, we have these covered. RNY, we have this thing called a pouch that dictates how much we can eat at any given time, and if we eat too much sugars or fried stuff, most of us are going to dump. Banded folks, they have more flexibility on the what…. BUT, it doesn’t mean we can just go on automatic pilot. Sure, early on it can be a struggle to even just remember to eat at times, but as we progress we probably have to pay more attention to what we eat then most “normal” people. There are ways to eat around the pouch and bands… something we need to keep in mind at all times.

Give it Time – This is huge. yea, with WLS (especially RNY), we see some results pretty fast in the weight loss side. But because of the protein thing, you will lose some muscle. period. And it will take time to get it back (and no small amount of effort either). My nurse told me that dudes can see quite a bit of muscle loss early on, but around the six-month mark is when they start gaining it back again.