I asked these questions in my journal in the hope that someone might give an opinion. Perhaps here they will get seen more.

I had major (I guess) surgery 3.5 weeks ago - total hip replacement. Since then & until June 11, I must walk on crutches with only about 20-40 pounds on the operated foot.

I know that I was about 217 when I went in, but weighed self on balance beam in the hospital and was back up to 221. Well, all they gave me to eat was sugar & starch, so no wonder!

I was advised to eat about 100 gm of carbs daily while healing (about 2 months) so have been eating good carbs (potatoes, bran bread & veggies) and also some bad carbs (cookies, ice cream, but not often).

The strange thing is that I am losing weight and am now lower than I have been in 2 years, despite months of strict LC.

So the questions are:

1. Does it REALLY take so much energy to heal & regrow bone and muscles that I am losing despite the high carb level?

2. Am I losing because I am doing BIG strength training by hauling myself around on the crutches?

3. My waist is about 2 inches smaller in the last 2 weeks. Why does arm exercise decrease the waist?

4. is it possible that my CCLL (see Atkins) is really much HIGHER than I ever thought and that I have been eating too FEW carbs for the last 3 years of a stall?

If you have ideas about these things, I'd really like to hear them. Thanks in advance.

BarB

Hi BarB. I'm glad you're on the mend, first of all!

As to your questions, I'm not entirely sure. If I knew how to maximize weight loss, believe me, I'd have lost more than 30 pounds in 20 months!

My experience is that I lose AS quickly at 20 and 50 grams of carbs. No diff at all for me between those two levels.

Yes, I think your CCLL might be higher!

I suspect some of the explanation for why you can eat this many carbs has to do with food allergies. If you (or I) are avoiding the foods we're allergic to (which will often be exactly the foods we once craved and binged on), I suspect that moderate-carb eating is not going to result in weight gain or a slowing of loss.
I have come to believe that there is not such thing as "too many vegetables," and that almost everyone would not slow their loss by increasing their veggie intake. With all the fiber filling us up as we eat them, it's darned hard to get over 35 grams of carbs that way anyway.

I assume you're losing inches at your waist because that's where you were carrying some excess fat. We tend to lose where we're genetically programmed to lose--not much we can do about changing it, either.

Yes, crutch use is MAJOR weight lifting work.

The other possible explanation has to do with the mind-body connection, which is mysterious but powerful. I think sometimes we don't lose because subconsciously we don't want to. Stress can slow loss--and there may be a rational endocrine explanation for that, or it may be more mystical an explanation. (I certainly don't know!) So perhaps your relief after the surgery (and stress before) has helped you lose more quickly.

Doreen would also be a great person to ask, with her incredible medical expertise!

HTH a little.

Barb, the only thing I have to add to what Raz has suggested is that you could have been eating too little food while LCing. An increase in carbs would mean and increase in calories; you may have needed that.

A higher CCLL isnt uncommon - I believe that people with CCLL's of <30g a day are the exception. Plans like Schwarzbein and Protein Power work with much higher carb levels.

Hope you're feeling better soon, Toots
Nat

Um, I'm reading razzle's response, and thinking to myself, yup, yepper, that's right all the way through. I have a few things to add though.

First, your metabolic/ calorie needs are higher during the healing process. Lots of repair and rebuilding going on during the early weeks post-op.

Second, you NEED more carbs post-op. I have no doubt that you lost a fair bit of blood during the surgery, and some bleeding/ drainage afterward. Red blood cells are one of the few tissues in the body which require glucose specifically as the energy source for their production. For the average lowcarber, a 20 gram level will meet their needs, and any extra glucose can be made in the lvier from protein, by the process of gluconeogenesis. But, for an acute loss of blood, such as surgery, you will need more glucose available to replenish what has been lost. It takes approx. 4 weeks to replenish your store of red cells. It's possible that in time you may find you require fewer carbs than you do now Blood lost through surgery or trauma is a different situation from giving a blood donation, where the person is able to eat and drink immediately after, and no other healing to take place in the body.

Razzle has a good point about eating more carbs from veggies, as opposed to other carbs. I've found myself to be stalled at a very low carb level, where the carbs came from dairy, processed meats, artificial sweeteners (15g ECC per day). Yet, weight loss would resume with a higher carb intake, when they came mostly from vegetables (25 to 30g ECC per day).

Losing inches from the waist may be due also to water-bloat loss. Pre-op, you were taking NSAID and COX-inhibitors for pain and inflammation. Those drugs are notorious for causing fluid retention.

Another reason, not as happy or upbeat .. is that you've likely lost some muscle mass in your hip and leg on the surgical side. Not a lot, but some. You've not been weight-bearing or using that leg for 3.5 weeks. I imagine that you are doing some isometric strengthening exercises to keep atrophy at a minimum, but loss of muscle tissue is seen as little as 48 hrs after being immobilized. As well, until the muscle has healed and reattached itself to the bone (it would've been surgically cut and moved aside to facilitate removing the diseased hip joint, and the prosthesis cemented in place) there won't be a lot of regrowth of muscle tissue taking place.

It may be a combination of a lot of factors, or only a few. Take each day as it comes, and be open to changing the routine as time goes on, and you're able to be more active.

Glad you're on the mend

Doreen

Thank you for all of this - what knowledge and wisdom there is on this board! WOW !!!

Yes, I lost about 950 CC of blood in surgery so am still taking some ferrous gluconate each day, as there was no transfusion necessary. (Hemoglobin was 105 post-op.) Wound closed almost immediately but there was a lot of swelling which worked its way down the leg. Had to keep foot mostly up for several days, and sleep with it above my heart.

Yes, I am doing the 10 isometric and range of motion exercises twice a day as ordered. I also do one they don't use: tightening buttock & thigh muscles while sitting & hold for 5 seconds, repeat 10 times. I apparently look quite funny, bobbing up and down in my chair. And lots of foot wagging immediately post op.

I will concentrate on getting lots of veggies now and later.

Many thanks to you all.

BarB