September 9, 2012

The Genesis Experience

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Written by S Bledsoe

Author- S. Bledsoe, M.D.

My patient was 20 months out from surgery and was a success by any measure.  She had lost more than 50% of her excess body weight.  Her high blood pressure and diabetes had resolved.  She went from 10 medications down to a few vitamins.  She was more involved in her life.  She looked better, felt better, and was better.  But, she still had 50 pounds to lose when she hit a plateau.  A 6-month lull in her weight loss resulted in an indescribable feeling of frustration.  Enter The Genesis Experience.

Successful weight loss surgery is defined as losing more than 50% of your excess body weight after your procedure.  Granted, that’s a bit arbitrary, but it’s difficult for anyone to come up with an all-encompassing definition of what “success” means for everybody in all circumstances.  One thing is certain, you may still be overweight or obese when you stop losing weight.

If you are 200 pounds overweight at the start of your journey and you lose 120 pounds, you are a success.  You likely feel better than you have in years.  Your medication requirements are surely lessened.  But, you are still 80 pounds overweight.  This is the predicament in which my patient found herself.

There are many thoughts on what to do at this point.  Many surgeons would simply shake your hand, congratulate you, and tell you to call them with any problems.  Some surgeons would offer an additional procedure.  While there is a place for contentment or revisional surgery, my first step is a recommitment to a strict diet and intense exercise.  This would require mobilizing resources and expertise that was beyond the scope of a single individual.  This is how The Genesis Experience was born.

The Genesis Experience was designed from the ground up to achieve a few overarching goals.  First, we wanted to bring solid instruction in proper nutrition using the Paleolithic model as the backbone.  With assistance from
our friends at Whole 9 Life, a custom nutrition guide was developed and implemented.  Second, we wanted to educate on proper exercise techniques using Crossfit at the standard.  The constantly varied, high intensity functional movements are perfect for someone wanting to improve their health and lose weight.  Third, we wanted to establish a new pattern in people’s lives.  We wanted to teach healthy lifestyles.

With these goals in mind, we laid out the requirements.  Crossfit three times per week with two additional days of fitness “homework.”  A strict diet based on principles found at Whole 9 Life was the backbone of new principles of eating.  To ensure compliance, a food diary was implemented with the food logs being checked weekly by a coach.

The inaugural class went to 6 individuals.  These people were all a success but all had plateaued prior to achieving their weight loss goals.  They varied by age, race, gender, and weight loss needs, but they were motivated to achieve their goals.  Some needed to lose only 20-30 pounds, but some stopped 80-100 pounds short of their ideal body weight.  Their previous metabolic derangements, health status and life experiences were hurting them.  This group represented an extremely challenging group, but we knew that if we could succeed at helping them, we could help anyone.

“My life may have started at birth, but at 40 years old I really feel like I am living, and living better than I  could have ever thought possible!”

“I’ve seen positive results: greater strength, greater stamina and endurance, greater mobility, better and steady energy (not high-low energy spikes), greater mental focus…and by the way, I’ve dropped two dress sizes in 8 weeks.”

“I have no food cravings like before.”

The functional goals achieved may seem modest by some standards but were mountain top experiences for those achieving them.  A first sub 10:00 minute
mile.  A first “girl” push-up.  Jogging 1/2 mile without walking.  12 inch box jumps.  The weight loss goals were impressive- 3.3 to 22 pounds lost over the course of 2 months.  However, the inches lost were absolutely stunning.  The 6 participants lost an AVERAGE of 17.5 inches.  One person lost a total of 25 inches, including 8 inches off her waist alone.  All of this in just two months.

The past 8 weeks was an amazing experience that was capped off by a “Paleo Potluck.”  We were all able to get together for a last hurrah and share with each other.  Although, it was designed to help the participants improve their health, I can say that the greater impact was felt by the coaches.  The determination and courage displayed by each of them was inspiring.  I can only hope that we were able to do as much for them as they did for us.

While The Genesis Experience was launched to help bariatric patients break through a concrete plateau, it is for anyone who wants to achieve health but doesn’t know where to start.  Do you walk into a gym and wonder where to begin?  Do you walk down the grocery aisles and grab boxes of “health food”simply because is says “heart healthy” on the box?  Do you desire health and you will work hard to achieve the goal, but you need help directing your energies?  The Genesis Experience may be for you.
September 7, 2012

My First Crossfit Workout

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Written by S Bledsoe

Author- J. Taylor

As I said in a previous blog, I am beginning an 8-week Crossfit exercise/Paleo diet regime called The Genesis Experience.  Doing just one or the other would be intimidating enough, but doing both at the same time?  Oy!  Are all my mental faculties intact????

After the orientation meeting I attended, my knees were weak, and I was truly intimidated.  I’m usually a fairly self-assured, determined person, when I set my mind to something; but, I confess, I have my doubts about this.  In fact, I’m so intimidated that I have the urge to run, screaming, in the opposite direction.

But, I know that doing that will not produce the weight loss I’m looking for.  If I stay in my normal pattern, I will remain on the nasty plateau I’ve been camped out on.

We began the first Crossfit workout by learning how to squat properly.  I never knew it was such a complicated task.  I thought you just squatted down and then came back up – boom, you’re done.  But, as I learned, there are a few things to remember with each squat:

  • Feet at shoulder width apart, with toes turned slightly out
  • Bend down, with your back very straight, and your bottom pushed out
  • Place your weight on your heels

After a few minutes of squatting, we began our Workout of the Day (which is referred to as “WOD”):

  • 7 Wall-balls
  • 7 Burpees
  • For 7 minutes

It sounds a little weird (burpee???), but it’s only seven minutes.  How hard can it be?  Wellllll, my friends, let me tell you – that one little word “burpee” contains several actions just to complete that one task.

Burpee:

  • Squat down
  • Place your hands on the ground
  • Kick your feet back, placing your body in a plank position
  • Do one push-up
  • Spring your feet back up into a squatting position
  • Jump straight up with hands over head

That’s one burpee.

 

Next we go to Wall-balls.  In this exercise, you use a weighted ball that has padding all around it (I’m sure it has a proper name, but I just call it a padded medicine ball.  Mine was six pounds).  Stand facing a wall about two or three feet away from it.

Wall-ball:

  • Throw ball up high against the wall
  • Catch the ball
  • Do one squat

That’s one Wall-ball.

 

Okay, so the WOD is 7 Wall-balls, 7 Burpees for 7 minutes.  I started out well, but a couple of minutes into the workout, that seven minutes seemed like seven hours.  I kept pushing myself to keep moving, even if my pace slowed down.  Push, push, push.

Five minutes into the workout, and I was sure the gates of Hell were yawning before me.  Could I continue?  I was so fatigued that I had difficulty getting my body to do what my mind was telling it to.  Thankfully, the coach kept barking out the order to keep moving, keep moving.

Six minutes, thirty seconds.  I’m almost there.  Victory is within my grasp.  Push, push, push.

SEVEN MINUTES!!!!  The angels sang out the Hallelujah Chorus, the clouds parted….oh that part was just in my mind.

In reality, I practically fell flat on my face gasping for breath and grabbing my water.  But you know what?  I did it!  To some, that WOD would be less than a warm up.  But to me, it was monumental…and I did it.  SWEAT VICTORY!!!!!

September 2, 2012

Starting An Exercise Program- No Matter What Your Fitness Level

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Written by S Bledsoe

Author: S. Bledsoe, M.D.

Sometimes the thought of starting an exercise program can be overwhelming.  I’ve had people in my office express significant concerns over how far they have to go in order to achieve health.  They had let themselves deteriorate to the point that they would be 150 pounds overweight, and their physical fitness suffered greatly.  A flight of stairs looked like the Matterhorn to them.  Walking from their car to the entrance to the grocery store seemed like an eternity.  Even tying their shoes would leave them breathless.

 

I’ll never forget one former Marine who came into my office.  He was over 60 and needed to lose about 125 pounds. His diabetes was out of control.  He blood pressure was steadily climbing.  He said the final straw that drove him to pursue bariatric surgery was a vacation he took to see his daughter.  He had to stay in their house most of the time.   At Wal-Mart, they had to get him a motorized cart to help him get around.  When he tried to carry his 4 year-old granddaughter from the car into the house, he didn’t have the strength to do even that.  This proud ex-Marine cried like a baby at where he found himself.  “Doc, I’ll be dead in a year if I don’t do something!”  The crazy thing is, he was probably right.

 

Where do you start someone like this?  If you are so deconditioned that you can’t walk around the grocery store, you are bad off.  You may know a few people like this, but I often find people at this point.  I am happy to say that no matter where you are starting, we can improve on your fitness with this 3-step approach.

 

Some common sense advice to start, get a physical from a physician prior to beginning any exercise program.  If you have spent the past decade on the couch, make sure that you are safe to begin exercising.  Get your heart checked out.  If you are having symptoms of heart disease, you may need medications or interventions prior to beginning.  If you are over 50 or extremely unfit, do not skip this step.  After a qualified physician has examined you and determined that you are safe to begin, go Level 1.

 

Level 1- buy a good pair of walking shoes and begin walking every day.  If you can only walk for 5 minutes, walk for 5 minutes multiple times a day.  Each day try to add one minute onto your times.  Continuously add time and distance until you can walk for an hour.  This may take a few months, but keep at it.  If you can walk for an hour, you have a relatively good baseline of aerobic fitness.

 

Many of my patients present with significant joint issues that limit their ability to walk.  For these, water aerobics is perfect.  The water creates buoyancy and lessens the pressure on hips and knees.  If they don’t have access to a pool, I tell them to purchase an arm bike.  Occasionally, I get excuse after excuse as to why they can’t exercise.  It’s almost like they want an exemption from exercise because of their situation.  I tell them the only people who can’t exercise are quadraplegics, so they need to exercise.  Everyone can do something.

 

Make sure during this phase that you are warming-up well and stretching in order to avoid injury. Once you have a baseline of aerobic fitness and reasonable flexibility, it is time to proceed to Level 2.

 

Level 2- begin resistance training.  The benefits of resistance training have been shown to be significant and independent from your aerobic fitness.  Many of the aging effects are the result of decreasing muscle mass as we grow older.  I also recommend a personal trainer at this level.  Stepping into a gym and seeing all the options will often paralyze you into doing little to nothing.  A personal trainer will provide you with a lot of information, set up a regiment, and teach you safety and proper form.

 

At this point, you are improving your flexibility with sensible stretching, increasing your aerobic capacity with aerobic training, and adding muscular strength with resistance training all under the watchful eye of a personal trainer.  After 2-3 more months at this point, you are ready for Level 3.

 

Level 3- your final work-outs will be changed to be comprised of 4 components: high intensity, interval training, heavy weights, functional movements.  It is beyond the scope of this article to fully describe each layer, but these 4 components will take your fitness to heights that you never thought possible.  Don’t think of your aerobic fitness as separate from your muscular strength.  View them as unified and work them simultaneously.

 

Crossfit is a great example of this, and I have written about Crossfit and the benefits of high-intensity interval training in other posts.  Once you hit this level of fitness, you are beyond the vast majority of people.  You may think that you can’t do it, but you can do it.  Once you see the benefits, you won’t want to take a step back.

 

These are the three steps to fitness with your starting point being ground zero.  Of course, everybody will progress through these steps at their own pace.  Some people already have a decent level of fitness and strength.  They should jump in at Level 3.  For some, they may start at the beginning and progress to Level 3 in a month or two.  For others, Level 3 doesn’t come for nearly a year.  The amount of your deconditioning, your current health, and how hard you push yourself will determine how quickly you progress through the stages.  Let me encourage you, though, to not stall at any level and be progressing to the final stage as quickly as possible.

 

As for my patient, today he is doing well.  He has shed well over 100 pounds and hasn’t taken a drop of insulin in over a year.  His friends can’t keep up with him, and he partakes in relatively vigorous exercise daily.   It took the hard work, self-discipline, and a do-or-die attitude of an ex-Marine, but he did it!  And so can you!

August 28, 2012

Bootstrap Therapy- Setting Goals After Weight Loss Surgery

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Written by S Bledsoe

 

Author: S. DeKeyzer James

Just before I went into surgery, I had told everyone that when I had lost enough weight I wanted to go horseback riding.   Well, some ten months and a few weeks have flown by and I’ve lost a lot of weight — enough that I’ve begun to think I’m about ready for that horseback ride.

Why now? Well I came to that decision because I’ve recently run into a kind of weight loss/emotional slump.  The weight loss is slowing down and I’ve been feeling a bit down lately – so I began looking around for something that would reenergize me – you know something that would pull me up by the bootstraps!  Horseback riding might just be the ticket!

Now I realize that you just can’t hop on the first horse you find and head for the open prairie – you need a little instruction — at least I do.  I haven’t been on the back of a horse since I wSuzanne and Oti 1.jpgas about four years old and according to my teenage daughter – that was when? – The Dark Ages!   So I “googled” beginning horse riding lessons for adults, plugged in my zip code for good measure and was offered up several hundred stables that fit those set of key words.

Since I know absolutely zip about how to select an appropriate equestrian instructor, I relied wholly on the guidance of the all-knowing right hemisphere of my brain in the selection of a stable and an instructor.   Late one night sat looking at about seven or eight stables closest to my house and I began narrowing it down to three that looked promising.

As I was looking and wondering if I was ready for this new adventure I ran across the Gilley Equestrian Center and got all gooey-eyed over a mature grey horse named “Sam” with a penchant for Starlight peppermints.  The manager and principal instructor was Holly Gleiser.  My right brain immediately sized up this young woman as a kind and competent instructor of children and adults in the art of horsemanship with infinite patience!   So before I could change my mind I made my appointment and showed up for my first lesson.

I showed up early, eager and excited — because I had arrived about fifteen minutes before my scheduled lesson time, I tagged along as Holly finished her chores. The barn was neat and clean and I knew that I’d picked a good place to learn.  Holly said I’d pair up with Oti, a chestnut gelding with big soulful brown eyes.  I learned to curry, brush and clean Oti’s hooves.  I was thrilled to be getting into the thick of things.  While brushSuzanne and Oti 2.jpging, I began to lose some of my nervousness and enjoy the contact with this large gentleanimal. I asked a lot of goofy questions and chatted with Holly and Oti as I continued brushing him.  Next was saddling up and putting on the bridle and reins.  Now it was time to walk Oti into the arena!

I had my daughter video my first ride so I tried to be nonchalant about the whole thing, but I can tell you I was thrilled and a little terrified at the same time.

Here I was down one hundred pounds and small enough and in good enough shape physically to climb up on the back of a horse and ride! It wasn’t an easy thing to do either! You have to be an active participant when you’re on a horse, not just sit there like you’re sitting on a barstool.

After my first few lessons I’ve already learned it is difficult to communicate through your body to an animal what you want it to do.  It’s even more of a challenge for me because I’ve realized I haven’t learned how to move around in my thinner body.  Being on a horse showed me just how disconnected I was! How’s that for a lesson in humility? If I can’t communicate my intent to Oti, he doesn’t know what I want him to do.   I’m glad that Oti is also very patient – when I don’t give clear instruction (which is often) he stops and looks back over his shoulder as if to say, “You poor thing, you don’t what you’re doing do you?”   And he’s right; at the moment — I don’t!

I know that over time all this will get easier – but for right now I’m enjoying learning a new skill and learning something new about myself.  I’ve grabbed my bootstraps and am pulling hard and with each lesson I feel a bit more in tune with myself and that’s probably what this is all about – communicating with yourself and learning to control your body and build confidence!

Let’s hope Oti and Holly can continue to be patient while I get to know myself.  Hey one day I may even — post a trot!

Suzanne and Oti.jpg

 

August 23, 2012

Weight Loss Surgery Over 60

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Written by S Bledsoe

Author: S. Bledsoe, M.D.

At 66 years old, my patient was in reasonably good health.  Her heart was strong, and her only medical condition was high blood pressure that was well controlled with medicine.  She was, however, over 100 pounds overweight.  “Am I too old for weight loss surgery?”  There was a time, in the not too distant past, when the answer would have been, “Unfortunately, yes.”  Fortunately for her, times are changing.

 

When I began training in weight loss surgery almost a decade ago, anyone over the age of 60 was automatically excluded from consideration.  We routinely rejected people 60 or older stating that they were “too old.”  I remember one surgeon during this time operated on a 62 year-old relatively healthy obese man, and it was pretty scandalous.  There was no consideration of risk.  The potential for an increased life expectancy, improvement in diseases, and better quality of life was not even discussed.  One day you qualified.  The next day you didn’t.  Only specialty centers and “aggressive” surgeons were routinely operating on these older patients.

 

In medicine, maybe more so in bariatric surgery, things are constantly in flux, and people began looking at the risks associated with operating on older patients.  In 2006, The American Surgeon looked at 1,339 weight loss procedures performed on people over the age of 60 at academic centers.  As expected, older patients had a slightly higher complication rate and risk of death, but the risk was noted to be less than other comparable surgeries on similar age groups.  In other words, they noted a lightly higher risk, but when you compare apples-to-apples, weight loss surgery is a very safe procedure for those over 60.

 

Another more recent study confirmed this finding as well.  Researchers at the University of Minnesota analyzed the results of 48,378 weight loss procedures on patients over the age of 65.  The data was collected from the American College of Surgeons and was published in the Journal of Gastrointestinal Surgery in 2012.  What they found was that patients greater than 65 years old did not have a greater risk of major complications.  The risk of dying was only slightly greater.  Again, in this extremely large study, the risk of surgery in older patients was only a fraction higher when compared to surgery in the younger populations.

 

There have even been studies with patients having their surgery when they were over 70.  A study that came from the Cleveland Clinic in Weston, Florida examined the effects of weight loss surgery on 42 patients all over the age of 70 at the time of their procedure.  They concluded that “bariatric surgery in carefully screened patients aged >70 years can be performed safely and can achieve modest improvement in co-morbidities.”

 

What should you do if you are over 60 and desire weight loss surgery?  You should act as though you are 40 and want weight loss surgery.  The only way to see if you qualify is to be examined by a bariatric surgeon.  They can help you assess your risk, counsel you about surgical and medical options, and give you realistic expectations concerning your procedure.  After your evaluation, you can then come to a fact-based conclusion on whether or not weight loss surgery is right for you.

In my own practice, I would have no problem operating on a healthy older patient.  Really, in my mind, the question is not how old you are but how healthy you are.  There are some 50 year-olds I would not operate on, but there are some 70 year-olds that I would operate on.  It all depends on the risks of that particular patient.

 

That’s where the science of medicine becomes an art.  Sometimes, arbitrary cutoffs don’t work.  Sometimes, “never” and “always” can become “perhaps.”  Don’t let your age discourage you from pursuing better health.  Find out if you qualify, gain as much information as you can, then make the best decision for yourself.

August 17, 2012

High Protein Diets vs. “Other” Diets

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Written by S Bledsoe

Author: S. Bledsoe, M.D.

Dr. Christopher Gardner from Stanford has been a vegan for 25 years.  He conducted one of the largest, prospective, randomized trials to date comparing four popular diets: Atkins, LEARN, Ornish, and Zone.  311 overweight and obese women were recruited and followed for an astonishing 12 months.  The results are discussed in detail in this video.  Yes, it is long but well worth the time investment.

This video describes the details of the study and gives some of the “behind the scenes” dialogue that takes place when doing any project.  I think it is also instructive to people trying to learn to interpret research.  He goes into brutally honest detail about the questions raised by his research and won’t postulate beyond where his research allows.  This illustrates the boundaries that smart researchers (such as Dr. Gardner) will place on themselves with their manuscripts.  They will go only so far and no further.

 

There were many things that stuck out to me.  The first was the high retention rate.  In some studies, a 50% retention is considered great, but Dr. Gardner was able to keep 80% of the subjects in the study.  That is nothing short of incredible over the course of a year.

 

A second thing was the difficultly with strictly adhering to many of the diets.  This is especially true about the Atkins and Ornish diets.  The patients were not as vigilant towards the end as they were in the beginning.  Of course, this is what happens in real life and what gives this particular study a great deal of credibility in my opinion.

 

A third thing is the relative success of the high protein and low carbohydrate approach of the Atkins diet.  As Dr. Gardner points out, the Atkins diet was superior to the other diets on many parameters but NONE of the diets were superior to Atkins on ANY parameter.  This is startling data to say the least.

 

The final point is the increased credibility of this manuscript due to the initial hostility that Dr. Gardner had towards the Atkins diet.  He virtually set out to prove the dangers he felt were inherent in the Atkins diet.  He states at one point that the writing about the benefits of Atkins was “a bitter pill to swallow.”  Hats off to Dr. Gardner for his honesty in spite of the fact it collides with his personal bias.

 

This is the largest randomized, prospective trial that I am aware of that compares various popular diets.  While there are certainly more to come, here would be the take-home message from this article.  Most diets will have some degree of success if strictly adhered too, but the hands-down winner in this manuscript is the low-carb, high-protein approach of the Atkins diet.  It is not an unsafe diet, as many detractors try to portray, but is a very healthy and helpful approach to weight loss and better health.

 

A high protein diet is the kind of diet that I place my patients on after a bariatric procedure.  I try to get them to put down the simple carbohydrates (sugars) and complex carbohydrates with a high glycemic index (breads, grains, starches etc.).  If they lived their lives on lean meats and fruits/vegetables, I would be very happy.  This is not a true Atkins diet but is closer to the Paleolithic diet that Dr. Gardner alluded to towards the end of the video.

 

Overall, this research is extremely promising as it relates to the health of high protein diets.  Of course, more data is necessary and some will never buy into the idea no matter how much data is available.  Maybe one day, the healthiest diet will be proven conclusively.  Until then, I continue to advocate for a high protein and low card approach.  What do you think about high protein diets?

August 12, 2012

A Painful Reminder

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Written by S Bledsoe

Author: J. Taylor

Nothing says “summer” like grilling out, a watermelon icing down in the cooler, and a fresh ear of corn.  My oh my, does that sound good!  A couple of weeks ago, that’s exactly what I had on the family menu.

 

I had passed a road sign that said “sweet corn” with an arrow pointing to a farmer’s field.  It had been ages since I’d had an ear of corn.  It sounded so good, and I knew my family would love it, too.  So, after work, I swung by the farmer’s field and picked up a bag of corn, freshly picked from the field. I took it home, shucked it, pulled off the silks, and put them in a pot of boiling water while my husband tended to grilling.

 

In no time, we sat down to a great  summer meal.  I put the butter on the corn and hungrily watched as the the butter melted between the kernels and dripped down onto my plate.  With my first bite into the corn cob, I could feel the kernels bursting with flavor in my mouth.  Then, like a type writer, I made my way down the cob.  The yummy goodness was just as tasty as I had anticipated it would be.

 

A while after I ate, I began to feel pain in my stomach, and I told myself I needed to remember to eat more slowly.  I had been so excited about diving into that corn, I had eaten faster than I should have.

 

An hour later, my pain had gotten worse, and I noticed it came in waves;  waves of terrible cramping.  I could not find a comfortable position.  I tried sitting several different ways, laying down, walking, etc.  No relief.  This was not good.  This pain was not from eating too fast; it was something else.  It was the corn.

 

Over the next several hours, wave after wave of pain,  I began to feel much differently about the wonderful, fresh corn I had fixed for dinner.  Suddenly, it didn’t seem so wonderful anymore.  As I thought about it, this had been the first time since my bariatric surgery I’d eaten corn on the cob.  It would also be the last time.

 

The buttery corn that was bursting with flavor just hours before had become a painful reminder that I need to be more diligent and on guard about what I put into my body.  I don’t think I will forget this lesson any time soon.  That watermelon is looking better and better!

August 7, 2012

A Healthy Dose of Realism After Weight Loss Surgery

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Written by S Bledsoe

Author: S. Bledsoe, M.D.

Goal setting is important in any endeavor.  If you want to do well in school, you set academic goals for yourself.  If you want to excel athletically, physical goals are attempted.  If you want to have success after your weight loss procedure, you should also set goals that you want to attain.  Realistic goals, though, are key.

The first goal that you should set is to try to achieve a healthy weight.  Identifying a healthy weight can sometimes be a challenge.  People can get discouraged when they see some of the doctor’s weight tables and realize that a “healthy weight” is what they weighed at 14.  A normal BMI of less than 25 is a good rule of thumb, but people with a stocky, densely muscled frame will have trouble attaining these BMI goals.  Talk to your bariatric surgeon in order to see what a good goal weight is for you.

 

A second goal should relate to your health.  Many of your diseases will improve dramatically after surgery.  Diabetes, high blood pressure, and high cholesterol are all very common diseases that respond remarkably well to bariatric surgery.  In order to attain these goals, simply follow your diet and exercise recommendations.  Most of your diet after surgery should be lean meat and fruits and vegetables.  You should be exercising most days if not every day.  Your workouts should include aerobic training and resistance training.  If you couple a healthy diet and lifestyle along with your procedure, you should be able to at least reduce, if not eliminate, many of your current medications.

 

The last goal you should set for yourself is to have a better quality of life.  95% of post-operative patients state that they have an improved quality of life after surgery.  This should be your goal as well.  Quality of life is very much an individual perception.  For some people that means being able to play with their children.  For others, it may mean being able to walk up a flight of stairs.  Others may perceive quality of life as having the energy to have a more rewarding social life.  Whatever it means to you- Aim for that goal!

 

Ultimately, setting challenging but realistic goals will cause you to push yourself to achieve more and will help you avoid discouragement.  As you reach each goal, you will feel a little better about yourself and a little more motivated.  I’m certain that if you push hard, most of your goals can be achieved.

August 2, 2012

A “Quest” for Protein Bars

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Written by S Bledsoe

Author: J. Taylor

Since having my bariatric surgery, two years ago, I am continually trying to find tasty ways of getting enough protein each day, and limiting my carb intake.

Eating eggs and chicken are always easy to fall back on but become tiresome after a while.  Sometimes I eat a cheese stick (Sargento’s brand truly taste better than other brands, in my opinion), or have a protein shake.

Recently, I stumbled onto a very yummy protein bar from a company called Quest (www.questproteinbar.com).  These protein bars pack a mighty 20 grams of protein each, plus they taste divine!  They have lots of flavors to choose from, and also offer variety packs.  In addition, they are low in carbs!

So, why aren’t all protein bars low in carbs?  Here’s Quest’s answer:

Because until now, there was no other way to make a bar that tasted good and didn’t rot on the shelf. We had to create a process so unique that we protected it by filing a patent. That’s why you won’t see any other bars like ours on the market. Quest is the first truly low carb bar with no simple carbs or harmful sugar alcohols. A perfect meal in your pocket!”

It gets better, folks.  Drum roll, please……..I can eat HALF a Quest protein bar and feel full for HOURS!!!  It’s true!  So let’s review the wonders of the Quest protein bars:

  • 20 grams of protein per bar
  • Low carbs
  • Tastes great
  • Fills you up
  • Large variety of flavors

I think I’m in love.

Dying for some dessert?  Heat up half of a Quest brownie flavored bar in the microwave, and voila!  craving tamed without guilt.

July 28, 2012

Tabata Intervals- High Intensity Interval Training At Its Best

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Written by S Bledsoe

Author: S. Bledsoe, M.D.

In 1996, Dr. Izumi Tabata published a study in the Journal of Medicine and Science in Sports & Exercise that demonstrated that significant aerobic and anaerobic gains could be made with a specific prescription of high-intensity interval training.  This manuscript was barely noticed at the time of publication but has since revolutionized modern exercise techniques.

 

In his research, he improved the anaerobic capacity of the subjects by 28% and their aerobic capacity by 14% with 4 minutes of training.  Do I have your attention?  Here are the principle components of the Tabata.

 

1)   Brief but thorough warm-up.

2)   20 seconds of extremely intense intervals

3)   10 seconds of rest

4)   Repeat 7 more times for a total of 8 rounds

 

The Crossfit method of Tabata’s that I have used is particularly brutal.  Choose 4 different appropriate exercises.  Go through all 8 rounds with one single exercise.  Rest for 1 minute.  Proceed to the second exercise.  Repeat until all 4 exercises have been completed.  This will take you a total of 20 minutes with 32 total rounds of intervals.

 

Some people change up exercises after each 10-second rest.  Find something you enjoy.  There are a lot of “right” ways to do Tabata intervals.  Here are some examples.

 

 

 

 

Let me warn you, Tabata Intervals are extremely challenging.  You cannot just put down the Cheetos, hop off the couch and dive into Tabata’s.  Make sure your physician has cleared you before beginning this, or any, exercise regiment.  You may want to ease into the training with fewer rounds and easier exercises.

 

In the original manuscript, Dr. Tabata used stationary bikes, but there is an assortment of exercises that can be used in Tabata style.  I have used all of the following (and other things) and find that all of them will result in an excruciatingly effective work-out.

 

–       Air Squats (a favorite of mine I do almost everytime)

–       Rowing

–       Sprints 

–       Push-ups

–       Sit-ups

–       Kettlebell Swings

–       V-Ups

–       Thrusters

–       Jumping Lunges

–       Deadlifts

–       Sumo Deadlift High-Pulls

–       Pull-ups

–       Toes-to-Bar

–       Box Jumps

–       Slam Balls

–       Push Press

–       Hanging Leg Raises

–       Wall Balls

–       Mountain Climbers

–       Burpees

 

There is no end to what exercises you can do as a Tabata.  Take any exercise and go as fast as you (safely) can for 20 seconds, rest for 10 seconds, and repeat for 8 rounds.  Notice a couple of things about the above exercises.  First, all of the exercises (with the possible exception of the core exercises), are multi-joint, large muscle group exercises.  Unless you are a professional bodybuilder, there is no role for single-joint/muscle exercises like bicep curls, tricep extensions or toe raises.   Second, they aren’t really complex movements like Clean & Jerks.  That’s important.  After your 3rd or 4th round, your form will suffer, and that’s when injuries occur.

 

You make time for things that are important to you.  If sleeping and eating are more important to you than exercise, you will always find excuses to be doing anything other than working out.  If exercise is important to you, nothing will keep you from it.  Tabata intervals are great, because they are incredibly efficient and remove the time excuse from the equation.   Everyone has 4 minutes a day…including you!

 
 
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