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Sumac Marinade for Lamb

I had this 2# lamb shoulder roast in the freezer and I decided I wanted to roast it. I’d read about sumac and got some from the Farmers Market and I wanted to use it on the lamb somehow. I’d used it on chicken and it was OK, but I wanted more punch. I read a few marinade recipes and came up with this one that is VERY flavourful! It’d probably work for chicken, beef or pork, too.

Sumac Marinade

This is for about 2# of meat. Double if you have a larger roast.

2 Tbl EVOO
1 Tbl sumac
3 cloves garlic, minced
1 tsp dried oregano
3 bay leaves, broken up
2 Tbl white wine
1 tsp salt
1 tsp black pepper

Mix together in a ziplock with the roast (if your roast is too big for a ziplock, then use a vessel that it fits in tightly and rotate it every hour). Ensure that the roast is covered and press all air out of the bag when you seal it. Let rest in the fridge for at least 2 hrs, up to 8 hr for lamb, pork or beef. No MORE than than 2 hours for chicken or it will get mealy.

Roast lamb at 325-350F for 25 mins per pound to get medium rare (145F at the thickest point). Do not cook lamb more than medium or you’ll rob it of its flavour!

Creamy Salsa Verde Chicken & Pasta

I tripped upon a salsa verde chicken recipe the other day that was interesting, but it did not have the veg and herbs that I normally use in my cooking, so I made my own recipe. This one makes a BIG skillet of food and is very creamy and satisfying. You can leave out the pasta and serve this over rice if that’s more your thang. :)

Creamy Salsa Verde Chicken & Pasta

Creamy Salsa Verde Chicken & Pasta

Creamy Salsa Verde Chicken & Pasta

4 boneless and skinless chicken thighs (about one pound), one inch dice
olive oil
1 small onion, diced
3 baby bell peppers or one small red pepper, diced
1 Tbl garlic paste or 3 cloves garlic, minced
1 tsp oregano
1/2 tsp fresh thyme (optional)
2 Tbl pickled jalapeño chopped or 1 SMALL raw jalapeño, minced (optional)
zest of one lime
1.5 cups chicken stock
1.5 cups salsa verde (I use Herdez)
1.5 cups UNCOOKED penne pasta (or any small shape, can be omitted)
1 cup Mexican crema (or sub heavy cream; add more salt if using cream)
3/4 to 1 cup shredded jack cheese or Mexican mix shredded cheese
1/2 cup queso fresco to top (optional)
juice of the zested lime

Cut up chicken and season, then sauté in a large hot skillet. I used a deep chicken frying skillet for this, with a lid. Don’t crowd or the chicken won’t brown. When the chicken is browned, push to the sides of the pan and add onion, peppers, garlic, herbs and hot peppers. Sauté until translucent, but don’t brown.

Stir chicken and veg together and add lime zest. Add chicken stock and salsa verde, bring to boil. Add pasta and cook at a slow simmer, covered, for about 8-10 mins until the pasta is al dente. You may have to add a splash more stock if it gets too tight. If you omit the pasta, just cook until you get the consistency you want.

Cut the heat and add the crema and jack cheese (use as much or as little cheese as you like). Stir until smooth and creamy. Crumble up the queso fresco and sprinkle on top. Add lime juice. I added more oregano on top for the photo.

Check your seasoning and serve.

Managing GERD Longterm

As I’ve talked about several times, GERD is a fact of life after VSG surgery. I am averse to taking medications for the rest of my life, but it appears I’ll have no choice. I don’t mind taking supplements, I’ve done that for decades, but medications that alter my body make me uncomfortable. Even if I’d been told about the GERD (I WAS NOT), I’d still have gone for the surgery. The benefits far outweigh (ha! PUN!) the GERD.

That said, I’ve been on a quest to find the right balance of PPI and/or H2RA to manage the GERD with the smallest dose possible. In case you’re new or unsure about all these acronyms, here is a quick primer to bring you up to speed:

GERD – Gastroesophageal Reflux Disease
VSG – Vertical Sleeve Gastrectomy, often called gastric sleeve surgery (not an actual sleeve, refers to shape of stomach)
PPI – Proton Pump Inhibitor, a drug that binds with certain enzymes and prevents the pumps from producing acid in the stomach
H2RA – Histamine Receptor 2 Antagonist, an antihistamine that blocks acid production in the stomach
NAB – Night time acid breakthrough
-zole drugs – any reflux drug that ends in -zole is a PPI class drug
-dine drugs – any reflux drug that ends in -dine is an H2RA class drug

There is a goodly amount of research and studies on both PPI and H2RA drugs, but there is still much unknown about long term use of them. Doctors tend to prescribe these drugs liberally, without taking into consideration their side effects and long term issues that will arise from taking them. I was not told a single thing about the PPI I was given, other than take it twice a day. That’s it. They also did not go into detail about other supplements a VSG patient should take for the rest of their lives. A passing mention was given to Vitamin B12, but no documentation was offered. The useless nutritionist never once mentioned Vit B12 supplementation, either.

Fortunately for any VSG patients reading this, you have ME to root through the reams of research and give you the info I’ve rounded up in a convenient blog post. :)

After finishing the initial month of Mexican omeprazole (Prilosec) in capsules, I switched to American omeprazole in tablets. I had already done the reading about the long term issues with omeprazole, such as calcium and magnesium blocking, which is very problematic. I tried switching to Zantac (ranitidine) twice a day and the side effects were horrible. I had ringing in my ears, constipation, diarrhea. I felt awful. And I still had some reflux. This lasted about two weeks, then I gave up and went back on omeprazole 20mg in the morning and famotidine 20mg (Pepcid) at night before bed. I spoke to the pharmacist about it and decided I’d split the difference. I’ve been on this combo for about 2.5 months. The famotidine also gives me some buzzing in my ears, but milder than ranitidine. But it’s got to go.

Today I’ve been reading about using PPI and H2RA drugs together and mostly it’s a wash. There is little evidence that taking the H2RA at night will help with Nighttime Acid Breakthrough (NAB). It’s pretty much worked for me, but the last couple of weeks it has been less effective. Most of the studies I read indicated that taking a PPI twice a day is more effective in general than the combo.

I also read that Nexium (esomeprazole) is slightly more effective than Prilosec (omeprazole) and the newer drugs Protonix (pantoprazole) and Aciphex (rabeprazole) are even better, but they are Rx and likely very expensive, so I’ve ruled those out for now. I will revisit trying them out if Nexium poops out on me in a few months. I’m betting it will.

So I’ve decided to switch to Nexium 20mg once a day to see how the NAB is. Probably going to suck, so I anticipate taking the PPI twice a day. The weak good news is that the typical dose of both Nexium and Prilosec is 60mg, so I’m taking a very small dose right now. I hope I can keep the dosage to a minimum, although one study said that the dosage is irrelevant to the nasty side effects. Calcium and magnesium are blocked just the same with 20mg as 60mg. But hopefully the ear buzzing will cease when I discontinue the H2RA.

To offset the calcium/magnesium issues, I take a cal/mag supplement as well as a D3 and Vit K2 supplement. D3 and K2 (NOT just K, but K2) help a lot with absorption of calcium and magnesium. I’ve listed details of what I take daily here.

I’ve found that taking Kyolic Kyo-Dophilus daily has helped with my gut issues. Taking PPIs and H2RAs wreaks havoc on your gut. Diarrhea, constipation or BOTH should be expected. Taking the gut flora caps seems to offset some of this. I recommend taking probiotics! Your gut is a mess after VSG. Between no food and taking 40mg of Prilosec a day, you pretty much kill off your gut flora. I wish I’d started the Kyo-Dophilus immediately after surgery, but of course, Drs (and apparently nutritionists) are not trained in supplements, so it was not mentioned. You should start this before and right after surgery. Get the yogurt with probiotics in it at the very least (Activia, I think it is).

My adventures in managing GERD after VSG have been informative if nothing else. I know more about how the stomach works that I ever did! I hope my blog posts are helping others who have gotten VSG and not been told all the facts. I know that Drs here AND in Mexico are extremely uninformed about the long term use of PPIs and how to supplement. I’ve spoken to people who’ve gotten VSG in both places and they have been told ZERO about what to take afterwards. Vitamin B12 supplementation is VITAL. So is calcium and magnesium! Not getting these vital nutrients can cause terrible side effects in the long term. B12 deficiency has been linked to dementia and of course calcium deficiency means osteoporosis. Magnesium imbalance can cause heart issues. So do your reading and TAKE YOUR SUPPLEMENTS. It is important to your long term health!

5 Month Under 200# Achievement Unlocked!

I did a video the other day to celebrate my first big goal: under 200#! Squee! It’s a long video at 26 minutes, but I cover everything up to now. I thought I’d also write a blog post to back up the video and give all the facts succinctly.**

Current stats:
Weight at beginning: 250 40 BMI, which is the minimum to get VSG.
Weight at surgery: 238
Weight at last weigh in: 196 (which was skewed) Actual weight: right at/below 200. BMI 34.4.
Waist at start: 51″
Waist now: 44″
Jeans at beginning: 18/20
Jeans now: 14 fat, but these are loose. I think I’m in a straight 14 now.

I had surgery May 17, 2016; exactly 5 months ago today! Happy surgical anniversary to me! The surgery was very easy for me. I had no gas, no pain, no issues. I think it was because I was at the minimum BMI and very healthy to begin with. The biggest thing to happen right after surgery was that all inflammation in my body ceased immediately. It was stunning. I am convinced that inflammation MUST be somehow linked to the stomach and gut. It’s the only explanation I have for the sudden and complete cessation of the inflammation pain I had.

I had one incision dehisce – which means pop open. It was a big deal because no one knew what to do about it. The Drs in Mexico blew up my phone checking on me (which was AMAZING!), but neither they, nor my dermatologist had any idea what to do. Luckily for me, I’ve got Amy as a friend and she is also a nurse. She recommended wet to dry dressing, which worked perfectly. I went for my gyno exam and my gyno knew exactly what to do and she said, “Of course you use wet to dry! Doesn’t everyone know that? We see this often with C Section incisions.” I love my gyno! That healed up fine once I started the correct dressing. No big.

You’ll be on an antibiotic and a double dose of omeprazole (Prilosec) for a month. They have omeprazole in capsules in Mexico, so you open these and the antibiotics and take them that way (tastes like FEET). Typically you are not cleared for pills until the 2 month point. I’ve listed the bariatric vitamins I used here.

I made my own diet for the recovery. The crappy yogurt, canned meat and refried beans diet given to me by the idiot Mexican “nutritionist” was tossed immediately. Not only did it have no actual nutrition, it had stupid amounts, like a cup of each item. Um, apparently no one told this person that post op patients can NOT eat a cup of anything. More like 1/3 to 1/2 cup. I made gobs of chicken stock, lots of pureed veg for soups and had the ubiquitous whey protein for shakes. I drank gallons of Vitamin water because it has vitamins and calories, which I needed because I could not eat. I was on solid foods (as in: not pureed, but still soft) at week FIVE. I ate lots of canned tuna and chicken and other canned veg because it’s soft. Also, eggs are your friend. Eggs are the perfect protein and they are easy to digest. I also ate a lot of cottage cheese.

I hit the weight loss stall early: at about one month. This stall depressed me and made me regret the surgery. This happens to everyone who gets VSG. Your body freaks out and tries to hold onto its weight because it thinks it is starving, so a stall WILL happen, it’s just a matter of when. But it also stops after 2-4 weeks and then your loss starts.

I did NOT lose a bunch of hair. I was bracing myself for this because everyone was screaming about it on the boards. Didn’t happen to me. You lose 150 hairs a day, people, so I think the hair loss is probably not as bad as everyone thinks. Also: you can lose hair after ANY surgery, not just bariatric.

Once I was cleared for pills and capsules, I began to bring back in the supplements I’d taken before surgery. Here is my current regimen. You MUST take supplements after VSG. You need Vit B12 in copious quantities, calcium/magnesium to offset the Prilosec and Vit D3 and K2 to help absorb the calcium. I took a vegan iron supplement (the vegan one does not make me sick like regular ones do) a few times, but it tasted nasty, so I stopped. When I get my blood tests in a few weeks, I’ll find out if I’m anemic. I’ve NEVER been anemic, so I doubt I will be, but if you tend towards that, you should take an iron supplement.

Reflux and/or GERD will be a part of your life after VSG. Just accept it. They don’t say much about it when you are given info, but it will be there. They expect you to take Prilosec for the rest of your life and it looks like that is accurate for me. I tried getting off it and that was a miserable failure. I take 20mg omeprazole in the morning and 20mg famotidine (Pepcid) at night. These drugs are NOT good for you. Prilosec (omeprazole or any -zole drug) blocks calcium absorption and is just not recommended for long term use. Too bad we have to take it forever. :( I just supplement the calcium/magnesium and hope for the best. I can’t stop taking it, the reflux is too severe. I am convinced it is the shape of the VSG tube/pouch that forces the acid up to the esophagus. I think they’ll eventually change the shape of the VSG to alleviate this.

You’ll also have to radically change your eating habits – which is the point, really. They want you to eat anywhere from 50-80 grams of protein a day. I counted protein like crazy for the first 3-4 months to make sure I got enough, but honestly? I stopped that shit. It’s too much like dieting, which I REFUSE to do ever again. You’ll need to stock up on Premier Protein shakes (30 grams protein, no carbs) and drink those every day for the first few months. I switched to the Premier Protein bars (30 grams protein, 29 grams carbs) about a month ago because I was sick of those shakes. I have to admit, tho, that I don’t eat a bar or shake every day. My average protein intake w/out a supplement is probably around 30 grams. I don’t have any idea of my caloric intake, nor do I care. I don’t drink a gallon of water every day, either, but I didn’t do this before surgery, so I drink what is normal for me. I drink no calorie flavoured fizzy water, 2-3 cans a day (La Croix!). YES you can drink fizzy water and beer – well, I can. No issues. Use your pee as a guide: if it is dark, you need more water.

The hardest thing to learn is when you are full. The pouch feels very different than your stomach did, so this definitely has a learning curve. I just recently got the hang of eating until I am full but not TOO full. As you’ll find out, overeating is an odd and unpleasant sensation. I drink while I eat, too. NOT MUCH, mind you, but a little. You’ll find your own balance. I eat anything I want, just not much of it. :)

Overall, this was the best decision I’ve ever made. The way I’m losing weight is different than any other time I’ve lost. I’m becoming overall slimmer, my legs are looking different than they ever have. I tell you what: if my calves get small enough to wear boots – I’m getting some expensive ass cowboy boots. Assuming I can find a pair that I can get my high instep into! Sadly the instep will never go away!

And finally, you must start to exercise. You lose fat and muscle when you do this (which is why protein is so very important), so exercise will build your muscles back and keep the fat burning. I can tell I’ve lost muscle – I am very weak now. I’ve started back walking and doing light weights.

Oh, and one last thing: get a blood test, full panels, done at six months. This is the best way to see where you are with iron and mineral levels and all the rest. It’s just a good thing to do. If you watch cholesterol or any of that, I’m sure you’ll see a massive improvement.

As in my video, I’d like to give a BIG shout out to Nick! He has lost FORTY POUNDS since my surgery!! He has been working his ass off every morning and he has joined me in the Eat-Like-A-Child club. Good job, baby!! XOXO

That’s it. I’m at five months, I feel great and I am very happy with the way I look. I highly recommend VSG – despite the reflux issues. It is totally worth it. :)

**My usual disclaimer: all these things worked wonderfully for me. Your mileage may vary. Listen to your body.

Shrimp & Apple Cinnamon Sausage Skillet

Occasionally, our Kroger will have uniquely flavoured sausages, such as apple cinnamon or gyro. They are raw sausage, not the precooked kind. This recipe was born – as many of mine are – from looking at what I had in the fridge and getting an idea from a googled recipe. This is a very easy meal and very hearty. This also freezes well, so you can double this and freeze half for a quick dinner later!

Shrimp and Apple Cinnamon Sausage Skillet

Shrimp and Apple Cinnamon Sausage Skillet

Shrimp & Apple Cinnamon Sausage Skillet

1/2 pound large shrimp (or whatever size is on sale), cleaned and cut in half crosswise, soaked in vermouth
2 Tbl dry vermouth or dry sherry to marinate shrimp
3 uncooked apple cinnamon sausages (or sub the precooked kind)
1 Tbl olive oil
2 Tbl butter
2 roasted bell peppers (jarred), diced (sub 1 fresh pepper if you like)
2/3 cup halved and sliced red onion (about 1/3 of a big onion)
3-4 cloves garlic, diced
2/3 cup halved and thinly sliced fennel (about 2/3 of small head)
6-8 sliced cremini mushrooms
3/4 cup basmati or any long grain rice, uncooked
1 cup chicken stock (half stock, half water)
1 Tbl mirin
1/2 can diced tomatoes with juice (fire roasted is best)
1 tsp dry mustard
1 tsp salt
1/2 tsp pepper
1/2 tsp smoked paprika
1/2 tsp red pepper flakes
1.5 Tbl fennel fronds, chopped

Mix together shrimp and vermouth (or sherry), set aside. Put olive oil and butter in a large skillet over med hi heat. Open the sausages and crumble into skillet. Sauté sausage until it starts to brown. Add peppers, onions, garlic, fennel and mushrooms and sauté until soft, about 3-4 minutes. Stir in the uncooked rice to coat thoroughly. Add stock, mirin, tomatoes and spices and cover over med heat for about 10-15 minutes until rice is cooked. Add more water if it gets dry. Check seasoning. Turn off heat and stir in shrimp and vermouth. Let sit another 5-8 minutes until shrimp become pink and opaque. Turn on low heat if the shrimp are not getting cooked enough.