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April 2006 posts

Fetal Fun!

I love the midwives. They're being quite proactive with me, one hundred percent more than the OB/GYN I saw at my PCP's office.  I have to go in tommmorrow for some repeat testing for something that came up in my screening.  Then, in a week, the blood docs, and another prenatal.  I assume at this point that I will get shots to up my iron levels - because I don't think the vitamins nor eating real food is helping.  If shots don't help, I'm in for some fun.  The positive, we're nearly at the deductible for the health insurance to kick in at one hundred percent with these tests coming up.

Is Obesity More Damaging Than Inactivity?

From Novartis:

Is Obesity More Damaging Than Inactivity?

Which poses the greatest danger to people with regard to coronary heart disease obesity or inactivity?


Both are obviously important, but which is the real culprit? A new study reported in the journal Circulation has attempted to find the answer. Judge for yourself if they were successful. Here's a summary of their findings.

What was done

Researchers at Harvard examined data from more than 88,000 women who were enrolled in the Nurses' Health Study. They were followed for up to 20 years from their enrollment, at which time they were free of cardiovascular disease and cancer. On entry they had full examinations, including body fat measurement, waist measurement, and waist-to-hip ratios. Every two years the women completed a questionnaire about their medical history and lifestyle. Those who exercised 3½ hours a week or more were considered physically active, and those exercising less than an hour a week were classified as sedentary. A BMI of less than 25 was considered 'lean' while those with a BMI over 30 were classified as 'obese'. All major coronary events (including nonfatal myocardial infarction and fatal coronary heart disease) were recorded. Based on data from the patients with coronary events, the relative risks for such an event for the four classes of subjects were calculated.

What was found

There were 889 cases of fatal coronary heart disease and 1469 nonfatal heart attacks in the whole population. Eighteen percent of the participants were classified as lean and active; using their risk as a standard (set as 1.0), the relative risks for the other classes are shown in the table:

Lean (BMI below 25)Obese (BMI over 30)
Active (3.5 hrs a week) 1.0 (standard) 2.48
Sedentary 1.48 3.44

It can be seen that while the risk for a cardiac event is increased by inactivity 1.48 times, obesity increases the risk by 2½ times if the subject is active, and almost 3½ times if the subject is inactive. Further evidence of the predominant role of obesity came from examining the role of the waist-to-hip ratios. The risk for a coronary heart disease event was greatest for those women who were sedentary and had the largest waist-to-hip ratios. Smoking also played a major role. Sedentary obese subjects who smoked were found to have the greatest risk for an event compared to lean, active non-smokers over 9 times greater, in fact.

What this means

We've published other articles that seem to indicate that 'fat but fit' is not too serious. The findings here belie this concept. The results of this study show clearly that obesity carries a considerably greater risk for a harmful cardiovascular event than inactivity. Dr Frank Wu, the principal investigator, has stated "the harmful effects of obesity cannot be completely offset by increased physical activity." The waist-to-hip results suggest that abdominal obesity is the problem. Abdominal fat leads to fat cells that secrete increased numbers of cytokines, which can lead to insulin resistance (and then type 2 diabetes) and inflammation, both of which are associated with the development of coronary artery disease. The data from smoking just adds to the information already available on the risks of this habit. The 'take-away message' from this work is the need to continue to try to keep relatively lean, and to exercise as well. And, of course, to be a non-smoker."

Source:  Novartis Nutrition.

Tuesday, April 25th is Free Cone Day at Ben & Jerry's, and you know what that means... free ice cream for you!

Because you might still have a normal digestive system:

"Tuesday, April 25th is Free Cone Day at Ben & Jerry's, and you know what that means... free ice cream for you! As a way to thank our customers for their support and to celebrate 28 years of scooping the chunkiest, funkiest ice cream, frozen yogurt and sorbet, Ben & Jerry's scoop shops are giving it away!

Around the world, scoop shops are opening their doors from noon to 8:00 pm, to serve up a free scoop of your favorite flavor (or better yet, a new one you've been wanting to try, like Turtle Soup™, Peanut Butter Swirl or Lemonade Sorbet).

So grab a pal and come on down to have some 'scream on us!
Like we said... Oh Happy Day!"

G'head.  Go.  Don't bring me any.  Though this is bringing back fond memories of the Ben & Jerry's factory visits with the little sampler cups.  Mmmmm, Cherry Garcia...  My favorite flavor was New York Supa Fudge, uhh, CHUNK.  I want to say that might be THE fattiest flavor. "New York Super Fudge Chunk® - Chocolate Ice Cream with White & Dark Fudge Chunks, Pecans, Walnuts & Fudge Covered Almonds."  Oh, the days of ice cream without puking!  Now this:  Baklava flavored ice cream!  OH MY GAWD.  I must click the little X at the top of the screen.

Support. Hose.

I got a prescription for support hosiery today.  How exciting is this?  I asked the midwife what I should do about my poor legs, and she wrote me a prescription for support hose.  She says most folks don't want to wear them because they're terribly uncomfortable and hot.

She's also sending me to a Hematologist regarding my blood (lack thereof) issues for testing.  I'm not an expert, but they say that if your levels are initially low in pregnancy, it's not like they go back up, you can basically just maintain or go lower.  My blood was tested in February, when I was about a minute pregnant - and I had low levels of many things, so it can only be worse now since I feel like pure poop.  The MW also wrote me a note restricting my work hours to no more than eight hours in a shift.  I know that doesn't sound any different, but I do ten hour shifts generally.  Eight hours will become less I'm sure, since I don't think I'm going to feel any better than I currently do from this point forward, and I'm not functioning anywhere near normal.  I'll probably end up phasing into purely part time hours until the birth, and then, who knows what will occur after that time. 

It seems as of right now, that I might have to actually stay at home again.  My preschool attends a sliding-fee program, and we have to reapply with my income, we might not qualify for an affordable weekly fee anymore.  If the fee goes up, I can't afford to send her to school so I can work.  That, and the costs of sending an teensy tiny infant to daycare along with her in full time preschool would be astronomical.  So, it seems I might have to be home again.  Working nights makes me want to tear my fingernails out - I am asleep by 9-10pm.  I don't even want to think about that now.  It's going to sneak up on us though.  I've got have have a plan in six months.

Midwife Appointment.

Tommorrow marks 13 weeks, and I finally have an appointment with my midwife.  (Since I quit the obstetrician.)  I haven't seen her since my daughters' birth four years ago - I swore I'd never see her again in this capacity.  (Yeah.)  I'd like to have her get some fresh bloodwork done, since my levels were not good last time, and it's been quite a while.  I'm hoping to also get an ultrasound scheduled at 16 weeks or after, which is pretty average for a little peek at the baby's gender.


Just because you're jealous.

Because, I have a lingering odor of vomit in my house, and I can't find it.  The boy child was cured as of yesterday morning, and we took him out last night after a couple days in the house.  Mistake.  He got very sick last night after dinner.  I sent him to bed with two buckets, towels laid on the floor, on top of a trash bag under the buckets and towels.  Thankfully, that was it for the cookie tossing.  As for me, seems that most everything I eat makes me dump or sick anyways, so I have to live with it.  I ate a few tortilla pieces and salad (salad = death) out last night, and had to stop on the side of the road to retch on the ride home.  My daughter was mortified, and I had to explain to her that "This is what happens to me when there's a baby growing, because I never know what will make me feel badly if I eat it."  She's a good food cop, though, and warns me when I grab a cookie or something, "Mama, you know that's going to make you sick."  But, she can't tell know, because it's not just sugar anymore, it's everything.

Just because a little vomit wasn't enough.

The sickness I had the other day has moved on to a child, who I'm particularly glad we allowed to have chocolate ice cream before bed last night.  Oh, the mess.  I was gagging in bed, trying to cover my ears while Dad dealt with his sickness.  Dad's on vacation - and how nice, right?  I am certain he's going to get it himself the morning he's to go back to work.  The other kids will get it too, probably when it's time to get back to school, just to mix it up and keep things fun. 

As they get sick, I still feel like dirt myself.  It's becoming difficult to choose what to eat - because things that never made me sick are now making me feel horrible.  Right now, I'm physically ill from eating "salad" which consisted of lettuce and a slight bit of dressing.  When I get hungry, I'm starting to dread the choices of food, since I never know what is going to make me feel bad, either with an actual dumping session, or the intense discomfort of not digesting like this.  Things that didn't bother me previously are bugging me now.  I'm absolutely horrified of my cottage cheese.  The cat has gotten his share of my uneaten cheese.  Breakfasts have consisted of mainly ham, or turkey, just a taste, hoping it stays down before I leave the house.  Then, I'll get a breakfast sandwich with just ham and cheese and pick at it for hours.  With working while pregnant and miserable in conjunction with still having no freaking kitchen, I'm eating whatever I can that is portable and hoping it doesn't cause a major upset.  I've gone to work with a baggie of pickles.  And, lots and lots of rolled up chicken or turkey breast.  Most days, I end up eating bits and chunks of things "from the salad bar" - that don't really make a salad.  Last time it was a piece of stuffed grape leaf, a few chick peas, two black olives, a spoon of feta cheese, cucumber slices, red peppers and ham shreds.  If eaten slowly enough, I don't get sick, even with fresh veggies.  I can't stand the inconsistency of it though, because just now, lettuce = the bowel death.  Last night, I had the intense over-full from a slice of pork, which I made the mistake of eating a bite of rice with.  The night before, intense dumping that made me fall asleep and writhe in discomfort. Coffee, amazingly, no longer loves me.  I'll order an small iced coffee, but after a few sips, it's dishwater to me.  I suppose that's the one positive nutritional habit I've gained in the past few weeks. 

Paying for public school?

"Parents have until Tuesday, May 9 to put their child's name in a lottery for a start-up program that offers full-day kindergarten. Tuition for the full day program is $3,500. There will be about 66 openings.  The full day kindergarten program will begin in September. Students will be chosen from a lottery system for the new program which has been under study this year by the school committee. The board approved the full day option at its last meeting. Names will be chosen by lottery on May 10 at each of the elementary schools. Parents will be notified by May 11. Families that receive government assistance may be eligible for a reduction in tuition or a waiver of payment.
Students not chosen by lottery will be considered for spots outside their neighborhood school district if there are openings at those schools."

Now, I replied to a survey regarding this, since I have a child entering kindergarten the year after next.  She's already in a full-time preschool program because I work full-time.  I expressed my opinion that I agree with having full-day kindergarten, since I'm already going to need after-school care, and it would really help to have her on the same schedule as the big kids, and to go to the same after-school care.  I hope that by 2007 they've got a system better than a lottery, because not everyone needs the full-time slots, and I find that unfair.  I'd like to see the spots used on a need basis first, if they are going to be so limited, even at a cost of $3500.00.  It's going to be very expensive for this family in 2007.

Sick of being sick.

Yesterday I went to work, feeling slightly yucky.  As the day progressed, I got yuckier.  I kept reminding myself, it's got to be "morning sickness" which in generally effects me all day long for nine full months every single time.  I told my coworkers that I was just pregnant and having a particularly bad belly day, but I'd deal with it.  I ended up running to the bathroom five or six times just hoping I could just throw up, but it wasn't going to come from that end.  Again, I blame the gastric bypass for the reversal of the nausea - vomit chain.  I still get nauseous, don't throw up, then nearly crap my pants EVERY single time I get a virus.  I assume now since I've felt like literal crap for two days that this is yet another virus, and not a pregnancy related problem.  I came home last night at 6:3opm, tried to sleep, got up and watched as much of American Idol as I could take minus the food commercials (DAMN YOU FRESH-SOMETHING SANDWICHES!!) and then got sick with House - and went to bed.  I woke up sick all night, and at 6:30am I had to decide if I could make it out of the house.  I've already missed two full days due to a stomach virus at work, and left last night an hour early, so I dragged my sorry butt in to the training this morning and prayed to the toilet gods that I wouldn't explode in the car on the way to the class.  Once there, I felt "okay", and only felt the urge to run madly to the bathroom three or four times, and didn't throw up.  I got distracted with nausea on the way home and inadvertantly took a scenic route.  I still feel gross in general, and this must go away, I'm not functioning well like this, and I'm getting very cranky.  So, don't piss me off.

:digs self out of pile of plastic grass and chocolate in various forms::

Early yesterday morning, I woke up egg-stra early (ha-ha, right?) and made like a good bunny and inadvertantly woke a few children up. My oldest decided to let the others know, "Psst, wake up, the Eastah Bunny came!" They ran down around the house, finding all the plastic eggs that came magically pre-filled, and then to their goodies. After dumping the contents of their various buckets, the little (big) one gave us a fashion show.

Bucket head.

C got a Peep'ed out bucket, and was perfectly thrilled with that, she's a collector of Peeps in various forms. 


Then, after a nice Sunday drive, we went to the in-laws house for a sick egg hunt.  There had to be a hundred eggs in the yard.

Where is it?

Easter Candy

Favorite Candy

If that wasn't enough sugar, we also celebrated the boy's birthday. He's now, like, all growed up and stuff.

New hat.

SPD Cake

Looking down

"Counseling Bariatric Surgery Patients"

An article by Dan Orzech "Social Work Today"

"More and more obese Americans are going under the knife to lose weight. Bariatric surgery—the medical term for weight-loss surgery—is growing dramatically in popularity in the United States as increasing numbers of people struggle to lose large amounts of weight.

Surgically shrinking the size of your stomach will definitely make you lose weight. But according to social workers, doctors, and others who work with people who are significantly overweight, bariatric surgery alone will not necessarily enable people to keep the weight off.

Nor will it necessarily make them happy. “We see a lot of clients who believe that all of their problems are based on their weight, and that once they lose weight, their quality of life is going to improve,” says Julie Latimer-Spears, LCSW, team leader of the obesity program at Resources for Living, an Austin, TX-based behavioral wellness organization that works with weight-loss patients. “It’s a common misconception that this is a magic bullet, that if they get the surgery everything is going to be better.”

While weight-loss surgery has been around for nearly 50 years, it only began to be accepted by the medical mainstream in the late 1990s. Until then, says John Pilcher, MD, FACS, a bariatric surgeon in San Antonio who does more than 150 weight-loss surgeries per year, “it was kind of like black magic.” Today, it’s a well-accepted medical procedure.

The psychosocial issues surrounding the surgery, however, have not received the same amount of attention as the medical aspects. “The emotional support issues and psychological aspects of the surgery have been recognized,” says Pilcher, “but they haven’t been well addressed. There’s decent research on the surgical techniques today, but there’s very little on the mental health aspects.”

An Epidemic of Obesity
The past 20 years have seen what the Centers for Disease Control and Prevention (CDC) call “a dramatic increase” in obesity—what many health officials are starting to call an obesity epidemic. CDC research, according to the nonprofit American Obesity association, has found that some 9 million Americans, or 4.7% of the population, are morbidly obese. That’s jumped from 2.9% of the population in 1994.

Morbid obesity, also called clinically severe or extreme obesity, is defined as having a body mass index of 40 or more, which typically translates to 100 pounds or more of excess body weight. That much extra weight increases the risk of a host of medical problems, including type 2 diabetes, breast, prostate and colon cancer, gallbladder problems, sleep apnea, stroke, and heart disease.

In a society obsessed with being thin, people who are severely overweight are often socially stigmatized and subject to discrimination in the workplace or school.

As surgeons have gained experience with techniques such as gastric bypass, which uses surgical staples to shrink the stomach, or gastric banding, where the stomach is surrounded by a plastic band, and laparoscopic surgery has minimized the size of the incision, more and more morbidly obese people have turned to surgery to help them lose weight.

The number of weight-loss operations has grown dramatically, from roughly 18,000 per year a decade ago to more than 170,000 today, according to the American Society for Bariatric Surgery.

The well-publicized bariatric surgery experiences of celebrities, such as singer Carnie Wilson and New York City TV personality Al Roker have also helped make the procedure more popular.

But many weight-loss patients, according to experts in the field, are not prepared for the amount of work involved in the process of losing weight after surgery, or for the changes that it may bring to their lives.

With gastric bypass—the most common surgical procedure—for example, “your stomach goes from the size of a fist, to a little bit larger than a grape,” says Mary Beth Chalk, chief operating officer at Resources for Living. “So your meals can never exceed 3 ounces at a sitting—the amount in one of those small plastic containers of water with the peel-off top that the airlines give you. That means you have to eat six to eight times a day.”

The surgery also bypasses part of the small intestine. “The purpose of the small intestine is to absorb nutrition,” says Chalk, “so these patients face an ongoing challenge with getting the nutrients they need, and they have to pay close attention to their nutritional supplement program.”

The result, says Chalk, is that “in short order, they have fairly complex lifestyle issues that they have to manage.”

Losing Half Your Weight
That’s not all they have to contend with. “Bariatric surgery patients find themselves having to deal with the sea change that happens in their life as they lose half of their weight, or half of themselves,” says Pilcher. “Their whole relationship with food changes, as do their relationships with spouses or partners, their family, and their coworkers.”

In the first year after surgery, Pilcher says, patients often find themselves “trying to figure out who this new and different person is that they see in the mirror. Adjusting their self-image is not easy. They know they’re wearing different clothes, and the number on the scale is different but, if they close their eyes, patients tell us that they still picture themselves as fat.”

The divorce rate after weight-loss surgery is extremely high, according to Pilcher. So is the rate of job change.

That’s not always a bad thing. Morbidly obese people, subject to a lifetime of discrimination, often come to feel helpless and accept situations others would not, says Pilcher. “Many patients, through the weight loss, become empowered to get themselves out of situations—work or marriage—that were bad,” he says.

Not everyone is affected in the same way, however. “If a patient in a long-term marriage was a normal weight when the marriage began,” Pilcher says, “that marriage is probably in pretty good shape to withstand the changes following surgery. If the patient was heavy at the time the marriage or the relationship began, however, there’s an 80% to 85% chance that that relationship is going to break up within two years of surgery.

“It may be that the patient’s partner becomes nervous because the patient becomes more attractive. It may be that there’s an abusive relationship going on, and the patient won’t tolerate it anymore. Or they might just decide that there are better options out there.”

The sudden discovery of many new options for relationships can be a challenge for some patients. “Promiscuity becomes a problem with some people, especially those who were overweight younger,” says Vickie Norrod, MFT, a marriage and family therapist in New Hampshire who has worked with bariatric surgery patients. “If they were obese during the years that they should have been developing a sense of themselves as a male or female and a sexual being, much of that development got sidelined.”

Defining Success
Whether patients get help dealing with these changes can be hit or miss. While there’s a growing awareness of the importance of the psychosocial aspects of bariatric surgery, says Chalk, “there’s not a lot of consistency across programs, and there’s not a lot of information out there about what constitutes best practices.”

Psychiatric evaluations before surgery are common, says Chalk. Beyond that, programs range from no psychosocial support at all to interventions that begin three to six months prior to surgery and then continue as much as a year or more of postsurgery support.

At the hospital in San Antonio where Pilcher operates, for example, psychiatric nurses and clinical nurse specialists provided mental health support for bariatric surgery patients for a period of time. Since those services were not covered by insurance, however, the hospital eventually reassigned the nurses to other duties. Now, Pilcher’s patients can attend a variety of support groups—if they pay cash out of pocket. “We see the need for more support than we currently are able to provide,” Pilcher says.

One reason patients are not getting that support may be the relatively narrow definition of success the medical community applies in evaluating bariatric surgery.

The generally accepted medical definition of the success of a bariatric operation, according to Pilcher, is whether a patient loses one half of his or her excess weight and keeps it off for five years. By that definition, the national success rates for bariatric surgery are in the 80% to 85% range, Pilcher says, “even without much psychological support.”

From a medical standpoint, it makes sense to call losing 100 or more pounds a success. When you get people to lose that much weight, says Pilcher, “you’ve made a very substantial lifetime impact on the medical comorbidities. Diabetes, high blood pressure, sleep apnea, and joint pain all tend to improve dramatically with 50% excess weight loss.”

But most surgeons, and most patients, would probably agree with Pilcher that this is not a fully adequate definition of success.

Take a patient who weighed 350 pounds before surgery, for example, and who’s lost 120 pounds thanks to the operation. If she’s 5’6” and in her mid-40s, her ideal weight may be 150 pounds, says Pilcher, so she’s lost more than one-half of her 200 pounds of excess weight.

But now, her goals may have changed. “When she weighed 350,” says Pilcher, “she may have told me ‘all I want to do is get rid of my diabetes medicines.’ And she meant it. But now, she sees a normal self within reach, but she’s not there. That’s where the psychological support becomes essential.”

That’s because gastric bypass surgery will generally cause patients to lose 100 to 175 pounds in the first 12 to 18 months after surgery, “pretty much no matter what the patient does,” he says.

Getting Help
What happens after that, says Pilcher, “really depends much more on the patient than the surgical procedure.” To maintain their weight loss, or to continue to lose, patients must make significant changes in what and how they eat and how much they exercise. For people who have been hundreds of pounds overweight, that almost inevitably involves significant lifestyle changes, says Susan Crum, LCSW, service delivery manager, health and wellness division at Resources for Living.

Many people have a tendency to use food to manage stress or deal with feelings such as sadness or boredom, she says. “A huge piece of the psychosocial work is just acknowledging what you’re using food for.”

Beginning these lifestyle changes early is key. “The stomach can eventually stretch after surgery, so it’s important to start working with patients long before the surgery to help them establish these behavior changes ahead of time,” Crum says. “Most bariatric surgeons like to see some successful weight loss before they conduct the surgery.”

Making the necessary lifestyle changes around food can involve every arena of patients’ lives, including how they relate to other people. Dealing with relationships is “a huge piece” of the work that patients must do after the surgery, according to Norrod. “If the way you relate to your friends is to go out every Wednesday for dinner, you’re going to have to find other ways to maintain your friendships. And what do you do if the only way Aunt Mary knows to tell you she loves you is to bring you your favorite pie—and you have to say, ‘I can’t have that any more?’”

Our culture, says Norrod, “has a huge emphasis on celebration through eating and nurturing through eating. It’s how you say, ‘I love you, I care for you, you’ll feel better.’”

In the bariatric surgery support groups Norrod has led, “the patients spent a lot of time trying to come up with their own ideas about how they could celebrate and nurture themselves and each other—in ways that didn’t involve food,” she says.

The most successful patients in Norrod’s groups were those who were able to make changes in their lives and who were realistic about the impact of the surgery. They recognized, she says, “that you can go in and cut out a piece of your body, and it will have an impact on your weight, but the majority of your life is going to stay the same. You don’t cut out your mother-in-law or your ex-husband or your boss. You don’t cut out life’s problems.”

Food Porn for Googlers. "Double chocolate chip creme frappuccino recipe"

THE number one way to find this blog lately, apparently?  "Double chocolate chip creme frappuccino recipe."  Nearly 75% of the keyword hits to the page are from those words.  UGH.  I've never even had a Starbucks Frappucino.  Stop it.  I did go to Starbucks (which is entirely out of the way) this morning, and got a nice iced coffee, with a shot of espresso (the usual), but a frappucino, fahgeddaboutit.  I just Wikipedia'd it, for those in the unknow like me: Frappuccino is the name and registered trademark of a cold beverage sold by Starbucks. It is made by blending one-part soluble or instant coffee, one-part proprietary flavoring, and three-parts ice, by volume. Alternatively, a caffeine-free cream base (what Starbucks calls Universal Beverage Base, or UBB) may be used instead of coffee to make the popular blended Crèmes (in contrast to blended Coffees). Most varieties include additional ingredients, including espresso, flavoring syrups, "chocolate chip" cubes and flavoring powders. You are all looking to mimic this at home, so of course now I'm Googling to find a mock-recipe too.  I posted a healthier version of this drink a few weeks ago, but apparently you want all the goodness of real sugar, etc.   Here's what I found:

Fake Frap #1:

4 tablespoon chocolate syrup
4 tablespoon chocolate chips
4 cups double-strength freshly brewed dark roast coffee
Chopped or crushed ice
Whipped cream (optional)
Chocolate syrup (for drizzle, optional)

Fill blender half full with chopped or crushed ice.
Add all ingredients (except whipped cream) and blend until thick and still icy.
Pour into 4 tall glasses, top with whipping cream and drizzle chocolate over the whipped cream.


Please, indulge me.  How many of you can't peel your cell phone away from your ear long enough to be waited on in a service environment?  Do you drive-through a quick-serve restaurant while chatting on the phone, nearly ignoring the order taker?  Do you hold a perhaps personal conversation loudly throughout a grocery store, while other shoppers are having to listen to your every one-sided word?  Do you have to chat all the way home in the car, not really paying any mind to the road?  I've had it with ignorant people on cell-phones all day long.  The conversations I hear one-sided are generally unimportant and could wait another five minutes.  Today, a young man came through the line, and was chatting extraordinarily loudly with someone on his cell phone, having a very bizarre agitated conversation about god-only-knows-what.  He kept getting irritated with the other person, and was making other customers uncomfortable because of his conversation - as it was quite, uh, different.  Now, his loud conversation made the transaction before him hard to do, since we could barely hear each other.  The customer in front of me was rolling his eyes at this punk kid behind him, asking if I could believe what I was hearing.  I tried hard not to giggle, but... anyway.  By the time I got to this kids' transaction, he was still chatting, not saying a word to me, just basically tossed the papers to me and got huffy because he was still waiting a while for me to finish.  No thank you, no recognition, nada.  I feel bad for that kids' parents.  I truly hope my kids are learning basic social skills, including shutting your damn phone to talk to a real live human when it is necessary.  Ignorance is unacceptable to me.

Side effect of a bean?

My hair grows.  Since WLS, my hair has been in a state of disrepair, often falling out, and at one point, looked noticeably thin to me.  Now, it's growing, and it's already to that point of "I must cut this off again before I can't stand it anymore" - and I've already got very short hair.  I've been lopping it almost entirely off for years and years, hair does me no good.  I guarantee that if I had enough hair to "do" anything with, I'd have it pulled up nearly everyday, so what's the point?!  I know when it's time to chop it off again when I have to do more than just blow-dry it, because it starts to fuzz and curl, and that's too much maintenance for me.  I meant to get a cut last Friday when I got my nails done, but ran out of time (and money, since my direct deposit for my paycheck never arrived.)  Of course the husband asks me why can't I just let it grow - but he doesn't blow dry, curl or even hardly needs to comb his little bit of hair.  I don't think short hair makes me boyish, unless I go out with a hat and running pants on or something, but I still look girl-ish, and you'll never catch me sans makeup, even in my pajamas.  (Well, except for like now, when I'm online before bed, because I've just washed my face and hitting the pillow before long.)

Jelly Beans & Fat Jeans.

Jelly Bellies!

We had a rare day off together today.  This morning we went out for breakfast with our oldest daughter, since the other two had a sleepover with grandma.  Last night my daughter and I went to a girls' only dance with a DJ for the scouts.  We had a good time, and we definitely danced enough, including the Cha Cha Slide, Cotton-Eye Joe & the Grease Megamix.  She kept singing along to songs I didn't recognize, and I know every word to every well known popular song out there.  Today I asked her where she heard those songs, and it turns out they're all from High School Musical from Disney.  We got the CD today, and the kids rock out to these songs.  Today, after breakfast, we headed to the annual Easter party at the mother-in-laws' work.  The kids had a good time, the pix are at the Flickr. 

This week is pretty uneventful, we're still waiting on the kitchen to get finished, and I'm truly getting sick of having no sink or dishwasher.  We've been stood up not once, but twice from the people who were subcontracted to install the granite.  They've yet to even come out and draw up the templates to cut the damn granite to fit the cabinetry, which have been in place for a while now.  I've been living with all my crap in Rubbermaid boxes in the dining room for weeks.  I'm very glad that the man who initiated the install talked me out of having the bathroom redone at the same time, or we'd be peeing in a pickle bucket.  The price of this entire install has increased also, so it's making Bob crazy.  Why do these kind of things - contracted installs and such - always go badly?  On that note- a family friend is going to make up plans to help us make a small addition to the house for more living space.  After the catastrophe we had a couple of weeks ago with our porch, we now have open space and an opportunity to start adding on in that area.  It will cost significantly less having people known to us do it, rather than the $50,000 or more to have a contractor take over.  I don't know any specifics, but it's likely we'll go ahead and add on living space for now.  We still are in desperate need of another bathroom, but the logistics of that are iffy.

Anyways, the Dateline MySpace expose is calling my name.... more later.

Curb your nighttime eating

While I eat crackers and cheese at 10pm, I give you this:

When is the absolute worst time to overeat, metabolically speaking? Many experts agree that it's nighttime, when our bodies have the lowest need for calories. Yet "in America, we eat more during dinner than any other meal," says U.S. Department of Agriculture researcher Shanthy Bowman, PhD. This is especially true for those of us who are overweight, according to a recent national USDA survey. It found that overweight adults tended to eat significantly more calories than normal-weight adults at dinnertime (while eating just a few more calories at breakfast and lunch). Dinner isn't the only problem, either. While afternoon is the most popular time to snack, evening snacks are in the No. 2 position. According to a recent study from the University of Texas at El Paso, snacking at night makes it all too easy to overeat. That's because eating late in the day may be less satisfying than eating the same amount of food earlier in the day. "Intake in the late night lacks satiating value and can result in greater overall daily intake" of calories, says the study's lead researcher, John de Castro, PhD, chairman of the psychology department at the University of Texas at El Paso.

Facts About Evening Eating Over the years, De Castro's research into meal sizes, meal patterns, and calorie distribution has turned up some other findings about evening eating: Meal size tends to increase over the day, with peaks at lunch and dinner. One study showed that participants ate 42% of their total daily calories during and after dinner. Our evening food intake tends to be relatively high in fat, compared to that at earlier meals. The longer the gap between dinner and the previous meal or snack, the larger the dinner. Interestingly, the gap between meals is a significant predictor of meal size for dinner only. People who eat lightly at night end up eating fewer calories and grams of fat overall than people who eat big dinners and nighttime snacks. According to the results of one study, people who had a light snack at night ate 9.3% fewer total calories and 10% less fat overall than those who ate larger nighttime snacks.

Obesity expert Edward Saltzman, MD, thinks the real problem is not so much that we burn fewer calories at night, but that nighttime eating tends to result from unhealthy meal patterns. The three types of meal-pattern problems Saltzman sees most often are: People don't eat during the day and then become ravenous and overeat at night. "If people wonder why they aren't hungry in the morning, it could be because they ate too much the night before," explains Saltzman, an energy metabolism scientist with the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Food is used for all sorts of emotional reasons at the end of a workday (as a relaxant, as entertainment, as a distraction, etc.) Eating becomes associated with sedentary behavior, like watching television. In other words, we get into a pattern of eating while we watch TV or use a computer -- activities many of us tend to do in the evening.

Why We Eat at Night

There are many reasons why so many of our total calories tend to be eaten during and after dinner, including physiological, emotional, cultural, and possibly evolutionary influences. They include: It's part of our culture to eat a large dinner. It's also customary in many homes to enjoy a large dessert after dinner. Some people, especially women, skip meals or undereat during the day. It can take quite a lot of food to satisfy the body's hunger after a day of undereating. Overeating at dinner or late at night may help to calm people from stresses that build during the day. Studies show that meals eaten with others are, on average, 44% larger than meals eaten alone. Since dinner tends to be the meal that is more often shared, this may partially explain why it's also most likely to be the largest meal. From an evolutionary perspective, nighttime used to represent the longest time period without food and activity. In modern times; however, artificial light allows people to remain awake and continue to eat, perhaps, contributing to obesity. Tips for Overcoming Nighttime Noshing But even with all this working against us, experts say, it is possible to avoid nighttime overeating. If you're a nighttime nosher, here are some tips to help you kick the habit:

1. Get in the habit of enjoying a hot cup of decaffeinated tea at night. Tea comes in so many great flavors that you'll never be bored. In the warmer months, have a glass of iced tea instead.

2. Many people snack at night because they're bored. Keep your evenings interesting, and you'll find it easier to refrain from mindless snacking. Take a night class, plan an evening exercise session, find a new and interesting book or hobby, etc.

3. If you've gotten into the habit of eating in front of the television, vow to eat only in the kitchen and only drink no-calorie beverages while watching TV. Or limit your TV eating to fruits and vegetables. Occupy your hands in other ways -- ride a stationary bike, do exercises with an exercise ball, take up knitting, pay bills, or write notes to friends.

4. Because evening meals and snacks tend to be the highest in fat, it's especially important to make healthy food choices at this time. Go for foods that are rich in nutrients, high in fiber, and balanced with some lean protein and a little bit of "better" fat (like olive or canola oil, avocado, or nuts).

5. Though you don't want to eat too many calories at dinner, for some people, a small dinner could lead to a late-night snacking tailspin. Eat a balanced, high-fiber dinner. If you get hungry later, enjoy a smart and satisfying evening snack like low-fat yogurt with a sprinkle of whole-grain cereal, fruit with a few slices of cheese, or whole-grain cereal with milk.

6. Have a balanced, higher-fiber lunch and afternoon snack to help avoid overeating at dinner.

7. Don't skip breakfast. "When people skip breakfast, they end up eating more calories by the end of the day, and we know that they end up compensating for this skipped meal with high-sugar, high-fat foods," explains Bowman.

8. People who eat small, frequent meals tend to eat fewer total calories and fat grams than those who eat larger meals less often. Try eating small, frequent meals to see if it improves the way you eat and feel.

9. If you're in the habit of finishing your day with dessert, try having a mini-portion. The first few bites of a food always taste the best, anyway. Experts say a petite portion is more likely to satisfy if you choose a dessert you truly enjoy, take your time and savor every bite, and accompany your treat with a cup of hot coffee or tea.

SOURCES: The Journal of Nutrition, January 2004. Physiology & Behavior, 1987, vol 40. Journal of the American Dietetic association, December 1994. Body Mass Index New Research, 2005. Shanthy Bowman, PhD, U.S. Department of Agriculture's Agricultural Research Service. John M. de Castro, PhD, chairman, department of psychology, University of Texas, El Paso. Edward Saltzman, MD, energy metabolism scientist, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston.

Risks of Gastric Bypass

Link is via Obesity Help: A presentation on the risks of gastric bypass surgery, when I clicked the link, I didn't expect to see my surgeon(s), but, here they are: 

Scott A. Shikora, MD, FACS

Professor of Surgery
Tufts University School of Medicine
Surgical Director, Obesity Consult Center
Boston, MA
Michael E. Tarnoff, MD, FACS

assistant Professor of Surgery
Tufts University School of Medicine
Staff Surgeon, Obesity Consult Center
Boston, MA

It's a flash presentation, click away and watch.  Informational for you.  Enjoy.

Not so much a hobby now.

Today is payday, and if I had actually received my pay, maybe my uhh, financial consultant would not have been on high alert with the checking account today.  I didn't get paid, my hours worked were just sort of lost, and my direct deposit didn't post to the account that pays the bills. 

At the same time, my uhh, financial consultant consulted the account, and noticed a $14.95 charge that has now repeated monthly for two or three months.  It didn't look bad until you're missing eighty hours worth of pay, suddenly $14.95 could feel like your $2K+ mortgage.  Seems that the free blogging is up, and we've paid for the Typepad account a couple of times already. 

It's funny how once something costs money, it's not very fun.  Granted, I'm very much out of weight-loss diet head mode, since I'm like, fat and pregnant and stuff, but... I'd like to continue to blog no matter what.  Goodness knows in about seven months I'm going to need to expunge all sorts of fatty evils, and I'll really need this blog to get back on the wagon and get back to goal.  So for the time being, I need to validate the cost of the blog to make it worth it to me.  I hate spending money.  Click the links - 'specially any of the ones related to Typepad and the ones in the orange box, since they can auto-pay the blog costs if I get enough traffic to their ads and such.