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August 2007 posts

Episode ...

Just for documenting, because it just happened -

  • Dinner 5-5:30pm.  Beef ribs, probably 2-3 oz meat in total from four very small ribs and steamed broccoli, and honey mustard sauce (high sugar)
  • Felt very hypoglycemic, 6:30, on: tripping, out of it, sweaty, shaking, disoriented - blood glucose 35.  Ate a five sugar gram granola bar that my daughter brought me (I asked her to.) 

Part two in a series, love letters from the internets.


I wrote:  "further contact is not advised."

Diana writes, to that:



Thanks, ma'am, will do.

In the spirit of being somewhat helpful to someone who probably doesn't deserve it from me, I suggest that you start your own blog.  Go to Google > search for "Free Blog Hosting."  Then, start writing angry-toned posts about your issues IN! ALL! CAPS! and then, when you're feeling nervy, put a donation button up.  Just Wait!  Then, you'll get your own hate mail!

Because I'm all about being honest - you must know - that the various evolutions of a donation button on my blogs have probably made a total of $200 in three years. 

What did it pay for?  This Blog, first off.  I paid for my blog.  I. Paid. For. My. Blog.  MY. BLOG.  It costs to write here.  Why would I pay to write?  I don't know - I never claimed to have much brains.

Then, I traded deleted because I am not allowed to talk like that, I'm a woman for Chrissakes for PayPal Donations towards multi-vitamins, calcium citrate and protein bars.  Right, ladies?

(ETA:  Please note, I Said Ladies, because my readers are entirely all women - haven't seen a man in 'dees here parts in, forever.  Please note, also, there was no inference of sexual harassment/innuendo inferred by such comment, I am referring to the business of "pimping" in which I would be paid for deeds done.  Also, this comment was entirely sarcastic, in which I am.  Very.  Much.  So.) 

Weighty Matters. A Flickr Group.

All things related to matters of weight. We all have a body. We all have issues.

Anything goes. Sharing photos of weight loss progression down to your goal, photos related to your weight loss journey, whatever path you choose.

Weight Loss Surgery Methods, Typical Diet & Exercise Plans, Lifestyle changes, or alternatively issues of the Eating Disordered. You are all welcome. Post.

Artistic and creative expression is encouraged.

So, join me at Flickr and share your photos. This group might be shared as part of a Flickr thingie soon (I talked with someone from the company - and she asked me if I'd chat about it.) So, please, let's fill it up with images of Weighty Matters.

Thank you!

baby buddha

baby buddha, originally uploaded by Melting Mama.

Time flies.

In love already., originally uploaded by Melting Mama.

One year ago today - our niece, baby E was born!  Happy birthday Miss E!

She's growing.

DSC_0027, originally uploaded by Melting Mama.

if baby ain't happy ain't nobody happy.

Methinks somebody is not tolerating the moo-juice.  She has been unpleasant.

The doc gave us the go ahead for whole milk at the babe's nine month appointment.  We've been slowly swapping the milk out for the formula.  The last week or so - it's been mostly milk.  The diapers have exploded and she's not happy.  Milk is for baby cows.


Hater mail. If I only had the noyve.

"YOU HAVE A LOT OF NERVE"  says [email protected]



I guess I shouldn't complain, this is the first hate-mail I've received in two years.

I haven't got a love letter like this since I first started blogging. 

A woman contacted me from her AOL blog - and wrote a nasty post about me, two years ago in July.  She, also, had debilitating issues, and took it out on me.

To THAT woman, from two years ago?  Honey, for all the "begging" I did, look how much plastic surgery I got so far.  NONE!  LMFAO!  That was two years ago, and I'm still not any closer, but then again, whenever there's a spare dime, it goes to my family.

Should I do this?  A page devoted to raising cash? 

No.  I blog, all the time. I am learning all I can, sharing all I can, and hoping to help others along the way while I make a few cents a day with my ad clicks.  I finally opened a checking account in my own name - and I'm depositing my "earnings" there for what I can do to better myself, whether it will be plastic surgery or college, hopefully both.  *sigh* 

Do I have to explain this to you?!  Do people really think I have ulterior motives?  I thought I was transparent.  Jesus! 


Holy foodgasm Batman.

I just got a shipment of ISS Oh Yeah Protein Wafers (and some Whey Protein Powder sample packets, which I will make and review for you.)


Would you believe me if I said I screamed when I opened the box?  I did.  Why? 

There was a flavor in the box that I never saw before - Vanilla.  Plain vanilla creme. (They are in a blue box.)  I adore the vanilla peanut butter flavor, but, straight vanilla - yumm-o!  I didn't tear into them, if only because I just ate a chocolate one.  (Because, I found a box in the cabinet on top of the baby food that I forgot I got from GNC during the B1G1 1/2 off thingie.) 

Why have I not seen this flavor before?  Hooray for vanilla protein bars!  You don't know how excited I am to have one later.

I'll do a review.  And, a YouTube, if my camera cooperates, and doesn't make me look like I'm dubbed over in pig-latin.

Here's a great price (the cheapest I've EVER seen) from a online store I have zero clue about:

Our Price: $11.50, 2 for $22.50, 4 for $43.99
Cost Per Serving: $1.28
Volume Discount: 4 or more at $11.00 each

Customer Review(s): Rating 5 Out of 5

Response to anonymous commenter. Now, fat kids fat adults.

This reader commented anonymously last night in response to my previous post.  Frankly, I wish more people would comment, but, not anonymously.  So, commenter, if you're a regular reader, don't hide behind a fake email, come out and chat with me.  Beware, this is probably very inflammatory to many of us:

"Hi there, you are remarkable in all you and your husband have done for yourselves! I wish I had. I'm still very fat. The one thing I have committed to - however - is to make sure our child does not have a fat childhood like I did.

Please take a look at your beautiful! children. A close look. And please do something now. Fat children become fat adults. Don't you, like I, wish you had never been fat?

Be mad at me for being so blunt - delete this comment. It is not meant to be mean spirited. I think you are a beautiful person (inside and out).

My husband was a fat kid - most his chilhood - as well as his older sisters. Then, his mother put an end to the chips and junk she was buying and he and his sisters slimmed to a normal slim size and were happier for it. He's still in average shape at 41 yrs old. My mother didn't and I now a big fat 41 year old who still has poor eating habits and little interest in any form of exercise. Our son is fit as a fiddle and runs around inside until he's winded if we don't get outside to run about. We never force him to eat or finish what is on his plate (the neighbor's dog is real fat - ha ha) - we just give him good choices and let him decide when he's done. Sure he likes junk - like any kid - and gets some of it too - but not as often as healthy natural foods and since he's never been forced to eat (not even a extra spoonful when a baby) he naturally knows when he's had enough and leaves behind chocolate and other yummy stuff.

I don't know how to end this now - because I feel like you will be mad about what I have said. But even if that is what makes you think critically - it will surely be better then not.

Do I really suck that much?"

Woman.  You don't suck.  But.  Your idea might?

You cannot predict what is going to happen to your one(?) child by what you think you are teaching him.

I am teaching my children all I can about food, making good choices, portion controls, nutrition, healthy fats, bad fats, sugars, carbs, protein, everything. I. can.  I try to be a good example and I choose not to bring unhealthy foods (with rare exceptions, and healthy "junk") into my house.

I have one "obese" ten year old.  I have two "overweight" children, aged eight and five.  I have one chubby ten month old.

Met at age four

Me @ Four.

What is it, exactly, you think I am doing wrong?

My boy.

We're not perfect, we know this.  But children DO learn what they live.  Regardless of the poop that spills out of my mouth, they will pick up habits that they are AROUND.  Environment causes obesity.  This poop spreads like wildfire in families and people co-habitating.

Without going into detail, my husband was fat because of his environment.  As were his sisters.  All 300-370 lbs.  All of them gained a huge amount of weight at the same time as their mother did.  (Three out of four have now had WLS.)

Wittle Bob.


I became morbidly obese when I moved in with HIM.  IT SPREADS.

Honeymooning, pre food poisoning

Now, with mom and dad at normal body weights, and spewing out being healthy, making good choices, blah blah blah, we still have fat kids.  Granted, they are thinner now than three years ago, in terms of BMI/growth, they haven't magically become skinny little cheerleaders.

When they say it takes a village to raise a child - it's true to terms of weight.  Everyone who has a hand in taking care of your child, including school - can influence your children's obesity.  EVERYONE.  This isn't to say I am blaming anyone else.  But, much of my oldest daughters' weight issue is directly attributed to extended family.  We're all guilty.

If I were the only hand in her food influence, would she still be fat?  Perhaps, because of part of her compulsiveness and love for food, as well.  Perhaps, because, I will still share with her a love for dark chocolate and an occasional fettucine alfredo with pancetta. 

But, more likely, the habits of others who still have a big part in her life, influence her much more deeply than they would ever recognize.  It's hard to write about.  So, I'm not.  But you can imagine.  I spend a lot of my time as a parent un-doing things.  Many of the reasons my husband was so obese are the same sort of things I have to un-do in my kids when they're influenced by other people.

So, woman... even if you think you're doing it right?  It doesn't matter.


A woman in Russia set her ex-hubby's pee pee on fire.  Just 'cuz he was sitting on the couch, naked, having a little vodka.  She's like, "Oh no, you ain't sittin on mah couch no more."  And, then he's "burning like a torch."  Ladies, if you think it's rough being single - HA!

That little tidbit made me giggle while I sip my coffee this morning, but, it gets worse, more penile humor here.  A freak show performer inadvertantly glued his member to a vacuum.

Why do I mention this?  Well, as I type, Bob is preparing to leave to go to the plastic surgeon to talk about his appeal for a panniculectomyPower To The Penis.  I am making a bet with my readers right now - that in the end - after all is said and done, he will get coverage due to the power of the penis. 

Likewise, I will be denied coverage after a similar appeal with a slightly more creative letter (video, perhaps!) because I do not have said appendage.  Then again, I can get boobies if we're self-paying, and he can't.  Well, he could, but then I might be setting fire to them.

Weight Loss Surgery Saves Lives? (But we're more likely to commit suicide.) Studies published tomorrow in NEJM.

We live longer, because we don't die from fat-related diseases, such as diabetes, cancer and heart disease.  We are more likely to die of non-disease related issues now, such as accidents and suicide.

Just as a devil's advocate over here: 

  • I won't die of diabetes now (which I never had as a morbidly obese person) but, I might have a blood sugar low and crash my car and DIE due to the WLS.
  • I wont have a heart attack due to my morbid obesity anymore, but my heart might stop beating if I get too anemic due to the WLS.

I see it as damned if you or don't.

From NEJM:

Although gastric bypass surgery accounts for 80% of bariatric surgery in the United States, only limited long-term data are available on mortality among patients who have undergone this procedure as compared with severely obese persons from a general population. 

Long-term total mortality after gastric bypass surgery was significantly reduced, particularly deaths from diabetes, heart disease, and cancer.
However, the rate of death from causes other than disease was higher in the surgery group than in the control group.

From WedMD:

Weight loss surgery is known to help severely obese people shed pounds and lower their risk of diabetes, heart disease, and other obesity-related diseases. Now two landmark studies show that the surgery also saves lives.

In one study, deaths decreased by more than 90% from diabetes and 50% from heart disease in severely obese people who had weight loss surgery compared with those who did not.    

In separate research, weight loss surgery was associated with a 29% reduction in deaths over an average follow-up of 10 years, compared to those who did not have weight loss surgery.  Both studies are published in the Aug. 23 issue of The New England Journal of Medicine.    

Longtime obesity researcher George Bray, MD, of Louisiana State University, tells WebMD that the new research provides the important "missing link" showing that weight loss surgery reduces mortality.

Weight loss surgery, says Bray, "is associated with a dramatic reduction in diabetes and other diseases associated with obesity, so it stands to reason that it would positively impact survival. But there has been some question about this, and a few studies have even suggested the opposite."    

Weight Loss Surgery vs. No Surgery

In the larger of the two studies, roughly 8,000 gastric bypass patients and 8,000 people who did not have weight loss surgery matched for sex, age, and weight were followed for an average of seven years.    

University of Utah School of Medicine researchers reported a 40% overall reduction in deaths among the surgery patients compared to the patients who did not have weight loss surgery. 

Surgery patients' deaths decreased by 92% from diabetes, 56% from cardiovascular disease, and 60% from cancer.

Researcher Ted D. Adams, PhD, MPH, tells WebMD that the difference in cancer mortality was very surprising.

"We did not anticipate such a large reduction in cancer deaths in such a short time, and we aren't really sure what to make of it," he says, adding that his research team is currently exploring the issue.

Death Rates From Causes Other Than Disease    

There was yet another surprise in the findings. While surgery patients had a lower death rate from diabetes, cancer, and other diseases than nonsurgery patients, death rates from causes other than disease, such as accidents and suicide, were greater.

Patients who had weight loss surgery had death rates from nondisease causes that were 58% greater than people who did not have surgery.    

The study offered few clues about the reason for this. But several previous studies have suggested a link between weight loss surgery and an increase in drug and alcohol abuse and other risk-taking behaviors.  Adams says the findings highlight the need for better ways to identify psychological "red flags" in patients who are considering weight loss surgery and for assessing mental status after surgery.    

A rare complication of gastric bypass surgery leaves its victims virtually disabled, Mayo Clinic researchers reported.

Action Points
  • Inform patients contemplating a weight-reduction operation that, although it is a rare complication, nesidioblastosis is more frequent among patients who have had Roux-en-Y gastric bypass than in the general population.
  • Note also that while the cause of the nesidioblastosis remains unclear, a partial removal of the pancreas appears to resolve the condition.
  • Advise interested patients that the so-called "dumping syndrome," whose symptoms include flushing, dizziness, profuse sweating, and weakness, is commonly seen in gastric bypass patients; however, central nervous system glucose deficiency is not part of the dumping syndrome.

But others said the complication, called nesidioblastosis, a hyperfunction of insulin-producing beta cells, may also point the way to new treatments for diabetes.

The complication leads to a potentially life-threatening deficiency of sucrose in the central nervous system, says Fred Service, M.D., a Mayo endocrinologist and colleagues reported in the July 21 issue of the New England Journal of Medicine.                         


They described six patients who were referred to Mayo between 2000 and 2004 because of severe neurological symptoms -- including confusion and loss of consciousness -- after eating.

The symptoms were so severe, Dr. Service said in an interview, that patients couldn't drive or work, and "had to be babysat" for fear they could have a potentially deadly episode.

The diagnosis was hypoglycemia, caused by excess insulin production, leading to a severe deficiency of glucose in the central nervous system (i.e., neuroglycopenia).

One patient had insulin-producing pancreatic tumors that were surgically removed, but the rest had enlarged and overactive islets without cancer. The mean size was significantly larger than in obese controls (214 micrometers versus 151, p=0.001).

When the first patient was referred, the researchers considered the Roux-en-Y gastric bypass to be coincidental, especially because the patient also had insulin-producing pancreatic tumors. But "subsequent experience…led us to raise the possibility of a link between the islet hyperfunction and the bypass surgery," Dr. Service and colleagues wrote.

Over the same time period, nine people who had not had gastric bypass surgery were shown to have nesidioblastosis at the Mayo Clinic, meaning that the gastric bypass patients formed 40% of the total caseload.

However, only about a tenth of 1% of the U.S. population has had a gastric bypass.                         

The treatment was partial removal of the pancreas, Dr. Service said, which appeared to ameliorate the problem in all but one of the patients. That patient had a recurrence of symptoms, possibly because not enough of his pancreas was removed.

The cause of the nesidioblastosis is less clear, but it seems "possible that beta-trophic factors may be brought into play after bypass surgery," causing the growth of beta cells and islets, excess insulin production, and post-meal hypoglycemia, the authors argued.

"There is some scientific evidence that gut hormones could be mediating this," Dr. Service said.                         

If that's the case, said University of Washington endocrinologist David Cummings, M.D., in an accompanying editorial, it should spur research to identify the mediators "so that their physiological effects can be harnessed" against diabetes.

"On the face of it, the paper is a report of a novel adverse consequence of gastric bypass surgery," Dr. Cummings said in an interview, adding that the condition remains quite rare. "It's hardly a public health crisis."

One of the effects of gastric bypass surgery is to cure type 2 diabetes, he said, and it may be that "the same physiology is melting away the diabetes most of the time and occasionally goes too far."

He added, "I see this a hopeful finding that there's something about gastric bypass surgery that causes beta cells to regrow -- and rarely overgrow -- and if we can find that thing we have the potential of bottling it and using it treat diabetes."

Dr. Service said he's not entirely comfortable with that view: "I think Dr. Cummings may be looking at this through rose-colored glasses."

If there is an upside to the finding, he said, it's that surgeons who perform Roux-en-Y surgery will be alerted to the possibility of nesidioblastosis in their patients.

"The follow-up of (gastric bypass surgery) patients hasn't been as assiduous as it should have been," Dr. Service said.                         

He said the symptoms should not be mistaken for those of the so-called "dumping syndrome" -- flushing, dizziness, profuse sweating, and weakness -- that is commonly seen in gastric bypass patients.

Related articles:

Additional  Pancreatic Diseases Coverage

Primary source: New England Journal of Medicine
Source reference:
Service, GJ et al. Hyperinsulinemic Hypoglycemia with Nesidioblastosis after Gastric-Bypass Surgery. N Engl J Med 2005;353:249-54.
View this abstract.

Additional source:
New England Journal of Medicine
Source reference:
Cummings, DE et al. Gastric Bypass and Nesidioblastosis -- Too Much of a Good Thing for Islets? N Engl J Med 2005; 353:300-1.
View this extract.

Argh. Med complications? Updated.

I finally got the RX for the Glyset, that took days!  I came home and looked it up as a potential risk with the Trileptal I have been taking.  It came up as a:

Moderate Interaction - assess the risk to the patient and take action as needed.

HYPOGLYCEMICS; INSULIN/BUPROPION - Additive side effects from both drugs

I just spent ten minutes on the phone with the pharmacist, and will call the endo, too... but... throwing it out there for any experience?  Trileptal can cause hypo (and hyper) glycemia as well.  Something I didn't pick up in my reading.

This is fantastic, because, now I sort of have to dig up that couple hundred bucks and go back to the pdocs office to get off of the meds?

PS.   While I am on the topic -  the pharmacy tech asked me, "You just have a discount card, no insurance, right?"  I'm all, "That's not insurance?" 

She says that the Medco card is a discount, that I'm paying for the medication, not co-pays.  NO WONDER!  ARGH.

I swear - who let this man choose the health insurance plan coverage?!

*Update:  I spoke with the endo.  No obvious issues with taking both meds.  He also reassured me that the Glyset would not trigger hypoglycemia.

The best description of the altered digestion. For reference.

From Diabetes.org:

"Gastric bypass divides the stomach into a small proximal pouch measuring ~30 ml and a separate large distal defunctionalized remnant. The upper pouch is joined to the jejunum through a narrow gastro-jejunal anastomosis (Fig. 2). The proximal divided jejunum is reattached to the jejunum 75–150 cm below the gastro-jejunal anastomosis, creating a Roux-en-Y limb. Thus, storage capacity of the stomach is reduced to ~5% of its normal volume, and ingested food bypasses ~95% of the stomach, the entire duodenum, and a small portion (15–20 cm) of the proximal jejunum. Initially, the operation relies on gastric restriction much like gastroplasty (6–18 months).

Subsequently, when the pouch and stoma have stretched, other mechanisms take effect to maintain the loss, accounting for the superior weight loss maintenance compared with purely restrictive operations.  The appetitive mechanisms of the diversionary component of GBP are achieved through the absence of a pyloric "meter" or "brake," allowing rapid transit via the gastrojejunostomy, and maldigestion caused by the absence of acid and pepsin and the grinding-mixing forces of the stomach. Thus, undigested food rapidly shunted into the small bowel can cause nimiety via mechanoreceptors and possibly satiety via chemoreceptors (17) or neurohumoral mechanisms."


How To Feel Really Super Extra DENIED?

When you open your mailbox and find not one, not two, but THREE, yes, THREE Denial Letters From your health insurance provider regarding your begging for pannilectomy surgery.

  1. For Me,
  2. For Bob.
  3. For His Mother!

She doesn't live here.  I guess they wanted me to feel guilty about saying that they approved her surgery, and sent me her denial instead.  I do not know why her letter came here, but apparently she was initially denied for a few reasons, and they sent it back to the insurance and it was approved.  But, whatever, that's over with, she's panni-free as of right this moment.

Now, for us - we were both given a standard letter with THIS as the reason for denial:

"The photographs provided for review did not demonstrate a pannus that extends below the pubis AND there is no supporting documentation indication difficulty with ambulation."

Does your pannus hang low, does it wobble to and fro?  Can you tie it in a knot?  Can you tie it in a bow?  Can you throw it over your shoulder like a continental soldier?  Does your pannus hang low?

Yes, Blue Cross, it hangs very low.  In fact - each sides mudflap hangs to or beyond the pubis if you must know, for both of us.

As for AMBULATING?  Will I have to make a video demonstrating said difficulty with ambulation?  Do I really have to share that?

You do realize that Bob is going BACK to the plastic surgeon tomorrow to resubmit his claim with new photos - and he's using the "I have to lift my big pannus to find my penis" as the reasoning. 

The doc is cool with this. 

Power to the penis.

If he gets coverage NOW, by whining about his penis, I will maim someone.

Beth needs a creative yet not pornographic way to prove my necessity for the lopping of the mud flaps.