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I lost one pound in three weeks, however my clothes fit much better.  I can fit into the clothes I was wearing last summer when I was 10 pounds lighter (before my lapband eroded).  Here's what I learned at this appointment (which I hope will be of benefit to others, especially the "slow losers" like me):

I kept a food journal with the following:  Time/Food/Amount/Hunger Level/Where & With Whom/Activity/Minutes Spent Eating/Feelings.  

1) I'm not really an emotional eater but I eat more when I'm stressed.  I also tend to munch a lot while I'm watching TV.  My action steps to improve these two areas include munching on fresh vegies instead of junk.

2) After 3+ years after WLS, I still have a diet mentality.  I can be very good "on", and I can be very bad "off".  I thought I was working so hard for minimal results, and most days I ate fairly well, but on my most stressful day I had 2800 calories!  Yes, anyone can sabotage any WLS by eating more than 1500 calories of pure junk in one day.

3) I can't lose weight if I eat when I'm not hungry.  That seems like a no brainer, but for years I've eaten every 3 hours because of my hypoglycemia that causes migraines if I wait too long to eat.  For example, I had a higher than normal calorie lunch, but still had my snack 3 hours later because it was "time".  I'm supposed to wait until I'm hungry and carry glucose tablets (15 calories) if I start to feel a headache coming on.  And carry a snack always for when I do feel hungry.

4) The "chocolate only on Fridays" rule doesn't work for me.  Once I start, I don't want to stop.  I need to just eliminate it completely for awhile.  Am I willing to do this to lose the last 10 pounds?  I don't know.

5) From the first appointment, the areas I was able to change:  I am now eating some yogurt every day (non fat/light); I increased my average miles of running each week from 24 to 28.

Lapband 
I chose the lapband because it was the least invasive WLS.  I was a very happy bandster for 3 ½ years.  I was able to reach my goal weight and never felt hungry.  There were days when I couldn’t eat any solid food (some think this is from hormonal fluctuations), and sometimes that pissed me off, but I was willing to live with this inconvenience in order to remain thin.  I also had my share of vomiting, but again I was wiling to live with this.  The port really didn’t bother me either.  I was VERY happy to be thin and keep my weight stable.  I was absolutely heartbroken when my erosion was detected.  I considered having another band placed, but the risk of erosion increases with this, and I just couldn’t handle the possibility of this happening again.  I elected the VSG procedure.

Lap band Removal w/ VSG 
From what I understand, the chances are greater of complications when the band is removed at the same time the VSG procedure is done.  However, I haven't heard of any serious complications from this.  You may have to stay in the hospital a little longer for example.  I had my eroded band removed six weeks before the VSG because my doctor said the hole in my stomach from the erosion would have to heal first. 

My BMI before the band erosion was detected was 21.9.  At first my doctor did not want to do the VSG procedure because of my weight, but I showed him my “before” picture, and he finally agreed.  My BMI on the day of the VSG operation was 25.4 – I gained 26 pounds in the 3 months that my band was unfilled and then removed.  I couldn’t believe how hungry I was during that time – hunger I hadn’t felt in over three years.  I have no doubt I would have continued gaining weight.

Recovery
I had a pretty rough first 48 hours after VSG (which again, may have been due to the scar tissue from the band erosion), but after that, life was good again.  Other than the normal tiredness, I was able to walk a mile after 1 week, and go back to work in 10 days.  And I could run much sooner after VSG because I didn't have that incision soreness at the bra line from the band.

Lap band vs. VSG 
The VSG is a cake walk compared to the band.  No "deer in the headlights" moments for me with the VSG.  I have not experienced any PBing, sliming, or pain from things getting "stuck".  I had to overeat once (and vomit afterwards) to test the limits of the VSG.  At six months out, I can eat any foods - including pasta, bread, celery, lettuce, ect.  Generally, my stomach can hold 1/2 a sandwich (made from home, not giant restaurant portions), 2 1/2 to 3 oz of meatloaf, or 2oz of meat plus some vegetables for example.  One of the biggest improvements is that I can enjoy salads again!

I still have the same challenges of sweet eating and grazing.  And with unlimited food choices with the VSG, it is easier to choose the wrong foods – foods that may not be as healthy as I’d like.  I eat more food (a larger portion, but not nearly as much as before WLS) than with the band, so those choices are even more important for me.  That is more easily accomplished without the nagging hunger that always ended my previous diet ambitions.  My weight is no longer a yo-yo and I try to focus on healthy foods to fuel my active lifestyle. 

Am I happy with VSG?  Hell yeah!

Well, I met with a registered dietician this week to get some advice about losing those last 10 pounds.  Since people have asked about how many calories we should be eating, I thought I’d share that the dietician advised me to eat 1800 calories per day.  I know that is double what some eat, but I just can’t stay that low without feeling deprived.  

I burn about 400 calories per day in exercise now and plan to up that average to 450 calories per day, so my net calories should be about 1350.  I think this is all doable if I can just stay away from the junk.

Here are my goals:

Eat 1800 calories per day (50%+ from healthy carbs)

Increase running from 24 miles per week to 28 

Limit chocolate and other junk food consumption to Fridays only – this will help me not feel deprived (I run 10 to 20 miles every Saturday morning to help burn some of this off)…Yippee!  Today is Friday!

Eat less processed and more complex carbohydrates

Eat more fruits and vegetables

Note:  My protein level is okay at 75 to 100 grams per day.  I go back to the RD in three weeks.

 

Woo Hoo!  I lost another pound.  I've now lost 15 of the 26 pounds I gained after my lapband eroded:

Month 1:  13 pounds
Month 2:  1 pound
Month 3:  1 pound

Okay, I'm a really slow loser!  Although I'm upset that I don't fit into last summer's board shorts, I can live with this.  Losing one pound a month is better than gaining 26 pounds in three months any day!!!!  

I'm writing everything down, calculating my calories in (eating) and my calories out (through exercise only, please!).  I hate doing this but at least it's making me more aware.  Knowing that donut I want is 270 calories is a motivator to stay away from it.  And it's also a tool to plan my eating so that I'm not grazing all day.  So I'm stuck with keeping track of everything for awhile.  It's okay, I have the process down to a science on my computer.

I started weight training again (stopped six months ago when I was depressed that my band had eroded).  Aah, now that feels good.  Along with my consistent marathon training and eating plan, I should be back in the 140s by summer.

My hunger struggles have improved somewhat.  I realize my head wants to eat more than my stomach.

I guess I thought this VSG thing would be easy.  I mean, I thought the weight I gained when my lapband eroded (26 pounds) would just fall off without any effort at all on my part, and that I would never feel hungry.  This VSG was supposed to be a "miracle".  I haven't become a true believer yet, but I'm hoping to get there.

In the last six weeks, I've struggled with hunger and cravings.  I've whined because I'm not losing weight fast enough.  And I've mourned the loss of my band.  Poor, pitiful me!

Okay, reality check.  I'm no longer overweight.  And more important, my weight isn't sky rocketing upward and out of control anymore either.  I've lost 14 of the 26 pounds I gained after band removal.  So what if it takes a year to lose the last 12 - 14 pounds.  Yeah, some days I say "you go girl", and other days I say "I feel so fat" (it might as well be 120 pounds not 12).

All I can do is keep putting one foot in front of the other and try to make more good choices than bad.

I was really worried about this marathon.  Although I had done 24 marathons before, this was six friggin' weeks after surgery.  I tried to talk my fiance and running partner out of this trip, but he wanted to do it so I made the plane reservations (with reservation, ha-ha).

Three weeks before "M" Day (three weeks post-op) I made an effort to run a long training run, which is usually 20 miles.  I could only do eight miles and had to walk the last two miles home.  I felt dead.  Discouraged, I decided to run the half marathon, which is "only" 13.1 miles.

Two weeks before "M" Day (four weeks post-op) I ran 13 miles and felt great.  I thought perhaps maybe I could run the full marathon if I added some walking.  Okay, here goes nothing!

"M" Day:  I did it!  Six weeks post-op I ran my 25th marathon and felt great at the end.  I think it was the combination of walking and running and reaching a milestone in recovery.  I feel "normal" again.  Next up is the Fargo Marathon in North Dakota - 5/19/07.