Posts Tagged ‘surgery’

The Quest Begins

So it begins. The Quest for 26.2 miles has started. It began yesterday in the bright sun and blessedly cool Sunday morning at SportsBackers Stadium. I am on Team Cocoa, which the coach, Ellie, joked about us looking like UPS drivers if we actually try to wear cocoa colored clothing. It is the slower team of the two intermediate teams. The faster team intermediate team looks like it is made up of human cheetahs. My team, not so much.

The intermediate teams were scheduled to run 7 miles, the novice team was running 4.

Gory details to follow:

Since I had poisoned myself the previous day with too many delicious but wildly greasy carbs at an awesome restaurant called My Noodle, my GI system was completely uncooperative. At the best of times, my pouch and small intestine (minus about 7 feet of it) are unpredictable, but yesterday’s reaction was completely predictable in the worst sort of way. It is the main hazard of being a Gastric Bypass patient and an athlete (dehydration being a close second).

Within the first 10 minutes of the run, despite my best efforts, I knew I was in trouble and I knew the only bathroom on the route was the bathroom in Bryan Park, which would be about the 3 mile mark (yes, I know almost every single open and available bathroom in the City). I suffered for those three miles, but I made it. While shuttered up in that sketchy little bathroom, I did the math and recognizing that there were no other rest stops along the rest of the 7 mile route, I decided to cut off the “Northside neighborhoods” section of the route and went straight back to the Diamond on the Boulevard. That took a little less than 2 miles off the planned route, but it saved me from more misery.

When I hit Brooklyn Park Avenue, where the planned route and my alternate route met back up, I wound up a pack of fast runners from the Green team; those human cheetahs. Most of them were running in the 8:30 minute/mile range and I couldn’t keep up, but running with them and being a half mile from the end, I knew I could damn well speed up. My insides cooperated long enough and I think I ran that last half mile in the 9:45 min/mile range. I was grinning like a hooligan in spite of everything. I could feel a change in my brain. I am really, truly, officially, and finally training for a Marathon.

You would think I would be unhappy or upset that I didn’t make the full distance on my first week of training, but I’m not. I know my body. I know its limits. I know I could have run those two miles if my system had cooperated. It was a beautiful morning and a familiar route. But I also know myself well enough to know that I would have ended up walking, with severe cramping and doing the “two-cheek-squeak” for the last miserable mile, and I would have felt horrible.

Two extra miles was not worth that kind of suffering.

So aside from all the miles I am going to log in the next 5 months, there are a bunch of other considerations to make to keep myself healthy and uninjured.

Diet: I want to limit repeats of Sunday morning’s gastro-intestinal festival, and that means being careful with carbs, avoiding dehydration, and seeking high quality calories. I need the most bang for my nutritional buck that I can get. No 3pm dashes to the vending machine for a rice krispy treat. I am trying to keep my desk stocked with nutritious options for when the mid-afternoon munchies hit. Whole wheat crackers and natural peanut butter (my variety has added flax seeds, for what that’s worth), mandarin orange pieces in no sugar added liquid, and high quality dark chocolates for those moments when chocolate is a must (it happens). Lunches will be lean protein and vegetables. Breakfasts will not devolve into an egg and cheese bagel from Cupertinos; hard boiled eggs, Greek yogurts, and occasionally things like steel cut oatmeal (have to be careful with oatmeal though; I need extra protein or my blood sugar gets a little wonky).

We regularly plan dinners that are pretty healthy, and they are usually planned on a weekly basis, with an emphasis on balancing Byram’s low-purine food requirement, my lowish-carb requirement, and my Mom’s need for variety.

I am making it a point to really focus on getting all my daily supplements in. I know what the FDA says about vitamin supplements, but their recommendations are for the general populace, not someone who has 7 feet of missing intestine and absorbs only about 2/3rds of everything she consumes. For me, vitamin supplementation is a must.

Cross Training: I know from my history that because I sit all day, my mid-section is kinda soft like a gummy bear, while at the same time, my hip flexors are tight as piano wire. The perfect recipe for injury. Mondays on the schedule are x-training days and I am going to focus most of those days on core strengthening and stretching. In fact, I am going to bring a yoga mat to work. There is a section of the 2nd floor where no one ever comes and I can do a full core workout without any gym equipment and never have to leave my building. Over the summer, when time allows, I might add in some evening swims with Grace at the Y. Being in the water will take my weight off what are sure to be sore muscles, while at the same time, you get some resistance training and cardiovascular benefits. Also, Grace time is Good Time.

Yoga: This goes hand in hand with X-training, but needs to become a regular act. At least on Tuesdays and Thursdays, I need to get up and do a yoga routine in the morning or before I go to bed if I run in the early a.m. during the hottest part of the summer. Again, injury prevention is my main goal; I can’t cross a finish line if I am too hurt to get to the starting line.

Sleep: it’s nature’s Reboot Button. It’s a key element of a good immune system (distance athletes are not famous for their abilities to fight off a cold). It’s when your body builds muscle. It’s when your whole system slows down and recovers from the strain of hard core training. I am going to start aiming to be in bed between 9-10 pm every night because many mornings are going to see me up and at them for early a.m. runs by 4:30 and 5 a.m. A morning glory I am not, but I am going to work on it.

Finally, and probably oddest…

Positive thinking: My mind is my greatest enemy. It is crueler to me than 100% humidity, 90 degree temps, and double digit distances. I have the power to make it my greatest ally. And so I shall work to that end. Stop the self-mutilating mental talks. “I am the slowest person on the team!” needs to become “I am lucky to be running with such amazing folks. I bet I can catch up to them just a little if I push just a little harder.” “Oh my god, 20 miles will feel like forever.” needs to become “I really cherish ‘my time’ and I am lucky to have the next several hours all to myself.” I can work on it, but the mind is the hardest thing to train. Wish me luck.

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4 Year Anniversary

Happy Surgiversary to me. 4 years ago today, I went under the knife to undergo RnY Gastric Bypass, willingly undergoing a life altering surgery with the hopes of getting a new grip on my weight and my overall health and well-being.

Since then, I have run over a thousand miles, 4 half marathons, a handful of 5ks, one 10k, and a few adventure/mud runs. I am training for my 5th half marathon, and so far, that is going fairly well. I logged 7 miles on Saturday morning, which was my longest run since the AmFam Half Marathon (at least I think it was). My IT band did not give me any trouble. My GI tract did unfortunately, but that isn’t unusual given that 7 feet of my intestines are not in use and at the best of times, things can be unpredictable.

Since my surgery, I have cut certain foods out of my life for good. Fast food hamburgers and fries? I don’t think I have had such a meal even once in 4 years. Anything that has to be consumed through a straw (e.g., smoothies, frosties, frappachinos, etc.) has been stricken from my diet. I have not consumed a single ounce of a soda, diet or otherwise, in 4 years.

Then there are things that I know I simply cannot eat or I will find myself shaking, sweating, heart racing, nauseated, and all around miserable. Cake. Pancakes or waffles. Commercially made biscuits (I can get away with a really tiny homemade one on very rare occasions). Ice cream in any serving larger than maybe a tablespoon or two. Fried chicken in anything larger than a kid’s size portion (Chik-fil-A’s 6 piece nuggets are the limit for me; I refuse to eat those fake nuggets anyone else serves). Honestly, deep-fried anything is a high risk for making myself ill; I just don’t go there except on the rarest of occasions (usually while traveling and there simply aren’t any good options). I can have one or two pieces of bacon, at most. I prefer to use it for cooking with these days.

Then there are foods that surprise me that I cannot eat very well. Salads are not easily digestible and tend to fill me up too quickly leaving no room for protein. That really doesn’t work for me, so they tend to be rare and almost like a treat.

Chicken breast is another surprising one. When I cook with chicken breast, I do best if it is cut against the grain, shortening those long muscle fibers, and then cooked with lots of veggies or a sauce to try and put some moisture into the meat. Otherwise, swallowing plain chicken breast is akin to chewing and swallowing a cotton ball, only it sits in my pouch, painfully holding up anything else that wants to go down.

Hard boiled eggs. They feel like I am digesting a blown up rubber glove. Scrambled is okay, but I get off-put by the texture these days. And frying an egg tends to leave me feeling not awesome, but I eat them anyway. I have to eat something on weekend mornings.

Nuts. Well, it isn’t that I cannot eat nuts, but if I do, the aforementioned “unpredictability” of my GI tract suddenly becomes VERY predictable, but not in a good way. I only eat nuts when I know I am not doing anything very active within the next 24 hours.

Pulled pork BBQ. Byram makes amazing smoked BBQ and every time I eat it, I feel sick no matter how small my portion is. I suspect the combination of the sugar in the rub with the higher fat content of the meat come together to make me miserable.

Oddest of all things I think is oatmeal. I love a bowl of oatmeal, though I prefer mine savory with a touch of butter and salt. That said, if the only thing I eat for breakfast is a bowl of oatmeal, within 2 hours my blood sugar crashes to the floor and I become a shaky mess. If I have it with something else, like string cheese or yogurt, it is normally fine, but I don’t usually have room for oatmeal AND anything else. It is perhaps the one thing I miss eating most regularly.

Dining out is a completely different experience post-gastric bypass. Everyone knows that by and large, restaurant meals are vastly oversized, heavy on oils and fats, salt and sugar. Most chain restaurants do not serve very high quality meals, as well. So for me, dining out just anywhere has lost much of its allure. Visiting any buffet is a rare thing anymore, but if we do, we usually go to Chinese buffets. I aim for sashimi and sushi, maybe some soup, and a small amount of any dishes that don’t look too oily. If I am forced to darken the door of a Golden Corral, I go for a rare cut of steak, any veggies that don’t look drowned in oil, and a cup of their chili. Pro-tip: chili at most restaurants is a great fall back for gastric bypass patients. It typically isn’t horribly fatty, it is full of protein, fiber, and lots of flavor (most of the time). I used to go for New England Clam Chowder, but now I know better that the fat to protein ratio is really not in my favor.

I check appetizer lists in menus a lot of the time. It is very rare to find much that is decent in appetizers, but seared ahi tuna has become very popular and in a typically sized appetizer, it is a perfect meal for me. Some places are featuring “Hummus platters” or “Mediterranean Plates” which work very well for me too, and are often large enough that I can share with the table and still go home full. Hummus, some feta cheese, olives, tomatoes and onions, some pita bread (which I eat very little of), and I am good to go.

I love tacos. There is no getting around it. But not tacos like Taco Bell; I like the awesome taquerias that have begun to pop up all over Richmond. An order of three tacos, with fillings like al pastor, carne asada, and even lengua (ooh, scary!), are all delicious and in small enough portions that their fat content doesn’t tend to bother me. These authentic style tacos are not like American tacos that are loaded with sour cream and cheese. These just have their meat, cilantro, salsa, and typically some pico de gallo or just diced onion. And I usually tear off some of the tortilla, or don’t eat all of the tortillas, just the filling in one or two of them.

Pho is a recent culinary discovery for me. Delicious broth, fairly lean meats, and yes, lots and lots of noodles, but I can eat as much or as little of the noodles as I want. Yes, the serving is typically massive (like measurable in gallons, right?), but something everyone should remember is that while we were all taught how bad it is to waste food, it is FAR worse clean your plate and then find all that food on your waist.

Four years on and I am far from perfect. I do eat and drink the wrong things, I slack off of my work out routines, I screw up. All. The. Time. But that doesn’t mean I quit. That I say “Well, I’ve gained back some weight, time to throw in the towel.” I fight. I am fighting right now. I consider my surgery a gift and it is not one I am willing to relinquish.

I write about my surgery to remind myself where I came from, why I do the seemingly crazy things I do (like go run in the pouring rain at lunch today?), and why it is so very important that I don’t stop. I write because I know a lot of people think about this kind of life-style change, they have questions, they wonder if bariatric surgery is right for them, they wonder what life is like on the other side. There are tons of bari-bloggers out there, I am just out here offering just another perspective.

So here is to 2014. I have big plans so stay tuned to see what comes next.

Jackpot

7 degrees. That is what the temperature was at my house this morning when I got out of bed at 7 a.m. It also happens to be the 7th day of the month of January. This particular date just happens to be my birthday. 32 years old today. And 7 more days from now will be the 4th anniversary of my gastric bypass surgery.

Almost two years ago, I wrote a two part series about undergoing surgery and then the intervening years and experiences to that point. If you are feeling curious, you can find them at Part 1 and Part 2. Be warned, they aren’t short essays and a lot has transpired since then. If I can, I will try and write an update to them in the near future.

I was at my desk this morning, diddling around at my work with my Gmail account open in a window, though lowered into the taskbar at the bottom of the screen, when suddenly it went from reading Inbox to (3) Inbox. It is highly unusual to suddenly get 3 emails so I opened it immediately to discover 3 almost unintelligible subject headings.

imATHLETE – “Welcome to imATHLETE”

imATHLETE – “Your imATHLETE Purchase Confirmation”

At that point, I am thinking I have been scammed, hacked, or picked up a virus. Then I begin to get it when I read the subject header of the last one.

imATHLETE – “2014 Yuengling Shamrock Marathon, Anthem Half Marathon, TowneBank 8K, and Operation Smile Final Mile”

Confusion changed to shock. I hadn’t even opened one of the three emails yet, but I knew I had been registered for the Anthem Half Marathon (or better known as the Shamrock Half Marathon). And I knew instantly that Byram had been the one to do it. I got him on the phone and asked “What did you DO?!?” Happy Birthday, he said. He explained that he had arranged for Crash Space with our friends Rich and Genie in Virginia Beach, so no hotel hassle was necessary. He said he believed in me, that this would be a great experience, fun, and challenging. I’ll say. I have 65 days until my next race.

Today is the 7th, it was 7 degrees at 7 a.m. What happens when you turn up 777 in Vegas?

Jackpot.

Off The Map

What happened? Just as I was recovering from the half marathon, I disappeared off the map. It’s true. DailyMile reminds me that the last time I logged in was April 2nd.

I lost my motivation, then I ran out of energy.

Last Wednesday, I saw my gastric bypass nurse and had my blood work done, and it turned out that my iron levels are in the basement. For a normal RNY gastric bypass female of child bearing age, they want to see my iron somewhere above 35. My iron level was 11.

It’s no wonder I haven’t had the energy to lace up my trainers.

Well, since last Thursday, I have been conscious of the low iron and am taking a hardcore iron supplement and doubling my daily multivitamin, but so far, all I have to show for my efforts is a confused GI system.

Sunday, Grace ran her first obstacle race, the Mini Muddy Buddy, here in Richmond. I think she would have had a blast except we had temperatures in the low 50s and rain that day, instead of the sunny, mid-80s we had the day before. I enjoyed running with her, even if I didn’t appreciate the cold mud and cold rain any more than she did. It helped me find my feet again.

Not working out only breeds more of the same, so I figured even a short run would be better than sitting on my ass again today. I took myself to the Y for a run on a treadmill. Tuesdays are always for speedwork, so that is what I set out to do. Nothing structured, nothing planned for today except to run at 10 min per mile or faster for as long as I could. I started at 6mph and bumped the speed up and down with the music on my MP3 player, as high as 6.6 mph. Pretty good for me, even if it made for a very short run. 1.3 miles is more than I have logged in 3 weeks, and it was run at a 9:52 pace, my first sub-10 minute mile in, maybe ever.

GI cramps (see the iron supplement comments above) and twingy, crampy muscles in my back helped end the run much earlier than I wanted, but it did feel good to run again. I felt really amazing running at 6.6mph on the ‘mill.

I hope to do a five mile run on Sunday.

A Little Ironic and Ass Backwards

So yeah, rest works.

I felt a thousand times better today than I had all week. I was psyched to hit the weight room at lunch and I am looking forward to my 8 miles tomorrow (though I do wish it would be a tad bit warmer).

Felt like committing attempted homicide on my entire upper body so I upped my weights across the board in general and hit it. I will write it out in the order I have my lifts listed on my sheet but that was not necessarily the order I lifted in.

Dumbbell Bench Press: 2 sets x10 reps w/ 20 pound dumbbells.
Dumbbell Military Press: 2 sets x10 reps w/ 15 lb dumbbells
Shoulder Shrugs: 2 x10 w/25 pound dumbbells
Lateral Raises: 1 x5 w/ 10 lbs dbs, 1 x10 w/ 7.5 dbs (holy crap these are hard)
Bent Over 1 Arm Rows (both arms) 2 x10 w/ 20 lb db
Standing Rows: 1 x9 w/20 lbs and 1 x7 w/ 20 lb dbs (failed both times)
Lying Pec Decks: 2 x10 w/ 12.5 lb dbs
Lat Pulldown: 2×10 w/ 27.5 lbs
Cable Row: 2×10 w/ 5 plates (no clue about the actual weight; the plates were just number 1 though however many there are; I am guessing somewhere between 30 and 50 pounds?).
Back Extensions: 2 x10 while holding an 8lb medicine ball
Crunches: 1 x10
Reverse Crunches: 1 x10
Plank: 1 for 1 minute (New record!!!)

This workout left me feeling amazing. My hands were trembling as I unlocked my locker. My pencil marks on my sheet were barely legible from my shaking arms. I left the Y with one of those true highs where I couldn’t stop grinning, felt amazing, and was warm all over so that I didn’t need a coat over my short sleeves.

Created a MyFitnessPal account to track my calories since I forgot the old system I used to use. Yesterday, even with fully trying to consume more calories, and with one regular beer and one unusually dark beer (Southern Tier Chocklat Stout; so good!), I came in at less than 1800 (which is where MFP wants to see me at based on weight and height, but it does not factor in my activity level). Today, I have already mapped out much of the days calories including our planned dinner, and I am almost 700 calories short for the day currently. I don’t want to up my calories with pure junk, though that would be easy to do, but I need a calorie boost in small packages. I already eat nuts, I got some 70% dark chocolate squares (had one today in fact for an added 55 calories), I drink milk (nutrient dense and calorie dense without being especially filling), and I am drinking protein shakes.

I think for now I am going to aim for 1800 calories or there about per day and see if the 200-400 calorie increase helps my energy problems; if not, I will have to go to even higher calorie foods at meals to get myself above the 2000 calorie threshold.

When I underwent gastric bypass, at the time, it never occurred to me that there might come a time when I was counting calories again just to make sure I was getting enough energy.

Yes, it does feel a little ironic and ass backwards.

Overtrained and Underfed?

I have been dragging terribly all week; particularly since Saturday’s 10 mile run followed with the afternoon spent moving someone out of their house. No energy. No motivation. Monday’s twanged quadricep made me nervous but that seems to have panned out okay. Tuesday I did an awesome interval run, bumping up the speed a notch this time, but by 23 minutes (2.25 miles) I was out of gas. Period. Nothing left and my gut was cringing and I threw in the towel. Yesterday, I was exhausted but talked myself into dressing out. I did my 5 minute warm up and I was so miserable, I turned around and came back to work, head hanging in shame.

I suspect a little overtraining. I haven’t done the resting heartbeat test, but all of the rest of the symptoms are there. Irritability, decreased performance, decreased energy, lingering mild muscle soreness, and so forth.

So today, I rested. I might do some gentle yoga tonight but that is as far as I would push it today. Tomorrow, I will do my upper body workout, and Saturday, I will go run my 8 miles with the team, but today, I rest.

I have done a lot of reading on overtraining this week; I think a major contributor to my issues has been my diet. My diet is not bad. In fact, since the first of the year when I first started culling the extra junk from my diet, my diet has been pretty awesome. I was so proud because for a few weeks I tracked my calories, and I mean all of them, including liquid ones, and was finding myself taking in 1400-1600 calories a day, which is perfect for my weight, and which, from what I am reading, is not enough to support my high level of activity.

Estimates range, but what I see a lot of is that a 30 year old, 155 pound 5’7″woman, running about 20 miles per week (and not even including the weight lifting I have been doing), needs to be eating 2200-2400 calories per day to maintain energy levels.

Not so proud of those 1400-1600 calories a day now.

This is a conundrum for me. I tightened up my nutrition a bit too much, but at the same time, I am not sure exactly how to get even close to that number of calories in per day with a measuring cup sized pouch rather than a football sized stomach.

God help me, I think I am going to have to go back to Obesity Help’s fitness board and ask others how they manage.

-243

Did nothing all weekend except feel like crap after poisoning myself with gin. Maybe I drank it faster than I have been. Maybe all the cold meds enhanced the effect. The quantity wasn’t different from what I was drinking a couple of weeks ago, but the effect was more pronounced, and the result was a wasted weekend for the most part.

Then I packed my running gear (including a new Underarmour-style long sleeved shirt and a new Champion heavy weight hoodie) to take to work this morning, and left the bag sitting on the couch. Another wasted day. Perhaps tonight I will put the exercise bike to use since they are calling for rain for the next day or so.

An aspect of training I have not addressed here yet is diet. My RnY gastric bypass requires me to aim for 60 grams of protein per day, and my pouch doesn’t allow room for all that protein and gobs of carbohydrates at the same time, so by necessity, I am on a “low-carb” diet, generally under 100 carbs per day. For the first 6 months or so, I kept it to under 50 carbs per day. Being at maintenance now, having a little more room in my pouch, and doing more aerobic activity, I allowed my intake to go up, but I struggle constantly still with the “white carb” cravings. I still avoid white pasta in large quantities, no white store-bought bread, generally no white potatoes (not much sweet potato either), and little to no rice. Now my mom is a baker and I get lots of delicious, homemade white bread in the house, and while it is a major struggle to not eat the whole loaf, I do allow one slice per day.

It is possible to cheat my surgery and I do, but I am growing more and more fearful of failure, so I am actively trying to make better choices and trying to make more good choices than bad ones. Yesterday was kind of an unusual day, but here is what my diet looked like.

Brunch at Bob Evans – 1 cup of oatmeal (didn’t finish it; only have room for about .75 a cup) (about 19 carbs and 5 grams of protein)
Mid-Day Snack/meal – S’bux Skinny Caramel Macchiato – 15 grams of protein w/ 25 carbs (yes, I will treat a latte as a meal)
Dinner – Kona Grill Miso Soup and 5 piece Yellow Tail Sashimi. (Miso has 5 grams of protein. 1 ounce of sashimi has 7 gr. of protein, so I probably had 21 or maybe 28 from those 5 slices)
Snack – Multigrain Pita Chips and beer

That is a pretty good day, especially if I had left out the beer. I needed a little more protein, and a few less carbs, but overall, that was pretty good.

Getting diet, aerobic conditioning, and strength training all working together is my goal over the next 240 days.