Showing posts with label gastric sleeve. Show all posts
Showing posts with label gastric sleeve. Show all posts

Thursday, August 13, 2015

Time flies when you're melting!

Oh my....has it really been 9 weeks since my surgery?!? 

Every Wednesday, I mentally celebrate the day I was reborn. Yesterday was 9 weeks out.....as of today, I'm down 43lbs! 
And now I'm 250lbs!



 
Most recent pic- smaller scrubs, baby!


So much has happened that's non-weight loss related: my husband and I are buying a house and, come the end of the month, I'll be getting one hell of a workout moving! 
I take my pre-nursing exam in two days, so I'm cramming and stressing (but not feeling the urge to stress eat- thank you, Sleevie Wonder!)
I've also been working like crazy since I returned to work full-time .

The downside to working full-time, 12 hours shifts at a job that is constantly chaos (welcome to health care) is that I've had to leave work and go to the E.R. for IV fluids. I promised myself that I wouldn't get behind on my fluid intake...but when you're running yourself ragged for 12 hours at a time, it's easy to get behind. I was staring at my computer screen and my vision went blurry, I felt light headed and dizzy, and the room was spinning. I realized this must be what it felt like when the dehydration kicked in- it was 5p.m. and I'd only had 20oz of fluid for the day at that point. 
I sat at the nurses station and sipped water with my eyes closed, trying desperately to shake it but, after 15 minutes, decided I'd be safer going to the E.R. and getting IV fluids in me so I'd get re-hydrated quicker. 4 hours and 1 bag of fluid later, I was good to go.

Know how it feels to be in the bed so you're humble when you're standing next to it


Another problem I've had is the dreaded hair-loss; it has begun. The hair loss happens for two reasons: first, because it's a normal reaction to anesthesia. Second, it's because eating and drinking for the first week after surgery is difficult, and you can't get much protein in. I'm not too concerned about it because I have a ton of hair...I think my temporary hair loss is will help me know how it feels to have average hair thickness. I'm also not worried because, early on, I was pretty good at getting my protein in. I've started taking biotin...I'll let you know how that works.
Drain hair after one shower!


Lastly, another problem I've run into is pain- not from surgery, but just from life in general. I have a bad back and a bad knee; since I can no longer take ibuprofen and Aleeve, my doctor prescribed me Ultram, a non-narcotic pain medication. The problem is, it does nothing for me! My back pain was so bad yesterday, I could barely get out of my car. I've had my tens unit running non-stop....I have an appointment with my doctor tomorrow to figure out what we can do. No doc...please don't suggest massage therapy =)

Because of my knee and my back (and killing myself at work), I'm not getting in my exercise like I should. My goal is to get better habits and make exercise a regular thing as soon as I'm physically able. Part of me is a bit nervous about exercising and sweating...I'm worried I'll just dehydrate myself again. I need to find the perfect balance.
 
I'm happy to report that I still can't eat much; I'm so full so quickly! I've been doing great with getting all of my protein in just eating real food. I haven't had to have a protein shake in a long time. 
Even with these problems popping up, I'm still thrilled with my results and I'd highly recommend this surgery. In fact, I've had a few friends talk to me and share that they're starting this journey. I'm so excited for them and happy to help them as much as I can; everyone deserves to feel happy and healthy! 

HW: 380lbs.
SW: 283lbs.
CW: 250lbs.



 

Saturday, July 11, 2015

It's easier than being obese

Hell, lots of things are easier than being obese.
Society isn't kind when you wear your problems on the outside.

At four weeks post-op, I went back to work. I'd been dreading this because it was already hard to get in all my fluids and protein when I'm sitting at home doing nothing- I'd anticipated it to be really difficult when I returned to my job as a nursing assistant in a hospice center. I spend 12 hours running after call lights, bed alarms, phones, bathing, feeding, bending, lifting, caring....it's hard to take time to take care of yourself when you're taking care of others.

On top of that, I went back to work to a full-time position and on day shift; ultimate craziness. When you're house hunting though, full-time income helps.

The title of this post comes from a conversation I had with a colleague my first day back; everyone knew why I was gone for 5 weeks. I have a blog about my surgery, so it's no surprise that I'm pretty open about it. She stopped me in the hallway to ask how I was, did I have any complications, and what my life looked like now- "how much can you eat? How about drinking?"
Lots of people ask these questions and I don't mind patiently answering them. After I explained to her that I have to measure out 3 oz of food every time I eat, she asked "isn't that hard?" My response popped into my head instantly: "it's easier than being obese". The look on her face made it seem like my answer really struck home for her...like a light came on.

Yes, my new lifestyle is hard. I'm constantly measuring food, liquid, checking the time to see if it's been 30 minutes so I can resume drinking, has it been three hours already? I need to eat again, tracking my protein intake, tracking my water, being sure to exercise, and lately, fighting off nausea every time I eat or drink....surgery isn't the easy way out. It's not for everyone. It takes discipline and commitment, same as losing weight any other way. The difference is, this way is more efficient and effective.
-stepping down from the soapbox-

My first day back went fine...I got all of my protein in, despite my nausea, and came in a little short on my fluids despite stopping and sipping every time I passed by the nurses' station. I only felt pain in my abdomen a few times when bending/lifting. My coworkers were great about not letting me do too much lifting, but still...it's part of the job.
On July 1st, I was graduated from pureed foods to soft foods- canned chicken, tuna, greek yogurt, soft cooked vegetables, things like that. I think that's why I'm having the nausea; my system may be in shock after being on liquids/pureed foods since May 28th when I started my pre-op diet.
The scale is stuck at 30lbs lost. It's frustrating, but to be expected. I'm still losing inches. The clothes I wore before surgery are now too big and the smaller clothes I had when I lost weight the first time are now fitting me. I'm trying to get out and be more active, but it's hard when you're so exhausted from taking in minimal calories. I feel like I could nap 24/7.

Another problem that's reared it's ugly head is my menses- between my polycystic ovarian syndrome and my endometriosis, periods are rough for me. Guess what weight loss triggers? For me, it was a two-week long period coupled with some of my ovarian cysts rupturing. Before surgery, the only thing that moderately helped was ibuprofen, and lots of it. I'm no longer able to take ibuprofen because it can cause stomach ulcers in my tiny new stomach; my only option is Tylenol, which is USELESS when it comes to ruptured cysts and endometriosis. I had to call my doc and ask her for Ultram, a "narcotic-like" pain reliever (I put that in quotes because, seriously? This stuff isn't stronger than tylenol, though is is better at taking care of period pain....but whatever).

As of Wednesday, I'll be 5 weeks out. Stats so far:
HW: 380
SW: 283
CW: 263
I'm gonna buckle down and see how much ass I can kick this week.

Friday, July 3, 2015

The things you learn after surgery

After having weight loss surgery, you have to learn your new stomach- you have to learn how to eat, how much to eat, what not to eat, how fast/slow to eat....I can understand why doctors advise taking at least a month off after surgery.

I'm pretty much healed up 23 days out...I still have some tightness/burning/pulling from my incisions, but nothing too bad. I go back to work next week. Honestly, I'm kind of nervous about it. Even when I'm home and not busy, I have to constantly work at/focus on my eating and drinking- getting enough fluids and protein in is hard with a 2oz stomach. How am I going to do it working in a field like healthcare where I'm constantly running for 12 hours? I had a hard time eating and drinking at work with a full-sized stomach!

Other things I've figured out include:

- When I get the hiccups, I'm full.
- I can now rattle off the protein content of nearly every food.
- My body DOES NOT like sugar (cue dumping syndrome)
- Bariatric vitamins are the DEVIL- they taste horrible and I have to eat 3 a day.
- My stomach is so noisy and loud after I eat, I can't be around sleeping babies.
- I have so much energy, it's ridiculous.

Also, 23 days out and I'm down 30lbs! (from starting my pre-op diet)
HW: 380
SW: 283
CW: 263

Thanks for being a part of my journey- I hope to inspire someone reading this and give them hope that there is a way to win this battle.

Everybody have a safe 4th!

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.

Thursday, February 26, 2015

And off I go!

I have been waiting for today since.....well, last August when I tried to get things going with St. Elizabeth. 

I met with my surgeon and a nutritionist today (which I'll abbreviate to "nut" from now on). When the nut was reviewing my 24 hour diet and list of foods I eat,her reply was "it looks like you eat pretty healthy!". Yeah...I do. Unfortunately, it's not enough.
"How many times a week do you eat out at a sit-down restaurant?"
Once. Sometimes twice.
"How many times a week do you eat fast food?"
NEVER (bleh)
Yuck...please...


She explained about how this involves a lifestyle change: I can only eat 2-4 oz of food at each meal, no more drinking liquids with meals, I'll have to follow a 2 week pre-op liquid diet, pureed diet for two weeks after surgery, soft foods for three weeks after, and I'll have to take a multi-vitamin daily for the rest of my life.
I've researched this thoroughly and I follow an amazing group of supportive people on Facebook that are pre and post op that I've learned so much from.
Got it.

After that, Dr. Northup came in. We reviewed my medical history and he asked if I have any concerns with having surgery....no. Being that I work in the medical field, I know too much. I have zero concerns. 
Check back with me when it gets closer to my surgery date...I might be a little nervous then.

Both my nut and Dr. Northup asked the same question: what are you wanting to get out of this?
"Well, I'd like for my knees to not hurt. I'd like for my back to not hurt from the weight I'm carrying around. I'd like to be able to physically be more active. I'd like to be fit. I'd like to not feel like I'm holding back my spouse (who has a healthy weight) from doing physical activities together."
"I'd like to be able to enjoy life"

To quote Dr. Northup (who said this several times)- 
"You are a perfect candidate for surgery".
*Happy dance!*


All my insurance is requiring is that I follow up with Dr. Northup and meet with the nut for three months. They don't care about me losing weight before surgery or my weight/medical history. Mercy and Dr. Northup, however, do require that I do the following:
  • A psychological evaluation. Everybody does it- they just want to gauge how realistic you are about understanding this lifestyle change.
  • Blood work. I've had some done in the last 30 days, so they pulled it into my chart from my doc (isn't electronic charting awesome?!?) and there are two things missing that they screen for. I just have to go have blood drawn so they can check for those two things.
  • Get a letter of recommendation from my doctor- I handed them two. One from my PCP and one from my OB/GYN since one of my comorbidities is PCOS.
  • Attend one support group meeting.
That's it.
I don't have to do a sleep study. I don't have to do a cardiac study. I don't have to have an endoscopy done to check for hernia's or ulcers. I don't have a gallbladder anymore, so I don't have to get an ultrasound done. Any I don't have any respiratory issues, so I don't have to do a pulmonary study.
My psych eval is already scheduled for April 2nd (seriously, that was the soonest opening they had). I can attend a support group meeting at any time. It's really just a matter of getting the three requirements done and seeing my surgeon/nut once a month. 
Is it May yet?!?

Tuesday, January 27, 2015

Baby(less) steps...

Went to my OB/GYN to have an IUD placed today. I had tried the copper one, Paragard, last year. I didn't think it was possible for my periods to get worse due to my PCOS and endometriosis, but ta dah- they did! They're actually had me in the emergency room a few times for 7+ hours while they tried to get my pain and hemorrhaging under control. My OB/GYN swears that Mirena and the progesterone in it will make them better. I'm focusing on getting things in order before surgery. Birth control is one of them.

According to Dr. Northup, women with PCOS become fertile myrtles after surgery due to the dramatic weight loss. It's not advisable to become pregnant within the first year after surgery. For me, someone who has no desire to have children, it's not advisable AT ALL. So, fingers crossed that the Mirena works out.











Part of my insurance approving me for the surgery is that my doctors advise/clear me for it. Because PCOS is considered a comorbidity, I asked my OB/GYN is she would be willing to write one recommending that I have the surgery. She did...ON THE SPOT (Dr. Magner is awesome if anyone in the Cincinnati area needs an OB/GYN). So that's one letter. I have an appointment with my primary care doc tomorrow (which I will now refer to as my PCP- it's healthcare lingo). My blood pressure the last few times I've had it taken was in the 140's/90's. Today at the OB/GYN- 158/110(!!!) So I'm meeting my PCP tomorrow to talk to her about my blood pressure and see if she'll write my letter of recommendation for the surgery. Wednesday, after a training class for work, I'm gonna swing by the weight loss doc I went to for copies of my charts.

At this rate, I'm gonna have every single thing they need from me before my appointment next month.

Also, I've been researching other issues that arise after surgery; depression and divorce.

There's a phenomenon known as "Bariatric divorce". Divorce rates are already high; for those who have had bariatric surgery, however, they're even higher (like 50% higher).
As one of many articles on the subject points out, it's likely that the marriages that crumble after surgery were ones that had a weak foundation to begin with- http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/relationship-challenges-before-and-after-weight-loss-surgery.
David and I have been together since time began (ok, fifteen years...feels like forever when you're thirty).
Us in our 30's....seriously
Are we perfect? No. Do we have our issues? Yes- we're normal like that. We're also best friends and have been through a lot. I don't know that I can definitely say no hard times will come from me losing all of this weight. That's why, just to be proactive, I'm gonna start seeing a counselor. One that can see both of us. Another possible side effect of bariatric surgery is, oddly enough, depression! I know- it's hard to imagine being depressed when you're shedding all of this weight that has been physically AND mentally weighing me down all of my life. According to the research I've done though, sometimes the changes the weight loss brings in your life are so sudden, people don't know how to cope. I figure our insurance pays for it so, again, be proactive and stay ahead of the game. 


Update- I just came back from seeing my PCP (I love Dr. Drake, you have no idea). We talked it out and decided that, for now, a low-dose blood pressure medication would be beneficial- my blood pressure was still a bit high today. Plus, another comorbidity doesn't hurt in my favor to have weight-loss surgery. I asked her to write a letter clearing me for surgery and recommending it and she did- right on the spot. She had time while I was blubbering to her about how embarrassed I am about gaining weight back and feeling embarrassed and having a hard time even leaving the house. I never cry- I'm not a crier! I just think I've been holding this in for a while (plus, I did have the Mirena put in yesterday- maybe it's from the progesterone in it? Yeah, I'll blame it on that). 

Now I have two letters of approval from my two docs that I see regularly, I have a couple of comorbidities, a more than qualifying BMI, and the tenacity to see it through:
is it February 26th yet?!?






 


Sunday, January 25, 2015

First contact...finally!

After several months of trying to get something started, it's happening!

Happy dance!

Mercy called with my insurance requirements for surgery: 3 months of a nutritionist supervised diet and a letter of clearance from my family doctor. That's it. 

Mercy, on the other hand, does a ton of testing before you can have the surgery- a sleep study to test for sleep apnea, EKG's for any heart problems you may not be aware of, labs to check my thyroid, iron levels, vitamin levels, and cholesterol levels, a psychological evaluation (do I tell them about the voices?), and possibly a GI evaluation to check for ulcers or a hernia. 

My first appointment is February 26th (it would have been March 17th if I'd waited until the doc was at Anderson, where I'd much rather go). Hey, to get in sooner, I'll drive all the way to Fairfield. 

When I count it up, if there are no complications with Cigna, that means I'll hopefully be getting surgery in May or early June!

Is it February 26th yet?




Saturday, January 24, 2015

Waiting and learning

I research everything to death....TO DEATH.
When I do my grocery shopping, I comb over every ad for every local store and cross-reference the sale items we would actually use for any coupons available. 

When my car was totaled, I spent hours researching cars, auction sites, car listings, repair websites...anything I could get my hands on.

When I've made a decision about something important, I didn't make it lightly; I've spent hours weighing all of the facts, opinions, and evidence. 
Since making my decision to pursue gastric sleeve surgery, I've kicked my research into high-gear. From medical websites to chat rooms to blogs to groups on Facebook, the resources are endless.

Don't know what the gastric sleeve surgery is? Allow me to school you:



  • In this procedure, a thin vertical sleeve of stomach is created using a stapling device. The remaining 2/3 of the stomach is removed. This limits the amount of food that can be eaten at one time.
  • Most popular surgical weight loss procedure in the nation.
  • Surgery lasts one hour and requires a hospital stay of one day.
  • Dietitians will provide on-going education on dietary regimen before and after surgery.
  • Typically results in a significant amount of weight loss.
  • Dramatic impact on weight-related health problems.
  • Excellent long-term results.
  • Allows for normal digestion/absorption.
What mostly drew me to the sleeve instead of the full by-pass was the fact that it just restricts how much food my stomach can hold. What happens with the gastric by-pass is malabsorption; meaning, you don't absorb all the nutrients. Also, with the sleeve, the part of the stomach that's removed is the part that secretes Ghrelin, a hormone that's responsible for making you feel hungry. 

I'm hungry ALL THE TIME. Especially since losing over 100lbs. It's almost like my body doesn't like that I've lost the weight and it just wants me to gain it all back. I try to trick it by drinking a glass of water 5 minutes before every meal; doesn't work...I'm just as hungry 5 minutes later. I eat a lot of protein at every meal. I even put protein in my morning coffee with this stuff-



It has protein, amino acids, and leaves no taste in my coffee. It does in my green tea (the green tea has a delicate flavor, after all) and, well, it tastes the way you'd expect ground-up bones to taste. But it leaves my hair and nails looking great, so I can deal.

Are you one of the individuals that thinks people who opt for surgery are "lazy" and "looking for the easy way out"?
Nothing could be further from the truth.

Many insurance companies have rigorous tests and requirements before they consider you for a candidate. Often, you have to do 3, 6, even 12 months of a supervised diet. You're forced to make lifestyle changes to prove to the insurance company that you're committed to this new lifestyle. Getting the surgery is just the beginning: most of the time, you're scheduled off of work for six weeks. Not because you need to heal from the surgery, but because you have to adjust to your new lifestyle and it takes 100% of your focus. 

Getting surgery isn't a "magical fix"; I've learned a lot from joining a wonderful group on Facebook of individuals who are in the process or have had surgery. It's still a lot of hard work and ups and downs. In one blog I read, the woman openly admitted she didn't change what she ate. She still ate chips, ice cream, cookies, etc. She just didn't eat big servings in one sitting, but rather snacked all day long. She's not gaining any weight, but she's not losing either. So no, the surgery is not a magical fix that will automatically make you a size two overnight.

I know what I should eat. I know how to eat and exercise and live a healthy lifestyle. I just need a powerful tool that can last me a lifetime. 

I'm tired of my back hurting. I'm tired of my knees hurting. I'm tired of being self-conscious and embarrassed every time I leave the house. I'm tired of being hungry all the time. Something is wrong with me, and I need help. I'm taking control and getting the help I need. So far, the only family support I have is David; he's been wonderful. I feel like my weight not only holds me back, but it holds him back as well. If I were a healthier size, we could get out more and exercise, have fun, and do more together. 

I'm ready to start living. Let's do this.




Thursday, January 8, 2015

Communication in healthcare(lack of)

I've spent a decade working in the healthcare industry; I've mostly been a provider but, occasionally, I've been a receiver. Have you ever played the game Telephone? Yeah, we get to play it every day, but with your medical information. Luckily, most of us are pretty good at it.

And then sometimes shit happens that makes the receiver want to choke someone.

I initially started this process back in August. I work for St. Elizabeth; I know people who have gone through the bariatric program with St. Elizabeth and had nothing but wonderful things to say. I know the surgeons, therefore, I wanted to utilize the same program. Our insurance is through Cigna. I got on their website to look up anything and everything about bariatric surgery coverage. Wonderful news, they cover 80% of it and St. Elizabeth is in-network! Even after the proceeding experience, I still would recommend St. Elizabeth's program- http://www.stelizabeth.com/weightmanagementcenter/.
Dr. Moon really is wonderful.

The first step of going through this process is sitting in on an hour-long information session. I called St. Elizabeth (end of August, keep in mind) and the earliest opening they had was early December; ok, fine...I'm determined, so I'll do what I gotta do and wait however long it takes. They take my information and ask me if I have insurance and, if so, who with? I give them my info, tell them Cigna, and they said "we'll see you in December!"
I get a call in October saying that they added another session in mid-November; would I be interested in coming sooner? Well duh...sign me up!


I get there and there's maybe 20 people attending. I sit down in one of the bariatric chairs. I'm sorry- I get horrible and judgmental here...but two people brought FAST FOOD to a weight loss seminar! 
That's like bringing a beer to an Alcoholics Anonymous meeting!
But ok, I get it....we all have our problems and that's why we're here.

I listened to Dr. Moon lecture for an hour about how damaging it is to your body to be obese, the dark outlook on our future if we remain obese, the qualifications for gastric surgery (I'll educate you fine folks on that in a bit), as well as what to expect before, during, and after the surgery. 

Now, here's some knowledge for you smokers; smoking effects how your body heals. I won't get detailed but, nicotine and carbon monoxide slow the healing process and put you at a higher risk for post-op complications (here's a link that gets into the details if you want: http://www.ncbi.nlm.nih.gov/pubmed/1323208
Dr. Moon told us that 90 days prior to and after surgery, due to all of the staples that go into the stomach/intestines, NO SMOKING.
No smoking?


The world is ending!!!
OMG!


You would have thought he told people they had to kill their firstborn child.

Hands shot up in the air all over the room- "Can we still vape?!?", one woman asked, clutching her chest. "Does it have nicotine in it?" was the followup question from Dr. Moon, a nod yes from her, followed by "well, then no". 

I wanted to stand up and say, "Look people, surely you're all here because you want to improve your health, quality of life, and extend your life expectancy, right? The surgery isn't a magical thing that fixes you- you're still responsible for dieting and exercising. There still has to be life changes; what's one more?!?"
Srsly, people?

In my head, I'm chanting "I'm not here to judge, I'm not here to judge...focus on your own journey..."

So before leaving, I schedule my initial consult with Dr. Smith (Dr. Moon's partner) and it's December 16th...ugh. More waiting. The MA's there make a copy of my insurance card and take the forms I've filled out. 

I show up a month later for my appointment only to be told "Uh...Cigna won't pay us therefore, we won't take Cigna."

*explosion in 3...2...1* "What are you talking about? Cigna has you on their website as an in-network provider, my plan pays for 80% of the surgery....what the fuck (yes, I dropped the f-bomb) do you mean?!?"

They get me the gal from the insurance department. She proceeds to tell me that yes, St. Elizabeth is in-network for any other surgery...except the one I want. "I've been here for three years and the entire time we've been fighting with Cigna to get them to cover us. We've had patients spend months going through the process only to get up to the point of scheduling the surgery, and we can't get an approval from Cigna because they say we charge too much."

"So why didn't someone tell me this back in AUGUST when I told you who my insurance provider was?!"
*crickets*......
"You've wasted four months of my life". Turn and walk out....followed by 5 minutes of sobbing in my car. Then a pissed off drive home, full of more determination than ever.
Do you see what I mean about the lack of communication in healthcare? Do you think that since my experience, they've told their staff to tell Cigna members to look elsewhere when they call about the seminar? I'm gonna bet no...

I called Cigna when I got home and told them all about my experience and asked them just who in the hell they will pay for; in the entire state of Ohio, they'll only pay OSU in Columbus (website here for more info: http://wexnermedical.osu.edu/patient-care/healthcare-services/weight-management/bariatric-surgery
 ...or they'll pay for the program through Jewish/Mercy here in Cincinnati: http://www.e-mercy.com/weight-management-solutions.aspx 
Or, in Kentucky, they'll cover St. Luke in Lexington or St. Mary's in Louisville.  

Gee...even as much as I hate Mercy, I'd hate to drive all over the country.
I've never had a positive Mercy experience; neither has anyone in my family, now that I think about it.

Last night, I sat through Mercy's version of the same seminar. No fast food and the doc didn't even mention the no-smoking, so it wasn't as entertaining (bummer). But I did learn that the Mercy programs has more benefits that St. Elizabeth didn't- they offer a free 6 month membership to all of their gyms, free lifetime cooking and nutrition classes, and right now, they're waiving their program fee that insurance doesn't pay for...it's a $750 fee. Thank you, thank you very much!

Now I'm just sitting and waiting for the insurance gals at Mercy to do their thing and call me.
 
Appropriate, since it's 6 degrees outside







 

A new adventure!

I. am. fat.
This isn't ground-breaking news to anyone; I've been obese since I can remember.
And to those who read "I. am. fat" and think of this:

To me, it's wrong. When you're morbidly obese, your fat consumes you. It does define you because it becomes an every day obstacle and it defines your actions. Which define you.
You have to pay outrageous prices for clothes and, to be honest, the selection is pretty limited (read crappy). You have to squeeze to fit into...well, everything- a car, a seat at a restaurant, rides at an amusement park, seats at the movie theater, or a waiting room chair. You feel constantly scrutinized, not only by strangers, but by well meaning family members...and yourself. Constantly.
Plus there's the health issues (just a bit of medical terminology- a health issue that you have because of another health issue is called a "comorbidity". For example, many morbidly obese people have high blood pressure or diabetes as a result of their weight. Therefore, their hypertension and diabetes are considered comorbidities). Comorbidities related to obesity include:
....the list of comorbidities related to obesity is endless. What it all boils down to is, people who are obese, or have a BMI of over 30, are not going to live a long or full life. Every time we get a morbidly obese patient in their 50's in hospice, they're in there at such a young age because of their weight. And I look at them and I see myself in 20 years...
So, I am pursuing bariatric surgery.
I know I've had some weight loss success in recent years. I'm gonna come clean- it wasn't 100% me- more like 80%. It wasn't all because I lived a low-carb lifestyle and exercised. I also took a weight loss medicine for a year called Phentermine(also known as Adipex). Would I have lost weight if I took it and ate whatever I wanted? No...I lost someone I had considered my best friend because we started taking it together and I had amazing success while she had none. The difference? I was disciplined while she wasn't. But I won't tell her story for her...

But the Phentermine did help greatly. I felt little to no hunger. I had tons of energy. It made me a bit manic, to be honest. But it also made me experience some depression too. It wasn't horrible; I could tolerate/cope with it. But after time, the effectiveness of the Phentermine began to decrease, which is normal. I was even able to maintain my weight. But, as with the majority of obese people, the frustration of working hard and getting nowhere began to take its toll. Life happened. Sometimes, due to work and school, I didn't have time to make a completely low-carb meal, so we had sandwiches. I'd go into work where there's always cake, cookies, and candies laying around and, during a stressful shift where I didn't get time to sit down and eat my healthy lunch, I sat down with a few cookies to eat while I charted. Life happens. Unfortunately, because of my PCOS and insulin resistance, a few cookies that wouldn't be enough to effect most people, makes me gain a couple of pounds. Then comes the shame. And the frustration. And then more food.
It's a vicious cycle. 

So why didn't I tell anyone about the Phentermine? Because of the stigma and shame that's associated with having help losing weight. The same stigma that's attached to having surgery. "You need to learn how to put down the fork. Eat more salads. You're looking for the easy way." You're damned if you do, and you're damned if you don't. Look, if all it took to be a healthy weight was to eat salads and go for walks, I'd be a size 2. I've eaten enough salads in the last 3 years(not drowned in croutons and dressing) and I've not only walked- I've RAN. My fat ass ran so much over the last summer, I developed wicked achilles tendonitis in my right heel. You know how much weight I lost over the summer? None- I only maintained. I starved myself sometimes and got nowhere. Nothing worked.
In fact, I've gained 35 pounds back since August. My highest weight was 380lbs- I had thought my highest weight was 370, but I revisited my PCOS blog from 2009 and I had stated my weight then at 380. Also, looking back at old pics from then, I can believe it.
Holy crap, my face! I had chins on my chins and I never realized it. Then there was the rest of me-
A svelte size 28 circa 2006/2007. I've been very lucky that PCOS and mild hypertension have been my only comorbidities. When I was sick last week and took the pic of myself saying "Thank god for makeup", I was shocked;
especially when compared to this face from when I was in the 230's.
I'm beginning to see that old, fatter face reappear and it's depressing.
In fact, I've been completely depressed the last few months because of the shame in gaining weight back. I've been letting it effect my life and my relationships. To anyone who's felt ignored by me for the last few months, I'm sorry. Quite frankly, it's been hard to leave my bed, much less my home. I'm embarrassed to be out in public.
I got down to 235 at my lowest last year and that was with STARVING myself. For a month, I only had one 12 oz hemp protein shake a day along with the phentermine and I couldn't get my body to cooperate and lose any more than that. I know a good handful of people who have had bariatric surgery and had amazing results with it. But I noticed one common factor with all of them; not a single one of them told anyone they were doing it until after they had the surgery. 
Why? I don't know; I can only speculate that it may have been because they didn't want to be judged as a failure for needing such a drastic measure. Initially, I had the same plan when I started thinking of this back in August. I wasn't even going to tell my parents because I didn't want anyone to look down on me for needing help. It's especially hard and embarrassing for me because of my past success.
Look, I can build a house by using a rock to bang boards and nails together;
But it works a hell of a lot better if I have a hammer.
My weight has been a lifelong issue- I NEED a lifelong tool I can use. 

So, I've decided to do something hard- I'm sharing my journey with anyone who needs it.
Or for anyone who wants to judge me- I'm over giving a damn. 
I need to do this for ME so I can be here longer for the people I love and have a better quality of life.