In This Issue

* Why Is It Now So Hard?
* PETA Made to be Accountable
* Fistulas
* Recipe: Grilled Chicken Fajitas
* Success Story: Debra Ostlund

Are you:

	Suffering from emotional eating and can’t stop?
	Grazing on carbohydrates and can’t control it?
	Lacking inspiration to lose the weight you have regained?
	Feel you don’t know what to do now that you have had surgery?
	Dying to be in better shape`?

 Then you are in luck! My Back on Track Internet
Mentoring Program is just what you need!

View a FREE Lesson and Listen to a FREE Telephone Seminar by
clicking here and scrolling down to the bottom of the page.

Dear Barbara,
I had a very successful laparoscopic gastric bypass over 5 years ago. Last month I was admitted to the hospital and it was discovered that my pouch ulcerated and formed a fistula between my pouch and my stomach.  The food is now going to both areas.  My doctor is doing a revision on Sept. 21.  How dangerous is this and have you heard of this happening before.  He did say that unless I am very careful, I will eventually gain the weight and problems back.  I have kept off about 110 pounds of the 120 I lost, but know that I am uncomfortable and bloated and have gained 10 pounds since the winter.  I just need to be directed to some answers and information.

Thanks,
Barb Woodall

Dear Barb,
Forming a fistula, which is a bit like a tube or connection between your pouch and stomach, is rare, but it does happen.  It happens less and less, because the surgeons who are performing gastric bypasses are now transecting the pouch.  This means that they completely separate the two which makes a fistula between the two much more difficult to happen.

The symptoms are bloating and severe stomach cramps. These are almost always accompanied by weight gain.  Your surgeon is correct, that you will eventually regain all of your weight if surgery isn’t performed to correct this.

The surgery is not any more dangerous than your original gastric bypass and is probably safer because you have lost 110 pounds and are in much better physical shape. It is however, a complicated surgery.

If you have had a fistula and have had it corrected, please contact Barb. I know she would like to hear from those who have gone through this. Her email address is woodallb@aol.com

Grilled Chicken Fajitas

2 Tbl. lime juice
1 Tbl. mild chili powder
2 tsp. olive oil
½ tsp. salt
¼ tsp pepper
1 lb. skinless boneless chicken breasts
1 pound tomatoes, coarsely chopped
4 ½ oz. can chopped mild green chilies, drained
½ cup chopped fresh cilantro (may substitute parsley if desired)
1/3 cup diced avocado
Eight 8-inch flour tortillas
4 cups shredded romaine lettuce

1.  In a sturdy plastic bag, combine 1 Tbl. lime juice, chili powder, oil, ¼ tsp. salt and the pepper. Add the chicken, squeeze the air out of the bag, seal and marinate at room temperature for 30 minutes or up to 12 hours in the refrigerator.

2.  In a medium bowl, combine the tomatoes, green chilies, cilantro or parsley, avocado, remaining 1 Tbl. lime juice and remaining ¼ teaspoon salt.

3.  Preheat the grill to medium heat. Spray the grill – off the rack – with cooking spray. Grill the chicken, covered, turning once, for 8 minutes or until the chicken is cooked through. Place the tortillas on the grill for 30 seconds to warm through.

4.  Thinly slice the chicken. Place 2 tortillas on each of 4 plates, spoon the chicken slices onto the tortillas along with the tomato mixture and lettuce, and serve. Top with a dollop of nonfat yogurt, if desired.

Serves 4

Nutritional value for each serving:
438 calories, 35 grams protein, 49 grams carbohydrates

If you have a recipe that you would like to share in future issues of this newsletter, please send it to me at Barbara@WLScenter.com

I want to offer a special thanks to Debra Ostlund for sharing her story with us.  

Dear Barbara,
My weight has always been a struggle. I was always a little chubby even some 20 odd years ago in high school.  My real weight gain started in 1995 while I was pregnant with my first child.  I gained 75 pounds being pregnant with her, and that put me at 236 pounds at the end of my very stressful pregnancy. 

My first pregnancy ended in tragedy with the death of my daughter shortly after her birth.  Three months after her death I found myself pregnant with my second child.  This pregnancy was quite different in that I had no complications and I only gained 15 pounds. 

After the birth of my second child I found myself a single parent, the stress of this situation along with the irregular work schedules that I had, allowed for me to pack on  more pounds. 

In October of 2002, I married my current husband and at that time weighed 280 pounds.  I had read a few things at that time about gastric bypass surgery, but really looked hard at it after a vacation with my son in 2005. 

From 1996 to 2002, it had always just been my son and I. We did everything together.  I worked very hard to bring him up not really emphasizing that he didn’t have a father around.  We vacationed quite a bit and I found myself supporting him in sports, mainly hockey, which for a single parent is not easily affordable.  In August of 2005, after the birth of my 3rd child, my son and I got a chance to take a vacation with just him and I.  We traveled by Amtrak Train from Minneapolis to Chicago. For an 8 year old boy, this was a dream come true.  We had a great time in Chicago. We took the Metro everywhere, saw a Cubs game, went to the Sears Tower, and also spent a day at Six Flags Great America.  We had so much fun that day at Six Flags and discovered that my 8 year old had a passion for roller coasters. 

I remember standing in line for 2 hours to get on this really great roller coaster.  As we got in our seats the lap bars came down and mine wouldn’t latch.  I remember the ride attendant coming over and actually standing on the lap bar to shove it down and try to get it to latch, but it didn’t.  So in front of hundreds of people I had to get off the ride. Because my son didn’t have an adult to attend to him, he had to get off too. 

I remember the mix of emotions as I came down the ramp coming off the ride. I’ve wasted time, and my son can’t ride because I’m too fat. It was a huge mix of feelings.  I thought that I was silently crying and trying to wipe my tears away, then I felt my son’s little hand slide into mine and he said in a soothing little voice, “Don’t worry mommy, we’ll find a ride you can fit on.”  I completely broke down right there because I truly knew then that my weight was not just affecting me, it was affecting my kids too.  What had happened to me!? 

When we came back from our trip, I began a program with St. Mary’s Hospital in Duluth, MN, I was 297 pounds at that time.  The program was a weight management program designed to help get your life in order and learn proper eating and exercise habits.  Although I didn’t lose any weight on this program, I learned a lot about balanced diets & the importance of regular meals & exercise.  I changed my career from working in a restaurant to working in an office setting with an 8-5 daily schedule and not surrounded by food.  This got me well on my way to finally making the decision to actually have my Roux-en-Y gastric bypass surgery, June 5, 2007. 

The day before my surgery my husband told me, “You don’t need to do this for me you know, because I love you no matter what. I married you because I love you and not because of what size you are.”  I told him, “I’m doing this for my health and the health of the kids.”  I know that the things I eat and my eating habits were influencing my son especially, and I didn’t want him to struggle like me.  I wanted to take an active part in my kids' lives. 

My highest weight was 332 pounds. This was 2 weeks before my surgery and before I started my liquid diet to prepare for my surgery.  The day I had my surgery, my Mom and Mother-in-law went to the hospital with me for support.  I was excited!  I knew that my life was going to change that very day, and boy did it! 

I am 2 years post-op and I weigh 166 pounds.  I love to tell people that I am exactly ½ the woman I used to be.  I run almost daily, and my son, now 13, is my running partner with my 6 year old daughter riding bike right next to us as we run.  I play on a co-ed softball league in the summers and cross country ski in the winters.  I have never been healthier or happier with any decision I have made in my life.  My husband and my kids are very proud of what I do and what we are now able to do as a family.  Last summer, 2008, we even had the chance to go to an amusement park and I rode every roller coaster there!  I can’t thank Dr. Medlin and the surgical staff at St. Mary’s Hospital in Duluth, MN enough for a second chance to be a great Mom and be active with my kids.

Debra Ostlund
Debra.Ostlund@enbridge.com

Congratulations Debra