Dances with DS

http://www.springerlink.com/content/up12178231681843/

So there we have switch-patients without stomach resection and they don’t lose weight? I’ve known about this for a long time but I don’t  understand it tbh. In patients with only the sleeve or resected stomach weight gains are not uncommon longerterm - and it’s the switch part that helps them lose more weight plus maintain weight loss.   So just what is the switch part doing and how come it works in such mysterious ways ?   How come it works one way - but not the other?  Same switch, just a different stomach…different outcomes.  I’m not eating that much less (well on a good day) than the person who has a normal stomach.

Is there a way this could be exploited to help patients with lower BMI who want the DS, but don’t want the big weight loss?

What is a touch worrying is the incidence of ileal ulcers. Yup, I know - weighed against the risks of unsolvable high blood fats and diabetes it’s still in context imo, but I digress.   I’ve not yet heard of a DSer with these but that probably means sweet blow all. I often wonder if DS & bypass patients might well not notice signs of such things unless they are in the dire stages.

It’s a worry I have about diverticulosis too.http://digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/index.htm

After my mum had it and it required extensive surgery, I started thinking if I had it due to the altered state of my intestines, I probably would not recognise the symptoms…after all bloating with the DS is not  uncommon and nor are altered bowel patterns.  I’d probably chalk the symptoms down to a jiggy system, swallow my acidophilus  and just go on with life.

It kind of makes me aware that we wls patients are operating in a pretty vast area of skewed ‘normalness’ and our perimeters of normal are not easily definable.

I’m not anxious, because these are just part of my ‘things to note & ponder’ - but reading such stuff and pondering on it makes me realise that a hugely missing part of the WLS equation is in preventative measures to hopefully ward off such problems. Patients should perhaps be informed beyond the area of basic nutrition for protein etc, but I suppose if we are not presenting with symptoms or have symptoms that we confuse with our surgeries, chances are it’ll be years until this aspect of WLS is fully explored.

Plus there is this mainstream attitude of not wanting to be alarmist or create panic over something that is just a maybe way off in the future & that’s probably understandable if not exactly constructive.

Still - it’s not going to hurt to introduce distal patients to good bowel practices like ensuring they address any blind loop bacterial overgrowths promptly. It’s not funny how often these exist and sometimes on a low level - ie a breath test shows it’s present but the patient may seem largely symptom free. http://www.gi.org/media/releases/2007am/Gastric Bypass Post-op Nutrition Issues.pdf

Measures of prevention could possibly include:

• using antacids and proton pump inhibitors as little and as short term as possible.
• Regular breath tests at post op follow ups.
• eating pre and probiotic foods daily or and/or taking acidophilus every few months.
• That we consume a good amount of varied complex carbs as soon as we have the capacity to do so.
•  That the importance of fiber, both soluble & insoluble  is discussed and understood by WLS patients.
• That the idea of reducing sugars and carbs is not just addressed in context of weight loss, but also in terms of bowel health.
• That supplemental vitamins and minerals are taken and zinc levels are regularly tested.
• That regular consumption of alcohol is discouraged longerterm as well as short term. (Okay shoot me! )
• That if a vitamin deficiency is picked up, not only is that addressed, but that the general gut health be assessed too.

One might argue that WLS patients should already be following most of the above steps.  However many of us seem to still  only understand dietary issues in terms of weight loss, not in terms of the bigger longerterm bowel health picture.  It’s a multi pronged approach that will help the synergy of nutrition plus bowel health maintainence be optimal for patients.  I might add that I spend a lot of time helping my peers sort out jiggy bowel problems so it’s not rare that they exist. Not all, but some of these problems are nicely resolved by simple things such as including more fibre plus acidophilus into the diet. Eating enough of the correct carbs can work small miracles too. Sometimes a course of flagyl or augmentin can provide a clear platform for improved gut function if followed up by use of pre & probiotics and healthy food choices.   Proper self-management might save our surgeons a lot of time so that they can get on with helping other more needy people.

…and long may it last. It’s about time. Maybe in the 7th year of surgery you get to finally be body-happy. It’s actually not ‘happy’ - happy is a kind of clappy ra-ra word. It’s hard to describe, ‘content’ maybe? Nah…..that sounds too smug. Like the perfect WLS patient who never ever god forbid, falls into the lap of even a momentary velvet chocolate rush. Ah, sod it - I can’t find the words…but you get me.

My cup has been runneth over for a small while about this but I did not want to get optimistic. The thing is a small while is exceptional for me. Okay it is only a few months but that has to be better than a few days.  It could all change overnight - it has in the past and then I have felt like a nincompoop for waxing lyrical the day before.  I have contemplated slitting my throat metaphorically, shutting my profuse blogging down for good, attending a zen retreat and not ever coming back to the real world,  or worse apologising for being so temperamental. ( I’m very proud so humility hurts me badly. )

So I have let it kind of infuse my soul without getting wordy about it until the past few days.  I’m quite surprised at it because frankly I am probably too skinny. I should be sad and bitch like hell about being this way but instead I just accept it - okay I am too skinny …so shoot me.I will eat more because a few kilo’s on won’t hurt,  but I am not going to start crucifying myself emotionally. It occurs to me that in dropping the subliminal stress, I might get there easier than I think…I already ate a slice of bread with yummy fat buttery greek beans and cheese plus 3 scrambled duck eggs this morning - 3 hours apart to be factual, but it is done!

I am very saggy baggy too and I still play with my excess skin in the bath to traumatise myself by the way it assumes the mouldable quality of play dough. Yesterday posing in my full length mirror arms covering what is left of my once voluminous boobies, I thought I might be brave and do a shoot of my semi nude body with a fig leaf of course (I’m not that kinda girl you know! )but today I’m having grave doubts.

It’s not about giving myself the bitch-crit - or a good old battering, but the following is my reality even if I can live peacefully with it. First it’s the belly button that is a bit freaky…it looks sad and that is literal. It looks like a little down turned mouth that has a pucker or two. It’s a little booger to clean too, but that’s besides the point. People researching WLS expect baggy skin ( I hope!)  and have probably looked at other post oppies sags anyway so that is not too daunting for me.

I contemplated because I was very curious pre-op about this. I wished more post ops did it but now I understand why they don’t. Generally it’s only done because the next pics at the side show the brave WLS patients post reconstruction, all smooth and undough like, pert boobies to die for and huge smile on face.  And I smile with them and feel happy for them because I know it takes guts or very deep self loathing of the body, to go the next step, both are big things to contend with and why should they not have joy & peace?!  It is right.

But the thing is they are usually saying farewell to not so sweet sagginess - so it’s a goodbye. The same way I could post up my morbid obesity pics because I knew that was going to be in the past. I could face it then.  And I don’t have the guts, the crippling self loathing enough, nor the backing of the NHS, nor the private funds to say goodbye to sick & twisted moments in my bathtub as I construct a face, a mushroom, a nuclear bomb or a wee hill out of my belly dough.      My pics would possibly remain in the archives for years to come and I might start loathing myself all over again and suffer regrets.

If this is body-happiness or whatever,  I must try to protect it because it is still vulnerable. It’s a little whispery bud in my being and I’m not used to it.  It might not last. It might only be for a few more weeks until the demon critical bitch archetype I unfortunately contain for myself alone,  starts to whisper nasties in my ear again and shoves a load of poison onto it. Mmmm - let’s not go there…

Booger the looks!  Today I am going to live in gratitude that I have a body that works. That I have a body that is champing at the bit to get up and go to meet the day head on. A body that fits into nice clothes. A body to hug my family with. Today I am going to be grateful for this body. I might be able to make a habit of that - who knows!

Sorry - it’s a feeble title but seeing as eggs continue to rule in my DS life  I thought maybe I’d devote a little blog to them.  I was enjoying my duck egg omelette just a few minutes ago and thinking that I’m going to switch from hens eggs to duck more often for a change.

When I first started to eat duck eggs  I had to work on getting through a head thing about them. I think that was because I was reared on chicken eggs and duck eggs made me think of cute fluffy little baby ducklings ( I don’t know why but hens eggs don’t bring fluffy chicks to mind)… also - I had read they had this stronger taste than chicken eggs which sounded mighty suspect to me.  So it was a bit of a mission to tentatively taste my first duck egg. To my surprise it was rich and creamily delicious and I have not yet tasted a ’strong’ flavoured one. I have found the flavour mild but just very yummily eggy. Since then I have become extremely partial to them. As a food to help both WLS nourishment levels and in my case to push a little weight gain - they can’t be beaten. Only wish I had known about them when I was recovering from my bowel obstruction surgery - they’d have been just the ticket for a good recovery.

I have had them every way possible except fried & soft boiled, I think that will take time . As scrambled or as an omelette they can’t be beaten. I find they do well with spicy toppings on an omelette. I eat mine with mild sweet chilli sauce sometimes, plain & simple. Today I tried a packet of chinese stirfry veggies(yummy mix with beansprouts, carrots, onion, chestnut etc) plus a little plum sauce on it  - DIVINE!

Here are a few idea’s for duck egg omelette toppings:

• As above: chinese stir fry with plum or other chinese sauce
• Mushroom, baby spinach, blocks of feta
• Homecooked tomato &  onion, fresh sage & oreganum if you can get it, (or use dried), thinly sliced courgettes, rounds of sliced mozzerella cheese - drizzle good pesto on top!
• Pre-cooked red pepper and finely sliced runner beans, chopped onion, little sundried tomato paste, touch of garlic, lean pork mince or strips of pork fillet. If you have cold good quality pork sausages this is a good way to stretch the leftovers. but good quality mind - none of those over processed rusk & testicle riddled excuses for a pork sausage!
• Lean lamb mince, chopped rosemary, tomato paste, thinly sliced red pepper, onion, green olives
• Simple: lots of chopped spring onion added before cooking - top with freshly shaved parmesan
• Smear omelette with low fat philadelphia cheese & top with smoked salmon, spring onion and dill.
• Fry the omelette in a mix of 50% sesame oil & 50% sunflower oil. Top with Za’atar: http://en.wikipedia.org/wiki/Za’atar - be liberal with the spice mix! You can make Za’atar yourself or get it at a Middle Eastern Deli.
• Satay omelette:  Use peanut oil for frying. Dunk pieces into sweet chilli sauce as you eat.
• Guacamole - pop down to Tesco’s or any other supermarket, buy a punnet of this delish stuff - smear over omelette - fast, easy  and very very moreish. Sprinkle freshly grated parmasan over the top for even more protein power!

Although I do like duck eggs for breakfast occasionally, sometimes they are just too rich. Imo they come into there own for a quick evening supper. I also   find duck eggs too rich with regular cheeses - but some people like it ultra rich. I opt for lighter lower fat cheeses on mine. For some reason duck eggs are delicious with veggies - nicer than hens eggs I think, so it’s a good way to get your protein & complex carbs all in one easy to eat parcel.:-)

The trick to a great scrambled egg (duck or hen) is to not cook it on a high heat. Rather cook for longer on a low heat…it is a pain as I am impatient but the result is a soft cohesive scrambled egg, not a tough crumbly mix, so I remind myself it is worth the wait. Also don’t beat the eggs to within an inch of their lives - a gentle stir with a fork until just mixed, helps keep the eggs soft & creamy.

Ducks eggs are prized for baking - but I would not know really as my DS does not mean I bake much - sometimes the odd banana loaf or banana muffins but that’s about it! I’ll give them a try next time I get the baking bug and see if they really are as good as is said.  One thing I do want to try is a baked duck egg custard…I love baked custard especially with a good drizzle of caramel sauce over it.  Mmmm, might try this tonight & will post up if it works well.

Nutritionally duck eggs are brilliant & exceed hens eggs on every score - check out this comparison. What excites me (gawd but it is sad! ) is the great array of amino acids present in it - same as hens - but higher nutrition value:

http://www.duckeggs.com/duck-egg-nutrition-compare.html

HAPPY EATING!

I am back home.   My mum got through major surgery successfully and we celebrated goodbye to the colostomy bag! It was not an easy surgery as her new surgeon basically found she was still riddled with diverticulitis. She has half her bowel left and is managing the situation well.  I was worried about short bowel syndrome but she seems to have escaped this, though things might change. We were left wondering why on earth the previous surgeons even bothered to operate as basically they had left her bowel in a mess.  But we decided  to move forwards with life & to be grateful that this time things appear well sorted out.

I am in a better space emotionally than when I left.    In the light of the terrible xenaphobia attacks in South Africa it’s hard to hold on to ones comparatively tiny little gripes with life. I did laugh at the use of the euphimistic word ‘xenaphobia’ - for goodness sakes when will they get real. This is APARTHEID. Plain and simple. As ugly, as shameful, as hurtful. Actually I wonder if anyone has tallied up the amount of deaths in SA under the current government vs the deaths during the apartheid era. Don’t get me wrong I detest all apartheid, but I think it is time for the press to stop couching the blow that this goverment is as hopeless as the last.  I found myself getting a lot of perspective. My country is in an appalling state, the reaches of poverty are everywhere, while the government only understands personal luxury. There’s nothing like the  ghastly pictures of people being burned alive to sober one up and to make one forget one’s own problems.   It’s horrendous what is happening there.  HORRENDOUS and not justifiable.  Most of all it is infinitely sad.

On other notes, Zenni survived his deworming . I’ve no doubt my boy had heartworm too as his grade 6 heart murmur has been regraded as grade 4.  He is in better nick than I have seen him in ages.   We  are lucky we never lost him too.

I am seeing  the bigger picture  of losing  Petal more clearly too.  As bigger pictures go it takes time to see the edges of them…but I’m getting there.I feel mighty embarressed fessing up to my communications with God because  I’m not religious and I’m ashamed that I ask for help when others have much greater needs, and when I have been shooting arrows at the heavens about my lot in life , but it is via these communications that I have reached some peace in my soul about everything to do with losing my Petal. Again at the risk  of sounding like a religious nut,  my prayers have been answered and I’m swallowing my pride about my  skeptic nature which has been verily shot to bits!  Sometime soon I might tell you about the Godstuff in my life even if it makes me look as if I have totally taken leave of my senses!    For now, let me say I have made my peace about the situation. I’m not  hurling sticks at tidal waves at the moment although there is no guarentee I won’t find myself doing that again some day!  I still miss my girlie awfully but I also know she is in a safer place now & no longer riddled with heartworm and I accept I had her light in my life for a short time only, but for a reason.

I  nearly missed my flight home as I messed up my arrival dates .  I thought I was leaving on the 12th for some bizarre reason when really it was the 11th! I discovered that I was to be at the airport  within 3 hours and I was only half packed! I think I lost about 5 kilo’s in the panic that ensued with my mum and me frantically throwing my clothes into the suitcases.  But I did make it - only just!

It is good to be home.  I’m slowly trying to catch up with everything here - my inbox is the usual chaos.

Pete left for Canada today  for a week. But the time will fly by. Meantime I am sorting out life here on domestic levels.

I’m focussed on eating plenty this week. I’ve not weighed myself but let’s just say my clothes are baggy. Again. I am wearing size 10 but size 8 fits me better now.  I ate extremely well in Cape Town so I think the weight loss is due to running around more than anything else. My family here tell me I look a tad too skinny, and I know I am. I’m not panicked as I feel in good health but  I know I  need  to focus on more food, more often. So it is big time eating for this DS girl this week! The good news is I think the zinc supplementation is kicking in as my hair is growing fast again &  my appetite (while not exactly   gargantuan) is at least back. Which makes eating a whole  lot easier. In celebration of a resumed appetite, I am cooking a chicken as we speak with a spicy  marinade and  cauli and potato’s in white sauce plus the good old broccolli.Dessert will be merangues, strawberries and cream. Life on the DS edge is not too bad I can tell you!