Allowing a little food

I'm a few days away from my surgery. I cannot live on liquids alone pre-op (I've done this a couple of times before, remember?) so I allow myself a piece of grilled chicken and a little Bibb lettuce once a day. I'll be doing all clear liquids the day before. But this was dinner:

How did I get here?

Where's my beautiful house?

I wonder all the time - how did I get here? Almost four years ago, I was banded. I was so hopeful. So determined. So.. naive.

After more than three years of eating more than I should one day and puking my guts out the next, I was genuinely worried. I had over a hundred adjustments on my band. I had two under fluoroscopy. No leaks, no slippages, no ulcers. Just weird fluctuations that never caused me to have the same day twice. It was infuriating and exhausting, not to mention disheartening.

I did research, as I tend to do, and decided to get rid of my band. There goes $20k, of course.. since I paid cash for my band (my insurance at the time was deplorable). No matter. Lessons learned. Besides, my band was the first and only tool I've used in my nearly 30 years on earth to lose and keep off 70lbs. That was the most weight loss my poor body had ever seen.

What I decided to do once my band was out was a whole other discussion.

Gearing up

I went to whole foods today. On liquids and feeling shite. Bought some organic chicken and this:

I'm still alive..

Update coming soon.

State probes weight-loss surgery deaths at NYU

State probes weight-loss surgery deaths at NYU: "

NEW YORK POST

State probes weight-loss deaths at NYU

By JOSEPH GOLDSTEIN

June 13, 2010

The state is investigating NYU Medical Center’s booming weight-loss surgery practice, after three patients perished — including a young lawyer who may have died of thirst — following bariatric procedures, the Post has learned.

Drs. George Fielding and Christine Ren-Fielding, the glamorous husband-and-wife team in charge of the NYU unit, pioneered lap-band surgery — in which a silicone band is looped around the stomach — and performed it on Jet coach Rex Ryan.

“We’re investigating the entire bariatric program” at NYU, said state Health Department spokesman Jeffrey Hammond.

The probe began within the last two weeks following complaints from ex-patients, a source said. The Post exposed new malpractice allegations against the Fieldings last week.

Weight-loss surgery is under scrutiny in New York, and new dangers are being alleged in litigation, including:

* At least six malpractice claims against the Fieldings — one brought by ex-Met Lee Mazzilli, after his teenage daughter was hospitalized with stomach “perforations.”

* 15 lawsuits against gastric-bypass surgeon Elliot Goodman at Manhattan’s Beth Israel Medical Center in five years.

* Allegations that a Westchester hospital hid the weight of a patient — who later died — to qualify her for surgery.

Even as the feds consider making weight-loss surgery more accessible — with lap bands for teens and patients on the cusp of obesity — long-term risks are only now coming to light, nine years after FDA approval.

“The long-term risk of the band may be as high as 25 percent,” said Dr. Paresh Shah, a surgeon at Lenox Hill Hospital.

Studies show the death rate for bariatric surgery is under 2 percent, but the research rarely accounts for deaths from complications after 30 days.

Christine Ren-Fielding admitted in an academic article that because some patients die months afterward, “the incidence of bariatric deaths in New York City is practically unknowable for us.”

“After the surgery, [doctors] just sort of wipe their hands,” said Lara Quatinetz, whose sister, Rebecca, 27, was found dead in her Stuyvesant Town apartment two months after NYU gave her a lap band in May 2008.

The young lawyer, who wanted to lose weight she’d gained while studying for the bar, couldn’t swallow food or water for days on end, lawyer Howard Wexler claimed.

He claimed the band was cinched so tight — despite adjustments made during six post-op visits — that solids and liquids did not reach her stomach.

The Fieldings didn’t respond to requests for comment, but George Fielding has claimed his NYU Program for Surgical Weight Loss, which operates on almost 1,000 patients annually, has “the lowest death rate in the world, in the history of bariatric surgery.”

The Fieldings “are incredibly competent surgeons,” Lenox Hill surgeon Mitchell Roslin said. “I would let either of them operate on me.”

Bariatric procedures — which are advertised in city subways and take as little as 20 minutes to perform — are big moneymakers. NYU billed Rebecca Quatinetz more than $26,000. Surgeons say their cut is often around $4,000.

Critics worry greed has led to surgeries on patients with less-than-severe weight problems.

Joan Delango said that one clinic told her daughter, Danielle, that she didn’t need a lap band but that Danielle, 25, got one at Lawrence Hospital Center in Westchester in 2008. Six weeks later, she died after collapsing in her bathroom, said Delango, who has filed a suit.

At the time of her death, Danielle weighed just 156 pounds, Delango said. Delango alleges that Danielle was listed as being shorter and fatter than she was so the surgery looked better to insurers and regulators.

On Danielle’s presurgery form — which the Post obtained — a doctor wrote, “Do not weigh patient.”

“I believe they changed her height and her weight to change her ideal numbers,” Delango said. “Why else would you not want to weigh her?”

"

post-bar weighin

318.6

more later.

You in 10 words

My therapist challenged me this week to come up with words I want people to think of me when they meet me. It's a project designed to understand the kind of image I project to the world. I've often felt that people don't take me seriously, or that I am ignored, or that I am assumed to be stupid.

Coming up with this list is difficult. It's been on my mind all week. The interesting thing is that every time I think about it, the first item on my list always relates to intelligence. Interesting.

Here's my list of ten descriptive words I want people to think of me when they meet me:

1. Smart
2. Funny
3. Pretty
4. Fun
5. Contagious (as in, they want to be around me)
6. Leader
7. Follower/Joiner
8. Happy
9. Stylish
10. Engaging

I think this list will be tweaked.. this is my first attempt at getting it out of my head. We'll see.

Visit to the Nutritionist

Well, she calls herself a Bariatric Dietician. She's very nice.

I met with her today to 'fess up my eating sins and get some advice for getting back on track. She wanted to know what a normal day for me is like, eating-wise. I told her my current lifestyle includes 24oz (wow, didn't realize that!) of coffee with 2TB of sugar and coffeemate to taste (holy sugar) for breakfast. She told me coffee =/= breakfast! Bad girl.

I also told her about my current meal plan.. which isn't really a plan. I'm not really hungry until after 1:30 or 2:00pm. I have been going to Saladworks and creating a salad that is comprised of romaine mix, hardboiled eggs, tomatoes, breaded honey barbecue chicken, cucumbers, bacon bits, and full-fat ranch dressing. It sounds very high in calories, but according to the Saladworks website, my creation only costs about 350 calories. 22 grams of fat, but still. I've tried the low-fat salad dressings, but they make me very sick. Bad for the gut, let's just say.

I sometimes eat the roll afterwards. It takes about an hour to eat. I also get a 20oz fountain pepsi to go with, but I drink that at least 2-3 hours later. I also may have another can of coke in class, along with peanut m&ms I have in my bag. Horrible eating, just horrible.

A few times after my class lets out, I've gone to taco bell and ordered 2 chalupas and 1 taco supreme. I eat all of it. It takes an hour, but I eat all of it.

It sounds like a lot of food. That's because it is. It sounds terribly unhealthy. That's because it is.

What about water? No water. Zilch. Coffee and soda are my fluids. I know I'm horribly off-track.

So we came up with a plan.

• Eat breakfast. Even if all I can get down in the morning is a protein shake. I need to start to get my metabolism going so it goes all day. My bod has been in starvation mode due to the one or two large meals a day. Huh!
• Keep a food diary. Bring it with me to appointments.
• WATER! Crystal Light COUNTS!
• Aim for at least 64 grams of protein a day. I've been slacking.
• Try to eat meals that are around 1 cup of food. Salads can be a little more because the veg breaks down. But, one cup.
• Exercise for at least 15 minutes a day. Walk! Wii!
• Eat snacks when I'm hungry (or on a schedule - whatever we find works best for me)
• If I go to saladworks, no bacon, no breaded chicken. Grilled chicken and carrots for a more colorful salad. Also, split the salad into 2 meals (ask for dressing on the side so the second meal later doesn't get soggy)
• Smaller, more frequent meals instead of one or two big meals
• Replace the m&ms with something like the FiberOne bars that I love to eat. They really are quite tasty.
• Use a measuring cup to know what 1cup is
• Eat more tuna - I can safely have 2-3 servings a week
• If I want taco bell or some other meal at night, try a protein shake instead
• Eat more whole grains - oatmeal, whole grain crackers, whole wheat pasta w/veggies - all good stuff
• My plate should be comprised of 1/2 protein, 1/4 veg, 1/4 grains

I have work to do! I start journaling tomorrow. Baby steps...

Soo..

Grades are officially out and I'm OFFICIALLY a law school graduate!

I'm knee-deep in bar exam prep now. Only a few weeks before the bar! Yeesh.

Saw the Doc today.. he wanted to take out 0.1cc and I wanted to add 0.1cc. We talked about my eating habits - I was concerned that I'm taking too long to eat, and therefore can eat more. I noticed yesterday that I finished an entire salad from the salad joint (big, huge thing) - but it took an hour. I asked him how much time to put on a stopwatch.

He said his concern was more that I was trying to choose foods I knew would go down easily rather than choosing denser, protein-rich foods first (like eating the chicken out of my salad first) and then I'd be fuller faster. He also wasn't concerned that I ate an entire salad (veg is good!) but if I was taking an hour to eat, say, mashed potatoes, however, he'd be more concerned.

According to his scale, I weighed 319. I know I'm 315 at home. Nonetheless, I was 326 the last time I saw him.

I let him take out 0.1cc and I see him again in a month. We'll see.

I'm also going to start playing with my Wii Fit again.. I promise. I PROMISE!

They have a new nutritionist at the clinic, though.. I made an appointment to see her tomorrow. I'm going to be honest and tell her what I eat and get some pointers.

Did you follow me on twitter yet? Huh? Check the link on the sidebar! --> right over there! -->

TWITTER!

I'm finally on Twitter! Well, for this purpose, anyway..

Come follow me!

www.twitter.com/55percentoff