On getting old.

As many of you -- I have had lower back pain for years, and in my normal Beth way I have ignored it or (...don't tell anyone!) medicated it with NSAIDS off and on, and heat, and exercise, and stretching.  AND GOD DAMN IT, IT HURTS.

Source - Healio 

NSAID use is contraindicated in gastric bypass patients as it can cause serious ulcers.  I started popping them like candy recently.  No. good.

The back pain comes  in cycles and never really goes away.  It gets to the point where I cannot ignore it and I am currently in a Flare Of I Cannot Sit Down Or Sleep Or Lay Down And Nothing Feels Right EXCEPT getting on my knees in 'downward dog' position.  When I describe it to other people they chime in with "Yep.  I live this." 

I had my husband take me to the urgent care MD on the weekend for X-Rays.  They show disc degeneration. No surprise. I suppose after ignoring it -- plus a few years of massive obesity, plus four pregnancies, losing all of the weight plus eating haphazardly and vitamin-deficiencies, it shouldn't be a surprise.  

Hooray.

I was prescribed an anti-epileptic drug instead of a pain-medicine, at my request because I do not want to be sedated, and that I am epileptic.  

Although as the doctor was describing the medication's side effects to me, he explained that it might cause "sedation, dizziness," and I stated, "... that it isn't like I do anything important anyway, I'm not using heavy machinery as it is."  

I do not know that he got my seizure humor. 

I don't feel much relief from a few days of this added medication -- and I do not feel that it will be of help to the pain, but there are more options.  I think that I will need to use exercise somehow, because this, just isn't working.  

I can't sit.  I can't sleep.  

I have a broken ass.  I. am. old.

That time I relived the Presidential Physical Fitness Test

"So you're a blogger, are you going to write about this?"

"If I told you..."

I might have already put it on Facebook because I have compulsive posting issues. 

I had my Very First Fitness Profile At A Gym yesterday.  

Just Because Someone Has Bariatric Surgery - It Does Not Make Them A Magical Athlete Who Runs Marathons, Lifts Weights Or Even Gives A Flying Fuck About Doing These Things.

"But all the people on the Facebooks -- they post photos of the try-athelete-a-thons -- and the Things They Can Do Just Six Weeks After Surgery,  and all their new muscles and how they can make it rain, and Why Can't I?"

No.  It is not *typical.

Here comes Beth -- pissing on your surgiversary parade again.  Boo-hoo.  This is my opinion only.  If you do not like it, fine.

However individuals that have bariatric surgery -- they are tore up.  One does not go from super morbid obesity to Athlete! *with added sparkles and instant motivation* overnight.  It just does not happen that way.   

Sometimes it takes a very long time to get some any motivation, inspiration to get your butt off the couch and do something anything!  In my experience over the past ten years post weight loss surgery:  motivation comes cyclically and there's always an underlying trigger and goal.

For a select few post WLS patients, just losing weight is enough of a motivation to get going.  You see this in the "honeymoon stage" of weight loss repeatedly - people get all sorts of excited during the rapid stages of weight loss and sign up for their gym - get into a class - buy a piece of equipment for home use - sign up for their first walk, run, "I did my first 5K!"  These kind of things are all common.

For me, this happened ever-so-briefly.  I got out and walked miles and miles and miles to the Black Eyed Peas - it was 2005.  I reached to my "goal" weight.  We joined the YMCA.  Things were going swimmingly in All Things Weight Loss!

But you know what - life happens sometimes.  

"WHAT IS THIS THING YOU CALL LIFE?!?!  HOW DARE IT INTERFERE WITH MY SIZE 6 PANTS?!"

Shit happens.  You deal.

I threw away my size six pants, bought maternity pants, and she's now seven. (And cute.  We'll keep her.) However that wasn't the only Life That I Got.  My life imploded at about the same time - and I haven't had a normal living/working situation since.  

Again, I'll say this:  

Shit happens.  You deal.  (OR.  You don't.  And it's pretty obvious when you aren't.)

Mostly?

My weight chart reflects the ... mostly.

It looks like a bad ride on the rollercoaster until about one year ago.  

And you know some health-coach-wannabe posted that on my weight chart a few years ago - and I nearly tore her head off.  It was truth.  

My weight chart reflects that I was not dealing very well with my shit.

That kind of honesty hurts sometimes - and I am sorry if it bothers you.  But we - as former current-always-cycling-obese folks (...I will always be a big girl) wear our issues.  When I stop weighing myself, checking in with my jeans-that-should-fit, eating as I know I should, I need to check MYSELF. 

Weight is very personal.  Let me repeat this.  When I stop weighing MYSELF - it means something is out of balance.  It means FOR ME - that I have made a choice to stop doing something right elsewhere:  usually my eating choices.   To be perfectly honest, it takes very little change in calories or types of food to increase my body weight at this stage so I notice upswings immediately.

(This is when the trainer reading this realizes he got way more than he bargained for.  Why did I ask for this URL!?)

A little more than a year ago - I was in a regain pattern.  I saw a number on the scale that frightened me.  (Personally.  We ALL have a number.  Your number may be different than my number may be different than her number.  I am five foot three, and my personal number was the qualifying number for WLS again.)  

I knew that something had to change and I knew that I had to do something different because I was stuck in a rut of this pattern up cycling up so many pounds and back down so many pounds.  

I have been a weight loss patient for many years - I know how to lose weight - goodness knows I can regain it - but - maintaining is different.  I had to think about it:  what haven't I done before?

Um.  #1 - Exercise on a regular basis.

*SHOCK AND AWE - GASP!*

No shit, right?  Nope.  My exercise motivation over the last ten years has been apathetic.  I have more excuses than most of you, honest.  I still do, and it's hardly worth throwing them out there because there are people out there with much bigger challenges than you or I - that are busting their butts - and we aren't.  

"What do you mean, EXCUSES, Beth?"

I can't drive a car, when I was diagnosed with intractible epilepsy I had to lose my drivers' license, I can't get to the gym on my own, I am not supposed to exercise near the road, I can't walk on my own, I have four kids, begging them to go is a pain... yadda yadda yadda...

And, the worst of all?

I. am. *lazy.  I have always been lazy.  I may always BE lazy.  I may never really enjoy Exercising On Purpose.  It may always feel like work to me.  

"Just put in a DVD."

That's where lazy comes in.  See?  That has happened maybe five times in my life -- and each of those times I ended up blogging about the video instead of working out.   TV + Me = No. 

So, there's that - I started moving my ass just a little bit.

It worked.  It did not take much.  I don't try very hard.  *See above, lazy.  I lost every pound of the regain, plus some, and I have maintained the loss for six months.  

*tiny party*

As for exercise - if you have been following me on Facebook - I try to get to the gym at least three days a week or more - it is increasingly difficult with my husband's work schedule and six of us in this house but we do what we can.  When I do get there - I aim for a full sixty minutes of cardio on a cross-trainer or elliptical machine, and sometimes another fifteen to thirty on another machine or treadmill at a lower intensity.  

I was not able to do that much exercise right away.  It was overwhelming to me -- which was why I started to write this post to begin with.  I started with FIVE MINUTES on the machine, many months ago and pushed through to where I am now.   Because you know what -- six months ago -- had you told me "Go do an hour on that machine --"  I'd have laughed at you.

That is why I am sharing - because - it's NOT too late to start.  I was nine years into my journey when I started "again."

#2 - Food journaling, eating of Le Crap.

*GASP!  What do you MEAN the Bad Girl Does Not Actually Eat Cupcakes?*

I cannot validate the caloric-cost.  Sorry.  I never really have.  To be honest:  I don't know why that was really ever equated with ME - because - I HATE CAKE.  If you knew me at all, you'll know that if we go to the local cupcakery  (1-2 times a year) they sell frosting shots, I buy ONE.  I put it in the freezer.  It's about 2 ounces of pure butter and sugar.  It's enough carbohydrates and fat to put a horse in a coma.   I am a SUGAR-CRACK-HEAD.   I dump on sugar.  Therefore, I can't, I don't.  But I would if I could.  I know myself.  I do not purchase nor eat much in the way of junk.  

Let me rephrase that: I eat a fair share of what I consider crap, I purchase none of it and I try hard not to allow a lot of stuff in my house.   I have a harder time avoiding it if it's in my face, I try to make choices based on what's left in my alloted calories for the day.   I do okay.

I aim for 1200-1400 calories, I land around 1400-1600 most days, some around 2000 calories.  

I journal about 60-75% of the time lately, days where I am distracted by stuff get forgotten (yesterday was totally lost...) and holidays tend to be screwed the heck up, but overall I have done okay with assessing my intake and my weight has stayed the same.

Where am I now?  Where do I "start?"

I passed everything except flexibility - which may have sucked because I just had a brain angiogram and I have a plug in my groin.  LOL.  (I didn't tell the trainer that.)  However, that sit-reach thing brought back awful memories of elementary school and the Presidential Physical Fitness Test.  Blech.  I couldn't ...

I find this quite amusing -- the suggestions were to lose "two pounds of body fat" to be in the "fit" range, which I did by taking off my clothes and going potty this morning.  

I'm fit.  "I fit."  

LMAO.  

And, to add resistance training - because my personal goal is to gain muscle mass and retain health. This is my start.

It's not too late.  Have you done a fitness profile?  

 

 

 

Is the obesity crisis hiding a bigger problem?

• What if we have it backwards?
• What if we've ... evolved?
• What if we treated the problem?
• Just a listen.  He is easy to listen to.

Weight Loss Surgery Connected to Increased Risk Of Colon Cancer

GET. YOUR. COLONOSCOPIES.  IT COULD SAVE YOUR LIFE.  Don't be scared. It's no big thing. Really. The preparation is harder than the procedure.  (My spouse is at this very moment, searching for a GI to make that appointment he canceled more than five years ago.  He's a high-risk patient with family history.)

With that, I tell you - BOTTOMS UP!

(Reuters Health) - Obesity is already linked to a higher risk of colon or rectal cancer, but a new study suggests this risk is even greater for obese people who have undergone weight-loss surgery.

Based on a study of more than 77,000 obese patients, Swedish and English researchers found the risk for colorectal cancer among those who have had obesity surgery is double that of the general population.

Though colorectal cancer risk among obese patients who didn't have the surgery was just 26 percent higher than in the general population, researchers said the results should not discourage people from going under the knife.

"These findings should not be used to guide decisions made by patients or doctors at all until the results are confirmed by other studies," said Dr. Jesper Lagergren, the new study's senior author and a professor at both the Karolinska Institute in Stockholm and King's College London.

Each year more than 100,000 people in the U.S. have surgery to treat obesity.

Lagergren and his colleagues point out in their report, published in the Annals of Surgery, that obesity is tied to elevated risks for a number of cancers, including colorectal, breast and prostate (see Reuters Health story of November 3, 2011 here: reut.rs/t9sYxO).

Whether surgery to lose weight can affect those risks is uncertain.

Two earlier studies, one from the U.S. and the other from Sweden, found that the chances of obesity-related cancers decline after women have weight-loss surgery.

But an earlier study from Lagergren's group found the risks for breast and prostate cancers were unaffected by obesity surgery, and colorectal cancer risk increased.

To investigate that finding further, Lagergren's team collected 29 years' worth of medical records on more than 77,000 people in Sweden who were diagnosed as obese between 1980 and 2009. About 15,000 of them underwent weight loss surgery.

In the surgery group, 70 people developed colorectal cancer - a rate that was 60 percent greater than what would be expected for the larger Swedish population.

When the researchers looked only at people who had surgery more than 10 years before the end of the study period, the number of cancer cases was 200 percent greater than the expected risk for the general population.

In contrast, 373 people in the no-surgery group developed colorectal cancer, which was 26 percent more than would be expected in the population and that number remained stable over time.

A two-fold increased risk for colorectal cancer is not a "negligible risk increase, but it should not be of any major concern for the individual patient since the absolute risk is still low," Lagergren told Reuters Health in an email.

In the U.S., for instance, 40 out of every 100,000 women and roughly 53 out of every 100,000 men develop colorectal cancer each year.

Doubling that risk would make the annual figures 80 out of every 100,000 women and 106 out of every 100,000 men.

Lagergren said that more studies are needed to confirm his results before they should be included in clinical decision-making about whether patients should undergo weight-loss surgery.

The study results cannot prove that the surgery is the cause of the elevated cancer risk.

And, Lagergren says it's also not clear why the surgery might be tied to an elevated risk of colorectal cancer.

• One possibility is that dietary changes after surgery, and increasing protein in particular, could raise cancer risk, he speculated.
• Because the gut plays a significant role in the immune system, he added, "Another potential factor is that the bacteria that naturally reside in the intestines may change after surgery and alter future cancer risk."
• Lagergren noted that he also couldn't rule out the possibility that residual excess weight and weight gain after surgery might be involved.

 

SOURCE: bit.ly/10TcCGy Annals of Surgery, online March 6, 2013

The study -

Annals of Surgery 

http://journals.lww.com/annalsofsurgery/Abstract/publishahead/Increased_Risk_of_Colorectal_Cancer_After_Obesity.98506.aspx

Abstract

• Objective: The purpose was to determine whether obesity surgery is associated with a long-term increased risk of colorectal cancer.
• Background: Long-term cancer risk after obesity surgery is not well characterized. Preliminary epidemiological observations and human tissue biomarker studies recently suggested an increased risk of colorectal cancer after obesity surgery.
• Methods: A nationwide retrospective register-based cohort study in Sweden was conducted in 1980-2009. The long-term risk of colorectal cancer in patients who underwent obesity surgery, and in an obese no surgery cohort, was compared with that of the age-, sex- and calendar year-matched general background population between 1980 and 2009. Obese individuals were stratified into an obesity surgery cohort and an obese no surgery cohort. The standardized incidence ratio (SIR), with 95% confidence interval (CI), was calculated.
• Results: Of 77,111 obese patients, 15,095 constituted the obesity surgery cohort and 62,016 constituted the obese no surgery cohort. In the obesity surgery cohort, we observed 70 patients with colorectal cancer, rendering an overall SIR of 1.60 (95% CI 1.25-2.02). The SIR for colorectal cancer increased with length of time after surgery, with a SIR of 2.00 (95% CI 1.48-2.64) after 10 years or more. In contrast, the overall SIR in the obese no surgery cohort (containing 373 colorectal cancers) was 1.26 (95% CI 1.14-1.40) and remained stable with increasing follow-up time.
• Conclusions: Obesity surgery seems to be associated with an increased risk of colorectal cancer over time. These findings would prompt evaluation of colonoscopy surveillance for the increasingly large population who undergo obesity surgery. 

Related articles

Weight-Loss Surgery's Weird Alcoholism Risk (It's not weird.)

No long-term cost savings with weight loss surgery

Leading Obesity Groups Call for Putting Health, Longevity and Quality of Life First When Considering the Economics of Bariatric Surgery

And what then?

“In case you never get a second chance: don't be afraid!"

"And what if you do get a second chance?" "You take it!” 

― C. JoyBell C.

 

I am wondering if someone out there is holding a voo doo doll of me and hastily stabbing pins everywhere but in me. Quit it.  You're missing the target.  

We are wrapping up the end of March over here with the third (..fourth?) major life-changing event of 2013.  

I thought that if I did not blog about the first (...as much as I have wanted to, I was told no and I have been SCREAMING on the inside!  Still.  AM.  :x) or second (more?) that these things would not occur in threes or more but they do.  I still haven't written, much at all actually.  

Because stop.

Currently - my father is sitting in the Beth Israel Deaconness Medical Center in Boston, MA awaiting a Triple Bypass Heart Surgery on Friday morning after two RED FLAG WARNINGS that landed him in the ER.  

11 years ago, he had a stent placed after a mild heart-attack.  These warnings (DO NOT IGNORE YOUR HEART, PEOPLE!) happened just after he lost his job and likely stress was of no help.

What is a Triple Bypass?  

When one of the heart's arteries gets blocked and a person has a heart attack, one common procedure is to perform heart surgery and sew in a new piece of blood vessel to bridge over (bypass) the blockage. In many cases, the surgeon will fix not only the immediate problem, but also other arteries on the heart that are starting to look blocked. If the surgeon repairs three of the arteries, it is called a triple bypass. If four arteries are repaired, it's a quadruple bypass.

The positives?  

He's losing weight rapidly while in the hospital.  He had lost weight in a medically-supervised plan with his physician's office just prior to this event, but now he's busted into the 200's.

He's off the nicotine, and mentioned that the nurses kept trying to slip him nicotine-patches and he doesn't crave them.  It's been nearly a week, smoke-free!  This is a huge deal.  Hopefully after surgery and rehab he can maintain living smoke-free, he's done it before.

He can rock this.

He appreciates your well-wishes.

• "What is a heart bypass operation?"  01 April 2000.  HowStuffWorks.com.  27 March 2013.
• http://www.heart.org
  

Related articles

Weight-Loss Surgery's Weird Alcoholism Risk (It's not weird.)

Cleveland Clinic study shows RNY bariatric surgery restores pancreatic function by targeting belly fat

Gastric Artery Chemical Embolization GACE Procedure Helps Shut Off Ghrelin Production Without WLS

Infertility in obese women may be due to damaged eggs, Brigham study finds

Infertility in obese women may be due to damaged eggs, Brigham study finds

Obesity has long been associated with infertility as well as lower success rates with in vitro fertilization, and now researchers think they understand why: Obese women are more likely to have abnormalities in their eggs that make them impossible to fertilize.

Brigham and Women’s Hospital infertility researchers examined nearly 300 eggs that failed to fertilize during IVF in both severely obese women and those with a normal body weight.

They found that severely obese women were far more likely to have abnormally arranged chromosomes within their eggs compared with women who weren’t overweight, according to the study published Wednesday in the journal Human Reproduction.

 

Chemicals in nail polish, hairspray linked to diabetes in women?

Chemicals commonly found in beauty products such as nail polishes, hair sprays and perfumes may increase risk of diabetes for some women, new research suggests.

Oh.

Diabetes can return after gastric bypass

21% of patients in a study had recurrence of their diabetes a few years after roux en y gastric bypass.  This suggests that those with diabetes might benefit from having weight loss surgery EARLIER in the course of their obesity and disease?  

It could be -

LA Times via Mayo Clinic -

A new study by researchers at the Mayo Clinic Arizona in Scottsdale, however, suggests that more than a fifth of those who are cured suffer a recurrence of their diabetes within five years, even without a weight gain. The results indicate that patients who had suffered from diabetes the longest were most likely to have a recurrence, suggesting that surgical intervention should be undertaken early in the course of the disease.

Dr. Yessica Ramos and her colleagues at Mayo studied the records of 72 obese patients who underwent a Roux-en-Y gastric bypass operation between 2000 and 2007 and who had at least three years of follow-up. They reported at a Houston meeting of the Endocrine Society that 66 of the patients (92%) had a reversal of their diabetes at some point. Within three to five years after their surgery, however, 14 of those patients (21%) had a recurrence of their diabetes. The patients who did not have a recurrence lost more weight initially and maintained a lower average weight during the study period, but they did not regain less weight than those who had a recurrence.

But the longer the patients had suffered from diabetes before the surgery, the more likely they were to have a recurrence. Patients who had had diabetes for more than five years were 3.8 times more likely to have a recurrence than those with less than a five-year history.

 

Year of abdominal pain -- Hydrogen Breath Testing

Update -

Mr took me into Boston today for the Hydrogen Breath testing.  I thought I took to be there super-early, turns out I waited in the wrong part of the GI unit for an hour before realizing it. 

I had to drink a lactulose solution, and puffed into a bag with a syringe on it.  My air was injected into a super cool gas analyzer machine and that's that.

I think I passed -- or I failed?  I watched the numbers of the machine during each breath sample collection and I saw an increase in the numbers, however the tech said that she didn't see "much change."   So, bacteria may not be my problem.  Interestingly, the drink triggered more pain.  Thanks!  I don't DO 'OSES for that reason.

Small Bowel Bacterial Overgrowth Syndrome (SBBOS) or Small Intestinal Bacterial Overgrowth (SIBO) - the patient is either given a challenge dose of glucose, also known as dextrose (75-100 grams), or lactulose (10 grams). A baseline breath sample is collected, and then additional samples are collected at 15 minute or 20 minute intervals for 3–5 hours. Positive diagnosis for a lactulose SIBO breath test - typically positive if the patient produces approximately 20 ppm of hydrogen and/or methane within the first two hours (indicates bacteria in the small intestine), followed by a much larger peak (colonic response). This is also known as a biphasic pattern. Lactulose is not absorbed by the digestive system and can help determine distal end bacterial overgrowth, which means the bacteria are lower in the small intestine. Positive diagnosis for a glucose SIBO breath test - glucose is absorbed by the digestive system so studies have shown it to be harder to diagnose distal end bacterial overgrowth since the glucose typically doesn't reach the colon before being absorbed. An increase of approximately 12 ppm or more in hydrogen and/or methane during the breath test could conclude bacterial overgrowth. Recent study indicates "The role of testing for SIBO in individuals with suspected IBS remains unclear." ^[2]

The excess hydrogen or methane is assumed to be typically caused by an overgrowth of otherwise normal intestinal bacteria.

Tomorrow is marked with the most exciting of several tests in an attempt to narrow down my year of abdominal pain. This test could show the presence of Small Intestinal Bacterial Overgrowth -- which is somewhat common in those who've got lower gut issues and also in those who have had gastric bypass or who have had abdominal surgeries.

Bascially -- I breathe into a bag every so many minutes for a few hours.  The samples are collected and tested for the presence of excess gases.  'urp. Reading about these tests, and watching test videos and the excessive use of the word METHANE only brings to mind ... cows.

If I get a positive result on this test -- I am starting a post bariatric energy company.  <sarcasm intended> There are far too many of us with broken guts who could probably power up our own houses with malabsorptive misfirings.

Hydrogen Breath Testing

The hydrogen breath test is used to identify lactose or fructose intolerance, or an abnormal growth of bacteria in the intestine. It is used to diagnose a lactose or fructose intolerance, which is the inability of the body to digest and or absorb lactose, the sugar found in dairy or fructose, the sugar found in a number of foods (fruit, vegetables, soda, etc.). Hydrogen breath testing can also be used to diagnose intestinal bacterial overgrowth. A breath sample will be collected and tested for the presence of hydrogen. To obtain the sample, you will be asked to blow up a balloon-type bag. Normally, very little hydrogen is detected in the breath. You will then be given a lactose, fructose, or lactulose solution to drink. Breath samples are collected every 15 minutes for 2 hours to detect any increase in hydrogen in the breath as the solution is digested. Increased hydrogen breath levels indicate improper digestion. The testing procedure lasts about 3 hours.

Super-fun, but likely the easiest of the tests because nothing goes inside me.  See? 

Next, is the capsule endoscopy. Then, the colonscopy for the holiday. 

Dear Santa, I thought I'd been good...