Our Gastroenterology Blog

 

Hello everyone! My name is Tosha. I’m starting a new weight loss chapter in my life and I'm kickstarting it with the Reshape intragastric balloon. I will be writing about my journey for the next twelve months in the hopes that I can give other people considering gastric balloons some insight into how it works and also so I can share this process with others who are also using ReShape to take back control of their lives. 

I had my final consult with Dr. Din on Thursday February 15, 2018. My procedure is scheduled for March 6th. In my initial consult I was told I had to lose at least 10 lbs. in order to qualify for the balloon.  In my mind I’m thinking how in the world am I going to do this, Lord you know I have a problem with losing weight. I was determined to do it, however, and although it was a struggle to lose the 10 lbs I put my  mind to it and got it done.

I am so excited to be on my way to a healthier me!  I’m preparing myself mentally and physically for the road ahead. I’ve started my exercise regimen by walking 30 minutes a day. I picked up all my medications that I have to take leading up to the procedure and during the time I’ll have the ballon system placed. I’ve actually started Omeprazole today 2/20/18. This medication you have to start taking two weeks before your procedure twice a day to help prepare you stomach for the balloon. I’ve purchased my liquids that I will be consuming for the first couple of weeks. I’m also hydrating myself a little more leading up to the day of my procedure. I have my support system in place. ( I thank God for placing these people in my life) For me it is so important to prepare myself and have that support in place.

I always tell myself in order to get where you’ve never been you have to be prepared to do something you’ve never done. My prayer is that while I’m taking this journey that I will be an inspiration to others.  If I can do what I thought was impossible to do then so can you. Peace and blessings

This time last year I decided to make a change in my life in two ways.  The decision to lose weight and get healthy was probably secondary to the launching of a new business area for our practice, perhaps because I could not have imagined the extent to which finally losing weight and more importantly getting healthy would improve my life in so many other areas.

I sometimes forget just how much progress I've made in a year.  When we were filiming the new ReShape video, Stacey who produced the video and is also one of my closest friends and staunchest fitness supporters, commented on how much I've changed physically.  I told her that I don't really see a drastic change unless I look at both videos together.  She then reminded me of the time we took the girls to a concert at the Verizon Center a couple of years ago.  The elevators were crowded so we took the stairs.  I could barely make it up the stairs without huffing and puffing all the way up.  Last year when I got my bloodwork done my cholesterol was up, I was deficient in several vitamins and minerals, and my thyroid medication had to be increased.  Needless to say I was always exhausted.

This morning Raj and I were out of the house by 7 a.m. and headed to our spin class.  We have done this together most Saturday's and Sunday's for the last several months.  As I was finishing up the last song I really let myself appreciate how strong I am now and really how much better my fitness level is.  I think I could give my college self a run for her money.  I truly did not think I would be here again after I hit 40. 

Last week I got my bloodwork back again.  I  no longer have high cholesterol and had to have my thyroid medication reduced.  My vitamin D levels are normal and I'm looking forward to completing the entire deficiency panel again to see how my new lifestyle has really impacted my health. 

I am so glad that Mildred and I opted to have this procedure done before our practice launched it.  It gives everyone around us a better perspective as we treat patients.  We are all believers in the jump start gastric balloons can give patients, but we also know that the balloon is truly just a tool.  My goal in sharing my own journey was to hopefully share what we have learned about a successful weight loss journey with gastric balloons beyond placement and removal.  I hope I have done that for you.  

We recently launched ReShape, the next generation in gastric weight loss balloons.  I'm going to sign off and turn the blog space over to our ReShape blogger, Tosha.  She will start her journey in the next week or so and we are so excited to share it with you.  Stay tuned and send Tasha some love as she shares her very personal weight loss experience with all of us.

The first week without my balloon has had a lot of ups and downs, but has given me a lot of clarity as to what the balloon has done for me and what I did for myself.

I started eating normally the day of the procedure and realized at 3 a.m. the next day that that was a huge mistake!  I went back to my post balloon insertion liquid diet for the next day and proceeded with caution for a day or two after.  That really helped me reset a bit.  Most importantly I met with my ORBERA coach, Coach Heather, who I had been studiously avoiding for the last couple of months since my weight had plateaued.  I decided that if I really want help losing more weight and keeping off the weight I have already lost I needed to come completely clean to Coach Heather.  That can be really embarrassing, especially when you are FaceTiming.  I think generally we like to talk about our "wins".  Our challenges can be a downer and not talking about them often means not thinking about them.  So this time instead of telling Coach Heather about the new spin class I love or my plan to run a 5K (all true) I decided to tell her about what wasn't working.  I confessed my inability to say no to pizza and pasta.  When she advised me to ask the waiter to not bring bread to the table when I go out to eat I told her how sad the thought of passing up bread made me.  There are literally restaurants I go to just for the bread (I'm looking at you Coastal Flats!)  She paused for a moment and spoke to me a bit about discipline.  I know that having discipline is really important for anyone trying to lose weight (or achieve any goal) but it is also really hard to do if you don't have it.  As we talked more about what I mean when I say that I have no control when it comes to pizza and pasta Coach Heather asked me how much of these things I eat when I do eat them.  As I told her about my portions I realized that in fact I do have discipline or rather the ability to acknowledge that I am full after a slice of pizza or a few bites of pasta.  As simple as this seems, it is information about myself that I did not have prior to this procedure.  I also realized that many of the things I implemented because of ORBERA have just become habits.  Coach Heather also suggested that I pick one meal a week where I don't limit myself if eliminating cheese, bread, pasta, and pizza from my diet makes me so panicked that I throw out all my discipline.  I agreed to that with the understanding that if I don't stick to it, I go cold turkey and eliminate all of these things to break the habit.  

Coach Heather then asked me about my exercise regimen.  I have been going to a spin class with my friend Maureen once a week  OR going for a walk/run once a week.  I was very honest with Coach Heather and shared with her that after a good workout I get busy with other things and don't prioritize another one and before I know it a week has passed.  She looked at me for a moment and then just said, "exercise four times a week."  That's it.  She promised me that if I do these two things she asked me to do I would lose 5 lbs. by our next phone call.  She also felt confident that I will reach my goal weight BEFORE THANKSGIVING if I keep following through.  I find that almost impossible to believe.  My goal is a weight I have not been since law school.  I will say that I have been following Coach Heather's advice this week, I cut out dairy(which I have a sensitivity to but eat anyway) almost completely, I had my full cheat meal on Saturday night complete with chocolate cake, and I alternate running/walking with spin class twice a week.  I made an effort to walk rather than wait between my daughter's basketball games on Saturday knowing that my cheat meal was coming.  Early Sunday morning I ended up in the ER with an allergic reaction.  It ended up being to a laundry additive, but it is the kind of thing that has historically sidelined me for weeks.  I'm on medications, I'm not sleeping well at night, wearing exercise clothes itches etc. etc.  However, I know that I can go one of two ways here.  I can gain all the weight I've worked to lose back (I've done it before) or I can keep moving.  I did take Sunday off, but on Monday morning I completed my run and this morning went to my amazing spin class complete with a Tom Petty tribute.  I felt pretty good already, but when I stepped on the scale one week after my balloon removal, I was in for a surprise.  I weighed in at 132 this morning.  That's 35 lbs. less than my starting weight.  I don't quite believe it since I look the same, but surely it could be losing the weight of the balloon combined with some release of water weight.  Whatever the case, I'll take it and use it to motivate me to keep moving both mentally and literally.  

One of the things that keeps me motivated is having things to look forward to.  We are sponsoring a team for the "Scope It Out" colon cancer awareness 5K walk/run in March, the exact date is yet to be determined.  I plan to run it.  I have never run in any situation before so for me it is quite a challenge.  I've started by preparing by downloading a really simple app, Couch to 5K.  My sister is joining me in training with the app as is our office manager Tia and we'd love to have anyone who feels they need/want the support to join us as well.  As for the 5K, the more the merrier.  We are planning a lot of great things around the event and would like to see as many of our patients, colleagues, friends and family come out and join our team. If you are interested send me an email at [email protected] and I'll put you on our update list so we can hit the ground running when the date is released!

November 28, 2017
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Mildred and I both had our ORBERA gastric weight loss balloons removed yesterday.   I'm going to speak for both of us unless there is something specific that we have different experiences with because my balloon buddy and I really did share a lot of the same concerns and have similar goals.

There were so many feelings attached to the removal of the balloon.  These 6 months have flown by but we have challenged ourselves in ways we wouldn't have considered doing last year.  We are definitely proud of that.  There is regret that we didn't give it our all.  Neither of us committed to a really disciplined workout routine nor were we as strict as we could have been on the diet portion.  One thing we did do, however, is acknowledge our own role in our setbacks and work hard to do better the next day.  There is fear.  On my way in to the procedure I was texting with Mildred who was already at the center and we both were worried that we would lose the ground we gained because the balloon wouldn't be there to help us.  The truth is that the balloon was a tool. It showed us what we could do if we put the work in.  It also does not accept blame.  If I choose to eat around the ballon (as some ORBERA patients do) or skip workouts it was certainly reflected on the scale and the only person to blame was myself.  I've gained and lost the same 7 lbs more times that I care to count in the last six weeks. That's on me.  There was definitely excitement.  At the end of the day, with all the ups and downs, we each lost a significant amount of weight, we mostly stuck to a program we committed to, and definitely felt a sense of completion as this part of the journey ends.

The procedure itself was quick, just like the placement.  There was no real downtime from the removal other than the usual sleepiness after being sedated.  I had a little bit of a sore throat from the tube, Mildred did not.  I had lunch immediately after my procedure I kept it light because of my sore throat, but also was surprisingly not terribly hungry.  I had my procedure in the afternoon and by 7 p.m. I was well enough to go to Michael's for my daughter's project, review my service contract with Verizon at the Verizon store, and hit the grocery store.  I still couldn't drive because of the sedative, but felt great otherwise.  Mildred felt a little "loopy" but otherwise energetic as well.  We are both back to work today and feeling pretty good.

So far no real difference in appetite, so that's good. I feel as if my body really has changed from the inside (specifically my brain).  We know that in order to keep making progress we have to keep changing and working hard. We have each lost about 30 lbs in six months and still have about 15-20 more that we'd like to lose in the next six months so this journey is by no means over.

Stay tuned as we continue working towards our next goal which will culminate at the Scope It Out 5K held annually in March.  We invite all of you to join us and will put out more information about our team as we get closer to the date.

UPDATE: I have to revise my initial account of post ORBERA recovery.  Mildred and I felt so good after the procedure we both probably overdid it the day after both in terms of activity and eating.  On day 3 we both felt some cramping and nausea and had some vomiting early in the morning.  We were told that this was likely because we went straight to full meals and because we were tired after a regular day and slept right after eating.  We are sticking to liquids today and after half a day of discomfort and an essentially liquid diet I am feeling better but should probably have taken the down time right after even though I felt I didn't need it.  So the updated recommendation is to reintroduce food to your system the same way you did once the balloon was initially placed and follow the same precautions.  Give your body a day or two to adjust to the change.  We will continue to keep you posted!

November 28, 2017
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This was written last month and is just being published now, so please excuse the delay! The picture on the left was taken by our office manager the day before my procedure and the one on the right was taken about a month ago in the same outfit.

The last month has been really busy with the end of Ramadan and a trip to Spain, I've survived both and even managed to make a little progress.

The difficult thing about Ramadan is that feeling that you "deserve" something fatty or calorie laden after a long day of fasting.  You can easily consume 1500 to 2000 calories in one sitting without thinking about it.  I tried to finish out the month by being mindful although I wasn't always successful.  What made it easier was the relatively short amount of time available for eating (from about 8:40 p.m. to 4:30 a.m.) and by the end of the month exhaustion sets in and all you can manage is some water in the morning and maybe a protein shake or a boiled egg. I found that particularly with the balloon, that was plenty of food to get me through the day.  By the time I got to the end of the day water was all I wanted and after a quick dinner I felt great and ready to do it again the next day.  The result was about 5 lbs of weight loss that I quickly regained once Ramadan ended.  As you can imagine I was REALLY nervous about traveling and gaining more weight out of my comfort zone.

Prior to embarking on our trip to Spain we checked in with our ORBERA representative who gave us the numbers of physician's trained in ORBERA in each of the cities we were visiting.  Although my experience has been really good and I travel with my doctor, I wanted to have a backup plan in case of emergency.  My biggest concerns were not being hydrated enough and not getting enough exercise.  I will say that this was a very active trip and we walked as much as possible.  Several members of our group (including Dr. Din) ran with the bulls in Pamplona and we were moving non stop.  Also, luckily for me I didn't love the food.  The downside of this is that I ended up consuming more carbs than I probably should have but I also ordered vegetables a lot and substituted fruit for meat in my breakfast.  The drinking was tougher because quite frankly I didn't want to use public restrooms.  I compensated by drinking most of my fluids at night once I was back in my hotel room or at lunches where I knew the bathrooms were clean.  At the risk of sharing too much information it is the most regular I have ever been while traveling!  

I did feel really bloated towards the end of the trip and was dreading stepping on the scale when I got home.  After a good night's sleep in my own bed, lots of water, and a shower I weighed myself the day after we returned.  The travel bloat had gone down and I lost the weight I regained after Ramadan and am now about 30 lbs lighter than my starting point.  I have between 12-15 lbs left to lose and am really going to try and reach that goal before my balloon removal scheduled for the last week of September.  

November 28, 2017
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One of the scariest things about any weight loss program is the risk of falling off the wagon when something in your delicate new routine changes.  Today marks the 11th day of Ramadan, which for observant Muslims is a month of fasting from dawn until dusk. This fast is a complete abstinence from food and drink (not even water).  I have fasted every Ramadan for over 35 years but I will admit fasting with ORBERA had me a little nervous for a couple of reasons.  The first is that I wasn't certain how my body would react to fasting.  Although I have done really well with the gastric balloon, I still have a foreign object inside my body that has instructions for use that include medications and certain routines particularly drinking lots of water.  The second concern was the fear that the change in routine that comes with Ramadan would throw my progress off and my discipline completely off kilter once I broke fast in the evening.

I made an agreement with Dr. Din that I would suspend fasting at the first sign of trouble.  I have had to miss fasting before for pregnancies and when I was breastfeeding as well as when I was ill prior to my hysterectomy.  It is disappointing when you have to miss a fast but obviously health concerns come first and I was prepared for it.  I have made it through the first third of the month of Ramadan without any issues thank God. Much of the credit goes to careful preparation and great advice from my ORBERA nutritionist.  She advised me to load up on protein for my pre-dawn meal and pass on the carbohydrates and fruits until my evening meal.  I start my day with 2-3 dates filled with peanut butter and perhaps an egg or some avocado on Ezekial bread (not really bread!)  I also make a point of drinking at least 32 ounces of water with my pre-dawn meal, at least two of those glasses AFTER my meal which is the amount recommended to rinse the balloon after eating.  Prior to eating anything I take my PPI (stomach acid prevention medication).  This has been really effective in keeping me full throughout the day.  I know that it is the diet and not the balloon keeping me full because this morning I deviated and had leftover Hakka noodles and I'm already starving at 2 p.m.!  

In the evening I break my fast with what we call "green juice".  It's a blend of 4 ounces of orange juice and an Isagenix product called "Greens". Greens are a mix of vegetables, herbs, and botanicals https://www.isagenix.com/en-us/products/individual/isagenix-greens?gclid=CjwKEAjwgtTJBRDRmd6ZtLrGyxwSJAA7Fy-hXLUFUyUXnTG-q71Phg9Kx3L72npYgq-4tAgJkJnwXhoCFe7w_wcB . It's a refreshing way to break fast, pack in some produce and take the edge off of hunger quickly.  It tastes good enough that my picky younger daughter requests it!  I also have a date to break my fast.  It is a tradition to break fast with dates, but there is also some science behind this.  The dates regulate blood sugar quickly and are full of digestive enzymes that help the body adjust after 18 hours or so of fasting. The fiber in dates helps with regularity and satiety as well.  I plan to integrate dates into my diet after Ramadan ends as it has worked so well for me. I also have two glasses of water immediately after breaking fast.  In my family we move on to a regular dinner after evening prayers.   Evening prayers after the initial green juice, dates, and water gives my body a chance to process what I've ingested so I'm not quite as hungry when I sit down to dinner. When we finally sit down to dinner I'm ready to make better choices for myself and have a 400-600 calorie meal that will keep me full through the evening but not so full that I cannot eat properly when I wake up to eat again at 4 a.m.  Also, I needed to figure out how to take my thyroid medication in a way that it would be effective.  Taking it at 4 a.m. with food rendered it ineffective and had me exhausted the first couple of days of fasting.  My friend Anika suggested I switch to taking my medication at midnight or right before bed so I had a few hours of an empty stomach to absorb my Synthroid.  It has worked really well and has limited my late night mindless snacking because I know I want to give my body at least an hour of an empty stomach to take my medication on. Focusing on getting my water in before bed keeps me from excessive snacking as well.

I have lost some weight in the last two weeks, about 5 lbs. but I don't know how long lasting it will be but I'm glad that I have not gained any weight this Ramadan as I often do!  This week my challenge will be to reincorporate exercise into my routine.  I am exhausted by the end of the day and more importantly I am preparing the evening meal for my family an hour before breaking fast which is also the ideal time to get a workout in.  Like everything else, fitting in a workout at the end of the day will take some preparation (a casserole in the oven instead of searing scallops right before dinner for example) but it can be done.  

I'll check in again once Ramadan ends (June 25th) and let you know how I've done sticking to the basics and how I'm doing getting back to the old routine.  My next challenge is international travel with ORBERA so I better get this straight before I take off!

November 28, 2017
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Today marks my 2-month balloon anniversary (the 1/3 mark for removal). This has been one of the best things I have done for my own health, not because the balloon has actually done the work, but because it has forced me to be introspective and make changes I should have made years ago.  I am halfway to my weight loss goal and only about 10 lbs. away from being at a “normal” BMI range, not something that means much to me generally, but it is the metric used for purposes of the balloon eligibility so I’ll use it as one more way to measure my progress as well.

Although I have a long way to go (about 18 more lbs.)  I do feel successful already.  I truly believe that much of this can be attributed to the people I surround myself with on a daily basis.  It is certainly helpful to live with the doctor that did the procedure on me, but that really is more because it has changed his perspective as my husband.  I think this process has given him, a person who has never really struggled with weight loss, a literal insider’s view on the process!  He is invested in my success in a way that he has never been before, essentially my success or failure impacts his reputation and so he is doing everything he can to help me.  This includes changing many of his habits that have weakened my resolve in the past like the daily after dinner dessert, or the cravings for cheesesteak or burgers that can pop up at any time.  Obviously I have some responsibility here, I could always say no, but having a husband who will never acknowledge you are fat combined with one who loves eating all the same things you do makes life happy but not always the healthiest!  He has really embraced my decision to make a change and we are actually enjoying many parts of it.  If you have a partner on board, it certainly will make it easier than one who actively opposes your efforts, but it is not your only place to seek support.

Our entire office has gotten on the health bandwagon and we are in it together along with our ORBERA patients (and really any of our patients who want our help).   It is so nice to go in to work and have everyone trying to keep up their water intake, pick the healthiest option for our lunches, and sharing ideas.  I am fortunate enough to have our medical assistant, Mildred, doing this with me.  We encourage each other, make suggestions for snacks, and do our fair share of complaining about everything from missing certain foods to aches and pains from exercise.  We try to not do it too loudly in front of Dr. Din :)

I can’t undervalue the professional help I’ve gotten through our ORBERA team and Isagenix.  The nutritionist has been so helpful in helping me figure out how to make this my life in a way that I enjoy versus a temporary solution.  Our personal trainer Melvin is instrumental in getting our patients on the path to sustainable fitness.  He is definitely tough love, but I reluctantly admit he was right about working out first thing in the morning!  What a difference it has made. Isagenix is the brand I choose for nutritional supplementation, but as much as I like the products what I really like are the coaches who have so many ideas on how to use the products as well as the real support they provide clients in setting and reaching goals.  

I have assembled the most beautiful group of girlfriends (inside and out) through the years.  Almost every one of my closest friends is in fantastic shape and looks great.  What has kept them my closest friends through the years is that for each and every one of them it is the least important thing about them and not one of them has EVER made me feel like I was somehow less because I had weight to lose. I actually blame some of them for keeping me fat by always complimenting me :)  Not that it would have mattered, because as my friend Neelofar says, “weight loss is like religion, you don’t convince anyone to do it by talking about it.”

There are women out there who obsess about their own looks to the point that you can’t take it for one more minute and those who derive their value from weight and as a result they try and make you feel inferior when you aren’t meeting that mark, but for me, they don’t stay friends for long, mainly because it bores me to tears.   I mention this because I think for women this is the most damaging kind of person to be around.  It’s not helpful and it isn’t what will make you successful.  They are also the easiest to replace.  I did it years ago and have never looked back.  The bonus of having healthy, supportive friends is that once you decide to get healthier these are the ladies (and gentlemen) who know how to do it.  My friends are my best cheerleaders and role models as I decide what to eat, where to eat, how to begin exercising again, when to take it to the next level, and when to give myself a break.  They have been my biggest cheerleaders and I have learned so much from them through the years.  Obviously friends who are in a different place in their journey may not be the best to be around RIGHT NOW as you are trying to acclimate, mainly because of the temptation to overeat, drink too much, and blow off workouts, but as long as the friends you have are supporting you they are an invaluable resource (I had to say that because obviously I was that friend two months ago!) 

My incredibly healthy daughters, who are far more athletic than I ever was especially at their age have been so supportive, except for the time I substituted half the cheese in their lasagna with spinach.  Jenna has walked with me to get my steps in, passed up on things I know she wants to eat because she doesn’t want me to feel tempted, and says absurd things like if I get any smaller people won’t be scared of me anymore.  Inshira FaceTimes me daily from college and listens to boring stories about new recipes, new workouts, and miniscule changes in weight and size, always supporting me and exclaiming, “you’re doing great Mama!” even if I’m not.   It does help that they are a little older now and that I can motivate myself by thinking about repossessing clothes I’ve bought them when I get to my goal weight. 

Last but certainly not least, is all of our patients, friends, and family who keep an eye on the blog and follow us on social media and ask me how the process is going when you see me.  It keeps me honest in a way nothing else has.  I’ve always heard that publishing your goals can be helpful in weight loss but never thought much of that idea.  First of all, it seems like a set up for a much bigger failure than if you just fail alone, but also it’s kind of a self absorbed, boring topic that I could never imagine anyone cares about.  This is all probably still true, but it has really been helpful for me.  Whenever I think about quitting, I imagine explaining to all of you how I ended up gaining weight with ORBERA and it gets me back on track!

Surround yourself with likeminded people, know that we will be your in house team even if you have nobody else with you on this journey, and put yourself first because nobody else will.

November 28, 2017
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We had the best weekend with our older daughter home from college, a family wedding we had all been looking forward to and an annual celebratory dinner with our closest friends (luckily we have something to celebrate every year!)  It was also one of the toughest in terms of staying the course.  The problem wasn't the weekend, but the fallout for the following week.

I had planned the weekend pretty carefully and it all went well. What really pushed me through was fitting into a couple of outfits this weekend. One was a custom fitted blouse I wore 15 years ago,  one outfit  that just fit when I tried it on 2 months ago but was actually loose at this point (no Spanx required!), and a pair of pants I bought in Vegas, loved and purchased tight with the plan that "someday" they would be comfortable.  I couldn't fit into them for years but they remained loose after a full dinner at Bourbon Steak, dessert and all.

I bought all kinds of amazing treats for my older daughter when she came home  last weekend, far too much for her to eat over one busy weekend, so guess where they are? Yup, sitting in my refrigerator and pantry waiting for a willing taker.  Additionally, although I planned carefully and moderated my intake, I opened myself up to some things I haven't eaten in weeks.  I had steak for dinner back to back on Saturday and Sunday night (with potatoes of course), and had a couple of bites of dessert both nights. Absolutely fine, I know that I won't sustain weight loss efforts if if I completely cut out everything I like, but I definitely get how this is like any addiction.  On Monday morning I woke up looking for the little cheese crackers I had bought for Inshira.  Tuesday I had some fries with lunch (good news, the balloon can tolerate crappy, greasy food now!) and Wednesday I had something called Krispy Krunchy Chicken purchased from a gas station while waiting out a stressful situation with a friend.   I didn't have much of anything but enough of everything to make me feel like I need to pull myself together  ASAP.

There is some good news here as well.  After my plateau and ankle injury last week, I did start my Isagenix cleanse.  I dropped about 3-8 lbs depending on the time of day, but even at my worst weigh in (late night after dinner) I still haven't gotten back to the height of my plateau weight.  I also started working out again.  I'm doing PiYo, a pilates-yoga combo low impact workout from Beach Body that is pretty great for someone just getting back into the game.  The stretching actually is helping my foot heal as well (not just my opinion, my podiatrist agreed this morning).  I'm cleared to "power walk" or get on the elliptical as well as continue PiYo, so I will keep doing it, hoping it will help me get a firmer grip on my discipline. 

One of the biggest motivators for me is the people around me.  When one of you tells me you are following the blog or have taken steps to get healthy yourself, I know getting through this is bigger than just denying myself free reign to eat or be sedentary.  More on that next week, but for now wish me luck, this is where I usually lose interest and slide back.  I'm at the halfway point and would really like to see this through.

November 28, 2017
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I'm entering Week Seven this week and while I am happy overall with my results there are certainly things that are frustrating me as well. Just as I was starting to get into my workout rhythm I injured my foot and am in a walking boot for the next week or two.  Getting my workout rhythym is no small task for me.  I make every excuse in the book to avoid exercise, but I had finally gotten to the point where my body was craving it and I was doing it almost happily.  Additionally I had hit the dreaded plateau that anyone who has tried to lose weight knows all too well.  After losing the first 10-12 pounds pretty quickly, worse than being stuck I'm actually going down and then up again!  I know there is some normal fluctuation in weight, but that doesn't make it any easier to watch.  Mildred (our medical assistant who is taking this journey with me) has advised me to stop weighing myself daily.  I'm trying but it's not easy.  I like to see the numbers move!  In the meantime I refuse to give up the ground I've gained and am trying to walk in smaller spurts and focus on exercises that don't involve my foot (they exist!)

What is happening, slowly moving scale notwithstanding, is a change in my wardrobe.  From jeans, to tops, to the one piece of clothing that never makes me happy to wear, dresses, I am finally excited to buy clothes again.  Although I'm just about at the halfway point for my weight, I am so happy with my new clothing sizes and more importantly how everything fits.  I've dropped down from a 10-12 to a size 6 in 7 weeks.  For a person with a build as small as mine that is hardly the end game, but it's a start that I'm really happy with.  I'm even back in my european sized jeans. 

I have a long way to go though.  As of this morning I was down between 15-20 lbs. taking fluctuations into account.  That leaves me with about 20-25 lbs to go.  When I spoke to my ORBERA nutritionist yesterday, she shared two really interesting pieces of information with me.  The first was that often when you've hit a plateau it's because you aren't taking in enough calories.  She advised me to stick closer to 1200 calories than 1000 calories.  Quite honestly I'm a terrible calorie counter and so I haven't really been watching really closely, just monitoring what I eat, making sure it's often enough, and relying on a lot of repitition.  

The second thing was her response when I shared with her my concern that I will gain all the weight back once the balloon is removed. She reiterated that the balloon was just a tool, and then reminded me that the balloon is NOT losing the weight, I am.  In fact, there are people who GAIN weight with the balloon if they do not follow the protocol.  While that did scare me a little, it also made me feel a lot better to know that I have done this myself and can continue moving forward once the balloon is removed as well.

With my newfound sense of empowerment, I've decided to take accelerating my weight loss to the next level by incorporating a cleanse that I like and has worked for me in the past into my routine this month.  It's called Isagenix and we carry it in the office, but more importantly we use the products in our home.  Something like this may not be for you, but for me I want to get through this plateau before I lose interest or become discouraged.  I've already incorporated the shakes into my diet (part of the repitition) and have added some supplements that are helping with the bloating and other digestive issues that come with a change in diet.  This week I'm doing the detox cleanse as well (it's two days this week and I'm already almost finished with day one).  I'm taking advantage of the balloon keeping me less hungry to get through the cleanse.  I have invested so much into this that I need to do everything I can to maximize my results.

Pictures are coming soon, I haven't posted them simply because I don't take pictures at the glamourous events I go to like the grocery store, AAU games, and work.  I'm headed to a wedding this weekend and I just barely fit into my outfit when I bought it 6 weeks ago. I haven't tried them on since, but  I'll share the pictures with you as soon as I have them!

Thanks to all of you for your support, I love your feedback and encouragement.

November 28, 2017
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I've completed 4 weeks, and I'm feeling pretty good.  There are the external rewards like fitting into clothes that have been sitting hopefully in my closet for years and there are the healthy rewards like sleeping better, but like anything once you stop working, the program stops working.  Now that I can digest just about anything, a lot more of what I'm eating and when is up to me.  This means that I'm not always making the healthiest choices and am able to consume a few more calories than I was able to last week.  While I am still trying to be mindful, and am generally sticking to the program, it also means I'm not losing as much weight as I did initially.  In fact, I actually saw a slight upward tick in my weight this week.  

While I have been advised by our team not to panic, this is a normal part of the process (my body fat percentage has actually continued to drop steadily), it's hard not to be annoyed when weight loss is your goal.  I decided that in order to replicate my post NYC results, I needed to get moving more regularly. Between my house, my car and my office I have literally been constantly sitting since getting back to Maryland. I have gotten up a few days this week and gotten on the treadmill for 20-30 minutes and walked at a comfortable pace, but it hasn't made much of an impact (what a surprise) I'm hardly squeaking out a mile.  I decided I needed to try something different that works with my lifestyle.

For about nine months out of the year, my lifestyle includes regular basketball practice.  Not for me of course, I just sit in the car and work or come home and get dinner ready, but for my daughter.  Right across the street from where my daughter practices I've noticed what looks like some sort of fitness studio, Solidcore.  I sat at my computer, looked it up, and before I could changed my mind enrolled in a class that coincided with basketball practice.  I did this an hour prior to the class so I wouldn't have time to back out, changed, dropped my daughter off, and headed to class.

Unlike me, perhaps you've heard of Solidcore?   Basically  Solidcore is NOT a beginner class, you should be able to hold a plank for 60 seconds before attempting it, and it is meant to push you to your mental and physical limits.  I think it also helps if you have a somewhat developed core before you begin!  The instructor was amazing but unforgiving, she really pushed me to do the full version of every move (I of course clung to the handle bars for support as needed anyway), and the regulars there were so kind and supportive I actually realized what a loser I must have looked like that these notoriously aloof Bethesda ladies each felt the need to come over and tell me how great I did.  I did not "do great" I promise you, I was humbled in a big way, but I appreciated the attempt.

This is not meant to discourage you from trying something new, in fact I'm going to try something new every week (I'd love suggestions if you have some).  I got through the entire 50 minutes.  I feel sore, but also really good about accomplishing something.  I have always been able to jump into a class at the gym and pick it up pretty quickly, so not being good at this was hard.  I also remind myself that I have not seen the inside of a gym in five years. I also needed to be honest about my "workouts" at home.  I definitely am not pushing myself enough, now I know that I can handle it.  I will be back at Solidcore, but I will go back when I'm strong enough to do it right.  See you there!

November 28, 2017
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Last week, just as I completed my third full week with ORBERA, my younger daughter Jenna and I embarked upon a trip to Manhattan.  We love New York for many reasons, but one of our top reasons is the food.  We dream about the manti (Turkish ravioli) from ABA, we have tried to replicate the famous New York kati rolls at home, and of course no trip to New York is complete without an authentic slice of pizza from a hole in the wall pizza place. Lots of caffeine normally helps me keep up with my fellow travelers who are more nocturnal than I am, and is a must in the city that never sleeps for a girl who likes her sleep.  

I had done pretty well adjusting to solids in week three.  I did have a couple of setbacks initially, specifically eating a little more after I felt full led to throwing it all up hours later and eating something too creamy left my stomach unsettled overnight.  The setbacks were good preparation for the trip in that I got a better sense of what full feels like versus "This tastes so good, I'm going to finish it."  I also found (under direction of my doctor) that a few sips of ginger ale helps settle something heavy.  Soda is generally off limits with ORBERA so I am very cautious to not overuse that one.  Although I was nervous to travel to such a delicious city with my restrictions in place, particularly no caffeine, I was excited to try.  The name of the game is making a lifestyle change I can live with, not a six month break from my regular life that will have me rebounding once it's over.  I also wanted to make sure that my daughter would enjoy this trip fully, food and all.

Planning really is the key to success with ORBERA and that is non negotiable when traveling.  Jenna and I decided to take the train up, so we knew that our trip would be about three hours.  I had one of my go to breakfasts, greek yogurt with Cheerios before we left the house at 7 a.m. and had to plan for a snack on the train around 10 as well as something for right when we got there prior to lunch.  I opted for Triscuits and string cheese for our first snack, the usual mid morning snack.  I also brought mini whole grain cheddar rice cakes just to tide us over until lunch. I had one serving (6 mini rice cakes) prior to getting off the train. The goal was to have something healthy for me, but also something Jenna would want to eat.  The more she likes the snack, the easier it is for me to maintain my portion control goals!  I also brought lots of water.  ORBERA requires two cups of water a half hour after eating.  Public restrooms (including on the train) are an unfortunate adjustment that I had to get used to.

We arrived at Penn Station and walked to our hotel.  In fact we walked EVERYWHERE while we were in New York.  We have always enjoyed walking in New York, but always took our share of taxis.  On this trip I made a conscious decision to  stay at a central location and get my steps in by walking whenever possible.  We planned our walks and left early enough to get to where we were going.  

We started our trip the same way that I would start a trip to New York with my father when I was a teenager, getting a slice of authentic New York pizza.  I was extremely nervous about this with ORBERA, but decided to give it a try.  We walked over to Empire from our hotel and took a look at the options.  Pizza is, and has always been, my Achilles heel when it comes to food.  The Sicilian cheese pizza had just come out of the oven and looked amazing but very bread heavy.  Jenna got a slice of that as well as a slice of my favorite, plain cheese pizza (I believe I've mentioned I eat like a 12 year old).  I ordered a slice of veggie pizza, loaded with broccoli, mushrooms, and fresh tomato. I have never eaten so many vegetables on my pizza in my life.  It was amazing!  I have missed pizza so much and have also surprisingly missed fresh vegetables as I've moved through the "soft foods" phase.  I focused on including vegetables in each bite, moving excess cheese off my slice, and bypassing most of the crust.  Part of the diet and nutrition portion is cutting back on processed foods, particularly bread, rice, and pasta.  I realized that even though I picked the "healthiest" version of the pizza available, it's the sort of meal that requires a little extra movement to work off the calories and extra effort to pack in some nutrition since I'm limited in how much food I can eat.  We walked for half an hour after lunch and walked to Macy's and back (about 4 blocks away) after getting settled in our hotel.  We had planned to get manti for dinner that night.  We didn't go to our usual Turkish restaurant, we went to one walking distance from our hotel and with an appetizer sized portion of  our favorite dish.  We each ordered our own and I ordered a salad as well.  I worked on the salad first, focusing on the more nutrient rich vegetables in the mix.  Once the manti arrived, I ate about 4 pieces really trying to enjoy each piece since each bite has to be chewed 20-30 times. Chewing anything 20-30 times gives you a real awareness of what you are eating.  For me the (sad?happy?) revelation has been that pasta is really gluey.  One of my all time favoirite foods has lost it's appeal.  I passed the remainder of my portion over to Jenna who happily finished it up.  I was surprised to see neither of us had touched the bread basket.  

We saw a show on Broadway that night and believe it or not I enjoyed it thoroughly with nothing more than my bottle of water.  These are the kinds of things that concerned me, can I watch a show without concessions?!

Max Brenner's Chocolate Bar is one of our favorite brunch locations, we headed there on day two.  Jenna got her usual milkshake and mac and cheese and I got the Guilt Free omelet with whole grain toast. The portion sizes are huge so I ate probably 1/5th of the omelet and one piece of the four pieces of toast that came with it. The real benefit of the gastric balloon is the mindset shift.  I know that I don't want to feel sick so the mac and cheese does not call out to me, I know that I have limited space to eat so I want to maximize the quality of what I'm eating and eggs really hit the spot in a way that pancakes or waffles would not.  I'm slowly developing a taste for whole grain that I never had before, I think primarily because it really fills me up in a way "regular" bread does not.  

The beauty of walking in New York is that there is always something to see or do along the way.  Jenna and I headed back to our hotel (a 20 minute walk from the restaurant) and wound our way through the farmer's market and various shops.  We stopped back at our hotel for an hour or so and then walked back to Macy's.  My first stop was new walking shoes.  I found a pair I liked and as we made our way through the Junior's section we realized it was time for my next snack.  I was not prepared.  We headed over to the cafe in the store and I was panicking a little at the options.  I ended up with a couple of pieces of asparagus, and a little tomato mozzarella salad from the salad bar and a bottle of water.  Jenna had a footlong hot dog.  My mistake here beyond not being prepared, was not getting a big enough snack.  I was hungry almost immediately.  When we left the store, Jenna wanted to stop at Baked By Melissa for cupcakes.  As she got cupcakes, I went over to Pret a Manger and found all sorts of appropriate options.  I settled on a whole grain vegetable sandwich in a half size (they sell half a sandwich here!) and it was perfect.  

Our main purpose in visiting New York last week was attending the Sweet Sixteen at Madison Square Garden, so we went back to our room to prepare for that.  We decided to have a light dinner in our hotel restaurant before heading out at 6 p.m. (I try and finish eating no later than 7 regardless of how long I'm awake) and walk over.  Keep in mind that part of the ORBERA  nutrition plan is a serious limiting of caffeine intake.  Up to this point I managed to do well on drinking nothing more than water.  Although we ended up spending over six hours at Madison Square Garden (we were lucky enough to catch the Wisconsin vs. Florida game that went into overtime until 1 a.m.) and walking back to our hotel after the game, I stuck to water and felt fine.

The next morning we were meeting my brother in law for breakfast and overslept.  We ran out of our hotel at 9 a.m. to meet him at a nearby restaurant.  Apparently you don't have to order the huge breakfast portions on the menu.  I ordered a poached egg and whole grain toast from the side dish menu and treated myself to a cup of black tea with milk and sugar the way I like it.  I ate a little of Jenna's rejected fruit bowl to get some produce in and felt full but good.   We stopped at Pret a Manger again before heading to Penn Station and picked up an egg salad and arugula sandwich to share on the ride back to D.C. as well as a packet of almonds.

We had one of our best trips to New York, I ate absolutely everything I wanted although what that is has changed quite a bit since my last trip. I lost 2.5 lbs between leaving on Thursday and checking on Sunday.  It is perhaps the only time I have ever lost weight after a vacation and I did it without sacrificing a good time.  

Wednesday March 29th marks the completion of week four for me.  I'm looking forward to seeing what comes next.

My older daughter is home from college for two weeks and one of my biggest concerns about having the procedure this close to her coming home was not being able to enjoy special meals with her.  I really agonized over not making lasagna or  going out to eat with her before she got here.  If you haven't guessed, much of what we do is food centered.  The first week she was home was also my first week with the balloon so we certainly were a little limited.  What I should have realized, but didn't is that my family is entirely capable of cooking what they feel like eating and are perfectly happy to eat whatever they are served.  The next thing I realized is that ORBERA really is a lot more flexible than  I thought.  It's a mindset change more than anything and my family has been very supportive of that. Once I made that mindset change, things became a lot easier.

This week I transitioned to more solid foods.  Although some people require pureed foods for longer than others, adjusting to the balloon really is different for different people.  I couldn't stand the thought of pureeing food before eating it, so I've stuck to softer foods that I can just chew a lot before swallowing for the most part.  I've tried chicken salad and egg salad sandwiches, meat sauce on a baked potato, lots of cottage cheese. I've done well with most things, spicy foods have been tough though.  I'm not a fan of spicy so luckily I won't feel too bad avoiding it.

We had a snow day yesterday and for my family that means EATING.  I made the usual preparations including a Morroccan chicken stew with couscous, modified to be healthier and ORBERA compliant.  The entire family loved it (my college girl even said it was one of her all time favorites!) I also got plenty of the usual junk food.  Here's where the mindfulness comes in.  I have made a decision to make a change to my dietary habits.  My family can still enjoy the foods that I am TEMPORARILY avoiding.  This actually gives me a lot of pleasure because I still get to provide them with special treats and I'm not particularly tempted by any of it especially if I eat before I present it to them.  Surprisingly, the rest of my family has started having sympathetic balloon symptoms as well!  Smaller meals, more water, and healthier choices for everyone. 

I have tried to stick to protein shakes or a yogurt drink (Oikos is my favorite) at night as it definitely does go down more smoothly than solid foods. Drinking 50-64 ounces or more of water throughout the day helps as well.  I also had my first consultation with the ORBERA Coach nutritionist. I've never met with a nutritionist before and am approaching it with an open mind.  Obviously what I've been doing hasn't worked so I'm willing to try it their way.  The biggest take away for me was that while I'm modifying my eating habits and portion sizes, nothing is truly off limits to me forever.  That certainly makes committing to it now a lot easier. 

As always, reach out to me if you have questions, I'm happy to answer them if I can.  I'm down 8 lbs this week and Mildred, our medical assistant is down 16! We are both really happy about our results but know we have a long way to go.  Thanks for taking this journey with us.

November 28, 2017
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It hasn't been a full week yet (2 days to go) but I have so much to share with you that I couldn't wait! 

The one piece of advice I have for anyone starting this journey, is be prepared.  That includes having options for nutrition and hydration at home, making sure you give your body enough time to adjust, and having your home team in place to help you out.  Like most good candidates for ORBERA, I'm fairly healthy. I have never had to juggle this many medications at once (don't worry, it's short term!) but  I was happy to do it to avoid  any nausea or vomiting (these are the most frequently reported symptoms).  Thankfully it worked.  What surprised me is that I felt  really weak initially.  It was so helpful to have a friend come over (thanks Anika!) and make a list of what medications I was supposed to take and when and make notes of how I was feeling and what alleviated my discomfort.  When we realized that standing and moving helped me tolerate drinking we went for a short walk.  I also spent a lot of time sleeping the first couple of days.

I also hadn't really planned for what my family was going to eat.  Luckily my friend Neelofar was on it and brought enough food for the rest of the week along with an array of drinks that were allowed on my inital clear liquid diet (first 48 hours).  The one that worked the best for me was the Honest Tea Orange Mango Flavored Herbal Tea.  It goes down smoothly (water was surprisingly hard to tolerate) and I felt good about the ingredients.  This is a quest for improved health after all, what goes into my body matters. 

I was driving by the next afternoon, but again felt really tired.  Once 48 hours passed and I could move beyond clear liquids things really improved.  I couldn't wait for that first protein shake!  My favorite is Isagenix Chocolate.  I have one for breakfast most days.  With ORBERA in place I really couldn't have more than a quarter of my usual shake.  It did, however, really help give me a boost of energy to be getting some nutrients in.  I've alternated that with an Oikos Greek Yogurt strawberry smoothie (the little bottles).  Initially  I could only drink about half. Perhaps the most helpful "full liquid" was a thin lentil soup (daal) that my mother in law made for me.  It tasted like real food, is rich in protein, and went down really well.  

As a person who hasn't really monitored food intake or been terribly careful about food choices the hardest part has been cravings.  I know that I'm not hungry but I have a running list of what I would like to eat.  Ledo's pizza (original College Park style), dinner rolls from Bourbon Steak, Burger 7, the spaghetti Neelofar made,  Rosa Mexicana, and the list goes on.  It has been incredible insight into why I make the choices I do and the no going back nature of the balloon has forced me to avoid "cheating". I realize that I always give myself a pass for special events, when I'm really hungry, when I'm really stressed out and countless other situations. Knowing that I will literally be sick if I eat something not on the list before my body is ready for it makes self control a no brainer.

The biggest motivator? I've already lost 5.6 lbs.  The instant gratification of the weight loss is really pretty great.  I know it will probably slow down as I acclimate to regular food, so ramping up my physical activity is my next goal.  I woke up this morning ready to go.  I was able to drink the entire yogurt smoothie (7 ounces) and start my prescribed workout, basically a 20 minute walk on the treadmill and best of all drink water normally. I'm back at work and looking forward to moving to the next stage.

November 28, 2017
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I had my balloon placement done yesterday at 8 a.m. One of my biggest concerns was the reported side effects.  I was not looking forward to nausea and vomiting until my body adjusted.  Dr. Din researched this procedure a lot prior to introducing it to our practice, but the unknown is always concerning.  He has picked a top of the line medicine protocol (the down side is that one of the medications that helps the most is quite expensive) and I followed it to the letter.  I started with an anit-nausea patch behnd my ear and the first dose of my antinausea medicine.

When we got to the endoscopy center I was ready to go.  The staff and physicians took great care of me, and my understanding was the procedure took approximately 15-20 minutes.  It is comparable to an EGD, a procedure Dr. Din has done thousands of times. 

I am happy to report that I have not had any nausea or vomiting and it has been a little over 24 hours since my procedure.  I'm trying to keep myself hydrated.  The biggest side effect I'm having is some reflux and mild cramping.   The antispasmodic prescribed as well as the over the counter medication FDGard has helped a lot with that. Walking around helps as well.  I was able to sleep in 6 hour increments yesterday as that is when the antispasmodic starts to wear off, so keep your medicine close to your bed so your sleep is as uninterrupted as possible.  

I'm surprised with how aware of my body the balloon has made me.  I was a little disappointed because I was feeling hungry and that was the biggest purpose of the ballon, to stave off hunger.  I mentioned this to Dr. Din and when I described my hunger pains he gave me the reflux medication and I was no longer hungry.  Have I been eating everytime I have reflux? That would explain a lot!

So far, so good.  Really looking forward to moving beyond this liquid diet (either tonight or tomorrow).  It has truly been a full reset in many ways, I look forward to continuing my journey and sharing it with you!

November 28, 2017
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One of the reasons I jumped on board to try ORBERA first was because I wanted to "test" it out before I started marketing it as part of my job.  I probably could have continued living a relatively sendentary lifestyle and gaining weight without too much concern for a while longer if this hadn't come along.  As I shared with you last time, part of preparing for the procedure was undergoing a routine colonoscopy and EGD that I had pushed off for far too many years.  At the end of the day yesterday, Dr. Din received my lab results from the colonoscopy. We were both really surprised to discover that the four polyps that had been removed were precancerous.  I am grateful to God on so many levels.  First that I was led to a place where I was pushed into having the colonoscopy (I had no symptoms that would have propelled me to do this otherwise) and second, that none of these polyps had advanced to beyond precancerous.  It has made me so very appreciative that the journey I am taking is one of health and weight loss and not something far more serious.  

This of course doesn't mean that I didn't panic a little and consider all the "what if's".  Dr. Din shared with me (as he has for many years without me really listening) some ways to reduce the risk of both the recurrence of polyps and prevention of colorectal cancer.  This time I'm listening a little more closely.  The risk factors that I've been ignoring include excess weight gain, inadequate water intake, excessive consumption of red meat, and a lack or exercise.  It must be noted that you can do everything right and still end up with polyps or colon cancer.  The best preventative measure is routine colonoscopies.  However, if I can make changes that will reduce my risk I have to do it. I am so glad that the opportunity to change some of these habits is right in front of me and that I have access to a weight loss tool and an incredible team  that will make this a little easier. 

The week before the procedure Dr. Din, Kelsey, Melvin, and all of our staff (the "Team") are already hard at work getting things set up.  I was surprised at how much I'm already doing to prepare.  I had my weigh in, my vitals logged, and my "before" picture taken, All my lab results are imported into our patient portal and I have started taking an acid reducer (Prilosec) which is basically used to prepare my stomach for the balloon.  

Dr. Din has called in my prescriptions and Kelsey and I have gone over what my first week will look like.  She's given me a grocery list so I can be prepared when I get home from the procedure.  One really important item to have on hand is a protein shake you like.  I like Isagenix myself and it requires ordering so I have to make sure I have enough for the first week.  

Melvin gave me my workout a few days ago, but honestly I let myself off the hook because I was still recovering from a cold.  Nothing gets you out of bed and on the treadmill like the realization that cancer could be knocking on your door.  I'm still coughing, but I got my workout in this morning and I'm ready to roll.

I'm signed up for ORBERA Coach,  an app we set patients up with.  It's primarily a nutrition tool containing recipes, places to log pictures of your food and enter how many steps you've taken each day.  Most importantly, this is the portal through which we meet with our nutritionist to design a customized plan.  I'm really looking forward to this part.  I have terrible eating habits and it seems like I'm supposed to avoid everything that I like eating.  I really don't think I can revamp my diet on my own, I'll keep you all posted on how helpful this is.  Kelsey will supervise everyone's progress through ORBERA Coach as well.  Although you may not have Kelsey right next door to remind you to take your Prilosec like she does for me, she will be with you every step of the way as well.

I've learned through countless efforts (sometimes successful, sometimes not) at weight loss that the support you have and the people coaching you through the process are as important as, if not more important than, the product or system.  Getting started has been the hardest part for me.  Once I made the decision the Team really took over. I'm really proud of the team we've built and can't wait to get started!

November 28, 2017
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Whether it's the "freshman fifteen", a little baby weight that never quite comes off, or weight gain due to hormonal changes as we get older, unless something is done to actively push back, weight gain is like a train that just keeps gaining speed.  That's how a friend described it to me several years ago when I first decided to try and lose a little weight.  I was successful that time around but about five years ago I completely lost control of my health. I went back to work full time, my father passed away unexpectedly, I had a series of health issues that culminated in a hysterectomy, and I turned 40, which for a person with hypothyroidism makes weight loss all the more difficult. Perhaps most importantly I put my weight gain and general health on the back burner and really lost any motivation to prioritize what I considered the least important issue in my life.  At 5"1 (and a half!) and 163 lbs I can honestly say I now weigh more than I did on the last day of each of my two pregnancies. More importantly, my cholesterol levels are rising, my normally low blood pressure is creeping up, and I am less healthy than I have ever been. The picture above is from this winter in Miami.  I don't love it but believe me it's not the worst one I have! I wanted to share it with you as we get started.

ORBERA came across my desk as Dr. Din's practice administrator.  It is part of my job to evaluate any business proposals or opportunites that come through our office.  Dr. Din rejects the vast majority of these.  With ORBERA he was cautiously optimistic  as he reviewed the literature and the intragastric balloons on the market.  After speaking to several peers who work in the field, reading all the studies available to him, and undergoing training in this procedure, Dr. Din is really excited to offer this weight loss system to his patients.  I insisted that I wanted to be the first person to get this done in our office.  The hardest part is going to be the commitment that all patients who sign on for the procedure and the 12 months of support agree to.  As Dr. Din's wife I  have historically also been his worst patient. This year I am going to trust the process, listen to our team and regain control of my health.  This makes me the ideal first candidate because if I can follow through on this, anyone can!  

I had a pre-procedure EGD and colonoscopy last week to make sure I don't have any pre existing conditions that would prevent me from being a good candidate for the procedure.  Most patients will have a regular GI exam in the office and an EGD immediately prior to the placement of the balloon.  I had mine last week because of course being a non compliant patient (in the past!) I was about 5 years overdue for my colonoscopy and EGD.  Other than a cold I've picked up over the weekend, everything was fine and if the cold clears up I am scheduled to have my ORBERA procedure on Wednesday February 22nd.  

Last night I met with Melvin, our fantastic fitness consultant.  You'll be hearing a lot more about Melvin.  He is an essential member of our team as ORBERA is just a tool for weight loss.  The real results come because of the changes you are making.  Melvin met with me and laid out my fitness plan.  It's really basic because there is very little I have done in terms of fitness in the last few years.  Each person who joins our team gets to meet with Melvin and develop their own plan for how they will be successful regardless of their current level of fitness.

On my agenda for this week is getting signed up for ORBERA coach, an app that walks me through the nutritional component of the program, lets me track my progess so the office can see what I've done, and is the portal through which I have one on one consultations with my nutritionist at my convenience.  I'll let you know how I like it once I'm up and running.  On Wednesday I have my physical and preparation meeting with the team at the office.  At this time I get instructions from  Dr. Din regarding preparing for the procedure as well as my prescriptions so I can get them filled and have them available for when  I get home.  I will also meet with our physician's assistant, Kelsey, who has worked hard to prepare information for our ORBERA patients so they know what to expect going into the program.  I will pick up my grocery list from Kelsey, so again once I get home from the procedure next week I'll have everything I need to follow the program.

I'm looking forward to sharing this journey to better health with each of you.  If you have any questions, you can email me directly at [email protected] and I'll do my best to answer them.  In about two weeks another member of our team will be joining me on the ORBERA journey.  She will be available to answer questions as well.  We are doing this as a team and are happy to have you join us as well if you are ready.

 

November 28, 2017
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We all have our own reasons for losing weight but ultimately it boils down to health and/or vanity.  I do believe these two can and should coexist, but I also know it is really hard to resist the temptation to just eat less or do drastic cleanses if it means losing weight faster.  One of the biggest lessons I've learned not just through ORBERA but through my post-baby years of trying to lose weight (that's going on 20 years now folks!), is that not eating appropriately actually slows down the metabolism and makes losing weight harder.  Forgetting to eat, skipping meals, putting the wrong kind of fuel in the tank all take their toll.  I have lost a significant amount of weight in the last 7 months and I know that I am healthier, but as I continue to  lose weight the emphasis is shifting from weight loss to increased health.  To that end I visited the office of Rebecca Bitzer, RD a dietician our office works with to have some testing done.  I had both my resting metabolism and nutrient deficiency tested. You can view more information about these tests here:  https://rbitzer.com/services/testing/  My goals for the next six months include improving my metabolism and reducing any vitamin deficiencies and in order to do that I wanted to have a baseline for both. Why make this any harder for myself than it has to be?  I also monitor my body fat versus just weight loss.  It's something that Kelsey in our office does for our ORBERA patients to give them another measure of improvement, and one that I think is far more valuable than a number on the scale.

During the balloon period, especially in the beginning, I was really limited in what I could digest.  As soon as I moved to a full liquid diet I incorporated Isagenix shakes into my routine. I've tried a lot of meal replacement shakes and these are hands down my favorite.  They aren't for everyone, but for me they were a life saver.  I have a shake after my workout most mornings and it keeps me going until my next snack or mini meal.  Even now when I can really eat anything, my preference is to have my shake first and start my day off right.  I've also added the Isagenix multivitamin into my routine.  I have been vitamin deficient in many areas through the years but haven't focused on remedying the situation.  These are a little complicated as they come in a.m. and p.m. packs and the have a daunting number of vitamins in each pack, but after doing it for a week I got the hang of it. I will say they also give me an extra activity that keeps me from eating and forces me to drink a LOT of water, so that's helpful.  I'm looking forward to seeing how this impacts my overall nutrition but also how it impacts my old problems like dry eyes and exhaustion that I've been told a multivitamin would help with.  Isagenix makes another product I love that would be especially helpful early in the balloon phase, it's called "Greens".  These are described on the Isagenix website as:

"Isagenix Greens features nutrition from over 30 vegetables, herbs, and botanicals, such as ginkgo biloba leaf, green tea extract, and grape seed extract, to promote overall health."  I blend mine with orange juice and drink it at bed time.  My younger daughter, Jenna, who gives me a run for my money in picky eating, loves "Green juice" and drinks it between field hockey and basketball practices in the fall. Again, this may not be for everyone, but for our family it is a great way to supplement our vegetable intake.  

I have found that the habits I created over the last six months have transferred well to my post-balloon phase.  Believe it or not, the misery of the first few weeks where you are having trouble digesting and not being able to keep down things you don't chew completely really is worth it if your body adjusts to your new normal.  You wll detox from things that you avoided initially because you had to.  I haven't had a diet coke in 7 months and no longer even want one.  You will be so much more mindful of what you eat. Focusing on health versus weight loss also gives you an additional boost in motivation.  You really consider each thing you put into your body and enjoy the choices you make when they aren't the healthiest far more than you would if you were eating mindlessly.  

My next project is going to be meal planning.  I've ordered little portion control containers and have tried to develop a rotation of healthy recipes.  I'm not much of a meal planner so I'm nervous about how that's going to go, but luckily I have a high tolerance for eating the same thing repeatedly as long as I love it.  The key is to stop repeating lasagna and beef stroganoff and figure out healthier go-to meals. 

If you remember, one of my biggest obstacles to weight loss motivation is my exceptionally positive body  image.  When I saw a picture of myself I was always horrified by how different I looked from when I looked in my mirror! While  I'm really excited about  my increased flexibility and strength, hopefully reducing my Synthroid dose, and feeling more energetic, it feels pretty good to look the same way in a mirror as I look in pictures for the first time in a long time.  

Wishing you all great health and success in your journeys.





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