Three or so margaritas into the afternoon, we got the bright idea to form a half marathon team in honor of little Zoe and give the proceeds to Arkansas Children’s Hospital (where she had gotten all of her care).  Needless to say, the next morning – in addition to a whopper of a hangover – I now had a commitment to propel my body 13.1 miles forward in space.  How many steps had I run in the previous decade prior to this commitment? Um……none.

But I put on my big girl panties and “trained”.  Sometimes I trained with more vigor, sometimes – like say, the whole month of November – with a lot less.  But I concluded my preparation two weeks before the race with a long “run” of 13.8 miles.  I say “run” because I would slog (slow jog) for two minutes, walk for one, take lots of potty breaks, change the channel…..anything to relieve the “ouch” of the effort.  My time? 3 hours 17 minutes.  Not really good, but the best I thought I could do.  I really wanted to do 2 hours 48 minutes which would be about a 13 minute mile, but I really didn’t see how I would shave a half hour off my time in two weeks so I didn’t worry about reaching that goal too much.

Yesterday, March 7, was the big day.  Half marathon in Little Rock.  Wanna know how I did?  Too bad, ’cause I’m gonna tell ya’ anyway.

2 hours 43 minutes which equals a 12minute 28 second mile. For 13.1 miles!! Five minutes LESS than my “I’ll never be able to do this” goal of 2:48 and about 34 minutes short of my previous “best” effort.

So what did I learn?

(1) Goals: you’ve gotta have goals.  You will never be able to fix what you don’t measure, think about and change.  If my husband (y’all know him as Dr. Hekier) hadn’t pushed me to define what time I wanted to achieve – and what pace per mile I needed to achieve that – then I never would have pushed a little harder on the hills, never would have glanced at anything but the scenery and certainly not at my watch.  If you want to lose weight, define for yourself how much you want to lose and how fast.  Each pound equals 3500 calories.  So how many calories do you need to not eat each day to reach that goal?  A goal you can measure every day or even every meal is realistic to follow and act upon.  A nebulous goal of “I want to be a size 6 by Christmas” doesn’t tell you what to do every time you sit down for a meal.  “I need to eat 400 calories this meal so I can meet my calorie deficit for today to lose one pound this week” is a measurable index.  And if you don’t meet it? Fine, you can meet it the next meal. If your goal is vague you’re much more likely to just give up and not try again next time.

(2)Amazing results don’t only come from amazing effort – sometimes they come from just some effort.  I am not a natural runner.  My legs are short, my endurance is terrible and I tend to stop any activity that starts to hurt.  I can’t tell you how many times I’d stop running and just walk when I got a little winded or tired.  But it didn’t stop me from getting on the treadmill two days later and trying again.  Over 7 months, even these half-hearted efforts made me stronger, faster and more resilient.  You may not want to eat the perfect “in the box” meal each and every day, three times per day.  But just by cutting out the junk – the chips, the sweet tea, the soda, the ice-cream – you will lose weight over time.  The harder you push – the more you stay in the box and the more you exercise- the faster the weight will come off.  But even some effort is better than none at all. 

(3) Be accountable.  I did most of my training by myself which allowed for all of the walk breaks I described earlier.  One reason I kicked tail in the race is because there were a lot of people around me who were exciting and inspiring.  There’s a lot of fun to be had in shared pain (no, really!), a lot of inspiration that comes from seeing someone older/sicker/heavier do something better than you ever could.  But it’s also human nature not to slack off as much when other people are watching you as well as the natural competitive nature that comes from doing something with another person with similar goals.  So many diets fail because we do them alone.  One of the great things about the band is that it gives you a community.  If you go to support group, you can be inspired by others’ achievements, you can get excited by their solutions to problems (e.g. night-time snacking) or if you want, you can find a friend and set up a little competition.  Who can lose the most weight in 4 weeks or who can increase their exercise time the most… or whatever.  And remember, your office visits act as automatic accountability because every 4-6 weeks or so, somebody’s gonna be watching and sending you to the principal’s office if you’re off course.  If that’s not inspiration to straighten up and fly right, I don’t know what is!

(4) Turn to experts-then actually do what they tell you to do.  With my training I did the same thing many bandsters do: I said, “I know, I know”.  I knew I was supposed to gradually increase the distance on my long run every week, I knew I should do some interval speed work on the track to get faster.  But knowing and having a willingness to do something are very, very different.  Speed work hurt, long distances can get boring.  What I wanted to do was sit on the couch and read cheesy novels on my iPhone Kindle app.  But now that I’ve caught the bug, I’m willing to look back at what a really rigorous training program looks like and I’m willing to surrender.  Yes, once per week I’ll go to the track instead of another slow run on the treadmill and I’ll do my long runs when and how they tell me to.  D’you want to lose weight? Stay in the box, eat three meals plus one protein heavy snack per day, take your multivitamin every day and exercise.  Don’t drink with your meals and don’t eat or drink crap.  Do you want to do all that? No.  We repeat it over and over and patients say, “I know, I know” over and over, but until you actually DO it….nothing happens.  I wanna crash and read books, my patients want to drink sweet tea.  We both have to make a choice, which leads me to my last point…..

(5) Success is sweeter than you can even imagine!!  When you really, really, really just don’t want to give up that third slice of pepperoni pizza, stop for just one second and think about your ultimate goal.  I can now tell you from experience that reaching that goal is an absolute slice of pure joy and wonderfulness.  And I’ve got a tangible feeling to carry with me while I train for my next race, even during those dark early morning hours when it’s cold and my nose is running and my ankles hurt.  If you get into a size 6 or 8, then even if you gain a little back, you can hold onto that feeling of goodness that comes with achievement and use it to power your drive to get back there. 

Once you achieve a goal, nobody can ever take that away from you.  If you got to a level of health or fitness or thin-ness that made your toes curl with excitement, then that is who you are.  You are NOT the overweight person you were when you first walked in this office, even if you gain a little back.  You will always and ever after be that person that achieved their goals, you are strong, you are capable but you might have just gotten off course – temporarily.  Let that person be in charge to get you back to where you need to be, not the defeatest person who failed every other diet they ever tried.  I will always be a runner now – because I ran a distance that makes most people shudder.  I wasn’t the fastest, the most graceful, the most challenged – but I was a finisher.  You may never grace the cover of a fashion magazine, but once you lose your weight, you will always be a finisher, too.  If I could, I’d even share my medal with you. Maybe.

But before you take these comments to heart, I want you to consider a few things first.

Remember that people who know you are used to seeing your face a certain way.  They’ve spent years gazing on full cheeks and a round profile.  As you lose weight, you’re not going to look like that anymore.  If they met you for the first time after you had lost weight, they would think you looked perfectly normal and fine.  But since their mental picture of you is with a different amount of fullness to your face, they’re just as inclined to think that it makes you look sick as that it makes you look good.  Not because you do look sick, but because you no longer fit their preconceived portrait of what you should look like (to them).

That’s the most benign explanation.  But of course, there are more insidious reasons that people may want you to feel badly about the weight you’ve lost.  Some may be jealous of the weight you’ve lost (wishing it were them), some may be jealous of the person you’ve become and of the people who now admire your figure.  Friends, spouses, siblings all may get jealous that you’re the cute new thing on the block while they’re still just themselves.  Some people will react to those feelings by putting you down to pump themselves up and make themselves feel better.

It’s this last group I most want you to look out for and avoid reacting to them whenever possible.  Their goals are not in your best interest, and if you let them sabotage your confidence, you’ll never know what you might have achieved.  You look in the mirror – if you like what you see, then don’t worry about the people who try to bring you down.    Trust me, we’ll tell you here in the doctors’ office if we think you’ve lost too much weight (and of course threaten to sit on you and unfill the band a bit, if needed).  Let your own inner voice be your guide, not the misguided or malicious (even if unintended) voices of others.

Weight Loss Surgery Channel and he was gracious enough to have Dr. Keilin and I share our knowledge with his audience.  (Craig is a successful gastric bypass patient from many years ago.)  After our filming session we got to talking and Craig shared his thoughts as a weight loss surgery veteran.  He says in his support groups he asks people who have fallen off the wagon “What was your f— it moment?  At what point did you say, awww f— it, I’m going to have a pint of ice cream.  F— it, I’m going to have that Chocolate Blizzard.”

Ask yourself.  What pushed you over the edge?  Now if you are about to have a F— it moment, stop yourself.

I came very close to having one myself just now.  Some background….  I am training on my indoor rowing machine.  (For some background thoughts on this check out my post from November 2008 : http://blog.noscales.com/best-exercise-for-weight-loss-and-fitness-indoor-rowing-with-xeno-muller.html )

Well, I am planning on competing in an indoor rowing competition in Boston next month, (it’s my mid-life crisis, I just turned 40 ), so I am taking this very seriously and really watching my diet.  I don’t think I’ve had any processed food or white flour in about 3 weeks.  No snacks, nothing.

I am following a strict training plan developed for me by an Olympic champion rower (Xeno Muller from the above post) and I just think I can’t handle the program from an aerobic standpoint.  There are 3 weeks left before my competition and I am freaking out.  In a rare display of frustration, I quit my planned 40 minute row after 25 minutes.   Upset, I came into the house, looked at the fridge and considered getting some junky food.  (Luckily we don’t have too much junk food, just some stuff we allow our daughters to have.)  I came close to saying “F— it.  My exercise sucks.  I am in crappy shape.  I will never reach my goals.  I should just eat an ice cream sandwich.  F— it.”

Well I stopped myself.  Internally I told myself “You are trying to progress.  You are trying to take a step forward.  You are frustrated that you are moving forawrd as quickly as you would like, but having that ice-cream sandwhich won’t help.  It will set you backwards, and make going forwards even harder.”

So I had 3 spoonfuls of low fat cottage cheese.  After I finish this post, I will have an egg-white omelet.  Then I will go to sleep and try for a better day tomorrow.  If you find yourself saying “F— it”, stop yourself.

But then a few weeks pass and dust starts to collect on the parts of the machine that are exposed.  The rest of the machine is of course, covered with clothes.  Suddenly instead of a glorious emblem of fitness, the machine is a convoluted hat-rack.  A very expensive, sometimes guilt inducing hat-rack, at that.

I may just be projecting because this has certainly happened to me with several different pieces of equipment, but I don’t think I’m alone in this.  I’ve talked to lots of people who have bought fitness “stuff” that just ends up sitting around ’til it gets sold in a garage sale at $0.10 on the dollar.

So what to do?  Here are my New Year’s thoughts on actually exercising and using what you’ve got.

1) You’ve got to like exercise before you actually do it.  If you dread it – whatever “it” is – you ain’t gonna do it.  Don’t buy a treadmill because you think using it will make you look like the skinny-Minnie marathoners in the magazines.  Buy a treadmill because you’ve got a stack of movies you’re dying to see and getting on the treadmill will allow you 30+ minutes every day to watch them.  Or better yet, because walking/jogging/running gives you a hit of endorphins that makes your whole day great!  We just got this slippy-slide thing that lets you mimic speed skating in your living room.  It’s a blast, so we use it.  But a stationary bike? Not my speed, so never had one.  Makes my behind sore.  But I’ve got patients that swear by them.

2) You’ve made your choice, now work it! You found something you like – so do it.  You can’t just go through the motions, tho’, you’ve got to actually sweat.  Are you an outdoors person and enjoy walking? Groovy – but 30-40 minute miles while chatting with a friend is called “strolling” not exercising.  If you’re a walker, pump those arms, move those legs, get some huffing and puffing going.  Here is a link to a program that will take you from barely able to walk out the front door to running (ok, slogging, but still!) a 5K. You can do it! http://www.c25k.com/

3) Speaking of intensity, here is one of the great fat burning programs of all times and it will accomodate anyone from the least to most fit, from the idle rich to hardworking folks with no extra time.  It’s called HIIT and it goes like this: warm up for 5 minutes, then for 15-30 sec exercise all out doing whatever you’ve chosen to do (run, swim, walk, jumping jacks, skipping, squats-whatever!), then go back to a restful, relaxed pace for 2-4 times that length of time, then repeat a few times.  For example, you run all out for 15 seconds, walk slowly for 45 seconds to catch your breath and let your  heart rate come down, then you repeat this cycle 10 more times, then cool down for 5 minutes.  Total time: 21 minutes.  For some people, the “all out” phase may be walking briskly, and the rest interval may need to be 5-6 times the length of the high intensity interval in order to do it again.  But you’ll find by doing this several times per week, that you’ll soon expand your exercise tolerance dramatically. Knees hurt too much to do this? Try doing it by tossing a basketball in the air or throwing it hard onto pavement instead.  There are all kinds of upper body-only exercises that will allow you to raise your heart rate in the high intensity phase.

Now get moving!

But let me tell you, starting all at once (with every change that you might need to make) can be a Herculean task (can you tell I signed up for a word-a-day email? herculean means something that would take the strength of Hercules to overcome).  Not even Lance Armstrong could step out his front door one day and run a marathon.  He would have to start with short runs and gradually build up to longer more extensive training as he got stronger.

What does this have to do with you? It’s extremely hard to change all of your habits in one fell swoop.  What would I like to see in an ideal world? I’d like to see all my patients exercise 5 hours per week, I’d like to see 80+% of your meals be within the box and I’d like to see everyone lose 1-2 pounds a week until they reached their goal. 

But Hekier and I just started a new nutrition program ourselves and making all of the changes above would be well nigh impossible given how hard it is for us just to make some minor adjustments in an already healthy lifestyle.  We’re trying to really focus on cutting out “carbs” (e.g. bread, rice, pasta) and focus on fruits and vegetables instead.  Just one little difference, and boy-howdy….. it’s tough!!  And when you don’t succeed it’s really tempting to just give up.  “Well, I already cheated with some toast, might as well just have rice with dinner.”

So my tips for getting started and staying on track-based on recent personal experience-are:

prepare, prepare, prepare: plan out your menu for the week, shop for everything you need, make as much as you can in one day so you don’t spend every day in the kitchen for hours.  Always bring your lunch/snack/dinner with you to work, never leave it to chance to figure out what you’re going to eat

Do a mental clean-up: get rid of any thoughts of who you “used” to be, of what you used to be able to wear or how long you used to be able to exercise.  Figure out where you are NOW, and then celebrate every success, no matter how small.  Doesn’t matter what was, only what is and what will be.

Get your posse behind you: want to start walking on the track? Great! Bring your children and let them run around on the grass in the middle of the track while you walk.  Or even better, let them roller-skate/bike/skateboard on the streets while you run/walk along with them.  Make your spouse vow to eat healthier with you.  Get some friends to join you in signing up for a 5K walk and train together.  The more people you have supporting you, the better you are likely to do.

“Just Do It”: there are lots of times I just don’t want to exercise but I promise myself I can quit after 5 minutes if I’m still not in the mood.  Know what? In the last 10 years, I’ve only quit once.  Once you’ve started, you’ll keep going 99.9% of the time.  If you can just start, you’ll finish.  But if you never start…… you’ll never finish.

OK, so I don’t know what to write about today, I’m having a little writer’s block.  But then again, I think of things to talk about every day that would be a help or provide a little encouragement or support.  Since I’m having trouble remembering any of them right now, I could just say, “I’m too tired to think about it today so I will do it tomorrow”. If I really want to rationalize my way out of writing a post,  I could do so by saying “writing a blog just isn’t part of my job description and I didn’t ask for it anyway!”  But then I start thinking ”writing posts is something I really LOVE doing” and once my mind starts going it’s usually hard to reign it in.

Anyone out there see a pattern here??  Those are all excuses for not doing something I really WANT to do!  People do it every day…..take
more time to figure out the reason they aren’t going to do something or spend more brain power trying to figure out how to get out of something
that they really want in the end.  The point is…..YOU ARE NOT EVER GOING TO GET RESULTS WITHOUT SOME SORT OF EFFORT!  It is imperative that for once in your crazy, busy, stressed out, complicated life you take time for YOU…..to learn how to do right by your band so it does right for you.  If you don’t, then bottom line is that your busy, stressed out complicated life will be potentially shortened due to a controllable illness that you just couldn’t take the time out to prevent. Conditions directly related to obesity include but are not limited to Diabetes, High Blood Pressure, Heart Disease, Stroke, Sleep Apnea, Musculoskeletal disease ie: back fusions, knee replacements…etc.

There comes a time in your life when you have the opportunity to take charge and choose to turn things around.  You already did that….you
had weight loss surgery. But having this doesn’t make you an instant genius.  It takes work and education, trial and error.  You may be on
your own in making the decision of what to choose to put in your body, but you are not on your own when it comes to learning what appropriate
choices are. And best of all…..its free!!!—-meet me at Wadley the second Monday of EVERY month at 7pm……Lori

Let’s give the docs a break from writing for a few days and let all of you have the floor.  Now this isn’t going to be the mushy I’m thankful for my family and friends kind of thing.  We all will just take it as a given that if you have them you are thankful for them.  This is a I’m thankful for whatever it is weight loss surgery gave you back or did for you.  I think in this type of forum you can help people to see that even the little things are important.

I will start it off…….I am thankful for the experience it gave me.  I never thought I would end up in a job helping those that are going through the same type of journey.  Life has a way of preparing you for things that you aren’t even aware of.  I became a nurse because of the way I was treated after my surgery.  Just because I “chose to do it to myself” (have weight loss surgery) was no reason to leave me walk the hallway alone or tell me I just needed to push the button again because I needed more pain medication for a “person my size” (anesthesia confirmed the morning after that my epidural had slipped out and I was receiving no medication post op).  At that time weight loss surgery was not as common as it is today and no I did not have my surgery in Texarkana as they did not do it here at the time.   After that hospital stay it gave me the strength to start college…..2 weeks later…and fulfill my dream of becoming a nurse…..4 years later!  I vow to you….you will not walk alone unless you choose that path.—meet me at Wadley December 14th at 7pm—–Lori

Give the docs a break from writing for a few days and let all of you have the floor.  Now this isn’t going to be the mushy I’m thankful for my family and friends kind of thing.  We all will just take it as a given that if you have them you are thankful for them.  This is a I’m thankful for whatever it is weight loss surgery gave you back or did for you.  I think in this type of forum you can help people to see that even the little things are important.

I will start it off…….I am thankful for the experience it gave me.  I never thought I would end up in a job helping those that are going through the same type of journey.  Life has a way of preparing you for things that you aren’t even aware of.  I became a nurse because of the way I was treated after my surgery.  Just because I “chose to do it to myself” (have weight loss surgery) was no reason to leave me walk the hallway alone or tell me I just needed to push the button again because I needed more pain medication for a “person my size” (anesthesia confirmed the morning after that my epidural had slipped out and I was receiving no medication post op). 

At that time weight loss surgery was not as common as it is today and no I did not have my surgery in Texarkana as they did not do it here at the time.   After that hospital stay it gave me the strength to start college…..2 weeks later…and fulfill my dream of becoming a nurse…..4 years later!  I vow to you….you will not walk alone unless you choose that path.—meet me at Wadley December 14th at 7pm—–Lori

While I don’t mind doing this a lot of the time, I would much rather teach everyone how to fish instead of just giving them a fish (as it were).  My favorite method of diet education is not, “make this smoothie in the morning, eat this salad at lunch, then finish the day with….” but more, “these kinds of food are good for you, these methods of preparation are calorie dense and therefore poor choices….” etc.  I write these blog posts to help guide people’s eating choices by using solid, healthy nuritional tips.  But I can’t account for differences in taste or particular challenges faced with eating some foods like amount of restriction, lack of access to a variety at the grocery store or lack of cooking skills.

Here’s one example: porcini mushrooms (you know those big, umbrella sized mushrooms?) make great substitutions for steak – you can grill’em, you can lightly brown them in a pan – and they have a  lot fewer calories and shouldn’t present as much of a challenge as steak would to a bandster.  But you know what? I hate, HATE mushrooms.  Can’t stand’em, don’t like the look/smell/texture/taste of them.  So a diet where you had to eat lots of mushrooms all the time would be a terrible fit for me.

All of you have specific likes and dis-likes, foods that go down easily and things that cause a PB as soon as you swallow them.  So I want to help you learn to navigate the supermarket, the restaurant menu and your own pantry, not dictate precisely what you can and can’t eat.  My bandsters that navigate by general principles lose weight without trying too hard.  They just make good choices (sometimes without even counting the calories) and by following the general rules, the pounds melt away.

So what are some of the biggest rules?

Don’t drink your calories (they run right through the band, won’t fill you up and will cause an insulin spike leaving you hungry an hour later)

Avoid anything and everything fried

Eat protein at every meal

Avoid empty carbohydrate-dense calories like white breads, chips, crackers, white rice and stuffing.  Substitute nutrient dense carbs like fruits and veggies

Don’t graze! Eat three meals per day and a protein snack if needed in the afternoon.

Don’t skip breakfast!

NO SWEET TEA!!!!!!

Learn to read nutrition labels so you can start to figure out where some diet saboteurs reside in your food choices

Peanut butter is not a good protein source (but is a great treat)

Avoid dessert in the form of cookies/cakes/candies.  Do start making a piece of super-ripe fruit your go-to dessert choice.

And biggest of all for banded patients: don’t drink with your meals or for at least 30 minutes after your meals. You’ll defeat the whole purpose of the band and it won’t help you with staying satisfied with small portions.

Write a comment and tell me some of YOUR basic rules.  I’m always looking to pass on good suggestions

Where are you….we miss you….and we want you to finish what you started!!  I have been to several health fairs and have come into contact with MANY people that have the band….. a few who still have some to lose…..many that have reached their goal. I say…..COME SEE US!!!!!! I had one person tell me they were embarrassed to go back because they had felt like they had not lost enough……all the more reason to come in for a fill. It’s a surgically implanted tool…YOU have control of the tool!!  I’ve had a couple that said they knew they had about 50 more to lose but they were “satisfied” now…..only to keep talking and find out they were a cash pay and economics would not allow them to come in……..call and talk to Susan….you never know what can happen until you try.  I’ve seen many that have reached their goal…..COME SHOW US!!!!

You LAP BAND patients are the best way we have of getting the word out about the Lap Band….there are so many people that only get to DREAM of having this surgery.  We want you more than satisfied….we want you happy, healthy and fulfilled.  We have the monthly support groups to assist you with just about any issue you can imagine…..short of getting your kid a date for the prom or taking care of your dog while you are away…..although that could be arranged (the dog not the prom).  Please do not let issues go unspoken.  Together we can find a way!!

On the other hand….if you are happy healthy and fulfilled at your goal or even with a little excess I say…Strut your stuff baby and tell them where you got it!!!! Just don’t forget to keep in touch….I just love going  “OMG YOU LOOK FABULOUS!!!!”—Meet me at Wadley November 9th at 7pm for support group—LoriWh