Mental Challenges

This last week or so has been a real mental challenge for me. I'm in a bit of a rut as far as weight loss goes - and there's probably three or four real reasons for that.

 First, of course, was surgery a week ago - really, it was only a week ago and I have to remind myself of that. Despite that hopefully being the last round of ass surgery, it will take some time for the incision she made to heal - so it's not unexpected that exercise will continue to aggravate it. Add the New Year's Knee Incident in, and exercise has been extra complicated.

Next, it's been fucking cold here this week, as in barely above freezing at all cold. Some of you in more northern climates might laugh at that, but for North Carolina, it's cold. Add that to carrying around 160+ pounds less than I used to, and it's cold! I've never worn layers in my life - I went to my WLS support group meeting on Thursday night wearing a long sleeved tee, a hand knit sweater, my suede jacket, a hand-knit cowl and hand-knit gloves. And I was still cold! Add to that, the cold tends to make me want hearty, warm, comfort food - which tends to be calorie dense.

I've been struggling a bit with brain cravings, or what I sometimes call "the nibbles". I think some of it at times is boredom, other times it may be putting off breakfast a little too long, and then the "need fuel!" signal doesn't seem to get turned off as it should. I love nuts and things like pumpkins seeds or sunflower seeds, but again - calorie dense, so I need to find alternatives that will give me the satisfaction of a snack without making my daily totals go crazy.

And finally, I've been in a bit of an emotional funk. After the news that the ass surgeries should be over, I can now make the appointment with our reproductive endocrinologist to see what testing he needs to do, if there's any hope of doing IVF on our own, or if we'll need to go to donor eggs. If we need to go the donor route, the expense goes up astronomically, as any donor costs are not covered by insurance. We'll have to weigh chances of success against the cost, a decision that will undoubtedly painful. On top of that, a dear friend's 20-year old daughter just had a beautiful baby boy. Unfortunately her life is a bit of a shambles right now, and the baby daddy is...well...not exactly a parental dream. I hope mother and child succeed, but there's quite a few roadblocks in their way, and it honestly breaks my heart for all involved.

So with all those things in mind, I'm trying to work through whether or not I've actually hit a real "stall" point in my loss. Mentally, I know I just want the loss segment to be over-  I'm so close, roughly 25 pounds to my stated goal, and maybe 15 more with plastic surgery and a smidge more loss, but 25 for now. That's really nothing, in the grand scheme of things, since I'm down 164, but it feels like a mountain right now.

I know I need to buckle down, get as much exercise I can with the limitations I have, make sure I'm maintaining 850-900 calories, and things will happen.

But....ugh.

What's For Dinner? Cheesy Chicken Corn Chowder

I was never this cold when I was fat! It stayed below freezing most of the day today, and the house was just cold, even though I had the heat set to 72, and a space heater going in my office. Until I went downstairs to the treadmill at lunch, I was huddled in a shirt and a cardigan sweater - something I'd never have worn in the past, but I was that cold! You don't really think about body heat too much when you're heavy, but it really did make a difference!

In deference to the weather, tonight I wanted soup and decided chicken corn chowder sounded good. I wanted to keep it relatively light, so I'd use broth and milk instead of cream, and I do believe this version was a success.

My Meals

Breakfast

•  1 cup Kashi Go Lean! cereal
• 1/3 cup whole milk

Lunch

•  1 Trader Joe's Chicken Tikka Masala with Cumin Rice
• 10 almonds

Dinner

•  1 serving Cheesy Chicken Corn Chowder
• 1 honey yeast roll
• 2 tsp butter

Exercise

•  45 minutes treadmill - 3.2 mph, 2% incline, 200 calories burned

Water - 72 oz

Daily Totals - 977 calories, 43.3g fat, 105g carbohydrates, 24.1g sugars, 53.5g protein

Cheesy Chicken Corn Chowder

This chowder uses a mix of broth and milk as it's base - lightening it up compared to some traditional cream or half and half based chowders.  Note that ore-shredded cheeses tend to be packed with corn starch or other additives that prevent sticking and clumping, which may result in some separation when added to hot liquids. I recommend shredding your own cheese for this dish.

• 4 oz cooked and diced boneless skinless chicken breast
• 1 cup yellow corn
• 1.5 cups low sodium chicken broth
• 2 cups milk
• 3/4 cup shredded cheddar cheese
• 2 slices bacon
• 1 small to medium onion,chopped
• 1 large carrot, diced
• 1 large red potato, diced (about 8 oz)
• 1/2 small red bell pepper, diced
• 3/4 tsp salt
• 1/4 tsp black pepper
• 1 tbsp fresh minced thyme

Slice bacon into 1 inch pieces and render in heavy bottom sauce pan. When browned, remove to drain on paper towels. Discard all but 1 to 2 tsp fat. Saute onion in bacon fat until translucent. Add carrot, potato, and chicken broth. Bring to a boil then reduce heat and simmer for 15 minutes until vegetables are soft. 

Add milk, salt, and pepper. Bring to a simmer (but do not boil). Add thyme and bell pepper. Stir in cheese until melted. Sprinkle reserved bacon over soup when served.

Nutritional information (1/6 recipe) - 221 calories, 9.4g fat, 19.5g carbohydrates, 7.1g sugars, 15.7g protein

What's For Dinner? Pork Tenderloin with Pomegranate Red Wine Sauce

First day back at work post-op and it went pretty well - no Vicodin during the day today, so that's good. I've got multiple meetings tomorrow morning, an interview for an internal job posting tomorrow afternoon, and I'm hoping that goes well.

I was browsing around for a recipe to use with the piece of pork tenderloin I took out of the freezer yesterday, concentrating mostly on something with red wine and ran across a lamb recipe with a pomegranate red wine sauce (which I will make as written at some point).

I decided to adapt it to my pork and was pleased with the results. The fun part was making pomegranate molasses. You can purchase this as a prepared food item from middle eastern grocers or online, but the lamb recipe author had a quick substitute available - so I did that, as detailed in the recipe. Be careful though, I went from a simmering and reducing liquid to a bubbling syrup in about 30 seconds - so you need to watch it at the end.

As happens some times, I got chatting with the Man and realized I was eating too fast - things still complain if I don't chew thoroughly, or swallow too fast - and I did it to myself tonight. I ate about half of what is shown on my plate (which was 3 oz of pork, 1/3 cup of rice and 1/3 cup of peas). Some day I'll learn!

Today was also the first day of any exercise post-op, it was pretty light - the Man wanted to show me the XBox Kinect Star Wars game, so I went through some of the tutorial stages of that (lots of lunges with arm swings), and then made him do some planks with me, and did my upper arm workout with the weights. My knee is still bothering me a bit, but I'm going to give it at least another week before setting an appointment with the ortho clinic. 

My Meals

Breakfast

• 1 cup Kashi Go Lean! cereal
• 1/3 cup milk

Lunch

• Approx 1/2 cup left over lasagna
• 1.5 cups romaine, 2 radishes, 1/4 cup corn, 2 tbsp Ken's Lite Options Honey French Dressing
• 2 small slices garlic toast

Dinner

• 1/2 serving pork tenderloin with pomegranate red wine sauce
• 1/3 cup rice
• 1/4 cup peas

Exercise

• 186 calories burned between Xbox Kinect, planks, and upper body weight work

Water

• 48 oz

Daily Totals - 1110 calories, 38g fat, 141g carbohydrates, 36.5g sugars, 61.7g protein

Definitely could have done without the bread!

Pork Tenderloin with Pomegranate Red Wine Sauce

Adapted from a lamb recipe over on the Closet Cook , this was a quick dinner full of flavor. Make the molasses ahead of time and keep left overs in a pint canning jar.

• 6 oz pork tenderloin, trimmed of any excess fat, flattened into medallions
• 2 tsp olive oil
• 1/2 cup red wine (I used cabernet sauvignon)
• 1/4 cup low sodium chicken stock
• 1 tbsp pomegranate molasses ** 
• 1 tbsp honey
• 1 tbsp balsamic vinegar
• 2 tbsp butter
• 1 tsp chopped fresh chives

Heat oil in skillet until it begins to shimmer. Sprinkle pork medallions with salt and pepper on both sides, then add to pan - saute for 3-4 minutes per side until cooked through. Remove to plate and keep warm.

Deglaze pan with wine, then add stock, molasses, honey, and vinegar then whisk to combine. Add butter 1 tbsp at a time, whisking to incorporate. Simmer for 8-10 minutes until sauce thickens. Serve sauce over pork, top with chives. 


** To make pomegranate molasses: In thick-bottomed sauce pan combine 2 cups pure pomegranate juice, 1/4 cup granulated sugar, and 1 tbsp lemon juice. Bring to a boil, then reduce heat and simmer for 40-45 minutes, whisking occasionally. Watch mixture carefully from about 35 minutes on, as mixture will turn from simmering liquid to bubbling syrup quite suddenly. Transfer to pint canning jar to cool.

 Nutritional information (based on 3oz pork and 1/4 sauce recipe): 249 calories, 9.9g fat, 10.6g carbohydrates, 9.6g sugars, 26.6g protein

Recovery and Long Weekends

It's strange, sometimes it seems like the simpler a procedure is, the longer my recovery takes. As I posted about Ass Surgery Round Four - I only had sedation instead of full general anesthesia. I don't have a rubber band ring hanging out of my butt, yet I've been parked on the recliner for two days keeping the Vicodin dose going full strength. Granted, she did cut open part of the fistula, and we were told I could be bleeding for a few days, but I wasn't expecting to need as much as I have.

That said, it's given me some time to try and focus on my first week's school assignments - neoclassic growth models in macro economics, and a review of single-equation linear regression for econometrics. That's fun when doped up, let me tell you.

I did manage to make dinner tonight, and was hoping to present a recipe for a bariatric friendly corn pudding, but I wasn't entirely thrilled with the result - a bit less corn meal, a bit more salt, and probably an added herb or two. I'll work on developing the recipe a bit more before presenting it to you.

Thankfully, as the evil banker that I am, I have tomorrow off for the Martin Luther King holiday. I'll be making good use of the day for additional recuperation. Hopefully that will also include a good dinner - I've got a pork tenderloin down from the freezer, so as long as I feel up to cooking, I'm hoping to have a yummy meal at the end of the day.

How was your weekend?

Could It Be? Last of the Ass Surgery!

Yesterday I went in for ass surgery round four - this time with the new surgeon from Wake Forest. I'll never willingly undergo surgery at Forsyth Medical Center again unless it's my absolute only choice. The difference in how things were handled at the two hospitals was just startling. It started with my pre-op anesthesia appointment. WF does it as a separate event, so I went in at 7am on Monday morning. First appointment of the day was awesome - they tell you it can take up to 2 hours, but I was in and out in just about 45 minutes.

We were told to arrive yesterday at the outpatient surgery center at 1:30pm for a 2:30 procedure. I checked in at the desk and had barely sat down and we were called back. After I was undressed and ready to go on the gurney, the nurse came in and started my IV, the anesthesiology resident and primary anesthesiologist both came in and talked with me, my surgeon came in, and then the OR nurse came in - I really didn't have an opportunity to read more than a page or two in the book I'd brought between visits.

My surgeon suggested that we could do what she needed under sedation rather than full general anesthesia - sedation like you'd have with a colonoscopy. I was a bit anxious about that, but she said recovery is obviously quicker (and having had a colonoscopy I knew this). I said I'd go with it if she assured me that if I had any negative awareness that they'd crank up the drugs. She laughed and said definitely, so we went with that idea.

The plan for the day was to have her take a look around at what was going on, and insert a seton - basically a loop of rubber band like material through the fistula tunnel that would connect externally - rather like an ass ring (oh, that's a painful visual).

They took me back, had me lay prone on the table with several nice foam pieces to keep my head positioned well so I could breathe. The next thing I knew, they were asking me to roll back over onto the gurney, and rolled me out into recovery. They brought the Man back in to see me, and he said the surgeon told him she didn't need to put in the rubber band, and had opened part of the tunnel up to heal on it's own, and the rest had gone away.

I'm still a little confused as to which part was opened and which had closed - the part closest to external was bigger than the internal bit - but I've sent my surgeon a message to clarify, and I have an appointment to see her in 2 weeks (I love Wake Forest's electronic patient access system - you can securely email any care giver, and they will answer promptly).

The Man said she seemed pretty confident that this was over now. Hooray! That means I can make the appointment with our reproductive endocrinologist (also at Wake Forest) and see what we might be able to do about baby making.

Success!