The Top 5 Reasons Bariatric Patients Attend Support Group

indexColleen M. Cook, President, Speaker, Author

From the “Do I have to go?” to the “I can’t wait until next month” attitude, feelings about bariatric support groups are as diverse as the groups themselves. At any one of the thousands of bariatric support group meetings held each month, you will find that those in attendance include:

  • Weight-loss surgery investigators seeking information and the “real story”
  • Anxious pre-op patients waiting for surgery
  • Early post-op patients or “newbies”
  • Long-term veteran patients checking in
  • Back on trackers seeking to re-lose pounds
  • Friends and family members
  • Volunteers
  • Professionals

Each person is there for a different reason, with different needs and doesn’t it make you wonder, “What is it that draws these people together? Why do they come?”

Our experience with thousands of weight-loss surgery patients and hundreds of support groups has provided us some valuable insight into why people attend support groups, how they are benefiting and why those who are not attending should. Here are just a few of the benefits that we identified:

Validation: From my own experience, I recall the weeks prior to my surgery were a time of great trepidation; a time full of questions.
For instance:

  • “Am I doing the right thing?”
  • “Will I be ok?”
  • “Will I succeed?”
  • “Is it worth the risk?”

Many turn to bariatric support group to find not only answers to practical questions, but also for validation for my decision to have weight-loss surgery. While each must find his or her answers to these questions and come to feel good about their choices, support groups can help provide insight, perspective and real world experiences from those who have been there and now are able to share their perspective.

Education: Quality support groups provide more than just social and emotional support. They provide a wonderful opportunity for learning. Some groups provide a more structured agenda, featuring scheduled topic presentations and discussions. Others enjoy participatory activities designed to reinforce key principles of success and help patients learn new how to incorporate them into their own lives.

Many groups often invite guest speakers. Some are bariatric professionals like dietitians, psychologists and fitness instructors. Other guests provide presentations on topics like grooming, dating and cooking. All are designed to educate, inform and provide a well-rounded foundation of knowledge for long-term success.

Motivation: There is a wonderful story told of a young mother wanting to have her little boy learn to play the piano. He was taking lessons and she was just sure that he would become a famous pianist. She made arrangements for him to go to Carnegie Hall to the see the Master Ignacy Paderewski play.

She dressed-up her son in his little suit and took him to the concert. They found their seats, settled down real close to the stage, and the mother turned around and saw a friend of hers and started talking. When she turned back around the little boy was gone, and she panicked immediately. “Where did he go? Oh, no!” Moments later, she noticed her son up on the stage, at the grand piano on Carnegie Hall, playing “Twinkle, Twinkle Little Star.” He had just learned the song. The audience was aghast – “Somebody stop him!” “That is awful!” “Somebody get him down from there!”

From the back of the room came the Master Ignacy Paderewski at a dead run, down through the aisle, up onto the stage, and behind the little boy. He began playing an accompanying melody to the little boy’s song and as he did, he encouraged, saying, “Don’t stop, keep going, you’re doing fine.”

As weight-loss surgery patients, we sometimes feel alone and misunderstood in the real world. It is so very important to surround ourselves with people who understand our decision to have weight-loss surgery and what it is like to deal with the many physical, emotional and relationship changes that we experience throughout our journey.

Support groups are a place to find people who provide us with understanding, compassion and encouragement.

Celebration: As pounds come off, health is restored and dreams come true. It is a wonderful thing to have an opportunity to share successes with others. Support groups provide just such a place. Whether formally or informally, comments like these abound: “I am half the woman I used to be!” “I can cross my legs!” “They didn’t even recognize me!”

What an exciting time for weight-loss surgery patients. Support groups provide patients a time to share their success; to have a moment in the sun, to be queen or king of the prom, to graduate, or to receive a personal recognition for their achievement with a pin, photo or certificate.

Re-dedication: The first few years following weight-loss surgery are awesome, but there comes a time when we reach, “the end of invincible.” It is not uncommon for patients to slip back into old habits, regain a few pounds and become discouraged. When and if that happens, support groups become an even more important connection to help stay focused, in control and successful. A monthly weigh-in or check-in at a support group meeting provides an important element of accountability and an opportunity to reconnect and rededicate ones self to long-term goals.

So, how does your support group measure up? How are you providing opportunity for patients to be educated, motivated, celebrated or rededicated? As always, BSCI is here to help. Click here for more information on our Support Group Leader Certification Courses, lesson plans, teaching aids and resources.

Tips for stress free support groups

My how time flies when things are crazy busy! At BSCI, are busier than ever doing all we can to support you, the bariatric professional, as you work to provide quality support and educational programs for your patients. We know that those who work in the bariatric community are some of the most talented, dedicated, genuine people anywhere. And we are keenly aware of the many hats you wear. You work tirelessly to improve the health and well being of the patients you serve. But, what about you? What about YOUR health and well-being?

For many, support group night comes at the end of an exhausting full day of work. The time and energy it takes to pull together a meeting agenda, lesson topics and activities when your best self has been all but spent, can turn what might be a fun and fulfilling end to you day to a dreaded obligation. We hear you! We have put together some helpful tips for Bariatric Support Group Leaders to help reduce your stress while planning, preparing and facilitating great meetings.

1. Calendar topics in advance. Time spent planning several months or even a year ahead for support group topics, guest speakers and activities will pay off great dividends especially on those crazy busy days. Survey patients for hot topics, reach out to other professionals, vendors and educators and schedule them in. Having a plan will reduce your stress and let your patients know in advance what great meetings they can count on.

2. Involve more patients, more often. Our research has shown clearly that patients want more patient involvement in support groups. You likely have a room filled with willing volunteers to contribute in a big way. Patient volunteers can arrange for room set up, welcome at the door, arrange for spotlight patient presentations, serve on special event committees, and even research and present a lesson topic. While it takes a bit to get organized, set guidelines and communication, involving patients will help them engage, while giving you a helping hand.

3. Invest in Lesson Plans. Since 2000, BSCI has been known for our research based, quality support group lessons. Each has a lesson plan, handout, activity and visual aids. Have a topic in mind that you don’t see? Let us know, we’ll put our heads together and see what we can come up with. Remember, those attending support group come for a variety of reasons. A good facilitator will incorporate a variety of teaching methods to give each participant opportunity to learn, grow and share in their own way. And in doing so, make the meeting exceptional!

4. Use readily available newsletter articles, stories and research. It is likely that you receive a variety of eNewsletters, updates, articles and research notifications every week from various sources within the bariatric community. For an easy and fun support group on the fly, print out several articles, ask patients to read aloud, then discuss by asking questions like: “Is this true for you?” or, “please share your thoughts and experience on this topic.” If the group is large, you could divide up, have each smaller group take a topic, discuss, then share with everyone.

5. End on time then go home! Many patients enjoy the social aspect of support groups and often meetings seem to go on forever and end way too late, especially for busy professionals. First, set your boundaries. Establish a reasonable time to end, and stick to it. (We find that most groups are about 1/1/2 hours). Dismiss everyone and suggest that those who want to continue visiting meet ‘in the lobby, or turn out the lights when they leave. You may want to ask a patient volunteer to arrange for the after support group get together. Finish your meeting on time – then, go home!  Go see your family and take care of you! We need you.

Activate Your Own Auto-Correct

 

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I have been thinking about typewriters. Both of my grandmothers had typewriters. I remember my Grandma Gwen, typing out letters and invoices for my grandpa’s construction business.  I also remember how cool it was that my Grandma Pearl had an electric typewriter. When I was a young teen I was able to use it to retype a letter and it was pretty great.

Back in typewriter days, if you made a mistake you had a few options. 1. You could completely ignore the mistake and act like it didn’t happen at all and then finish your document. 2. You could backspace and X out the wrong word or letter, or 3. You could backspace and type the right letter over and over again until it was darker than the wrong letter. Option 4. was to use erasable typewriter paper – (I think it was called onion skin).  If a mistake was made, you could take the paper out – use an eraser to erase the error and then put the paper back in, hoping that everything would line up ok, but often it didn’t.

Then along came the infamous ‘white out’ Great stuff. If you make a mistake, you could use white out to cover it up. At first white out came in a liquid, then correction tape, and eventually some typewriters included a white out key to type over the mistake, like my grandma Pearl’s. I learned quickly how important it was to let the white out dry before starting again to type the right word or letter or it would smear and make a terrible mess.

As we look back, the evolution from typewriter to word processor is truly remarkable. Today, we are fortunate to have word processing programs with spell checkers! Right now I am typing in a Microsoft Word Document. If I make a spelling or a grammatical error – it marks it accordingly. And, it suggests possible corrections.  That’s cool. But what is even greater, is the auto-correct feature. I have used this program long enough that now it recognizes some of the words I use often and it automatically completes my words and sometimes my sentences – without me!

What a great feature – auto-correct. Wouldn’t it be awesome if we could train ourselves to auto-correct our bad behaviors, before we made a mistake? I personally would love to be able to engage an auto-correct feature that would prevent me from eating the wrong thing or making a bad choice.  I think that is possible. Somehow it seems to me that thin people have great control over their auto-correct feature.  So how can I?

I suspect that each one of us is at a different point of being able to engage our ability to auto-correct ourselves.

Take our eating habits for example. When we eat the wrong thing, some ignore it and move on. Others try to X it out or cover it up with miss-placed beliefs like – if I eat it fast the calories won’t count. As I have thought through this analogy, I have challenged myself and now challenge you to spend some time thinking not just about your mistakes and wrong choices, but more about what you do about it ‘after the mistake has been made and what it might take to activate your own autocorrect feature for next time.

Next time you eat something that you consider a mistake, pause a moment as ask yourself these questions.

  1. How did this food get here in the first place? Likely it was a conscious choice when shopping. Auto-correct with more mindful shopping.
  2. Was it in-sight or did you have to search for it, deliberately go for it. Auto-correct with out of sight or hard to reach placement.
  3. Were you really hungry? Auto-correct with using the HALTS technique. Ask yourself am I Hungry, Angry, Lonely, Tired or Stresses? Then act accordingly.
  4. Was there something else I could have eaten instead? Auto-correct by surrounding yourself with better choices – again that decision is made in advance.
  5. So now that you have eaten that cupcake what are you going to do now? Auto-correct by coming to understand your own metabolism and know that if calories went in you need to work them off!

Like you, I have come too far to allow myself to repeat mistakes over and over again without making an effort to understand and correct them. I don’t want to ignore my mistakes or attempt to cover them up, “X” them out, or white wash them.  We all make mistakes, but we also all have the ability to mindfully engage our own auto-correct feature. Here’s to lessons from a typewriter!

5 of 5 Ways you know the WLS Honeymoon is Over

Even at 20 years post op, I still clearly remember that fateful day when I reached the “End of Invincible” That fateful moment when the honeymoon phase ended and the real work began. I am anxious to share with you what I have learned about the top 5 ways to recognize that your personal WLS honeymoon is over and what to do about it. Here is the fifth of five installments in this series.  (Subscribe to this blog)

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#5 You stop attending support groups, telling yourself “They are just for the newbies anyway.”

We always suspected that those who regularly attend support groups after weight loss surgery are more successful than those who don’t. Thanks to our collaboration with Stanford University Medical Center, we now have the hard data to prove it.  Put simply, “Successful WLS patients are 3 times more likely to participate in support groups than their less successful counterparts.” (Read Research)

Unfortunately, sometimes we find that support groups focus on and cater to the newbies, leaving the veteran patients bored, un-motivated and less likely come back. If the topics in support group are not of interest to you, suggest some that would be.  Work to be part of the solution. Perhaps offer to do some research, share your experiences or even prepare and teach a lesson.

If you have found that you have lost interest in your support group, please consider that if you don’t need the support group, perhaps the support group needs you.

I, for one am so very grateful to the two WLS patients who at 10 years post op volunteered month after month to share their story, coach, encourage and teach those of us coming along behind them. Perhaps it’s time to give a little back by paying if forward. (Become a BSCI Certified Support Group Leader) There is nothing more motivating than having people look up to you, learn from you and help keep you on track as a good example.

For many, support groups go way beyond, “What is the topic?” People view support group attendance as a commitment to themselves to stay connected and accountable. Support groups offer opportunities to connect a network of like-minded people who understand your journey as many do not. So many life-long friendships are established at support groups.

Make support group attendance a must do on your calendar to help you stay on track and accountable. If you are unable to attend a live group, web-based forums, Facebook groups and telephonic groups are easily found. BSCI’s DreamTeam of educators host free telephonic support groups every week. Fun, easy and a great way to stay connected. Telephonic Support Group Schedule

Read our  Support Group Survey and gain insights and perspective from over 1,000 bariatric patients and how they view their support groups.

4 of 5 Ways you know your WLS Honeymoon is Over.

Even at 20 years post op, I still clearly remember that fateful day when I reached the “End of Invincible” That fateful moment when the honeymoon phase ended and the real work began. I am anxious to share with you what I have learned about the top 5 ways to recognize that your personal WLS honeymoon is over and what to do about it. Here is the fourth of five installments in this series.  (Subscribe to this blog)

Learning

#4 You Realize You Should Have Paid More Attention to your Bariatric Team

It seems that through the years the bariatric medical community has made great progress in ensuring that prospective patients are better educated and more prepared for surgery. As many of you know, there is a long checklist of todo’s prior to surgery. Consultations, evaluations, exams, tests, support groups and the list goes on and on.

An interesting thing happens though. When surgery is imminent, our focus is primarily on the details surrounding the actual procedure, hospital stay, pain management, how it will feel, etc. The classes and information are helpful, but unfortunately, we are not really listening. We are trying; we nod our heads at what our dieticians, nurses, mental health and exercise professionals are telling us. We commit to being compliant, eat right, exercise, take our vitamins and attend our follow up visits.  But are we really listening? Are we learning?  Perhaps not.

Following surgery, it’s “Whew, I am alive!” And once we are released from the hospital we begin our journey, sticking closely to what we have been advised. We start to really pay attention. Then, something magical happens. Our  surgical tool starts to work, just like we had hoped. The weight starts to fall off!  But, then we learn that no matter what we do, whether we follow the rules or not, the weight still continues to fall off.  A dangerous realization.  You see, once we think of ourselves as invincible – we stop listening.

Sadly, we see that it is only when people reach a plateau or heaven forbid, begin to gain weight that they are really ready to listen and learn. We are told so often, surgery is a tool, it’s a tool, it’s a tool. Again, we nod our heads. Now that our honeymoon is over we must be ready to learn. I mean really ready to learn.

We have “graduated” or are have been “released” from our bariatric clinic and may wonder if we missed our shot to learn. Surgery was a success; we have lost weight and now we need to learn how to maintain. Wishing we would have paid more attention earlier on, we might wonder where can turn.

For me, I turned to all of the successful patients I could find, to learn what they knew and do what they did.  As I expected, there are very particular habits that those most successful have made part of their lives. In fact, I have spent the last 20 years seeking out the most successful wls patients, identifying their habits, learning from these long term losers and sharing my research all over the globe. Read research here:

Learn more about The Success Habits of Weight Loss Surgery Patients.

So often, we hear struggling patients comment that they did not learn these important principles during their initial weight loss. If that is the case with you, it is not too late. Read the book, take a class, participate online. Remember your surgical tool will serve you well for a lifetime as long as you learn to use it properly. Learn what you might have missed, learn what successful patient have to teach you, learn all you need to know about your own body, metabolism and food addictions. It’s never too late.

Subscribe to this blog to receive: #5 You stop attending support groups, telling yourself “they are just for the newbies anyway.”

3 of 5 Ways you know the WLS Honeymoon is Over

Even at 20 years post op, I still  clearly remember that fateful day when I reached the “End of Invincible” That fateful moment when the honeymoon phase ended and the real work began. I am anxious to share with you what I have learned about the top 5 ways to recognize that your personal WLS honeymoon is over and what to do about it. Here is the third of five installments in this series.  (Subscribe to this blog)

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#3 THE SCALE STARTS TO GO IN THE WRONG DIRECTION

Perhaps like me,  you spent many years not knowing what you weighed. I hated the scale and would avoid it at all costs. But, I loved nothing more than weighing myself during the first year after my surgery.  It seemed as though I could weigh in the morning and lose even more weight by the time I returned home in the evening! Talk about motivating.  For the first time in almost forever, the scales were tipping in my favor and it was exciting!

As many do, I reached a plateau a time or two on my way down to my goal. So, perhaps you too have plateaued along the way, but this time, you sense it is different. You have reached your goal, stayed there and celebrated your success, but then, your weight starts to climb back up. Panic sets in and you know that glory days are over. Thoughts like, “I was afraid this was too good to be true.” or “I knew this couldn’t last.” keep surfacing. Self- doubt sets in and you worry that like so many times in your life, you lose, then gain. (And often with a bonus). You hoped it would be different with a surgical intervention, you hoped it would be easy. And in some respects, it has been but now reality hits and you know it’s time to pay attention.

At this critical juncture. it is time to ensure that you have put into place the Success Habits you must rely upon every day for the rest of your life in order to maintain your weight. We all know how to lose weight, we have spent so many years on diets, off diets, thinking about a diet, researching a new diet, cursing diets, getting on and falling off diets. But learning how to maintain weight is a completely different mindset. Take this time as you transition from losing to maintaining to remind yourself that obesity is a disease. And one that you will struggle with for your entire life; surgery or not. You have a remarkable surgical tool to help you manage it as long as you learn to use it properly. Commit the time and effort to learn about your own personal metabolism, your triggers, and your relationship with food. It is up to you to evaluate your behaviors, stop doing what you might have gotten away with during the rapid weight loss phase and focus on everything you have learned. Memorize and internalize Success Habits of Weight Loss Surgery Patients.

Subscribe to blog for #4 You Realize You Should Have Paid More Attention to your Bariatric Team

 

2 of 5 Ways you know the WLS Honeymoon is Over

Even at 20 years post op, I still  clearly remember that fateful day when I reached the “End of Invincible” That fateful moment when the honeymoon phase ended and the real work began. I am anxious to share with you what I have learned about the top 5 ways to recognize that your personal WLS honeymoon is over and what to do about it. Here is the second of five installments in this series.  (Subscribe to this blog)

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#2 PEOPLE STOP RAVING ABOUT HOW YOU LOOK

Boy, do I remember this. Of course I would, it was all about me! Like many of you I enjoyed months and months of friends, family neighbors, work associates and even strangers, raving about how great I looked. One of my favorite comments was “Look at you, you are going to blow away!” Loved it!

I think I even walked at little taller, and had a new strut and swagger as I showcased my success. When I knew would be seen by someone who didn’t know about the new me, I was ecstatic!  Then over time, people started to get used to my new size. I slowly began to fade into normal, the newness wore off and all of the attention nearly stopped. I missed the rave reviews, I kept wondering to myself, “Do I look fat?” Am I gaining weight?” “Why doesn’t someone say something!” Messed with my mind to be sure.

If that has not happened to you yet, trust me, it will. And it is important to be prepared for the emotional and mental grief it may cause. When it does, it will be a good time to do a little evaluating of your true motives for choosing weight loss surgery. Ask yourself why you made this decision in the first place. Did you do this for someone else? To look feel better for yourself? For revenge? To improve your health? This is a time to reconnect to your personal why. Remind yourself of what motivated you in the first place. Pat yourself on the back and learn to improve your ‘self-talk.’

Then, move on. Rather than having it be all about you, now is a great time to turn and support those coming along behind you. Opportunities abound for successful patients who want to give back by paying it forward. Motivate, encourage and support new and prospective WLS patients.  Help with an event or patient celebration, work as a hospital volunteer, become a Support Group Leader. Share your successes online and participate in one or more of the many Facebook Group discussions. You look great – now be great by helping others.

Subscribe to this blog for #3 THE SCALE STARTS TO GO IN THE WRONG DIRECTION

Oh What Tangled Web We Weave..

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“Oh what a tangled web we weave,
When first we practise to deceive!”

Sir Walter Scott

As I walked by this web this morning, this quote buy Sir Walter Scott  came to mind. Honesty has always been so very important to me.  I try to be honest in all my dealings and respect and admire those to strive to do so as well. It can be tricky sometimes. For instance, I have found myself having to decide if I should tell someone the truth even though I knew it would likely hurt them.  I have also been in a spot where I had to decide if I should break a confidence because I believed doing to would ultimately benefit that person. Perhaps you too, have found yourself in similar situations and struggled with what to do.

A few years ago I attended a workshop at BYU  taught by Dr. Quinn McKay, Author of “Is Lying Sometimes the Right Thing for an Honest Person to do.”  It was an engaging and  fascinating discussion about honesty and integrity and how often in today’s world people justify dishonesty for a number of reasons. We discussed an example of a corporation sending out a batch of checks unsigned, in order to buy time buy time to make sufficient deposits to cover them. Was that deliberate stall dishonest? He shared a story of a time when the Boy Scouts of America, short of the funds needed to maintain their charter in a particular area, falsified the numbers in order to continue their work, justifying their actions for the good of their very worthy cause. Was that dishonest act justified?

Dr Mckay used a variety of real life examples of people who did not straight up lie, but left out some important details, in essence leading the other person to draw their own inaccurate conclusions.

So interesting all! I very much enjoyed the workshop and the book. My take away from both is this a new personal definition of honesty.

“Honesty is not just to tell the truth, but to convey a true impression.”

May we strive each day to be an example of honesty and integrity in all we do.

A Way Around

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Do you notice anything odd about this gate?  It sure seems strange to me.  It is a nice gate, well built, strong and sturdy.  And the sign is clear that “No Trespassing” is allowed. I don’t want to trespass, but it seems that if I did, it would be very easy.  I could go around to the left, around to the right, over the top or perhaps even under.If I, or anyone else decided to ignore the gate – we could.

Like an experience I shared in an article several years ago: Hog Tight – Horse High, I instantly drew a comparison to my surgical weight loss tool. Those who have had weight loss surgery have a tool, or a gate if you will. The tool is designed to help us reach and maintain a good, healthy weight, by restricting how much we can eat.  For most, it works as it should, it does exactly what the tool was designed to do.

However, it seems that through the years we discover ways around, over and under it. I have heard comments like “She has learned to eat around the band” or “If I eat sugar with _____ then doesn’t cause dumping” or, “I can eat a lot more if I drink a little with my meals”  And I admit that I have sometimes said, “I cannot eat much at one time, but can eat the wrong thing all day long.” Hello?

Do any of these sound familiar to you?   If so, then essentially you are not using your tool as it was intended. You are finding ways around, under and over the “gate”. Find out why. After all you have been through, what is it that would would cause you to cheat yourself out of the success you once desired? What is it that is causing you to sabotage your success by not taking full advantage of the surgical tool? Hard questions, all.

May I invite you to do a quick self evaluation of your behaviors. Are you taking full advantage of your surgical tool?  Ask yourself, “Am I allowing my surgery to do what it was designed to do? Or am I looking for ways to cheat, go back to old habits and still maintain my weight loss?

Our surgical tools will serve us well for a lifetime as long as we commit to using them properly.  Years of research (Read Research) have taught us all that there are very specific habits that successful long term patients have made part of their life. Learn what they know and do what they did to take full advantage of your surgical tool.  The Success Habits of Weight Loss Surgery Patients

As shown in this picture, the gate and weight loss surgical tools work. They do exactly what they are designed to do. That is, unless we choose to go around, over or under.

Feel Like A Slug?

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Last week on my morning walk,  I encountered a little slug on my road. And I wondered, do they ever get where they are going? Do they even know where they’re going? And most importantly do they even care?

Some days I feel like a slug. I act like a slug. And I am afraid I might look like a slug. Do you ever feel like a slug? Well, I know that on some days I surely do. I am 56 years old now. No wait, I’m  53. Hmm, no. I was born in 1959 so that means this October I will be 57? Really? I guess it just stands to reason that as I begin to loose my mind,  I am also slowing down and as a result, sometimes feel like a slug.

I don’t want to slow down. And I never want to be slows as a slug. But I also know that though I do not have control over the natural aging process, I can choose to stay fit and healthy. That is and will always be my choice.  Just as it is yours. So sluggish or not, each day I exercise. Sometimes with a slow and sluggish start, I still make myself get moving.

I prefer to exercise in the morning. But, it seems that it is especially hard to get started in the morning. They say that once something is emotion it will stay in motion. But that first motion that is by far the hardest. Like you,  I’ve learned that exercise simply must be part of my daily routine.  (See: The Success Habits of Weight Loss Surgery Patients ) A walk in the woods, a hike up the hill, jumping jacks in the yard. (Fooled you didn’t I? ) I never do jumping jacks in the yard. LOL.

With our move to Star Valley Wyoming, so many of my routines are having to change. My exercise routine is a critical component to my well-being. For years  was a member of the coolest gym in the world and now, well, lets just say going to the gym is not what they do around these parts. So, after a few out of sync weeks, I am adapting. I am walking and hiking each day with our dogs.  I am nothing if not flexible. It has been an enriching and fulfilling experience and one that I am enjoying very much. It is still a bit cold here in the mornings, and that first step up the hill is a rough one. But, I am up, I am out and I know where I am going and why.  I feel less like a slug.

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