EMMC Surgical Weight Loss | 905 Union Street, Bangor ME 04401 swl.emmc.org | Phone: 207.973.6383

An article summary from Your Weight Matters Magazine, Summer 2014 (“Sugar: It’s not as sweet as you think” by Tracy Martinez, RN, BSN, CBN)

Sugar in the diet is on the rise. Over the past 25 years, the intake of sugar has increased nearly 20%. In fact, the average person is taking in 300 calories from sugar alone. What’s more disturbing is that most of that intake is from refined sugars like high fructose corn syrup (HFCS), which is a non-natural sweetener that is found in hundreds and thousands of processed and packaged foods. Sugar comes in many forms. There are sugars from fruit, milk, malt, table sugar and more. If there is a single sugar molecule, it is called a monosaccharide. If there are two molecules combined, it is called a disaccharide.

Monosaccharides: glucose, fructose, galactose

Disaccharides: maltose, sucrose, lactose So what about high fructose corn syrup – where does that fit in? This is a sweetener that is made from corn stalks using a chemical enzymatic process, creating a product that is 55% fructose and 45% glucose (regular table sugar is a 50/50 split.) One of the reasons this product is so popular is that corn is a subsidized food, so HFCS can be made more cheaply than table sugar. Plus, high fructose corn syrup is even sweeter than your typical white granulated sugar. According to a review by The American Journal of Clinical Nutrition, HFCS was found to be absorbed faster than regular sugar and that is does not stimulate certain hormone triggers (insulin and leptin) to make you feel full. This may lead to overeating, which can certainly lead to weight gain. What does sugar do to the body? Well, studies have shown that sugar releases the feel-good hormone dopamine. Sugar stimulates the same receptors in the brain as does morphine and cocaine. Isn’t that wild? Additionally, eating sugar causes the body to release insulin, a hormone that works to control blood sugar which comes from the pancreas. For some people, type 2 diabetes can develop if the pancreas is overworked over time. Finally, a diet high in sugar is linked to weight gain, and a diet low in sugar is linked to weight loss. Specifically, a study from 2012 in the Journal of Nutrition found that diets high in fructose were linked to increased levels of belly fat, increasing a person’s risk for diabetes and heart disease. (Continued on next page)

SURGICAL KNOWLEDGE INFORMATIVE NEWSLETTER FOR THE NEW YOU October 2014

(Continued from previous page) What is a person to do about all this sugar? Well, the first suggestion is to avoid any obvious sugar sources in the diet (candy, sweet foods, juices, syrups) – also, consider choosing whole foods, recipes made from scratch. The more boxed, pre-packaged and processed foods a person eats, the more likely they will be taking in added sources of sugar. Here is a list of alternative names for sugar you may find on a food label:

• Corn sweetener • Corn syrup, or corn syrup

solids • Dehydrated cane juice • Dextrin • Dextrose • Fructose • Fruit juice concentrate • Glucose

• High fructose corn syrup • Honey • Invert sugar • Lactose • Maltodextrin • Malt syrup • Maple syrup • Molasses • Raw sugar

• Rice syrup • Saccharose • Syrup • Treacle • Turbinado sugar • Xylose

Mindful Eating Class Update

The next Mindful Eating Class will be held Saturday, October 25th from 10-12:30pm. This is an exciting offering to all SWL patients! Cost is $50 and we do not bill insurance for this class. If interested, e-mail Krystal Tracy at ktracy@emhs.org or call (207) 973-4037. Deadline to register is Oct 10th for this session.

Mindful eating has been shown to help people:

1) Reduce overeatingi 2) Lose weight ii 3) Cope with chronic eating problems, and reduce anxious thoughts about food and your

bodyiii 4) Improve the symptoms of Type 2 diabetes iv

i Kristeller J. L. and R. Q. Wolever. 2011. "Mindfulness-Based Eating Awareness Training for Treating Binge Eating Disorder: The Conceptual Foundation." Eating Disorders. 19(1): 49-61 ii Tapper, K., C. Shaw, J. Ilsley, A. J. Hill, F. W. Bond, and L. Moore. 2009. "Exploratory Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention for Women." Appetite. 52(2): 396-404. iii Rawal, A., J. Enayati, M. Williams, and R. Park. 2009. "A Mindful Approach to Eating Disorders." Healthcare Counseling & Psychotherapy Journal. 9(4): 16-20. iv Faude-Lang V., M. Hartmann, E. M. Schmidt, P. Humpert , P. Nawroth, and W. Herzog. 2010. "Acceptance- and Mindfulness-Based Group Intervention in Advanced Type 2 Diabetes Patients: Therapeutic Concept and Practical Experiences." Psychotherapy and Psychosomatics in Medical Psychology. 60(5): 185-9.

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Surgical Weight Loss Support Groups

We encourage regular attendance to these groups. Attending groups is one way to re-affirm the importance of your commitment to surgery. Studies show those who attend groups, weigh themselves regularly, and record dietary intake are more likely to manage their weight. Send your e-mail to Lynn Bolduc if you would like to be put on an e-mail reminder list for any one of the groups— Lbolduc@emh.org Bangor: EMMC (for all patients, before and after surgery)

When Where Time Leader Upcoming Groups

1st Friday of every month

Brandow Conf. Room at Eastern Maine Medical

Center

4:30-6:30PM

Lynn Bolduc,

RD

Oct 3, 2014- with Dr. St. Jean Nov 7, 2014 – with Dr. Dayhim Dec 5, 2014 – Lead by Tama Fitzpatrick w/ Dr. St. Jean

3rd Tuesday of every month

Brandow Conf. Room at Eastern Maine Medical

Center

4:30- 6:30PM

Tama Fitzpatrick,

RD

Oct 21, 2014 – with Dr. Dayhim Nov 18, 2014 – with Dr. Toder Dec 16, 2014 – with Dr. Toder

Bangor: EMMC Healthcare Mall: Staying On Track Support Group (for patients who have had weight loss surgery):

*Due to the small room size and sensitivity of topics discussed, we ask that you come alone to this group. This group is now open to ANYONE who has had weight loss surgery. The group size is typically small.

Presque Isle: TAMC

Bar Harbor: MDI Hospital

Waterville: Inland Hospital

1st Wednesday of every month

Inland Hospital: Medical Arts Building Conference Room

5:30-7 PM

Ev Jackson, RD

Oct. 1, 2014 Nov 5, 2014 Dec 3, 2014 Jan 7, 2015

Greenville: CA Dean

1st Thursday June, October, March

CA Dean Whitman Board Room

364 Portland Ave Greenville, ME

5:30-6:30 pm

Tina Haluska, RD

Oct 2, 2014 – Dr. St. Jean March 5, 2015 – Dr. Toder June 4, 2015 - TBA

2nd Wednesday of every month

Diabetes, Endocrine, and Nutrition Center,

Classroom 905 Union Street

Suite 11

5:00-6:00 PM

Dr. Nina Boulard, Clinical Psychologist (taking over for Dr. Prescott)

October 11, 2014 November 12, 2014 December 10, 2014 January 14, 2014

1st Wednesday of every month

The Aroostook Medical Center; McCain A Conference Room

5:00-6:00 PM

Nicole Doughty, RD, Kate Parsons, RD, & Angel Hebert, RD

Oct. 1, 2014 Nov 5, 2014 Dec 3, 2014 Jan 7, 2015

3rd Thursday Quarterly

MDI Hospital, Bar Harbor: Conference

Room B

5:00-6:00 PM

Caitlin Henrikson, RD Amory Davis, LD

Oct. 16, 2014 – Dr. St. Jean Jan 15, 2015 - TBA

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"Time for ME"

I have fought with my weight my entire life. My highest weight was over 240 lbs. I’ve tried

multiple dieting “tricks” including Weight Watchers, Spark People, etc. I would lose a little bit of weight

and then gain it right back each time feeling like a failure. I was always thinking about my weight. I

tried to hide behind people in pictures and joked about hiding my chins. I changed my Facebook

settings so that I had to approve tags before they posted on my page. I even went as far as emailing

friends to ask them if they would delete a picture of me because I was so embarrassed thinking

mutual friends would see it on their page. I spent vacations wondering how the pictures were going

to look at the end of the trip. I used Photoshop to fix pictures that showed too much or I would crop

myself out completely. People complimented me on my eyes so I tried to hide behind them as much

as I could, wearing make-up or colors that flattered them hoping people would not see the body

attached.

On February 19, 2013 I began the Surgical Weight Loss Program at EMMC weighing in at 231

pounds. For 4 months I worked with a team of professionals to learn how to manage food, exercise

and address my self-sabotaging behaviors. During that time I lost 26 lbs.

I kept this process a secret from most of my friends and family in fear of what they would say

or think of me. And then it hit me! I was giving everyone else the power that should remain mine.

On June 30, 2013 I posted a letter on Facebook that contained a lot of the information I have written

here. This was the most important statement. "I want your support, not your criticism. If you cannot

stand with me, stand back in silence. I am ready and it is “Time for ME”. I received a lot of support

but with that some criticism as well. Some of that criticism came from those closest to me. That was

hard and some of those words still resonate with me. There were quite a few people who said they

would support me but still didn't quite understand why I needed surgery. They thought I looked fine.

Friends asked me why I was still pursuing the surgery since I had started losing weight and I

explained that it was because there was hope. This procedure is not a “Band-Aid”. It is a tool.

Knowing that this tool was about to become available to me helped give me the energy and willpower

I needed to lose those 26 pounds.

On July 26, 2013 Dr. St. Jean performed a Sleeve Gastrectomy without any complications. I

have lost 70 pounds making the total weight loss since the start of this journey 96 pounds. I have met

my goal weight of 135 and I feel amazing. My hip pain is gone and my headaches have diminished

greatly.

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I have had very few minor side effects that have been easily managed and resolved. From the

start of the program, I've done my absolute best to follow every guideline. I am not perfect by any

means, but I am proud of myself and my commitment.

Friends and family are stunned when they look at photos prior to the surgery. They often state

that they never saw me that way. They just saw Marsha. Now they understand why I felt trapped

within myself. Some have even apologized.

When I see someone I haven't seen in quite some time and they ask how I lost the weight. At

first I hesitated but now I usually say "A lot of hard work and help from the EMMC Surgical Weight

Loss Program." I've enjoyed talking to others about the program and I always advise them to make

the decision that is best for them.

I continue to change physically but more importantly I am aware of how I am changing

emotionally. "Self confidence is the most attractive quality a person can have. How can anyone see

how awesome you are, if you can't see it yourself?" -Author Unknown

Looking for Stories… Do you have a story, poem, healthy recipe, or question to ask the team or something interesting to share? Please e-mail Lynn Bolduc, Tama Fitzpatrick, Valerie Curtis of Kaileigh Duym for submission to the newsletter @ lbolduc@emhs.org ; tfitzpatrick@emhs.org ; vncurtis@emhs.org ; kduym@emhs.org

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Quarterly Newsletter

If you want to receive this newsletter electronically, please register by going to: www.swlp.emmc.org ; click on “Support after surgery” then find “newsletter.” Hard copies of the newsletter are distributed at the support groups and dietitian visits. The SKINNY is published four times per year. You can also e-mail Lynn directly at Lbolduc@emh.org and she will add you. Once on the mailing list you will monthly receive electronic e-mail reminders about the group

Clothing Swaps

In an attempt to help our patients as they change sizes quickly after weight loss, EMMC Surgical Weight Loss has been having clothing swaps since 2000. We ask that you consider donating gently used, clean clothing. You do not need to donate clothing in order to take advantage of the swap. You can take clothing without giving and give without taking. No money will be exchanged. The clothes not taken at the end of the night are given to charities such as Salvation Army, Goodwill or Shoestring Thrift shop. People usually bring the clothing between 4-4:30P on the night of the clothing swap and the swap part happens immediately after the support group (6:30pm). This is a patient led activity which can always use more volunteers. Please contact Lynn Bolduc at lbolduc@emh.org if you are interested in how to pay-it-forward. Due to construction at EMMC, the December clothing swap will be postponed until 2015 (date TBA) as support groups will be held in a smaller room during this time (Brandow). *Please note that we do not have a way to store clothing brought in advance and left at our offices.

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Avocado and Greek Yogurt Chicken Salad Serving Size: ½ Cup; Serves 6 Ingredients:

• 1 ripe avocado, removed from skin • ½ cup plain nonfat Greek yogurt • ½ tsp. garlic powder • ½ tsp. onion powder • ¼ tsp. ground black pepper • 2 cups chopped or shredded chicken breast,

cooked • ½ red onion, chopped • 1 small lime

Directions: In a medium bowl, mash together the avocado and yogurt until smooth. Stir in spices. Add chicken and red onion to avocado mixture and stir until well combined. Squeeze half the juice from the lime into the mixture, taste, add second half of lime juice if desired. Serve in a low cal wrap, pita, lettuce leaf or as is!

Nutrition Information per serving: 151 calories, 17 grams protein, 6 grams carbohydrate, 7 grams total fat, 46 mg sodium

Jennifer’s Story (Continued from July 2014 issue)

Shortly after the informational session, I started reviewing all of the

different information that’s included in the educational manual and began following the Phase 5 High Protein Regular diet by eating the foods that were on the list and just playing around with my portion sizes. I wanted to fully commit myself to this process and I wanted to get my mind heading in the right direction with the food I was eating!! I also had to try numerous protein shakes to find a few that I liked before surgery because one thing I will ALWAYS remember is how important PROTEIN is while going through this process!! It may sound silly but I also needed to train myself to actually “CHEW” my food which is honestly amazing how much better most foods tasted to me when I actually chewed them up really well! One big thing I learned NOT to do before my surgery while eating was drinking fluids thirty minutes before to thirty minutes after my meals. It really gives a whole new meaning to my meals and I enjoy them a lot more! When I had questions, I would e-mail Lynn from time to time to make sure that I was eating the right things and taking the proper vitamin! January 2013, I thought to myself “This is going to be MY YEAR!!!!” I had completed all of my appointments for the surgical weight loss program and was “cleared” on all accounts to go ahead with my surgery! I told Lynn that I wasn’t picky about a surgeon and I just “wanted to do this!!” Dr. Michael St. Jean was available for an appointment on February 4, 2013 and I took it! I told him that the sleeve was my choice. We talked about the bypass but I stuck to wanting the sleeve. He was ok with my decision because I was young and didn’t have any serious health problems besides my weight! We had a nice chat and I felt that he was the perfect fit for me and was happy that he was going to be my surgeon! Within 48 hours, my surgery was approved by my insurance company and I had my DATE… MARCH 5th!!! March 5th SURGERY DAY, the start of my new life!!! I was up early and was ready to go!! My husband was more nervous than I was about my surgery; he was shaking the whole drive to Bangor. We got to the hospital around 6 am and I was READY!!! They took me in almost immediately to get prepped and my official surgery weigh in was 327.9 lbs. which means I had lost 49.1 lbs. before surgery!! My husband, my mom and my dad were all out in the waiting room the day of my surgery and there were lots of people on stand by waiting to hear the news! I was in surgery for three hours and everything went FANTASTIC! My mom was the first person to come see me in recovery and then my husband (he was a mess and

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Jennifer’s Story Continued… was pacing the waiting room the entire time!) and he was relieved that everything went great and that I was ok. Then my dad!! He of course had to be the one to make me laugh and everyone else around me! I will always be grateful for the three of them waiting for me during my “big moment”.

When I finally got up to my room, my cell phone and facebook were overloaded with messages and comments from my close family and amazing friends showing me their support and sending positive wishes my way! It made me feel so loved! My cousin had initiated a “wear blue” day as a support to me because it was my favorite color and my co-workers had a group picture posted on my page along with a few other people!!

So here I am!!! 15 MONTHS after surgery! I weigh in at 237lbs which is an amazing 140lb WEIGHT LOSS and I have lost a total of almost 100 inches overall (I’ve been keeping a diary!!) I started out wearing a size 26/28 shirt and a 30/32 pant and now I am wearing a 14/16 shirt and 18/20 pant!!!! WOW, that’s the only word that comes to mind! Never thought I would get to this point and I seriously feel having the surgery was by far the BEST decision I have ever made for myself! Granted it hasn’t all been sunshine and rainbows because it has been the biggest challenge of my life time! My eating habits are completely different now! I love to exercise because it makes me feel great because I am not gasping for air after walking or even jogging! I’ve done 5k’s and I am going to be doing a 5k obstacle course in September!

THANK YOU to the entire Eastern Maine Medical Center surgical weight loss team for being so encouraging and supportive throughout this journey and having such an incredible program!! Yes, I’m only 27 years old but I feel like I have been given a second chance to restart a healthier life! My #1 goal in life is to be the BEST mommy in the world for my future children because kids mean the world to me and there is nothing like holding a precious little one and just staring down at their little face! Looking back, I psychically hurt just sitting on the floor playing with my nieces and nephews and now I’m chasing after them and just enjoying life! I’m just waiting for my 18 month post op appointment with Dr. St. Jean because then it will be official and it will be my time to start my family! I’m beyond excited for that moment and think about it every day! This whole journey is going to be worth it even more when I am holding my own little bundle of joy!

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Jennifer’s Story Continued…

I also want to thank all of my followers and mainly to my family and close friends who have been there by my side along this whole journey and when I have “those” days they pick me back up and say “Take a look at how far you have come and don’t be discouraged because the scale isn’t showing the results you want… look at your pictures and all of the changes you can see it’s amazing!!” and it certainly is amazing! If you would like to follow my journey, you can find me on Facebook “Jenny’s Weight Loss Journey”.

Here are a few pictures to show my progress, I hope you have enjoyed reading my story!!! I will finish with one of my favorite quotes: “Whenever you find yourself doubting how far you can go, just remember how far you have come. Remember everything you have faced, all the battles you have won and all the fears you have overcome.”

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The Turkey Trot is Coming!!! For those who need a fitness challenge, or just want something active to do the Sunday before Thanksgiving (Nov. 23rd), I encourage you to enter a 3 mile road race in Brewer, Maine. Participants can walk, run or a combination of the two. Applications can be found on the Sub 5 Track Club website (www.sub5.com) or by sending an email to Lynn Bolduc (lbolduc@emhs.org) with “Turkey Trot” in the subject line. Lynn will be trying to organize another group photo after the race, so if you plan to participate please email her so that she can forward the details to you for the post-race photo. The race is fun with lots of prizes and is not just for the fast. After the event the participants sit on the gymnasium floor while lots of prizes are awarded based upon your entry (and not on your time). The final prize is a cash prize representing $1 from each participant’s entry fee stuffed into a paper mache turkey. In 1996 Lynn Bolduc entered her first Turkey Trot and won $512 (but has not been fortunate enough to win anything more than a free movie rental since). Last year’s prize was over $600. The average number of calories burned in a 3 miles run or walk ranges from 270-400 depending on your size and is certainly not enough to justify the pecan pie on Thanksgiving, but this is a fun event that you won’t regret signing up for! Pictured below: Lynn Bolduc with Surgical Weight Loss patients after completing the 2013 Turkey Trot.

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