Tuesday, June 23, 2015

Starting the after

Wow...I can't believe tomorrow is two weeks since my surgery. It's been such a hectic two weeks; I should have blogged sooner.

I had my surgery June 10th at 11:30- they got me into the pre-op area where I was gowned, started my IV fluids, got my vitals, took a pregnancy test, weighed in, yadda yadda...

They gave me something on the way into the OR to start the process of putting me under; I remember getting into the OR, transferring over to the surgery table, talking with the staff, and then it was lights out.

Surgery took about an hour and a half- waking up took me another two hours.

Waking up from anesthesia is the hardest and most miserable thing: you're in pain, you're nauseated, you can't breathe....you feel like the biggest complainer in the world. Nurses in recovery have to be the most patient people in the world. I got dose after dose of every pain and nausea medicine they could possibly give me. I had a catheter inserted during surgery which really wasn't a terrible thing; what was horrible was having a crotch full of goo from the lube they use to insert it.

Have I mentioned that anesthesia removes your ability to filter what you say? I saw a good-looking male nurse walking around in recovery and told my nurse that, if I were single, I'd have asked that male nurse to help me with my itchy crotch-full-of-goo situation. She laughed and told me he played for the other team (true story- he ended up being the nurse helping me to my room and helping me put on a clean hospital gown/transferring me to the bed...and I think he had heard about my earlier request for his assistance....I still wasn't embarrassed). 

Once in my room, I was hooked up to a pain pump that gave me .2mg of Dilaudid every ten minutes (another true story- I watched Jeopardy that night and pretended that it was my buzzer...best. episode. EVER). I also had continuous IV fluids. My family didn't stay long because it was after 3 when I woke up, and I told them to go so they wouldn't have to fight rush hour traffic. I laid there and dozed off and on most of the evening anyways...who wants to sit around and watch that? 
After surgery selfie!


The pain pump did its job, but I did have some intermittent nausea, so I had to request some IV Zofran every now and then; the first 24 hours after surgery, you're NPO. The next day, I had to go down to x-ray and swallow some contrast so they could check and see if I had any leaks. The contrast tastes as good as it sounds; it's thick and syrupy as well. I thought several times that I was gonna puke on the poor guy doing my x-ray. When I got to turn around and see my new stomach, it was shocking; it looked like a Twizzler. It was so small that even the doc, who sees sleeve gastrectomy stomachs on a daily basis, remarked "wow, he made it really small". This isn't my actual stomach, but this looks very similar (and just a bit bigger)
After my surgeon came in and checked on me, I was discharged home with Zofran for nausea, Percocet for pain, and Omeprazole for acid reflux, which is common after this procedure. The ride home was painful- it definitely makes you realize how many holes are in the road. I settled in with some Percocet and went to bed. A few hours later, I woke up to a huge wave of nausea; fortunately, I had a pan next to the bed because it was anticipated. Unfortunately, it was behind me and I was so sore, I couldn't move fast enough to grab it, so I ended up puking on the bed. It was all yellow bile except for one, pea-sized blood clot. I probably should have been more concerned about it but, at 2am, I wasn't. I was still NPO, so I had water and Jello the next day. I probably didn't take in more than 200cc's of fluid, it was so hard. I was so sore; sleeping was horrible because it's hard to get comfortable sleeping on your back when you're a stomach sleeper. I ended up doing a lot of sleeping in my recliner. 

The first 4 days after surgery were horrible because of the pain, nausea, and trying to stay hydrated.I have 5 incisions; the incision that hurt the most (and still does) is the one furthest to my right- that's the incision where they insert the hook that lifts up your liver so they're able to get to your stomach.
incisions 3 days post-op


We went on vacation 4 days after surgery. Nothing too far away or extravagant- we just went a few hours away to the Indiana Cave Trail in southern Indiana. It was a little hard at first because I was taking in so few calories and had little energy. I ate mashed potatoes, scrambled eggs, and drank protein shakes. I could only eat about 2 oz at a time. My biggest struggle was getting in 48-64 oz of fluid a day. Even now, 13 days out, I still have to sit here and focus on drinking constantly. I'm just getting to the point that I get in all my fluid plus 40-60 grams of protein. 
I'm no longer needing my pain medication, but I do still need my anti-nausea and reflux medicine. I've backed off from the protein shakes (I may have one every other day) and I'm eating things like scrambled eggs with cheese (1 egg), italian baked ricotta (super delicious), refried beans with cheese, and string cheese. I made the mistake one night of having some canned chicken and it was incredibly painful....Sleevie Wonder wasn't ready for that yet. 
My only complication at this point is that my top incision is getting infected- I noticed it looked red yesterday and when I was cleaning it, I gave it a gentle squeeze and a pea-sized ball of green pus came out, followed by serous fluid. My two week follow-up is tomorrow morning, so I'm just keeping it clean and watching it.

I went into surgery weighing 283 lbs- today, 13 days later, I'm down to 272. Counting my pre-op diet weight loss, I've lost 22lbs since May 28th. 

So, my stats are:
HW- 380lbs
SW- 283lbs
CW- 272lbs

Can't wait to watch those numbers drop!

Tuesday, June 9, 2015

Every new beginning comes from some other beginning's end....

13 days ago, I started my pre-op diet; I've been surviving on protein shakes, Carbmaster yogurt, sugar-free jello, oatmeal, raw veggies, sugar-free pudding, and soup. Lots and lots of soup. I've been hangry the entire time; my road rage is off the hook. I'm just thankful I haven't been at work terrorizing my poor coworkers and patients. My poor brain is suffering from the lack of calories- I feel like I've been in a fog for a good week now. And don't get me started on the exhaustion....
My life for the last 13 days


I'm not nervous about the surgery; I'm more excited than anything. I'm excited to gain back my confidence. I'm excited to not feel self-conscious every time I go outside. I'm excited about my back not hurting me. I'm excited to actually enjoy buying clothes. I'm excited about enjoying life.

I want to try ziplining. I want to try aerial yoga. I'd love to take up horseback riding again. Oooh, surfing....definitely gonna try surfing at some point.

It's also a break-up from one of the longest and unhealthiest relationships I've had. I've been over 200lbs since I was in the 6th grade. I wore women's size 16 pants in the 6th grade. I've always been the biggest person out of all my friends, my graduating class, hell....even my family there for a while.

I thought I knew everything there was to know about living a healthy life from my two years living a low-carb lifestyle...I was wrong.
I had no idea that I was a stress eater. I caught myself doing it a few times. I'm breaking up with that bad habit. 

I'm breaking up with seeking comfort from food.
I'm breaking up from celebrating life with food. 

I'm moving on and I'm gonna enjoy everything else life has to offer. 

My highest weight is 380lbs- I got down to 237lbs after two years on a low-carb diet with Phentermine. Then it stopped working and I gained back almost 60lbs while still living a (mostly) low-carb lifestyle. Surgery is an extreme measure, yes, but I'm an extreme situation; I can gain weight without batting an eye and I've seen how high it can get (PCOS+poor diet= BIG PROBLEM). Even after starving myself for the last 13 days, I've lost 11lbs. It would take nothing for me to put it back on.

The exciting thing is, after I get below 237lbs, every day that I get on the scale, I'll be at my new lowest adult weight.

So here's how my stats are gonna read from now on:
HW(highest weight): 380
SW(surgery weight): 284 (the scale may be a pound or two lighter in the morning)
CW(current weight): ???

I'm ready for tomorrow.

Tuesday, May 12, 2015

Counting down...

As of yesterday,I'm officially scheduled and educated for surgery (have I mentioned it's June 10th?)
Squeeee!


I was nervous because of the 4lbs I was told I had to lose before I could be approved surgery; I was committed the entire two weeks to replacing meals with protein shakes, exercising, food journaling, eating right....with my clothes on, I just barely made it. I'll admit, the night before my appointment, I took stool softeners (every bit helps). My appointment wasn't until 1pm, so no eating all day.
I had my morning coffee and a protein shake- that's it. Standing naked on the scale, I came in 6lbs lighter! I took a pic, in case my clothes put me over the limit. I was the third one to sign in, and the first to be called back (probably because my ass was on the line if I didn't lose the 4lbs). I got on the scale at the office- tah dah! 

Still 6lbs lighter- and I'm still bloated and on my period(yes, mine can last 2+ weeks). They also took pictures and measurements so I can see and measure how much I'm shrinking when I go for my two week, six week, three month, six month, and yearly follow-ups.

Along with my weigh-in, I had my consent signing, pre-op, and post-op nutrition class yesterday. Being that I spent 2+ years living a low-carb lifestyle, I already knew a lot about protein intake and how to maximize it. I learned that I'll have a catheter inserted before surgery (ugh...yay) and that I get to start soft foods only three days after surgery; I'd thought it was only liquids for the first two weeks! Not that soft/pureed foods sound appealing.....



I spent all yesterday evening looking at David and just squealing "I'm having surgery in less than a month!" and his response was just a blank stare- he's 170lbs on his heaviest day, so he has no idea how exciting this is. 



Nobody knows how exciting this is for me. Today, I start crying every time I think about this because I'm so damn happy...and hopeful. I haven't felt this much hope in a very long time. I was 237lbs at my lowest adult weight, and that was with starving myself and living at the gym; that's no way to live life, drinking 1 protein shake a day and being miserable and hungry all the time. 

I was 292lbs yesterday at my weigh-in. Granted, my heaviest weight ever is 380lbs, but still...gaining back 55lbs that you've already lost is incredibly depressing. I have so few clothes that fit me anymore, I hate to leave the house because I'm so uncomfortable in my body, my knees hurt, my back hurts: I'm more miserable now than I was when I was almost 100lbs heavier.
 

Someone asked me a few days ago if this surgery would shorten my life; realistically, because of how much this is going to improve my health, it's going to prolong it. Honestly, I'm to the point that I would still do it if it shortened my life by five years- it's not about quantity of life, but quality. I'm depressed and miserable right now: if my weight stays like this (or, most likely, I'd keep gaining), my quality of life isn't worth it.

I just want to be able to live a full life without being depressed, in pain, self-conscious, and miserable. I firmly believe this is the solution. 


I'm ready.

Monday, April 27, 2015

Take the bitter with the sweet (surgery date!)

...........June 10th! My surgery will be on Wednesday, June 10th. It's not the two-week window of the last two weeks of May that I was given, but I'll take it.



Now we just have to re-work our vacation, work schedules....but, whatever. 




I go back on May 11th for my pre-surgery nutrition seminar and to sign consents....and to get re-weighed.



I started my period yesterday and it did me no good to explain to my MALE surgeon that I tend to gain about 10lbs of water weight around my period (hey, I have PCOS and endometriosis....there's a lot in inflammation going on there).

He didn't believe me and said that, to show that I'm still committed, I have to lose 4lbs in the next two weeks.



Ugh.....fucker (that's kind of the period talking, but not really).


I also have to go see my PCP for a pre-op physical, which I've already got scheduled for June 1st.

So for now, I'm just working on making a birthday cake-flavored protein shake since my birthday is 9 days after surgery.....happy early birthday to me!
(this will easily be the most expensive (and best) birthday present I ever get).

Wednesday, April 15, 2015

Shopping spree!! (not as fun as it sounds)

*tick*...*tock*.........*tiiiick*............*tooooock*

Yup...time is moving that fast. Is it the end of May yet?

Mr. Stanley has his countdown...I have mine.

 Still, while the time is dragging, I know that if I don't start preparing, it'll sneak up on me and I won't be ready. I've started stockpiling vitamins and supplements when I catch them on sale. Gummy multivitamins, iron, Biotin, calcium....you name it. Between the coupons and sales, I've done pretty well.
 I have to get into the habit of drinking lots of water, so I've also been looking for water bottles. I try to be environmentally conscientious, so I've been wanting to get glass water bottles. Because they're glass, they're not made with the chemicals that are in plastic, so you don't have to worry about BPA, and I think that the plastic ones make the water taste odd after a few washes. The problem is, the glass ones are so expensive! They run $25 and up. While walking around Meijer today, digging through the clearance aisles....tah-dah! CamelBak glass water bottles on clearance!



I know....I'm a klutz and carrying a glass bottle? These come with a silicon bumper sleeve that, according to the reviews I've read, do a great job of protecting them. I'm tempted to go back and get a few more so I can recycle all of my plastic bottles!






I also thought ahead about vacation: we're going to Florida while I'm off of work for surgery. I'd hate to buy cases of bottles water to take with us, and I'd hate to lug around a Brita pitcher just so I can filter my water. Meijer also has their Bobble bottles clearanced for $10. Bobble bottles are the ones that have a filter inside of them so that the water is filtered as you drink. Perfect for traveling!

Now for the protein: I've read so many nutrition labels, it makes my head hurt. My nutritionist recommends the powder they sell there, but it's marked up considerably. Plus, it only has 26 grams of protein per serving, and I KNOW I can find a higher protein content elsewhere. After reading multiple lables, I've decided on the Isopure Zero Carb line from Natures Best. It has 50 grams of protein per serving and lots of vitamins and nutrients. 

Honestly....it tastes horrible. I ordered it from Amazon in the vanilla and unflavored. I learned about a trick of adding sugar-free pudding mix to shakes to change up the flavor and I buy Torani sugar-free syrups, so I'm hoping to make them palatable. 
 
I think I've stocked up on most everything I'll need. My last appointment with my doctor and my nutritionist is on the 27th- I'm hoping to get an official surgery date. Until then.....

*tick*.............*tock*....................
 
 

Thursday, April 2, 2015

What do you know....I am mentally competent!

For those of you've who've known me for more than....20 minutes, you know I'm a bit out there. Goofy. Odd. Wacky. Inappropriate.
And this suits me just fine.

I was a bit nervous about my psychological evaluation today; mainly because I didn't know what to expect. 
It started with an interview with the doctor- where did I grow up? How would I describe my childhood? Any siblings? How long have I been married? Highest education level? Highest adult weight? Any traumatic experiences due to my weight? What do I hope to achieve with surgery? Am I a crash/yo-yo dieter? Am I physically active? Etc...

Then I had a 20 question test, circling the statements that best described me:
I feel ashamed of my weight an never go out because of it.
I feel like others judge me because of my weight.
I feel comfortable in public. 
I can't control my eating.
I'm constantly thinking about food.
I binge eat and feel guilty after.

Things like that. Then a 165-question scantron test (sweet jesus, my hand hurts) that consisted of true or false questions like:
I have high anxiety about my medical problems.
I feel like no one cares about me.
I feel that because of God, nothing bad will happen to me.
I like detailed information about my medical problems.

I think they're trying to pick up on any depression, anxiety, hypochondriacs, or substance abuse issues. 

After my initial interview, she gave me the green light and said she had no concerns about my goals or expectations. 
All that's left is my last appointment on the 27th with my nut and my doctor and then it's all up to Cigna to give me an approval. At my last appointment, I was given the time frame of the last two weeks of May....fingers crossed!

 

Monday, March 2, 2015

FMI (for my information)

Every so often, I find a great article that I bookmark. I think I'm going to post some of them here so they're more accessible to me and others that are around me while I'm eating.

No matter how fast or successful you were in initially losing weight, these are the top ten things that can and will sink you!
1.Drinking with Meals
Taking a big glug of iced tea with a mouth full of food is normal for many. But after weight loss surgery, drinking while you are eating washes the food out of your pouch. This allows you to refill your pouch and eat around your surgery. There are some who do this on purpose so they can eat more, adding the twist of psychological sabotage.
People come up with the excuse that they have to drink because they are thirsty. Drink a glass of water before you eat. Problem solved. You can drink right up until you take that first bite, but once the food starts, no more drinking unless you are choking. This is critical to long term success. No drinking with meals. Forever. Period. Done.
After bariatric surgery no drinking with meals 2. Drinking Soda
Having a pop doesn’t do anything as dramatic as explode your pouch or even stretch it, BUT it does take many back to a time when they would drink a twelve pack OR MORE of Dr. Pepper a day. There are many people who drank a LOT of soda before their bariatric surgery. It is better to not go back there. Post ops are also more likely to drink their soda with meals and that is a combination that will eventually get you back to pre op weight.
3. Not Making Good Food Choices
We obviously made more bad than good choices or we wouldn’t have needed weight loss surgery. We envy Slim People as genetically blessed and don’t realize they watch their food choices and exercise as their normal. When I would lunch with my naturally slim and fit friend Veronica, I would think ‘She is so thin, why is she eating grilled salmon on a house salad? She can afford to eat the bacon blue cheese burger and fries!’
It never dawned on me that she was slim because she didn’t choose burgers and fries plus she exercised in her living room every single morning. I had it backwards and it took me a long time to own that I ate differently than others.
Cook fresh food, stop with the processed ‘dead’ food, fast food, convenience foods and surround yourself with better choices. For the rest of your life, ‘Protein First, followed by lower carb Vegetables’ is the plan. Keep repeating it. Stick to it. You chose surgery knowing this was the deal. Why have your stomach removed if you never truly intended to change toxic food choices?
No alcohol for one year after bariatric surgery 4. Not Understanding Alcohol
Not a drop of alcohol for the first year after surgery. The liver and other organs are already pushed beyond normal limits by massive weight loss detox. Non negotiable.
Your prior experiences with alcohol are no longer valid as things change with your bariatric surgery. Without a handbag sized stomach for digestion, the cocktail dribbles directly into the small intestine and is sucked into the bloodstream at almost full proof. You can get deliriously sloppy and dangerously drunk in seconds. With RNY surgery you can additionally become ill from sugar as specialty cocktails can easily contain 50 grams of sugar.
Never drink alcohol unless you are with someone with whom you can trust with your life. Period. Your Match.com date does not qualify. Things can go very wrong with alcohol and if you are alone or with someone who does not understand your surgery, it may place you in grave danger. Never do a shot or feel pressured to keep drinking as alcohol poisoning can kill you.
There are studies that show a slightly increased rate of alcoholism in the bariatric set that may be due to a transfer of compulsive behavior. Be aware of this. If you find you are drinking more than occasionally or cannot stop, get help. Call your surgeons office, they won’t judge and will know what to do.
There is a strong pull to go out, dance and party after being released from the bonds of obesity and social drinking can be a part of that life. We are not a website that tells you to not drink, just have a plan before that first sip. There was a woman in BE Support Group who asked in open forum which cocktail she should drink for her wedding as she was one year post op and had not tried alcohol. Not a good idea to have your first post op drink at your own wedding, the office holiday party, or a business dinner with your boss.
5. Not Taking Vitamins or Supplements
Let’s cut to the chase. It’s ridiculous to think that you could have most of your stomach removed or cut in half with intestines bypassed, or a silicon band choking down the organ to the point where forced malnutrition causes a 100 pound weight drop in a few months and NOT need to take vitamins. Professionals TELL US we must take bariatric supplements yet most don’t. It is shocking how many don’t bother and wonder why they are sick! They insist they chew ice because they LIKE it, when unbeknownst to them they have a ferritin stored iron level of *3*. Serious iron deficiencies can damage your heart.
How long can someone last when food intake is restricted and they cannot absorb nutrients? Take vitamins. Take vitamins. Take vitamins. If you have bariatric surgery at age 35, what happens to you after 25 years of deficiencies? It does not end well. The numbers of post ops who break a wrist or ankle in minor trip and fall accidents would shock you. Longterm post ops are horrified that their teeth have loosened because of osteoporotic jawbones. Many need much more involved dental procedures including bone grafts when the underlying structures won’t support a root canal or implant.
There are serious conditions and symptoms that can hurt you when you are deficient in vitamins, protein and or minerals. There are neurological conditions caused by not taking essential supplements that are irreversible and can even lead to death. Yep, death.
The image below is from the surgery report when I fractured my ankle in a motorcycle accident 8 years post op. “The bone was extremely osteoporotic”. That straightens you right up. These stories are common. Wake up and pop a couple of capsules!
Fractured ankle with Osteoporosis, gastric bypass 6. Not Drinking Enough Water
Dehydration is the number one reason for hospital readmission and is a largely preventable complication. Your surgical team is not kidding when they tell you to keep sipping. Many come out of surgery feeling good and then after the first ten days slide into dizziness, nausea, headache, not being able to keep focus and falling asleep mid sentence. It gets progressively worse and unfortunately lands them in a hospital bed where they are fortunately hydrated with a fluid IV. Stay in front of the problem and drink water on schedule to prevent this.
Adequate water intake will also help flush fat metabolites from your system as you lose weight. Drinking water releases water weight so you will lose more pounds.
Our Hy Water app will help you and its free at GetHyApp.com where you can download it at The App Store. Tap the screen and every set number of minutes there is a fun reminder to DRINK UP.
650x366 7. Grazing
Plan and eat actual meals. Three meals plus Two small Protein Snacks; this is also called Five Small Meals. Grazing is eating a bite here and a bite there, never really filing up. Your small pouch is the strongest tool and not filling it is giving up a powerful way to control fullness.
Sit down with your plate then slowly and deliberately eat your meal; fullness or satiety will tell you when to stop. Grazing is a behavior that allows you to consume a larger amount of food over a longer period of time as pouch fullness does not happen. If you realize you are grazing, stop it by eating enough solid protein to feel full, a hard cooked or deviled egg, rolled up deli turkey, half a protein bar.
Much of what we call grazing is due to ‘head hunger’ where we think we are hungry or actually just looking for something to do. Take up beading, play online games, read, anything to take attention from food!
8. Not Exercising
Obese people think that people who go to the gym like to exercise. The truth is that people who exercise WANT to look and feel good. Few really like the act of working out, they like the result.
EAT LESS BURN MORE is a mathematical formula to lose weight! The boost provided by even 10 minutes a day of jacking up your heart rate will help you lose weight faster, give you a chance at keeping it off longer, help you LIVE longer and make you look & FEEL better. I cannot believe the energy I now have and I am happy. I wasted so much time feeling so tired and sad.
If you are right now formulating silent excuses that ‘you would’ but have bad knees, medical maladies, no money for gym membership and no time, we have BE exercise plans for you that are done at home, using no equipment, place zero impact on joints and take up just 10 minutes of your day. Poof. Nice try. Excuses gone. If you choose to be a slug, OWN IT! Sorry, but walking around Walmart doesn’t count for squat. Get real.
This short video features BJ Gaddour of Men’s Health and StreamFit and shows how LITTLE exercise you can do – I promise that it will make a difference! This low impact full body movement is called a Ground Zero Jump. Your feet do not leave the floor. Anyone can do it and it can be done anywhere. Stand up and give it a try. It will make you feel proud to do it!
9. Eating Too Many Carbs
Let’s lay it out there. A big post op problem is HUNGER and many do not get that carbs are the reason.
Protein crowds out the carbs which controls hunger and forces weight loss. While a Little Debbie cake may have the same carbs as a dish of blueberries, it has zero nutrients. The little cake is a processed or dead food with no nutritional value. Choose the berries for great taste, fewer calories, tons of nutrients and use the energy to burn stored fat! All around a much better deal.
Carbs like pretzels and biscuits burn quickly and leave you hungry for more. Ever notice that eating crackers just makes you want to eat more crackers? Once you are at goal you can have a small amount of anything you want but make it your choice rather than a compulsion and only once you are in control of food.
When people are gaining weight and keep a food journal for a few days, its usually obvious that its the carbs that have wiggled their way back into the kitchen. Clean them out, stop buying them and get some fresh lower carb foods that bring nutrients to the party.
10. Assuming Surgery Has Cured Your Morbid Obesity
Calling it a Honeymoon Period is an accurate description. When weight is falling off and suddenly the world is brighter and all is good it is hard to imagine you will ever face the problems of morbid obesity ever again.
Here’s your wake up call. THE WEIGHT LOSS PARTY ENDS. During those first seven months of massive weight loss you are not driving the bus. You will lose the same amount of weight no matter what you do. There are some who don’t catch on to this and happily think that they have somehow cheated the system and are still losing weight while eating french fries. This does not end well in the long run.
It is common for post ops to not lose all the way to goal weight or over the years regain a substantial portion or even all of their weight back if they have not embraced making completely different foods choices. Even those paying attention can get hit with a gain, just like people who have not had weight loss surgery can gain weight. As with most successes, you create a long term plan and follow it. Weight loss surgery is not effortless nor does it last forever without serious commitment to the new way of life you create.
Change is hard, even with weight loss surgery. While we all thought this would be less difficult and more permanent, it turns out that just like in non-surgical life, once out from under the burden of 150 plus pounds it still comes down to diet, exercise and our willingness to change.