Virtual me at 18 stone 12

ME RIGHT NOW 16 stone 3Virtual me at target weight of 11 stone 7lb
I need these boosts occasionally. I have been really really bad the last week or so. I haven't eaten over 1500 cals on any day, but its all been crap. I have tried to include my veggies and stuff, but my Dad's operation and situation is really taking its toll on my eating. I don't even bother to try and stop myself. I look at chocolate and just eat it. Its like I am resigned to it.

Bunk mate - I am sorry I haven't been in touch. I was calling around all the rest of the afternoon trying to tie up a fill with Dr. Dillemans. Sadly he is on holiday next week so its not gonna happen. However if you phone EOC they have now got a new deal with www.WLSgroup.com and they have spaces on the 5th April... that's next Saturday. The first is a consultation and stuff for £120 for EOC patients, and then fills are £85 a go. You can go there every 2 weeks, and if its not right within that 2 weeks you can get it filled/unfilled again for free. I was already going to see them the last couple of times, so I have booked another appointment with them on Saturday at 12pm. If you wing EOC they will arrange a time. After that we were going to take DS to the Natural History Museum if you wanna bring Your DH and the DD's.

It would be nice to catch up.

I have just come home from Mum's. Tensions are running high and everyone needs Dad to get better. He has really been going through it the last few days. The stuff they never tell you about before an operation man!

Here's a run down... (If you are queasy... don't read!)

Tuesday: in Hospital in the morning. Enema's and nothing to eat or drink

Wednesday: in hospital waiting for operation first thing in the morning... and waiting... and waiting until 3pm when he was finally taken down to theatre. Out of theatre and into the Intensive Care Unit at 8:30pm. No visitors all day. Had tumor removed from rectum, bowel cut and hole cut into the side of stomach. Bowel pushed through stomach wall and secured with a plastic rod and wing nuts making 'the stoma' where he will wear a bag over for the next 8 weeks. Reality is this 7cm round red raw bit of gooey meat hanging out his side. Massive 40cm incision vertically from breast to pubis stapled together and covered with dressings. 8 cannula's in various parts of the body... back of hands, arms, neck etc. Drain on opposite side of the stomach leaking blood into a bag, and a catheter for urine.

Yea Gods.

Thursday: In hospital in High Dependency Unit. Blood pressure raised and very bloated from surgery. In obvious pain and wincing at ever couple of words he said.

Friday: In normal hospital ward. Developed chest infection and having to cough up sputum into a pot. in pain. Epidural dosage doubled by his surgeon as he said its not high enough for him (2 days too late me thinks!!). Not in pain except when coughing. Was very sick after having first 'meal' of an ice cream and soup. Brought up green and black fluid.

Saturday: in ward looking flushed. All cannula's removed except one administering a drip with antibiotics in it. Epidural removed because if fell out during the night and soaked into the sheets. Was in increasing pain, doctor called to administer Morphine. Immediately unconscious and slept all night. In the morning awoke to feeling very bad stomach pains. Nurse inserts tube through the nose and down back of the throat and draws off 6 large syringes of green and black watery liquid. Apparently this has FECAL matter in it as the bowel stoma is swollen and everything is backing up into the stomach again! Tube left down back of throat to drain waste water and faeces from stomach into a bag. No food allowed, just clear liquids... like water.

On top of all this awfulness my Granny throws a fit and gets in a strop about not being picked up because we are obviously a taxi service. She upsets my Mum, and in turn Me, DH and DS. She should be supporting my Mum not making herself another burden. My Mum doesn't know which way to turn.

We have come home now and hopefully she can then have some peace and quiet and space to get her head around everything. Although she obviously loves having us there... 3 extra bodies makes 3 lots of extra mess and bother and DS is boisterous and jumping up and down. Its not conductive to thinking straight!! If she needs me, I will be there in a blink. I think that the thing she needs most now is to just be thinking about herself and Dad for a bit and being able to do what she wants rather than what everyone else wants for a change. Everyone worries about the person in the hospital bed, but no one really gives much support to the one trying to keep everything together and cheer everyone up and keep everyone's spirits up.

So, when I have more news I will post it. A simple operation it was not. This is one horrible nasty little cancer that hopefully has been stopped in its tracks.

Poor Dad. I would rather do this for him myself if I could.

Coddler Fever & Fun Friday

Greetings Neighbors!Coddler Fever? Have you caught it yet? Link HereHas Spring Sprung in your part of the world or perhaps a nip of fall is in the air for our Down'Under friends. Either way, the weather is always perfect at the LivingAfterWLS Neighborhood!Today is the final Fun Friday of March 2008 and it puts a song in my heart to invite you to participate in our weekly get-to-know-one-another

Act As If You Are already Slim

Here's some good advice about the positive benefits of visualizing yourself as already being at your ideal weight;

The law of attraction states that you get more of what you put your attention on. When you are overweight your attention is focused on fat, food, diets, calories, etc. You are negatively focused. You are focused on the problem. The key to using the law of attraction for weight loss is to stay focused on the solution.

One of the most powerful ways of doing this is to act as if. Act as if you have already manifested and created the body and weight loss you want! Act like the thin person you want be!

Acting “as if” creates a powerful energy shift. Your actions will begin to align with your new intentions because it creates a positive expectation of success.

See more weight loss secrets and good advice at Secrets of a Weight Loss Master.

Visceral Fat and Dementia

This study was released today, demonstrating in 6,583 patients that visceral fat mass in the 40s predicts the risk of dementia in old age. Patients in the highest quintile (20% with the most visceral fat mass) had an almost three-fold higher risk of dementia than patients in the lowest quintile. This is a greater effect than you see from "genetics". Overall fat mass was less strongly correlated with dementia. This study is so timely, they must have heard about my blog post.

They used a measure of visceral fat called the "sagittal abdominal diameter", basically the distance from the back to the belly button. In other words, the beer belly.

What we're looking at is another facet of the pervasive "disease of civilization" that rolls into town on the same truck as sugar and white flour. Weston Price described it in 14 different cultures throughout the world in Nutrition and Physical Degeneration. Diabetes, cardiovascular disease, obesity, cancer and dementia all seem to come hand-in-hand. It's hard to say exactly what the root cause is, but the chain of causality seems to pass through visceral fat and insulin signaling in many people.

Visceral Fat

This week, I stumbled upon a very interesting series of articles from the lab of Dr. Nir Barzilai.

The first article I came across showed that surgical removal of the visceral fat deposit of rats increased their lifespan. Visceral fat (VF) is the "beer belly", and consists of the perinephratic fat around the kidneys and the omental fat in front of the intestines. It doesn't include subcutaneous fat, the fat layer under the skin.

VF is tightly associated with the metabolic syndrome, the quintessential "disease of civilization" that affects 24% of Americans (NHANES III). It's defined by three or more of the following criteria: high blood pressure, large waist circumference, low HDL cholesterol, high triglycerides, and high fasting glucose. The metabolic syndrome is associated with a 3-4-fold increase in the risk of death from cardiovascular disease, and a 6-fold increase in the risk of developing type II diabetes. From a review on the metabolic syndrome (parentheses mine):

The most common alteration related to the impaired glucose metabolism with aging is the progressively increased fasting and postprandial [post-meal] plasma insulin levels, suggesting an insulin-resistant state.

This is all well and good, but who cares? What's to say VF plays any role other than as a simple marker for overweight?

The longevity paper led me to Dr. Barzilai's previous papers, which answered this question rather thoroughly. Rats raised on standard rat chow, which is a sad little compressed pellet made of grains and added nutrients, develop elevated insulin and insulin resistance with age, just like humans. Unless they don't have VF. Rats that had their VF surgically removed did not develop insulin resistance or elevated insulin with age, despite rebounding to their original total fat mass rather quickly (VF accounts for ~18% of total fat in these rats). These parameters are unaffected by removing an equal amount of subcutaneous fat, which has been shown in human liposuction patients as well.

Removing VF also improved diabetes-prone Zucker rats, which are profoundly insulin-resistant (leptin receptor loss-of-function). It kept wild-type rats just as insulin-sensitive as calorically restricted controls, which had a small amount of VF. This shows that VF isn't just a passive player; it's essential for the development of insulin resistance. It also shows, along with human studies, that insulin resistance is not an inevitable consequence of aging.

Adipose (fat) tissue is being increasingly recognized as an important endocrine (hormone-secreting) organ. It produces many different hormones that affect insulin sensitivity and appetite regulation, among other things. These hormones are collectively known as fat-derived peptides (FDPs). At least one of these FDPs, TNF-alpha, promotes insulin resistance.

Dr. Barzilai's group went on to explore the mechanism of VF contributing to insulin resistance. They increased the rate of glucose flux into the fat tissue of rats by infusing either glucose or insulin into the bloodstream. These treatments both cause increased glucose uptake by fat cells. What they saw when they dissected the rats was striking. The VF had ramped up its production of FDPs from 2- to 15-fold, while the subcutaneous fat had barely changed. Incidentally, insulin increased glucose uptake by VF twice as much as subcutaneous fat.

I'll say this again, because it's important. They forced glucose into VF cells, and those cells dramatically upregulated FDP production. And again, no visceral fat, no FDPs.

In earlier papers, he also showed that the removal of VF dramatically reduces the expression of TNF-alpha and leptin (two FDPs) in subcutaneous fat on a longer timescale, showing that VF and subcutaneous fat communicate to alter the metabolism. Again, TNF-alpha promotes insulin resistance, making it a possible link between the fat tissue and peripheral effects. VF removal had no effect on triglycerides, suggesting that they're only a marker of insulin dysfunction rather than a cause.

Now to take this research to its logical conclusion. Here's a plausible sequence of events leading up to the metabolic syndrome:

• A meal high in quickly digested carbohydrate elevates blood glucose. OR, excessive fructose causes insulin resistance in the liver which leads to high fasting glucose.
  

• Visceral fat responds by increasing production of FDPs.

• FDPs, directly and/or indirectly, cause insulin resistance in the liver, muscle and other tissue. Liver insulin resistance causes alterations in lipoprotein ("cholesterol") profile (more on this in another post). Fat tissue remains insulin-sensitive.

• Fat tissue (including VF) grows in size, because due to its insulin sensitivity it's taking up more than its share of glucose.
  

• The vicious cycle continues, with increased visceral fat size and glucose uptake increasing FDP production, which makes the liver more insulin resistant, which increases glucose production by the liver, etc.
  

• In the absence of lifestyle changes, the cycle only stops when the fat tissue becomes insulin-resistant, at which point you lose control over blood sugar and become diabetic.
  

Okinawa and Lard

The inhabitants of Okinawa, an island prefecture of Japan, are one of the longest-lived populations in the world. Their diet and lifestyle have been thoroughly studied for this reason. Papers typically focus on their consumption of vegetables, fish, soy, exercise, and the fact that some of them may have been mildly calorically restricted for part of their lives.

The thing that often gets swept under the rug is that they eat lard. Traditionally, it was their primary cooking fat, and they use it liberally. Of course, they also eat the pork the lard came from.

I'm not saying lard will make you live to 100, but it certainly won't stop you...

Health Benefits of Vegetarianism

Diana gave up meat many years ago. She said it made her feel sluggish and mentally slow. Diana is 55 years old and teaches yoga classes. She says eating meat affected her yoga practice.

See an interesting article about the health benefits of vegetarianism. They say people who cut meat from their diet have about half the cancer risk and are 50 percent less likely to develop heart disease. Vegetarians are less likely to be obese. They have lower cholesterol, blood pressure, rates of hypertension, type 2 diabetes and prostate and colon cancer.