Two weeks prior to my scheduled surgery, I started my pre-op diet which consisted of two high-protein/low-sugar shakes to replace breakfast and lunch, followed by a reasonable dinner of lean protein and veg - no carbs, no starch, no sugary beverages, no alcohol.
"Piece of cake," I muttered to myself as I packed the car and headed southeast to northern Alabama to cover one last fishing tournament before life, as I knew it, would basically be altered forever. I figured pounding protein shakes on the road, my mind distracted by time in the wind and on the water, would be much easier than missing "real food" sitting at home in an office chair.
There are times when I think I know myself so well, and then suddenly I have no idea who the person is staring back at me in the mirror. Ever happen to you? It happened to me in northern Alabama.
One of the things I love most about my job in the fishing industry (I work for a little soft-plastic bait company as a content manager) is that I get to travel outside my tiny northern Arizona town to places hither and yon. Due to the fact I live forever and a day away from a major airport and I'm usually traveling with lots of digital equipment, I manage to talk the boss into letting me drive. If you know me, you know that road trip is synonymous with food adventure. If I did not work in the fishing industry, I'm doubtful I would have had the opportunity to experience places like Franklin BBQ (Austin), Hot and Hot Fish Club (Birmingham), Parachute (Chicago) and Sportello (Boston). Enjoying exceptional food on the road and recreating it in my little kitchen has been what this blog is about, mostly. I knew this trip to Alabama was going to be different - I wouldn't be able to spend the majority of my free time exploring food destinations like I normally would - but it was harder than I thought it would be.
But I am an adult, and adults manage to handle things like that without much fuss.
I want you to know that I did handle it - but not without much fuss. Suddenly, it seemed like there was a doughnut shop on every corner in Muscle Shoals. And why did the myriad of fast-food signs seem to glow brighter and more sinister as I drove past them on my way to the lake, taunting me with their unavailability? On days that I'm not on the water shooting pics of people catching little green fish, I normally spend the day sampling the local breakfast, lunch and dinner spots. On this trip, I found myself regulated to decaf lattes at a coffee shop all the kids from the University of Northern Alabama hang out at on the corner of Seminary and Mobile Street. No trendy toast for breakfast, no wood-fired pizza for lunch.
I muddled through that first week on the road, and by the time I made it home I was feeling quite positive about my mostly liquid diet. I was already starting to lose weight by eliminating the carbs I loved so much and I began to wonder if having something as dramatic as bariatric surgery was really necessary? If I kept up this mostly liquid diet, I'd lose the weight I needed to lose.
And then I remembered the day I first met my surgeon, Dr. Alderidge, at the information session required prior to making an appointment for qualification to the program. At that point I was still skeptical and inquisitive - was this the step I needed to make? It all seemed so drastic, and so permanent. Dr. Alderidge shared a lot of information about the different procedures available and the long-term health benefits derived from each of them, but then he closed by saying, "The chances of a person who has been very obese for a very long time losing weight and keeping that weight off long term is very slim."
And that is when I knew that the years of gaining and losing the same 50 pounds needed to come to an end, and this was a tool that could help me do that. Yes, I could drink protein shakes and cut carbs for several weeks or several months at a time and lose weight, but who wants to drink protein shakes for the rest of their life? Who wants to completely cut out all complex carbs for the rest of their life simply to maintain a mediocre amount of weight loss?
Some people can work with that, and if that is you, you're my hero. It's just not me, and I knew what I had to do.
Making the Decision
There are three types of bariatric procedures the program in Flagstaff, AZ offers: the Gastric Band, the Gastric Sleeve, and the full Gastric Bypass. Based on the research I did, I felt the procedure that would work best for me was the Gastric Sleeve procedure.
The Sleeve is the newest procedure and while it has less data to refer to, I found that is simpler than a full bypass procedure (which involves removing a large portion of the stomach, bypassing the small intestine, and connecting the new stomach pouch to the large intestine) in that while a larger portion of the stomach is removed, the new stomach "sleeve" remains attached to the small intestine. So there is a bit less "rearranging" of parts, and it is nearly as effective (85-95%) as the full bypass procedure (which is still deemed to be the gold standard of weight loss surgeries). The band wasn't an option for me - I knew I wanted something that was more "permanent" and I didn't like the idea of having to go back to to have them fiddle with re sizing the band through a port under my skin (eebee-jeebies!).
Generally, human stomachs have a volume of about one liter, which is a little more than one quart. Since the stomach has the ability to expand, it can hold much more food. The human stomach can be distended up to four liters, which is more than one gallon. One gallon! I may have been eating whole foods, complex carbs, and generally healthy meals, but over the years I just ate too much of all of that. With the gastric sleeve, the portion of your tummy they remove is the most "stretchy" part. Your new sleeve/tummy is less stretchy, but you have to maintain it to keep it that way, and I'll be sharing a lot about that maintenance here on the blog.
This procedure, as effective as it already is proving to be FOR ME, is merely one of many tools that people can utilize if their goal is to lose weight. Bariatric surgery is not for everyone, and I'm not here to advocate that everyone who weighs more than they should needs to consider it, or doing anything else for that matter to lose weight - unless they feel it's in their best interest.
Living for as long as I have, as overweight as I am, has not been easy. On top of dealing with fat-shaming (doing it to myself and experiencing it from others) I just didn't feel good. It hurts physically to be as heavy as I was. Being very overweight kept me from enjoying things in life that normal people take for granted every day and I wanted that to end. The cycle of holing up in my house eating because it was too painful to talk a walk, go on a hike, ride a bike, enjoy being outdoors ... that madness had to stop. This is the decision I made for myself, but I will never assume anyone else should make the same decision.
Today I am two weeks out from surgery and on my second week of pureed foods. Every bariatric program is different, but I'll share a little bit about mine: Since your new tummy, whichever procedure you've elected to have done, is much smaller and a bit swollen and grumpy after surgery, it's important that you introduce foods that are not liquefied very slowly. One week after surgery I began eating 1-2 tablespoons of pureed or super-soft protein, plus 1-2 tablespoons of pureed fruit, vegetable or starch, which I switch up for breakfast, lunch and dinner. That doesn't sound like very much, because it isn't very much - but right now, it's all baby tummy can handle!
Getting enough protein in a day is paramount. Protein aids in healing, keeps your metabolism stable, and helps build muscle. But the thought of pureeing lean meat (chicken, turkey, fish) just made me, um, not want to eat that, so the protein I've been eating a lot of right now is scrambled eggs and low-fat cottage cheese. That was fine for the first week, but going on my second week of pureed protein, I was hoping to switch things up a little.
I stuck with eggs because they're protein bombs, they're soft, and I just really love eggs. If you don't like eggs, we can't be friends. Okay, we can be friends, but I'm going to need you to get some counseling. Food and Wine's June issue has been a god-send. The issue is simply brimming with protein-heavy recipes that are perfect for the grill. I've dog-eared nearly every page in anticipation, but I still can't eat solid foods quite yet. Enter their recipe for an herbed egg salad and I am saved from a second week of scrambled eggs!
Fresh herbs give finely chopped boiled eggs a lift, and using Greek yogurt with a bit of olive oil ups the protein value and healthy fat much more than regular mayonnaise would. F&W's version includes chopped cornichons and capers which I would normally include, but right now I need to keep foods extremely smooth so I've omitted them in this recipe. Feel free to toss some in if you'd like!
Herbed Egg Salad
*Recipe based on Food and Wine's Egg Salad with Herbs and Pickles
4 large eggs, boiled, and finely chopped
1/4 cup Greek yogurt
1/8 cup finely chopped parsley
1/8 cup finely chopped tarragon
1/8 cup extra-virgin olive oil
Okay, so it's not difficult to boil an egg in theory, but technically, it can be difficult to turn out a boiled egg where the whites are set (but not overcooked and rubbery) and the egg yolk is creamy and just cooked through. And then there's the peeling factor as well.
Here is how I boil eggs and it works well for me every time, but there are a lot of different techniques out there, including a brilliant new technique from J. Kenji Lopez-Alt in his Food Lab Cookbook which you can also find on the seriouseats.com website here. I am just about out of boiled eggs and plan to try his technique soon. It looks promising, and not any more trouble than my technique below. I suggest you look into it!
1. In a small bowl, mix the Greek yogurt with the minced herbs, olive oil, and season it with salt and pepper to taste.
2. In a large saucepan, bring two quarts of cold water, plus four eggs to a boil. Remove the pan from the heat, cover, and let sit for 10 minutes. While the eggs are cooking, create an ice bath in a large bowl and have it on standby. Drain the eggs and gently tap them to crack the shells a bit, then let them rest in the ice bath for a few minutes until they are cool enough to handle.
3. Peel the eggs under running water (I like to use a mesh strainer over the drain to keep the egg shells out of the garbage disposal) and cut them into small dice.
4. Gently fold the herbed yogurt mixture into the eggs. Taste again for seasoning and add salt and pepper if desired.
While I eat this egg salad completely on it's own at present, it would be yummy over crisp lettuce leaves with an additional splash of good quality olive oil, and of course as a sammy using some hearty whole-grain bread.