Is it really November?

I cannot believe it has been a month since my last post.  Time flies when you'rre losing weight!  I am officially down 34 pounds since my surgery 6 weeks ago.  It might not sound like a lot compared to some people who have had weight loss surgery but it is all relative.  My doctor considered me to be a "light weight" before surgery and even called me "skinny" which is laughable.  He reminded me that some of his patients after surgery lose "me", meaning 200 or more pounds.  My pre-op weight was 227 and I am now 193.  I cannot remember the last time I was under 200 pounds, seriously.  Maybe middle school, maybe early high school?  I may have been just under 200 in the mid 1990's but it would have been only a brief time.  Even when I had Pancreatitis (twice) in 2004, spent six weeks in the hospital and had nothing but TPN, which is IV nutrition and nothing by mouth, and lost 50 pounds, I was 220 then. After that weight loss from being ill,  I easily got back up to 275 in just a couple of years. 

So far, I really can't see a big difference in my looks.  My husband says he can tell, but I am sure it is hard for him because he sees my everyday.  The exercise physiologists at my gym/surgeons office say they can tell-especially in my face, they say.  I can feel my bones a little easier now, especially my clavicles, or collarbones, ribs, and spine.  Fortunately, my hands and feet are losing their chubbiness.  My wedding and engagement rings are too big to wear now and a lot of my shoes are way too loose on me.  But thats all okay, I mean what girl doesn't love an excuse to go shoe shopping?  I see some negative differences though.  My upper arms have a lot more sagging skin, what many people who have lost an excessive amount of weight affectionately call "bat wings", lovely... and I had them just in time for Halloween!   I am surprised at how quickly the arm transformation happened, despite the weight training I have been doing.  The fat pockets in my inner thighs are more like sagging skin now-not attractive! I am upset about this because this means I will most likely need some sort of plastic surgery to wear a normal swimsuit again, meaning one without a skirt or swim shorts.  Plastic surgery is not in the immediate furture though.  Usually they recommend you be at a maintained weight (after the excess is gone) for about a year.  Not that I am jumping to get back on the operating table anyway.

I have had a few episodes in the past week of feeling food was getting stuck and pain in my chest that makes me pace the floor hoping for relief.  It felt like an elephant was sitting on my chest combined that feeling you get right before you throw up. My surgeon attributes it to eating too much or too fast, I am not so convinced and I am worried I am developing a stricture.  He tells me that strictures usually do not develop so quickly after surgery and are more commonly seen when a patient 3-6 months post-op, not that they are common in the first place.  So, on his advice,  I am reverting back to a softer diet for a week to see if things improve, if they do not, I may get an endoscopy.  An endoscopy is a procedure where they pass a lighted scope with a camera down your esophagus into your stomach (or in my case, pouch) to check things out.  I have had a million of them done before, I have a long history of heartburn, acid reflux, ulcers, etc.  Gastric bypass surgery gets rid of the reflux for the most part because the pouch does not produce acid and that is why it is so important to chew your food so well after this type of surgery.  Hopefully, things will ease up on their own and I can avoid a procedure at the hospital. However, if things do not get better, I want the test to make sure all is okay in there.

My husband and I spent the past several weekends going through the basement and a lot of my clothing.  I am a shopper and have/had a lot of clothes.  Most of the stuff in our basement has been too big for me for awhile but I was holding onto them "in case" you know, in case I gained a bunch of weight I would have stuff that fit.  I ended up donating about 12 large black plastic garbage bags of my clothes plus another 30 or more hanging items.  We have an SUV and it filled the whole trunk and the entire back seat too.  I would say that half of my clothes in my main closet in our bedroom (my husband has the closet in the spare bedroom) are too big as well so I'm going through them next.  I have a good rotation that workout clothes that fit, and other than that have about 6 pairs of pants/jeans and a dozen shirts that fit and thats it.  It felt good to get rid of all of those fat clothes.  I can't wait for the next round of Goodwill donations, when the stuff I am wearing now is too big!

Officially a Post-Op

 WARNING! This is going to be a LONG Post!

The Surgery

I had Laparoscopic Roux En Y gastric bypass surgery on 9/21/2011.  I got to the hospital at 6:30 a.m.accompanied by my husband, Michael and my Mom, who flew in for a couple weeks to help out after my surgery.  I didn't sleep too well the night before, I maybe got 4 hours of sleep.  I was pretty anxious about the surgery, not about my decision to have it, but I was mostly just worried about complications, etc.  When we got to the hospital I was asked to give a urine sample for a pregnancy test.  I had a birth control implant placed in my upper inner arm about a week earlier because fertility can return when one rapidly loses weight and pregnancy is not recommended in the first year after surgery for many reasons.  First of all, pregnancy in the immediate post-op period can cause very serious complications with the actual surgical area-the weight and pressure from the pregnancy can cause stress on all of the newly stapled and sewn areas-very bad.  Also, because vitamins are not absorbed as well, these deficiencies can post major risks to a developing fetus.  Back to the surgery.  I then was given a gown and socks to change into-the gown was for someone much larger than me and I asked for a smaller one but was told that was the gown that all of the bariatric surgery patients were given, so I dealt with it.  Then my vital signs were taken and I went over to the scale to get weighed and reviewed my surgical consent.  My nurse went over my medications and some of my medical history and then started an IV, which took 2 tries to get a vein.  After that, the anesthesiologist, Dr. Chen came to talk with me.  He was so nice and went to medical school at Washington University in St. Louis, which is where I was born and raised and where all of my family lives.  He asked if I wanted a little something to help me relax and I decided that I did, so he ordered some Versed, which is a medicine that is given before medical procedures or before anesthesia for surgery to cause drowsiness, relieve anxiety, and prevent any memory of the event, but you are still awake and able to follow commands.  Dr. McPhee came by and signed my surgical area and spoke with me when he got to the pre-op area he answered some questions and then went to change for surgery.  Right after that, I was given the Versed, and do not remember much after that.  I know that the doctor came back out to check on me and my mom told him she didn't think I needed surgery and she and the rest of my family were worried-or so my husband told me.  My husband told me that Dr. McPhee told her that I was very sure I wanted the surgery and we had many talks about making sure that I wanted to have gastric bypass, which is absolutely correct. I guess she just needed to get that off her chest, I don't really care because I know she only expressed her concern because she loves me and she had told me that she would support my decision to have surgery. After that, I was wheeled back and that is all I remember.  The surgery itself was very uneventful and for that I am blessed and thankful. I absolutely love my surgeon and his partner. Their practice is incredible. It has a huge area for support groups with chairs in all sizes, a demonstration kitchen, and a gym with their very own exercise physiologists. I had the whole "what have I done" questions for the first two days post-op but I haven't felt that way since. My pain was pretty intense, considering I have chronic back pain and live with pain daily. I even asked to keep my PCA, which is IV pain medicine that I received by pressing a button, an extra day which my doctor was fine with. I remember at some points those first 2 days counting the minutes before I could push that button again.  The pain medicine also caused me to itch all over so I had to get benadryl shots every 4 hours to prevent me from scratching all my skin off.  The other main discomfort I remember was the amount of bloating and abdominal distention I had in my abdomen. My doctor discontinued my IV pain medicine at the end of day 2 and switched me to liquid Lortab, which wasn't as great for the pain but it was managable.  When I woke up on past-op day 3, my pain was a lot better.  I walked a lot more, was able to start sipping Crystal Light, and take a shower.  I went home later that afternoon but was scared to already be going home.

The Recovery

 I should not have feared going home, I had lots of help, had better sleep and was overall, more comfortable.  I haven't taken any pain medicine since post op day #5 and I have to say the worst part for me was the bloating and gas. The day after I had surgery I was 16 pounds heavier-crazy!  I bought some Gas-X chewables and they help a little bit as does walking. Now, 13 days later, I am amazed on how great I have been feeling and while I am not at my full energy level, I am pretty close to it, my exercise physiologist contributes it to my high level of fitness pre-op, which is one reason why I am so anxious to get exercising again.

Yesterday I had my first post-op appointment. I am down 16 pounds in 13 days. I told my doctor that I thought I would have lost more by now and he told me doesn't even look at weight loss amounts until 3 and 6 months post-op.  He scolded me for getting on the scale so frequently (2-3 times a day) which I know is bad, but I just can't help it.  My husband told him he would keep me off the scale but I have already weighed once today-I just can't help it, it is exciting to see my weight consistiently go down-something that never happened to me on the dozens of diets I have been on in my life.

I am working my hardest to get enough water in but not nearly reaching my goal-it was easier to get water in during the full liquids stage (Days 3-12) because I do not have to wait 15 minutes before and 1 hour after eating to drink. I am also not reaching my protein goals but my dietician told me that during the first few weeks post-op I need to gradually build it up and it is getting easier to achieve on pureed. After being on full liquid meals for the past 2 weeks, my doctor released me to start pureed foods yesterday.  Lunch was my first meal and I actually ate babyfood.  It was the brand started by Chef Tyler Florence inspired by his children called Sprout.  I had the Chicken with Mixed Vegetables, it looked like vomit, but with the addition of some sea salt, it tasted decent-kinda like chicken noodle soup that had been put in the blender.  I only bought a few baby foods, mostly fruit and plain veggies to moisten meats that I have finely chopped or shredded.  Dinner was probably about 2 oz of shredded Hormel Turkey Breast in Gravy (1 gram of fat and really tasty) and 2 spoonfuls of mashed potatoes.  I was absolutely stuffed!  Later I had a yogurt for a snack for more protein.  I scrambled 1 egg this morning and was stuffed after eating about 2/3 of it. My eyes are so much bigger than my stomach, it is mindboggling! But, when your stomach goes from the size of a football to the size of your thumb it makes perfect sense. 

I need to start Iron, my dietician told me to try crushing up a high potency tablet (I was on it pre op due to anemia) and mixing it in applesauce with lunch. I am pretty sure it is going to taste horrible so I probably should go buy a bariatric chewable Iron tab.  I also take 2 chewable multivitamins, twice a day, calcium chews three times a day, Vitamin B12 once a day.  That will be a regimen to follow for the rest of my life and that's a lot better than taking pills for multiple medical problems.  Speaking of which, my type 2 diabetes is gone and I now longer have to take medication for heartburn and gastric reflux-woohoo! I am also leaving behind high cholesterol, triglycerides, and sleep apnea (and that horrible cpap).

I love being a LOSER!

Getting physical

Wow, time flies, I haven't posted in awhile because I have been pretty busy preparing for my surgery this Wednesday - only 3 days away!  I saw my doctor for my pre-op physical, had my labs, EKG and Chest x-ray done last week and was cleared for my surgery.  The only glitch was that my iron is low so I am taking high potency iron daily until my surgery.  I made arrangements to have a nurse come to our house when I am in the hospital to help my husband with his dialysis.  My mom flew in town Friday and will be here for the next 2 weeks to help out, I am so thankful to have her help and support!  Today is my second day of "clear liquids only" until my surgery and let me tell you, it's not fun but it isn't as bad as I thought it would be.  Maybe it helped that my "Last Supper" as a pre-op was being treated to The Melting Pot for dinner Friday night with my hubby and my mom.  If you've never been-go!  I feel blah and tired-but it is probably better for me to deal with sugar withdrawal now instead of while I am immediately recovering from my surgery in the hospital.  The clear liquid diet helps to shrink the liver and visually and spacially makes the surgery a little easier for my doctor.  And whatever makes the surgery safer for me and easier on him, I'm gonna do wholeheartedly.  My husband cooked a yummy smelling mexican chicken crockpot soup/stew for him and my mom and I am thankful I didn't have to deal with cooking while fasting.

Now I want to post a little bit about something newer in my life: EXERCISE.  My bariatric surgeon's practice has a gym for their patients on the floor where his office is located and I usually go there 3 times a week.  There are two wonderful exercise physiologists that work there that keep me on my toes.  The are great guys and even though it is a longer drive than my other gym, I like the direction and advice I get there, the fact it is only used by bariatric patients, and getting to see the progress of others who are preparing for or have had surgery is an added bonus. Plus, making appointments for my work outs makes me more accountable. I started going to the gym back in February and I never thought I would enjoy exercise as much as I have.  For me, it is a stress reliever, mood booster and really increases my energy and stamina.  When I first started going there, I did about 20 minutes on the treadmill at about 2.5mph, and at the time, thought that was a good workout.  And really, it was a good work out, but not for me, not for a 37 year old woman.  Now I am proud to say that when I get on that treadmill, it is for warm-up or a cool down.  I do not run because of the instability of my right knee, which I had reconstructed back in 2000.  I am actually buying time for a total knee replacement because of stage 4 arthritis, caused not only by my injury but also because of the excess weight I carry around.  But, I want to get past my weight loss surgery first and think about my knee later.  When I saw my knee doctor a while back for some cortisone injections in my knees (temporary but necessary relief that makes it possible for me to exercise at all), he told me that for every 10 pounds of weight someone loses, it is like 100 pounds of pressure off your knees, wow...  If I end up losing 75 pounds or more, as I hope, it will take 750+ pounds of pressure off my knees-unbelievable!  I had my last workout as a pre-op patient on Thursday and I spent 32 minutes on the ARC trainer including intervals and 30 minutes of weight training. Typically, my exercise physiologists want to see me doing 30-40 mins of cardio with 20-30 mins of weight training. I also use the row machine, the XR bike (works arms with legs-it is recumbent), treadmill, and the elliptical when I think my knees can handle it.  I hope that during my recovery I do not lose too much stamina, but even if I do, I know I will gain it back.  I like that, lose weight & gain stamina!

Time to help my hubby with dialysis....

Grocery Shopping

So, today Michael (my husband) and I went to a drugstore in town where they sell a lot of the bariatric friendly vitamins, supplements and protein powders that will become the mainstays of my diet after my surgery.  Basically, my new grocery store.  I walked out with lighter wallet ($110.00) and 10 different items.  I'm sure I overbought, because when it comes to food, I almost always do, lol.   The products I purchased included;

Nectar protein powder in Chocolate Truffle (seemed to be the favorite flavor of everyone I have asked)
Nectar protein powder, Unflavored (I plan to add this to soups and other savory-type foods but I assume it will work well in puddings and cream of wheat and rice cereals)
Bariatric Advantage sublingual Vitamin B12 (sublingual means it dissolves under the tongue, because the part of the intestine that normally absorbs it is bypassed during the surgery)
Dry Peanut Butter powder, for adding to shakes, pudding, etc.
Bariatric Advantage Calcium Chews in Lemon
Bariatric Advantage Calcium Chews in Caramel
Pure Protein Gelatin cups-6 pack in Tropical Fruit flavor (bought on a whim, mostly for the clear liquid stage).
2 Types of gummy vitamins, my doctor okayed them for me to take because all of the different powdery type bariatric chewables I tried made me feel nauseated.

There were a lot of different flavors of the Nectar powders, from fruity to coffee and vanilla.  Fortunately, a friend at the gym gave me a huge sampling of all of the ones she has which is great because I can avoid buying big containers of unpalatable flavors. I also read that adding powdered milk to some recipes can boost the protein count without dropping as much cash as buying the unflavored protein powder.  I also think I'll be buying other supplements such as Biotin and Iron, anything to prevent or lessen dreaded hair loss stage after surgery.  I can always add them once I see how my pouch handles the main vitamins, kwim?

Are you a post-op?  What were your favorite products and flavors during the different diet phases?

Introduction

This blog is about all of the different plates in my life. There are many plates, with duties that include; being a wife, daughter, sister, caregiver, friend, nurse, and patient. They are all full in varying degrees. One of the plates, is my actual meal plate, and it has always been too full. It is time to clean it up, make the portions smaller and wiser, and let it be my ally instead of my enemy. It will be paired with a new pouch, which is the name given to "new" stomach that the doctor give me when I have gastric bypass surgery in 18 days. I first started researching weight loss surgery about 8 years ago, while living in Florida.  Several different states and health insurances later, I finally have coverage for surgery. I am excited, scared, nervous, sad, happy, hopeful, and a million other feelings all at the same time...