February 22, 2018


In a completely deranged fit of solidarity, I decided to mimic P.J.'s pre-op diet this week.  No one in their right mind would do this, but being in my right mind isn't something I have to worry about, so no matter there.

Two shakes a day, two "snacks" (a cheese stick, two ounces of meat, one egg, some raw vegetables ... that sort of rubbish), all the beef broth you want, and a dinner consisting of three ounces of lean meat and some vegetables with olive oil on them.  We wrote in "and coffee" at the bottom of the list.  (P.J.'s having to detox from coffee to avoid the nightmare headaches.  Fuck that right in the eye socket.)

You know I couldn't just sit there and eat mashed potatoes and BLTs at her while she sipped her shakes.  There's fair, and then there's sadistic.  Please don't tell her where I stashed my mug of coffee.  Solidarity only goes so far.

Transitive law:

a = "Lean Meat"
b = "Dry."
c = "You go through everything in the refrigerator door and there is nothing that can be used as a sauce because everything has fucking sugar in it except for the ketchup and you can't eat that on fish and you can't even use applesauce and how do they expect a person to choke this down because it's like chewing thread and you can't even drink water with your meal and you start to look at the green beans as a beverage because they have oil on them."

a = b, and b = c; therefore, a = c

Okay, maybe it isn't just out of solidarity that I'm along for the ride, though it's self-evident that volunteering to go through this again is firmly rooted in an unsound mentality.  I'm now officially ten pounds above my nadir and not at all amused.  I'm wrapping up the Bariatric Foodie Challenge this week and made this my last goal.  The weird thing is, I'm on day four, and I haven't killed anyone yet.

Yet.  Plenty of people have been submitting their applications for the chance to be first in line.

Metabolic flexibility has never been in my profile.  I'm one of the people for whom Mars, Inc. started putting "HANGRY" on its Snickers bars.  The "food mood" is real.  Four hours to the minute after I last ate something significant, I become confused and irritable.  You can see it appear on my face, hear it in my voice, almost instantly.

I was pre-diabetic and bumping right up against the full-blown disease when I had my gastric bypass.  The Roux-en-Y froze my A1C numbers and bumped the range down just a bit, and there it sits, sort of permanently pre-diabetic.  I can live with that and so can the nutritionists.

My body seems to be tailor-made for a low-carb diet.  I would have found my way to this eventually even if low-carb had never become a popular thing to do.  Some doctor would have set me on the right path.  I did well for a while after surgery, until the Bagel Addiction ("but the cream cheese has protein"), replaced later by the Triscuit Addiction ("but I'm eating them with a cheese stick"), took hold.  My brain loves it some carbs, never mind what's optimal for my body.  The pleasure center is all like, "Bruh!  Where you been?  Just been chilling here with nothing to do.  Sure, there's room - move your stuff in.  Mi casa es su casa."

Thomas' came out with their benighted maple French toast- and s'mores-flavored bagels exactly one week after I swore off bagels for good.  They need to be collectively violated with a cactus dipped in lime juice and rolled in salt.

My diet has progressed these last months so that it's now about eighty percent carb-based.  Even being a dumper hasn't deterred this.  And the weight has crept up.  And I've been sad about that.  So I've eaten more carbs to stop being sad.  I've been back in the craving cycle, hungry all the time, then eating when hunger has nothing to do with it.  Eating just because I enjoy the hell out of it.  Hunger hasn't been an issue because I never have a chance to feel it.  Hey, my intestines aren't absorbing as much of this stuff, right?  And if I drink with it, it just washes through.

They call this "eating around the pouch" and it is the nemesis of all bariatric graduates.

There are rules.  Chew each bite of food thirty times.  Do not drink liquid thirty minutes before or after you eat.  Take thirty minutes to consume your portion-controlled meal.  Don't get into the habit of snacking, especially on crackers.  Use protein shakes to make up for what your body needs.  Journal everything.  Always take your specialized vitamins to avoid dangerous deficiencies.  Get your protein in first, then vegetables, then carbs if there is room (there shouldn't be much).  Hydrate.  Be mindful.

What having an egg-sized pouch for a stomach does, when you follow the rules:

- It makes you feel full with much smaller portions of food during meals.
- Because you are full, it triggers brain-gut hormonal signals the same way a large meal would.
- It makes it possible to eat correctly and not suffer from constant hunger.
- A shorter intestinal tract means you absorb fewer calories from the food you eat.
- Insulin levels and associated maladies are (almost always) reversed.

What having an egg-sized pouch for a stomach does, when you don't follow the rules:

- *sound of whistling wind*
- *tumbleweed drifts by*
- *crickets in the distance*

And what having an egg-sized pouch for a stomach cannot do, regardless:

Handle being in recovery for you.

I'm a food addict in recovery.  Recovery from food addiction is identical to recovery in any other sense ... alcohol ... drugs ... gambling ... except that you can keep out the liquor and heroin and you can avoid your bookie, but you can't not have food in the house.  Recovery basically resembles the mentality one has when being on a diet, except that it's forever.  No going back.

My brain wants a hit, man.

I thought the same things everyone else thinks, in the beginning.  This will fix it all for me.  (My procedure was for intractable acid reflux, but it was also for weight and diabetes, so I'm not sure why I always throw in that qualification.)  And I will not be one of the people in the stories you hear who gain all of their weight back.  How does that even happen?  What the hell is wrong with them, after all they went through to lose the weight and get healthy?

Boy, did I go through it.  Two surgeries and seven days in the hospital with a huge tube down my nose and constantly collapsing I.V. sites.  Five decorative trochar sites plus a G-tube sticking out of my belly that had to stay put for two months.  Thrush.  A painful hematoma on the left that took weeks to subside.  Two weeks of narcotic meds that left me out of touch with most of reality.  A nurse that farted in my face and didn't say excuse-me.

Okay, so the feeding tube was actually kind of awesome, even though it stung constantly because the wound isn't allowed to heal and close.  Hydration wasn't an issue because I could just pour water in  through the tube without having to drink it.  One night, I poured in a can of traditional [read: rhino-shit nasty] V-8, just because I could.  It stained the tube pink.  This pleased me, because it would make the doctor ask why my tube was pink, and then I could tell him that I drank V-8 through my tube, and he would be weirded out.

And the thrush was awful, because you can't become incorporeal and run away from yourself, even though you really want to.  I had to get Cat Ear Medicine (oh, all right, Magic Mouthwash, but it still had to be refrigerated) from our pharmacy and use it, and because of the Lidocaine in it, our friends would always ask me to say "ssssssufferin' sssssuccotash" while my tongue was numb.  Our friends were assholes.  That's why we loved them.

But back to how it all looks in the shiny new beginning:  How in the hell could anyone let their weight start slipping after going through all of that?

You'd be amazed how many of us do.  Jesus Christ on a cracker (with cheese), it's so easy to do.  I have an inkling that I've just arrived at the threshold of The Hard Part.  The honeymoon is over, baby.  All of that wholesome stuff that makes me wrinkle my nose, commitment and self-discipline and exercise and the word "healthy" (*ptooey*), it comes into play now.  Shit just got real up in here.

I didn't form the habits I was supposed to form over the past two years.  It's not too late.  I can form them now.  I'm on a brink, and it's time to make a decision, to stand and deliver.

I went along with a Piyo DVD for fifteen minutes last night.  It's all about learning the various poses at first, and I think I might look like a fermata when I'm trying to do Downward Dog.  There isn't a mirror.

I haven't had a cracker in four days, either.  Or any sort of carb.  And there are even stretches of several minutes when I don't think about Milton's Crispy Sea Salts.  I keep peeing on Keto-Stix but I know it's early days yet.  After I lose what I've gained back, I'll have to strike a balance somehow, out of ketosis but staying away from the trap of all that is carb-y goodness. And then?

"Do, or do not.  There is no try."  Smug-ass Yoda.

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