59 weeks on 7/11/17

Wow, is it seriously Summer??  And how did I go so long between posts?

Ok, well I can answer the second one...sort of.

I found myself in the hospital for 3 weeks, late January through mid-February, totally unrelated to surgery.  So, what is nutrition like when you're inpatient and you have to educate the nutritionist on what a bariatric diet looks like?  I'll tell you, it's not easy.  I had taken protein shakes and bars with me, as well as a few things for snacks - thankfully!  The nutritionist couldn't really meet my needs, but agreed to send up 2 hard-boiled eggs three times a week.  I know it's a bit debatable right now, but I didn't want to risk my cholesterol by having eggs every day and/or multiple times a day.

So there I was.  Stuck in the hospital.  Limited to shakes and bars, plus a few cheese sticks, carrots, and hummus.  Oh, and since water makes me nauseous, I had taken an insulated cup with me along with a pitcher and a ton of powdered drink mix.  Good thing or I would have been dehydrated in no time!  But I survived.  I was able to speak with the dietitian at my surgeon's office and get some tips before admission.  My hospital's nutritionist had little interest in talking with my dietitian.  Again, it was a good thing I did some advanced planning or I would have been in bad shape!

Back up until the beginning of January and I joined and gym and was meeting with a trainer twice a week.  Then the hospital hit, but after I got out, it was back to twice a week with SL (the trainer).

Plugging along, I get to March and start having problems with my right (and dominant) hand.  Alas, I have an EMG and find out that the carpal tunnel has gotten worse in that hand (I had surgery a few years back when the left one was the worst of the two).  A couple of visits later and I'm scheduling surgery.  More surgery, but this time it was going to impact my ability to function since I couldn't type or really do any chores at all.  It would seriously interfere with my training.  After getting the stitches out, I started back with the trainer, but hate to admit that it's been sporadic the past couple of months.

Some junk has come up, which I won't go into, but it's taken most of my time and all of my energy.  Ugh!  I feel like there's something at every turn really impeding my ability to be successful here.  I'm not making excuses, but this has been my reality.  Because of it, and surgery, I haven't been able to workout with my trainer much.  I had some consistency there, but that's gone, along with much of my motivation.  I need to get back there...or at least start walking (the dogs would love it if we took them!) or riding my exercise bike here at home.  Oh, one development is that we learned of a place where they refurb donated bikes and sell them for cheap.  We went there a week-and-a-half ago and ordered some bikes.  They had yet to be refurbed so we're waiting on them, but hopefully that'll get us moving, too!  This past weekend I did a bunch of yard work.  Especially when it's 90 degrees out, that's a workout, for sure!  It's something, right?

Ok, I had my ONE YEAR surgiversary appointment the end of May.  He seemed pleased and I was glad to be losing, albeit slowly at this point.

If you'll indulge me, I'm going to jump around a bit more here...

When I was in the hospital, it was like I was at a nursing home.  Breakfast was at 7, lunch at 11:30 and dinner at 4 (or was it 4:30?).  By nighttime I was famished!  Everyone around me was snacking and I had only no-sugar-added dried cranberries.  Blah.  There is only so much of one food a person can have.  At least with protein bars, there are oodles of flavors, so that didn't get dull.  Sometimes I had bars for breakfast since I didn't take my sugar-free coffee syrups to add to the shakes.  I had to mix it up.  Anyway, while everyone was snacking on cookies and chips at night, I sat there, ravenous.  And then it happened, I discovered sugar-free cookies.  It was a dangerous discovery and one which haunted me for months.  Just recently, however, on a call with my dietitian, we discussed the added calories these cookies are adding to my diet.  It took a bit, but I've given them up.  I keep fruit on hand to satisfy that sweet craving, but it's so much better than those cookies!

My cousin was married a couple of weeks ago and hubby and I went to the wedding.  Since I'm able to shop in actual stores and not limited to online, I got a great deal on a dress to wear just for the wedding (see picture).  I guess it's sort of funny, but I forgot my dress sandals and was forced to wear the ones you see in the picture.  Guys may not understand this, but most women will - there is something about heels that gives some level of confidence.  For me, I'm just excited that I can wear them and not (basically) know that I'm bound to fall.  But I forgot them...grrrr!  At least I had my non-dress sandals and wasn't forced to wear sneakers ;)

It's a funny thing.  When I was 326 lbs, I'd lose 20 lbs and nobody would notice.  Now, I've been stuck, losing only 20 lbs all year and people seemed shocked at how "great" I look.  It's a percentage game, I guess, but I feel like I've gotten nowhere and that's not what people see.  I think of how I lost 40-45 lbs before my wedding and went from 180 to 135/140 and the man at the bridal salon's jaw dropped when he saw me.  But at 300 lbs, 40 lbs feels like it doesn't even make a dent.  I find myself questioning if people feel like they have to say I look good because they know I had surgery and want to be encouraging.  Man, between that and the body dysmorphia, my head is messing with me - big time!  At the wedding last month, I definitely chalk it up to a good "gut-sucker-inner" - aka fake Spanx.

The guy that has operated on both hands now came up in a database of surgeons who also do skin removal surgery.  He has known me for several years and has seen the transformation so when I saw him yesterday, I said that I'd like to talk skin removal surgery at my next appointment.  My bariatric surgeon wanted me to wait until I was closer to my goal.  I'm praying that will happen by November when I see him.  Having my belly skin removed should be covered for medical reasons (rash), but I'd love to have my super gross thighs, arms, and chin done, plus (sorry guys), I'd kill for a boob lift!  Gravity is not a middle-aged woman's friend, let alone one who has lost a person in weight.  Since we can't afford to private-pay, I'll take what I can get.  Maybe for my birthday in January, I'll have this dang belly skin removed!

Vacation... we're going to Disney World!!  This isn't new for us and if you've read any of my blog, or know me in real life, you know that hubby and I are fanatical!  We're first doing a quick Disney cruise and then staying at WDW for several days.  Food is going to be very different from past trips.  In the past, food was a huge part of our trips there.  So many options, so many yummy options!  This year, I went through the menus available online and we chose places where I knew there'd be something I could enjoy and which (hopefully) wouldn't make me sick.  It'll be in the Fall but I'll still have to put on a bathing suit!  GASP!  What?  Yes, a bathing suit.  I did get a catalog which shows bathing suit bottoms which are capri pants (yee haw!), although I may go the longer shorts route.  I'll still have to display the bat wings, but I'm trying to keep a good attitude and say that they're war wounds.

I'm on a super supportive bariatric site.  I've been frustrated seeing people lose more weight than I have in over a year, when they're maybe only 6 mos out.  I admit, it's upsetting.  Someone wrote the other day that we each have our own journey and one person's isn't anothers.  It was something I needed to hear.  Heck, I'm on psych meds which slow my metabolism; I'm a woman and we have slower metabolism than med (super unfair, right?), and I'm in my mid-40s.  None of these things add up to quick weight-loss.  I've also been inconsistent with my workouts.  I have to keep my eye on the prize and know that I'm still down a lot of pounds and it's my journey and nobody elses.  Easier said than done, but I am so thankful to the woman who wrote that, just when I needed to hear it!  It's still part of the self-hatred, though....  Hey, what can I do but work on it?

Ok, well I'm going to try to keep this from getting any longer.  I'll also try to post more often.

Short and Sweet: my Failed Attempt at Weight Loss Surgery

Ok, ok, I can hear it now - it wasn't your fault, you aren't a failure, you didn't fail, the doctors did what was in your best interest.  Yes, logically I know all of this.  Emotionally, well that's a different story.

And it begins.  April 26th, the day ingrained in my whole world.  I had a countdown clock on my phone and could look at any point how many days I had left until my life would change.  Yes, I've made plenty of positive changes since my first visit with the surgeon on 12/30.  Between then and 4/24, I lost 40 lbs!  Granted, I was on the mandatory 2-week  liquid diet, which certainly helped matters, but still - 40 pounds!  I'll tell you right now that I've gained about 14 of those lbs back since the infamous failure day.

I arrive at the hospital and am almost giddy with excitement.  I may have been the only person in pre-op who was joking around and happy to be there.  I was PUMPED!  The doctor came in, telling me he had plenty of sleep the night before... whew!  My mind was at ease on that one (not that I even considered it a factor).  I was there for one reason: to start an irreversible journey.  Yes, before I move on, I know several people who have taken this journey and wound up gaining some or all of the weight back.  Here's my reality, though.  I HATE to vomit.  While I've always had weight issues, I have never even considered (even as a dancer) purging.  I know life after this surgery will be radically different.  I know my relationship to food will forever be altered and that there are foods I won't be able to eat ever again (without the whole puking thing).  It's sort of very hard to fathom right now, but the thought of never having gnocchi or my Mom's red velvet cake again may be a reality.

So, returning to the hospital.  The anesthesiologist comes in and puts in an IV.  She said that she didn't really like the vein (especially considering I'll be on IV fluids for a few days and it needs to be a strong vein), but it was good enough to put me under so she doesn't torture me while I was awake - I sincerely appreciated that, since I know I have horrible veins.  She gives me a muscle relaxant, to which I'm nearly immune, given that I used to be on something like 2 mg three times a day of Xanax.  I remember them wheeling me into the OR and putting the mask over my face.  After that, the next thing I know is that they're rushing me through the hallways telling people to get out of the way.  I wasn't really alert to know what, if anything, this meant (I mean, it could have been people on break having lunch or talking on the phone for all I knew).  I am slightly conscious and am asked if I'm in any pain, I'm shocked to be able to say "no."  I mean - major surgery brings with it some discomfort - at least - and I felt ok.

When I'm awake enough someone (either the anesthesiologist or the Fellow working under my surgeon) says "you don't know yet, do you?"  Ummm... know what?

Well, I woke up to needle sticks all over my body - from my foot to all over my hands and arms.  I don't think twice about it because the anesthesiologist said she would try to find a better vein.

So, here's what I didn't know.  They didn't do the surgery.  You read that right.  It turned out that when they put me under my blood pressure tanked.  I can't remember how low it went, but I think hubby said something about the bottom number being in the 60-range.  I was also told that when they took the oxygen away, my O2 level dropped to 80.  They tried for 40 minutes to increase my levels, but to no avail.

Everyone in the Operative Waiting Room was getting calls that their friend/family member was done with surgery, because they would get up to go to the PACU (post-operative care unit).  Then hubby saw my doc.  In person.  Coming to speak with him in the waiting room.  No other doctor did that.  First he said that I was fine and took him into what has come to be known as the "bad news" room.

I spent the day sobbing, and the rest of the week crying on and off when I'd think about it.  The Fellow came to see me often.  They ran a chest CT to make sure I didn't have a pulmonary embolism and a blood gas (I can't remember what that was for, but they had to get blood out of my artery -- in my wrist - OUCH!  That thing still stings if I hit it the wrong way).  They wanted to make sure they ruled out all life-threatening causes.  It seems that it was probably because I was on 2 bp meds and the ace inhibitor (not the beta-blocker) likely kept them from upping my bp.  Just FYI: I'm working with my GP and we think we have it figured out -- that I lost the weight to the point where it affected my need for as much medication to lower my bp.  One time when the Fellow came in, she asked if I was ok.  My typical answer for the day was "physically."  I said, through my tears, that I felt like I was over-reacting.  I have to say, she was wonderful!  She assured me that I was not...that I was truly expecting something life-changing to happen...something I'd prepared for since 12/30 by getting clearances and doing testing.  She thought my reaction was normal.  This conversation happened after I had the CT.  Prior to that one of the nurses in the PACU got an order from my doc to have lunch.  When the doc came in, he explained again what happened I sobbed to him that I could NOT do the 2-week liquid diet.  That just about killed me!  He said that he's done it and wouldn't make me do it again.  I would later find out that he'd only require 1 week.

People were coming and going and absolutely not eating in that unit, but as soon as I got back from the test, I ate (somewhat differently than had I had the surgery!).  Hubby had gone to get lunch during this time, so my conversation with the Fellow was private.  I was on that unit for the entire day!!!  The protocol/rule is that there can be 1-2 visitors at a time for up to 15 minutes.  Hubby was there nearly all day and we had a friend there who stayed for probably an hour into the PACU, but there were no seats and he was getting uncomfortable.  When my nurse came back from lunch (she rocked, by the way - hugely rocked!), she made the "isolation" room available to us.  Rather than being surrounded by curtains, it was a private area with 4 walls so I could be with hubby (and he could sit) and it could all be very private.  I'm sure anyone who was there heard the sobs, despite how discrete they were (and they really were).  I was told that the doc said he'd re-arrange things to get me in asap, which I thought was incredibly thoughtful and kind.  I found out that he did feel guilty that it didn't work out, especially since I was so excited in pre-op.

It was up in the air if I'd be admitted for the night or go home.  When they left the decision up to me I made it clear that I was in no shape to make decisions.  My depressive symptoms had reared their ugly heads and decisions weren't my "strong" suit.  The Fellow came back a bit later and said that the doc would release me if I wanted.  Somehow when she put it that way, I felt free to say that I just wanted to come home -- see my furbabies, sleep in my own bed, wake up in my house in the morning (and avoid hubby having to drive downtown again, paying another $25 to park).

I called the office the next day and the nurse said she'd have the scheduling people call me.  I heard back from them and the woman said she could schedule me sometime in June.  JUNE?  HUH?  I asked if that was the first and went into a bit of what had happened before; she said she'd talk with the surgeon.  They could fit me in on 5/24.  It is two weeks from tomorrow.  While I'm not required to do the 2 weeks of liquids, I'm going to try to do as much as I can.  I am mortified at the amount of weight I gained from my post-failure-op emotional eating.  I can't even write it down.  Hubby and I were talking on the drive home about what I wanted to eat.  Trust me, I had a good long list.  Spaghetti and hoagies from a certain place topped the list!

So, I had spaghetti for dinner tonight (with pesto - yummy!).  I've been trying to do 2 shakes a day.  Now that hubby is going to the gym at night (since there is no pressure to cook for the both of us), I'm more free to do a 3rd shake.  I'm supposed to have one within the first hour I'm awake and then every 3-4 hours later until I go to bed.  This is in addition to my 64 oz of water.  Well, with my previous overnight incontinence issues, I've tried to stick to stopping any food or drink in my body within 3 hrs prior to going to bed.  It leaves me lacking and will be especially difficult after surgery when I'm forced to take only sips of a beverage.

Ok, that was my not-so-short-and-sweet surgical failure.  I find myself less excited this time around.  I guess I'm just more aware that it's not guaranteed.

On the good side of things, we had some great coupons and rewards dollars so went shopping and I got some 1x and 2x clothes.  I held up one of the 1x shirts and thought, as I teared up, is it possible that I might fit into this?  It was surreal.

And I'll leave it at that.

Just a Few Days Left

Well, here we are.  Surgery is in 5 days!!!  Ahhhhhhhh!

I've been on a liquid diet since last Tuesday and have to go through next Monday (obviously I can't eat or drink the day of surgery).  Let me tell you - this is HARD!  The first few days I was cranky as cranky gets!  I needed to CHEW something.  NOW!  My poor husband :(  Well, I went back to the paperwork and saw that I can have Jell-O!  Now there's something I can sink my teeth into - literally!  Let me tell you, I've gone through a lot of Jell-O, but it has kept me from causing anyone physical harm.  Ah, the power of Jell-O!

I had my pre-op appointment a few weeks back and loaded them with questions.  They say that they love it, but I can't help but question what it's like being burdened down with questions and if that hinders their schedule, etc.  It's me, being an idiot, being overly sensitive, being overly considerate.  I've been told that I have to take care of me and that I'm worth their time.  Now that's a hard pill to swallow. Haha ( you'll see why I laugh at that soon enough).

I've learned so much about nutrition and reading specific things on food labels in the past few months.  This will be an uphill battle.  I'm not ignorant to that fact.  We will be taking a LOAD of stuff to the local food bank because I'm not strong enough to have it in the house and not eat it.  I can't go to the grocery store at this point because even the smells from the bakery will have me wanting to give up on the whole surgery (ok, so maybe that's a bit extreme, but you get the idea).

I'm having protein drinks every 3-4 hours and trying my darndest to get in my 64 oz of water.  The thing is, I'm trying to perfect the art of "sipping" pre-op so it won't be such a transition afterwards.  Who knew sipping was an art?  I'm thankful that my program allows the use of straws, which is a variable among programs.  My doc's program told me (I asked specifically) that there is no definitive research to prove they provide a risk.  I know there are other programs who prohibit their use.  While it's going to make it difficult to get in 64 oz (which doesn't include the protein shake... BOO!), sipping also makes it very difficult to get down all of my meds (the list seems endless) and supplements/vitamins.  Some of the supplements are ordered by the bariatric surgeon; others I take because they're healthy or one specifically I take to prevent or slow down macular degeneration which is now in 2 generations of my family.  Well, my psych meds are a must - I absolutely, 100%, no question cannot miss those!  There are also my meds for blood pressure.  The cholesterol med isn't necessary for the day of surgery, nor are many of the others.

So, I guess that's the latest in the wonderful word of the hippopotamus.  Now, as the world of bariatrics says: I'm getting ready to climb onto the loser's bench.

Pre-Op Work-Up

Oh my word, this has been one heck of a journey so far and I'm only just starting.  It is required for all bariatric surgery candidates to have a list of clearances before surgery.  I needed a psych eval and my psychologist of nearly 16 years could provide far more information than any psychiatrist they would have me talk with for a couple of hours.  I needed a sleep study.  Well, I already use a C-Pap, so I just had the doc print out a report of recent use.  I needed some initial blood work, which I had done from my primary a few weeks prior.  I mailed all of that out to them.  Finally is my cardiac clearance.  He wanted me to have a nuclear stress test (since I can't go running on a treadmill - if I couldn't I likely wouldn't need the surgery in the first place) and an echo.  I received calls after each of these to say that the results showed no abnormalities.  I see the cardiologist on Monday and assume I will have that clearance then.  The surgeon's office also ordered a number of labs, but when I went to have them done, I found out that my insurance wasn't going to cover those tests under the diagnostic code they used, which had added up to well over $500 and they hadn't run all of them through.  I called the nurse at the surgeon's office to see if there was another code they could use (of course without committing insurance fraud).  She called the lab and there are hoops she needs to jump through.

So, the next step is an endoscopy.  The doctor is willing to allow me to do it in the hospital out here in the suburbs (usually all of this is done downtown and I don't drive downtown).  He is going to speak with my GI to coordinate something.

I'm drinking protein drinks one meal per day (at this point) and am having high protein yogurt at least once a day.  I'm testing things out and figuring out what works.  I got a special bariatric surgery cookbook and it is providing a ton of information!

We joined a gym, although my membership is suspended for now.  They offer aquatic classes and I plan on doing that.  I don't know when I'll be allowed back in the pool and right now, I'm just waiting to see when surgery is.  In the meantime I am riding my exercise bike.  I'm losing - slowly but surely, I'm losing some pounds.

I am going to see an additional therapist to deal solely with my food and eating issues.  I mean, obviously I have some, since I am a hippo.  I can't go back to eating the way that caused me to become this.... well.... fat.  I am an emotional eater and did find a book which deals with this topic, too.  Perhaps it will be a jumping off point for that therapy.  We'll see.  My OCD has had me create a binder of information, printed from the computer and in page protectors, divided by topic.  So yeah, I'm well-versed and ready to tackle this!

When's surgery?  Everyone asks and I have to explain the above process to them.  Hopefully soon I can give a solid date!  Excited and Terrified.  That's where I stand.  And I think that's normal.

Dear Fat People (link), Followed by My Musings....

I'm going to just post the link to this video and a response.

I am one of those "obese" people.... I am super obese or morbidly obese.  You may have seen this video already.  In fact, since I've been gone for a while, I missed all of the hoopla surrounding this.  I'm glad I did.  I'm in a pretty vulnerable place right now and hearing all of this (I'm sure it was all over Facebook, too!) may have done me a lot of harm.  I am not a fan of the language they use, but I think it gets the point across.

I'd like to know who got together and decided what BMI is and what weight/height determines your BMI.  Several years ago I was trying to determine my BMI and came across these numbers (I'm sorry, I've forgotten the site so cannot reference it directly):

>18.5 = underweight
18.5-24.9 = "normal"
25-29.9 = overweight
30-34.9 = obese
35-39.9 = severely obese
40-49.9 = morbidly obese
50-59.9 = super obese

Another stat I found at that time was that the CDC says a person who is 5'5" and 180 lbs has a BMI of 30.  Yes, that is heavy, but obese?  I think we're putting ourselves in these boxes that force us to reach a certain number, be it weight or BMI.  We're trapped by that number, as if it defines who we are.  I am fat and it is the first thing people notice about me, making it the last thing sometimes.  Hubby and I switch between 2 different eateries before we go to the grocery store.  We often have the same servers.  They often won't recognize us until they see me.  I am fat.  I am memorable because of it.  That is truth.

Here is the NIH BMI calculator.  Frankly, I find it absurd.  I once found myself getting excited that I was severely obese.  I had lost enough weight that my BMI made me slightly less likely to die from the effects of being a fat chick.

What are your thoughts?  How do you determine when you've reached a goal you have in mind for losing weight?  Personally, I want to walk up a flight of stairs without getting out of breath.  I'd like to take my dogs for a long walk.  I'd like to fit in a bathroom stall comfortably.  I'd like to take walks with my husband.  I'd like to not squish my husband in an airplane - I mean you have to admit that you or someone you know is thankful they aren't next to the fat girl on an airplane.  I'd like to be comfortable in my clothes (being comfortable in my body is too far off to be realistic; I've spent 43+ years hating myself and my body so that won't get fixed by losing weight).  I'd like to go into a medical appointment and be told that I have to lose weight - some docs have gone so far as to say that I need to lose 150 lbs, as if that will solve all of my problems.  I'd like to shop in a store and not be limited to clothes in a catalog, hoping they fit.  I actually hit the last one about this time last year, but both my husband and myself went on some binges.  My emotional eating came out in full a lot and I gained back all the weight and more.  Now I have to lay on my bed and suck my stomach in after putting on jeans or shorts and sitting in them for a bit to stretch them out so they will hopefully button and zip.  Even then, it's quite a chore to get them on again.

So, those are my musings immediately after hearing of this video and watching it, as well as the response.  I do want to add that I accept the responsibility for each and every bite of food I put in my mouth.  It is my doing that I can't walk well.  I also want to say that my age (43), my medications, and both of those add in to a horrible metabolism, making it even more difficult to lose weight.

I'd really love to hear others' thoughts.