One Year Plus

It's been almost 13 months since I had my gastric bypass surgery. Weight at first surgeon's visit - 198 pounds (I am 4'10.5") Weight on day of surgery - 178.5 pounds Today's weight - 117 pounds Total loss - 81 pounds I am way, way overdue on seeing my surgeon and getting my blood work so no update on those. How do I feel? Physically...I haven't run in about 3 weeks which means "stuff" hurts more. I also need to see my regular doctor because I think I have tendonitis in my arms and shoulders. So, I wouldn't say I feel great, but definitely better than before. Psychologically I'm doing pretty good...most days. I believe my body is near (if not already there)to my lowest weight. There is usually some "bounce back" gain, so I need to be prepared for that. When I look at my old photos I can't believe I was that...puffy. I knew I was overweight, I just didn't see myself as large as I actually was. Now I have the opposite problem. Sometimes I see my reflection and I'm satisfied, but there are plenty of times where I think, "Ugh, I still look fat. I'll never look good!" I'm a work in progress in many ways. But I am a happy person. Two years ago I was coming out of a diagnosed clinical depression, now I'm a healthier, happier person. This whole weight loss surgery process is the cliched "journey." I think it is always changing and that I will never "arrive." Which is cool and interesting to me. I am drinking a lot of hot tea, eating greek yogurt, tomatoes with goat cheese, and simple sandwiches. I do go out to eat and generally stick with seafood and salads, mostly because it's what I crave and sits well in my redesigned stomach. I can and do eat regular food. I track everything I eat on MyFitnessPal.com I worry that I will regain weight, but that helps keep you on top of things. I've had to buy all new clothes, which mostlyI get on Good Will's online auction site and Ebay. I FINALLY bought and started wearing new underwear last week. That was tough for me because, in the past, tight (or fitted) clothes pointed to me being overweight, now I'm just wearing panties that are my size. I also cut my hair a couple weeks ago because all the post-surgery hairloss finally caught up with and my tiny pony tail looked terrible. If you have any questions you can either leave a comment or email me at dunesummer@aol.com. I have decided to use this as my regular blog so I hope to update more frequently.

15 and a Half Weeks

It's been 15 and a half weeks since my gastric bypass surgery. So I guess this is my new normal. The next new normal will be when my body decides where my natural weight will be and I move into the next, and permanent, phase--maintenance. I am sure that will be the hardest part. When I saw Dr. Basa the first time I weighed 195 pounds (naked and on my home scale) and I currently weigh around 145 pounds for a total loss of 50 pounds, so I am over half way to goal. I saw Dr. Basa about 3 weeks ago and she was happy with how I'm doing and my blood work was good. The only thing I needed to work on was my iron level, so I am now taking two iron supplements instead of one. I can't remember what my A1c was, but my average morning blood sugar is 103. I would like it to be under 100 but it pretty darn close! I feel good. I'm still not feeling as energetic as I would like, but I think that is due to sleep apnea. If I still feel this way when I am close to goal then I will ask my doctor for a sleep study. I was going to Curves, which I have always enjoyed, but I started the Couch 2 5K program (C25K) and I'm really enjoying it. The goal of C25K is to ease you into running so that by the end of 9 weeks you can run a 5K. I'm taking it slowly, so I did the first week twice. Week one is a 5 minute fast walk, followed by 8 alternating one minute runs and 90 second recovery walks, and ends with a 5 minute cool-down walk. Monday I will begin week 2. I don't know how far I'll get due to arthritis in my knees and I know I also have a Baker's cyst in my left knee, but I'm enjoying the challenge. I have never run as an adult except two times, and both times I developed shin splints immediately. I figured that since I am inexperienced and have bad knees, I would try "barefoot running" because it is supposed to be lower impact. It's not really barefoot, but the shoes are designed for that running style (like the shoes with toes, but they don't have toes). My muscles were incredibly sore the first few days, and now it's not super easy, but I enjoy it. Eating is still a learning process. Some days are easy, others are not. Last week I thought I might be developing an ulcer because I couldn't eat or drink without feeling nauseous. It must have been a bug or a "touchy pouch" because I am doing much better. It's scary when I think I have eaten too much and I'm not uncomfortable. The process reminds me of motherhood, I'm always second guessing myself. I wore a new dress to Marina's high school graduation. I got a lot of compliments, John even said I looked great. After I saw photos though, I thought I looked terrible. My arms are already super saggy and my calves looked huge. It's hard to be a female in our society, we are rarely taught (successfully) to feel good about how we look. I'm working on it and I have my good moments. I would eventually like to have surgery to remove excess skin on my arms and belly. I don't know if it will be financially feasible, and in a way I feel like I deserve to have some "scars" from being so fat for so long, but it would be nice. I am so touched by the strong support I have received! People have gone out of their way to compliment me on my weight loss and how I look. I truly appreciate every bit if support. Thank you!

Three Weeks and One Day

Wednesday was my 3 week "surgiversary." I am officially on full liquids and happy that it includes yogurt. Because I cannot tolerate protein drinks right now, I'm trying to get my protein in with food. I love black beans, and if I chew them to liquid consistency I do very well with them. I have discovered that I do NOT tolerate pork or chicken. No matter how well I chew I end up feeling like my chest is in labor for an hour or two, and I've never been so happy to throw up in my life. I am finding that this time is for learning about my pouch, which is interesting only to me--but to me it is fascinating. :D My glucose levels aren't where I want them to be. They range from 110-145, fasting, when it needs to be under 120. It's a matter of patience, it can take some time to reach good levels. My weight is slowly dropping, which is what I expected since I am a "lightweight." I've lost about 12 pounds since surgery and almost 30 pounds since my first appointment with the surgeon. This process is teaching me to forgive myself for mistakes and also delayed gratification. Pretty cool!

I Survived!

I had my surgery and I'm doing great! I had to be at the hospital an hour before my 6:30 a.m. surgery. Almost everything had been prepared ahead of time, so it was quick and easy and I was in the operating room before I knew what hit me. I'm kind of foggy about waking up, but I was taken to ICU as a matter of protocol. I remember my mouth was so dry. When they told me I couldn't have anything to drink, not even ice chips, I was really bummed. Fortunately, the nurse showed me that brushing my teeth really helped the dryness. The orders were to get me walking every two to four hours, which was really only tough the first time. The most painful part of the process was how much my back hurt. I've had a back fusion and I have an S curve (scoliosis), and it HURT. When I was filling out the paper work for surgery I fudged a little on some info because I didn't think I needed a sleep study. Bad idea. Based on the alarm going off everytime I fell asleep, I believe I would have failed the study. The next day I was moved to regular care. My meal tray would arrive and all it had on it was two medicine cups with 1-2 ounces of Jell-O another 2 ounces of broth. It was kind of funny. I was able to go home on Friday and it was nice to collapse into the Lazy Boy, take my lortab, and sleep! I look the pain killer Friday and Saturday and haven't needed it since. I really feel good! In fact, my knee (still recovering from surgery 6 weeks ago) is much more uncomfortable. I am walking, doing light cleaning (can't pick up anything over 10 pounds and don't want to bend over at incision lines too much), and even cooking for the family. I'm on a clear liquid diet and supposed to get at least 64 ounces of fluid and get 80-100 grams of protein. The fluid intake has gotten pretty easy. The protein, not so much. Protein shakes, drinks, and powders s*ck. I cannot stand the smell or taste. The doctor's office suggested "protein bullets" sold by GNC, but they are even worse. They are a thick liquid and they taste like magnesium citrate (the stuff you buy to "clean" you out before surgery). Bad! So, I'm trying my best for now and I know with each stage of the post-op surgical diet it will get easier to meet my protein goal. Some evenings are difficult. I'm not physically hungry, but I have head hunger. I miss eating. I've made a couple of minor mistakes, but I really am doing well. I'm not going to do anything to risk my new eating system. My blood glucose levels have been good, ranging from 94-114, although this morning it was 126. I did some research though, and usually takes a few weeks after surgery for the levels to settle down, so I am hopeful that my doctor will declare by diabetes to be in remission. Since that was the reason for me to get this surgery, I really, really hope this does happen. I go for my post-op this Wednesday, I should get the go-ahead to move to stage two, full-liquid diet.
Consult wt 195/surgery wt 178.5/current wt 171 pounds

Surgery On Wednesday

I can't believe I'm practically on the operating table! I had my pre-op last week, tomorrow I pay the surgeon and the hospital, and I have had the magnesium citrate and started my two day liquid diet. I'm supposed to have part of the upstairs cleaned so we can have our air conditioner replaced, but as usual the paralyzing excitement has set in and I'm not finished. Rut Roh. Yesterday we had "the last supper" at my mother and father-in-law's place. I totally enjoyed eating the ribs, beans, baked potatoes, and bread with butter. We also had angel food cake with ice cream and strawberries. Delicious! I even snuck in some extra ribs before the cut-off.

I stopped reading some of the weight loss surgery message boards because it was getting depressing. I know from past experiences that boards like that are filled with pre-ops, post-ops, and those that are unhappy with the results. On the wls boards there are also plenty of people in their honeymoon phase, the first two years while they are still losing. Then there are the people who are coming back to get help with regain. Some weight bounce back is normal, the body adjusts, but some people ease back into their old eating habits and start gaining weight again. It was making me depressed and worried. Then I found a really nice thread that was more specific to me and my situation, and decided to quit while I was ahead. Plus, let me just deal with what's going on now and let tomorrow take care of itself. :) Thank you, Jesus. Yes, I have definitely been praying about this.

Sooooooo, I am asking for prayers for me to come safely through surgery without complications and that it puts my diabetes into complete and permanent remission,(and what the heck)for successful weight loss. Also for my family, some of them are worried about me. Thank you! And I will update on the other side as soon as I can.

A New Surgery Date!

Big news first! The surgeon's office called today and asked if they could move my surgery up, so now I will have it on February 15. I would have said yes if they had asked to do it tomorrow. I have less than two weeks to prepare, but I am very happy!

This morning I had an EGD, which is where they put a camera down your throat to check for hernias and also take a couple of biopsies to check for h-pylori. Fortunately it's done under light anesthesia because that doesn't sound like much fun. I was in and out of there in about two hours and I should get the results in a few days. There was a little bump in the road earlier this week. The results of my lab work finally came in and the parathyroid level was low, so I had to go in and give more blood to test my levels of vitamin D and K and Magnesium. At least I think that's what they did.

I had an NSV, non-scale victory, this week. I was afraid to do this, but I tried on the jeans I wore to my first surgeon's appointment--and they were loose! I'm officially down 17 pounds, of course that's after completely emptying my body of all clothing and fluids. TMI? I also looked at clothes online, and they weren't plus sized. It gave me a cheap thrill. But really I can't even imagine wearing normal clothing. I'm getting low on some of my medications and I'm not sure what I'm going to do about it. I will talk to Dr. Basa about it at my pre-op appointment on February 9th. Some, or all, of them are too large to take after my surgery. Plus, hopefully I won't need to take some of them. I will need to take my antidepressant, so we need to work something out for that one. I've ordered some vitamins and protein powders. There's just a few more things I will need and then I'm set to go. The countdown continues!

Thank you for all the very sweet messages I have received. I appreciate the kind thoughts and prayers.

I Have a Surgery Date!

Hooray! The doctor's office and I have had some conversations back and forth. First they said possibly February 7, then February 28 (that's Marina's 18th birthday), and now we have agreed on February 22. I am so, so excited! There's just something great about knowing when the next step begins.

I have finished all the requirements except the EGD (scope/biopsies), which is next Thursday. I attended the exercise class, which was very helpful. The instructor was the director of PT at the hospital and we learned about the different types of exercise, why we need to do it for the rest of our lives, and how much we need to do. It's a litle daunting. There have been times when I worked out regularly and enjoyed it, but I'm not there currently.

Dr. Oz had an episode on Monday about the "One Surgery People SHOULD Be Getting," which was about gastric bypass. It was nice to see it recommended and learn a little more about the surgery.

I have started freezing a few meals for my family to eat while I'm recovering and only allowed clear liquids. I should be set by February 22. I need to get more done around the house since I won't feel like doing it for a while. I'm still losing weight but I haven't done much exercising due to my knee surgery. I'm still hoping to start using the eliptical again very soon. I would say that things are going very well and I'm feeling optimistic about what lies ahead. :)

Moving Forward!

I'm definitely getting closer to surgery! Last week was full of medical appointments and classes, or at least it felt that way. I went to the mandatory support meeting. The guest speaker was a rep for a leading bariatric vitamin suppliment company. I picked up lots of samples. Part of gastric bypass is malabsorption of food and nutrients. Eventually the body compensates for the food part, but not for the vitamins. For that reason a bariatic patient must take nutritional suppliments for the rest of their life. The second class was the first part of the dietitian's class (I already completed the second half). It was about what I will need to eat for the first six months after surgery (not much). Friday I had meniscectomy on my left knee. It went very well and I am walking around a little stiffly, but doing my exercises in hopes that I won't need to go to official physical therapy. I'll find out for sure this Friday. Today I went to see a very good looking cardiologist. I had an echocardiogram and a good conversation. Boy, the echo was so much quicker and easier than the one I had 17 years ago! He said everything looked good. That I probably do have some plaque in my arteries due to my lifestyle, but there is nothing to prevent me from having gastric bypass. Hooray! Later this week I meet with the counselor for her clearance. She said it is going to take two to two and a half hours. Yikes. So, things are progressing at a good speed. I still get scared sometimes. I was worried about the pain, but that has pretty much passed. I guess now it's mostly about regain. Apparently some regain is almost par for the course as your body adjusts and compensates. Most of the time I feel prepared. I can do this! If I gain a little, well, I can lose it again! I am doing this for my health. I want to live a long time! I want to babysit my grandchildren! I want to sit on the floor and read to them AND be able to get up again! I CAN DO THIS! Yay me? Yeah, YAY ME!
I'm sorry if this gets repetitive, and thank you, thank you, thank you for all the support!!!

Getting Closer!

We are back from our cruise! I loved spending New Year's Eve on a ship filled with party-goers. The best news is that I had no noticable weight gain. That's great news! I ate a lot but tried to walk and take the stairs even more. My knee was killing me, especially the first 3 days, and one or two days the ankle of that foot swelled up a fair amount. But it's back to normal now and I'm having surgery this Friday to clean up my knee. Then soon after that I will be cleared to really exercise. I didn't gain weight while on vacation and I managed to lose a couple more last week, so I am down (at my absolute lowest of the day) to 186 pounds. Today I had an appointment with Dr. Basa, to check in and see how I'm doing. According to their scale I have lost the 10 required pounds. Hooray! I need to keep losing because they will postpone surgery if I'm not still 10 pounds down, plus it reduces the size of the liver and makes surgery easier and safer. This week I will attend the support meeting and the first part of the nutrition class and get my lab work finished. I have an appointment with a cardiologist on January 17 (I think), and I need to make an appointment with the psychologist. All that's left after that is an exercise class that I will attend the last week in January and an endoscopy that will probably be scheduled around the same time. I think they are going to call and give me a surgery date soon--probably early to mid-February! I can't believe it's coming up so soon! I've been scared lately. Should I have surgery? Is this the right surgery? What if I fail? What is weight loss surgery failure? It's just normal nervousness--this is a lifetime commitment. I believe surgery is right for me because, besides the weightloss, I want to not worry about diabetes (and high blood pressure and high cholesterol) and it's complications. I also believe gastric bypass is the right surgery for me. The other surgery that I've been thinking considering is the duodenal switch. But I don't want to increase my chances of bathroom problems, I have enough of them. Plus, it doesn't help with reflux, which I would like. I'm sure it's more expensive, and I'm self-pay. And the malabsorbtion is greater and doesn't decrease with time, so you have to commit to taking A LOT of vitamins and increased chances of problems with that. Failure would be to not lose weight (not going to happen) or regain (frequently happens a few years out due to a return to old habits, less malabsorbtion, and the body readjusting), which can be lost again. I will praying that I can deal with the changes and be vigilant in maintaining good habits. See, chilly feet. It's all good!

Carrying On

Last Thursday I attended my first of 4 mandatory classes. It was the about preparing for surgery and part two of a nutrition class. I haven't taken part one yet, but this one was the meatier of the two. The amount of information you need is overwhelming, so it's good to get it all at once and then revisit as needed. I learned about the different types of food I will be eating at different times after surgery. It goes from two weeks of clear liquids, to full liquids, to pureed and then soft foods. Eventually I will return to normal foods, but you definitely don't want any food getting stuck in the new stomach and intestinal connections while they are still swollen. John attended the class with me and said he hadn't realized the life changes that go along with gastric bypass.

Yesterday I met with the same nutritionist for a one-on-one meeting. We discussed how I normally eat, losing weight before surgery, and tips for making changes now rather than waiting until it is necessary. It was very helpful.

I have been making several changes in my diet. We went to one of my favorite Mexican restaurants last week and I didn't eat ANY tortilla chips. They are so addictive that I didn't want to risk even one. I'm trying to stay around 1200 calories, which is much less than my norm and I have been starving at night. Tonight is the first night that it hasn't been distracting. I am also tracking what I eat with an online program. So far I have lost around 4 pounds, which feels good. The next couple of weeks will be tough, given the holidays, but I'm not worried. I'm not going to try to lose weight, just maintain.

MERRY CHRISTMAS!

Early Struggles

I am trying to get started on those 10-20 pounds I've committed to losing before surgery. I guess it's not shocking that I am struggling. I do fine during the day, but oh those nights. I get soooo hungry. At least that is something that the surgery will help by reducing my hunger. It's not head/emotional hunger, just plain (staying up too late) hunger. I forgot that I was planning to get my lab work done tomorrow and I ate well after midnight, so I guess I'll shoot for Friday morning to do it. I have made some positive steps. I love sweets but I have been able to reduce the quantity of what I was eating. Also, I'm definitely eating healthier, concentrating on proteins (which will be very important post-surgery) and fruits and vegetables. Tomorrow I plan to attend my first required class, a meeting with the surgeons. Today I made an appointment with the dietitian for next week. Things are moving right along! A benefit to all these preparations is that I feel good about myself because I am actively doing something to improve my health. :)

Answering Questions

I am blown away by the support I have received so far and I'm very grateful! Today I would like to answer some questions that I have been asked on Facebook and here on the blog. I have tried to adjust my settings to make it easier to comment.

Q. So you're not wanting to do the Biggest Loser camp because it's $10k, you have to work hard to lose weight and make a lifestyle change, but instead rather put that money towards unnecessary surgery so you can continue to be lazy? That makes a lot of sense.
A. I have a 25 year history of dieting and you can guess by my current weight that it hasn't been very successful. I'm not even one of those people who loses 50 pounds and gains it back. My most best attempts have been 12-15 pound losses, followed by the usual regain. The reason I don't want to go to the Biggest Loser Resort is because I don't think that it is the solution that will work for me. I'm sure it works for some, just not me. The reasons I think my chances are greater with gastric bypass are because my stomach will be much smaller and fill up faster, the part of the stomach that produces the hormones that cause you to fill hungry and crave sweets is removed from the digestive process, the stomach's ability to absorb all the fat is temporarily decreased, and your eating habits are changed, hopefully permanently. It is NOT the easy way out. It is major surgery that is meant to be a tool, along with eating well and exercise, to help you lose weight. The statistics for those who lost weight with surgery and kept it off are much higher than just with diet alone. I am also hoping that paying the $25,000 will contribute to my seriousness in taking this path. For me, the benefits are not just losing weight, I also have a 90% chance of leaving the hospital with my diabetes in remission with little chance of coming out of remission. That's huge! My mother, grandmother, and grandfather all lived with the complications of diabetes and died due to them.

Q. I'm so excited for you Jackie! It's very cool to see you hopeful about this and your determination to make this work. What will you be doing to lose weight before the surgery? You go girl!
A. Thank you! I am taking it slowly. I am starting by cutting down and then cutting way down on sweets and carbs. I will reduce my calories to about 1000-1200. I am also trying to increase my activity level to actual exercise. :)

Q. Did they prescribe a vitamin or do you need suggestions?
A. For now I just supposed to take a regular multi-vitamin. Next week I will have my bloodwork done and it will show any deficiencies and they might change what I take.

Thanks again for the support!

Meeting With The Surgeon

My first meeting with Dr. Basa was on Monday! The weather was cold, and although it wasn't part of my evil plan, I wore jeans and a big belt. That added a good three pounds to my first weigh-in. The nice thing about that is that it will look like I've lost more weight than I have (if the next time I wear my usual uniform of exercise shorts and a t-shirt). I'm not trying to play games...really. Anywho, the appointment began with someone taking my vitals and then meeting with the bariatric coordinator. The BC asked me a lot of questions like what are my trigger foods and do I binge eat things like a whole bag of chips or a half gallon of ice cream. I said maybe a half of a bag of chips or a pint of ice cream. Chips truly are a trigger food. I enjoy them but they aren't my favorite food, but I can't stop once I start eating them. We talked about my diet history (Weight Watchers, Phentermine,lots of unsuccessful attempts), when my weight gain started (late teens, but really after the birth of my first baby). What kind of surgery do I want (RNY, aka laparscopic gastric bypass)? How long have I considered weight loss surgery (around 5 years, not entirely sure)? Why do I want to do it now (I want to see my grandchildren and not die a horrible death like my mother, and other reasons)? The doctor came in and pretty much asked the same questions. We also discussed my recent 4 year depression that I am so HAPPY to have gotten behind me. Dr. Basa said that I am a good candidate for bariatric surgery and she agreed with my choice of RNY, especially with my diabetes. I signed a contract agreeing to lose 10-20 pounds before surgery. I also agreed to start exercising, start taking a multi-vitamin, and quit drinking caffeine. Before having surgery I have to lose the weight, attend 3 classes (nutrition, exercise, and a surgeon's meeting) and attend at least one support group meeting. I also have to see a cardiologist, nutritionist, a psycho-therapist, and Dr. Basa will perform an endoscopy (I think) to check for any hernias and ulcers. I also will be having some lab work done to check for a bunch of things including vitamin levels. I am waiting to talk to the finance guy, but as I stated earlier, I will be self-paying. After the meeting they took my first "before" photo. It was very exciting to feel like I was getting closer to undergoing this surgery, which looks like it might be happening in February. Wow!
PS Thank you for all the support!!!

A Quickie

I just wanted to write a quickie post about Thanksgiving and telling everyone about getting bariatric surgery. Apparently it's one of the big questions, whether to tell people or not. I am not a very secretive person so I decided I would not hide the fact that I am pursuing surgery. I can't hide my butt, why hide how I'm trying to fix it? Everyone took it very well, which made me happy. My mother-in-law even gave me a hug. My father-in-law was pretty quiet, but I totally expected that he would't agree with the idea. The day after Thanksgiving, my brother-in-law called my husband and suggested I look into the Biggest Loser Resort. For around ten thousand dollars you spend a month at a fancy fat camp. It actually looks pretty cool, but I know my track record and I don't think that will help me in the long run. Those kinds of successes are short term for me. I am still very excited about undergoing the surgery. I had my appointment with the surgeon on Monday. I hope to write a post about that in a day or so.

Gathering My Info

I was lucky to not have a long wait to attend the required seminar presented by the bariatric surgeons. I had one week and in that time I filled out all the required health history forms, gathered my doctors' letters of support from my pcp and the orthopedic surgeon,filled out a three day food diary and found out what my insurance covered--which was a big fat zero percent. I believe the clause that includes weight loss surgery was denied by my husband's employer. My husband is self-employed. I found the seminar very interesting. The surgeon, Dr. Basa, explained the different procedures that she offers and the pros and cons of each surgery. I actually changed my preference from a gastric sleeve to gastric bypass because I believe it will have a greater effect on my diabetes. People who have gastric bypass typically lose a greater percentage of weight. She also introduced three former patients that answered our questions. A couple of days after the seminar, which was well-attended, I received a phone call from the bariatric surgeon's office letting me know that my insurance does not cover the surgery. I told them that I intend to self-pay and we set up an appointment with the surgeon. I'm super excited! Now, I'm reading three different weight loss surgery message boards and trying to find out as much as possible about gastric bypass. Next time I'll write about telling my extended family about my choice. Fun times.