Month: October 2016

Goals and Gadgets

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Apple Watch Nike Plus model
Gadgetry for Geeks

I struggle with coming up with the right rewards for the right goals. Now that I am almost two-thirds of the way to my goal, I decided to increase the stakes. 

I already have an Apple Watch but it’s the first version. Now that Apple has launched this new model, I’ve declared this to be my final goal reward. I’m a data nerd and the Apple Watch has been an important tool for my journey, between timers, tracking workouts, the activity app and other features, it only makes sense to upgrade as part of my upgrade. Extravagant? I’m worth it. 

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“Support” Group 

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Before my surgery, I had to sign an agreement to go to the monthly support group meeting for a minimum of 6 months. I had every intention of checking it out before my surgery, but for whatever reason didn’t make it. 

My first time at support group was about 16 days after my surgery. I was leaving my house in actual clothes for the first time since my surgery follow up. 

The group was so unbelievably negative. One lady said to me “you don’t even look like you needed the surgery.” The last people I expected to judge were baritric patients. I remember this other lady walking in and talking about hot guys at her gym. I didn’t make it to the next two sessions…wonder why. 

The October meeting was different. I received an email, in advance, about the meeting and there was going to be a new therapist facilitating. I decided I would give it another go. Aside from the fact that it took me 90 minutes to drive there due to an accident and 5PM traffic, I made it. The meeting had already started when I got there and I guess they were doing introductions. There were two women who hadn’t had their surgeries yet so they were looking to hear about the experiences of the “veterans.”  This was hilarious. 

There was a guy, who I will call Mr. Lapband, who interrupted to throw in his completely unsolicited 2 cents providing horribly wrong information and the facilitator let this go on a while. My favorite input from him was about how he eats to much and throws up all the time but got used to it and it doesn’t taste bad. OMG — what kind of advice is that?  Then comes the woman who had gastric bypass and discovered she doesn’t get dumping syndrome while trying Halloween candy. Why would you do that???  

What’s my point? There are a lot of options for support in the bariatric community, including Facebook Groups where everyone is an expert ::sarcasm::  

You have to figure out where you need support and seek it there. I wouldn’t seek medical advice from anyone in these groups although it is interesting to see what other people are experiencing. And to hear how people who have been successful at maintenance have managed their lifestyle. 

Now I am curious. In November I am going back for more! 

Running out of clothes

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Back in 2009 when this story started at size 22, as I lost my weight, I was able to “shop” in our spare bedroom going through all the clothes that no longer fit me as I gained weight over the years. In 2001, I was a size 14. As I gained, I put my clothes away for the day I lost weight.

Needless to say, I had a lot to choose from as I lost weight. I was able to get into a size 12 by 2010, but over the next 5 years, I hovered in the size 14 range. I always knew when my pants got too tight, it was time for action.
Fast forward to my surgery date, I was pretty must well into size 16 before my surgery, and even that stuff was tight. So on my way down, I had the bulk of my wardrobe to choose from in the 14 range.

I am 106 days out from my surgery and pretty much everything from size 14 has been bagged and donated, my size 12 stuff is too big and that leaves me with 3 pairs of pants. I am so reluctant to spend any money on clothes because I seem to be going down a size every month. So…if you see me walking around in baggy clothes, you will know why.

I discovered a consignment shop in Woodland where I think I will shop every now and then to get a few things to tide me over. It’s a lot to wrap my head around. I get to shop in the front of the store where the small and medium stuff is instead of all the way in the back where the big girl clothes are. Seriously, it’s a crazy mental game and it’s tough. Again, no one can tell me I took the easy way out.

Bored!

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I am so bored with my food choices right now. Since my serving size is a whopping 1/4 cup (that’s 4 tablespoons!), it’s hard to make exotic culinary delights for every meal.  And I end up with leftovers that are impossible to finish.

I can’t even eat a whole container of yogurt without having left overs.

Since my little setback surgery, my tiny tummy has been angry and bitter with me. I’ve gone back to the basics. Yogurt, cottage cheese — smooshy foods.

Need to revisit my Pinterest page to find some good recipes to spice stuff up.

I have a cabinet full of protein powder and I am bored with that too. I actually went to the evil empire of Walmart (the neighborhood grocery version) to get some Premiere Protein drinks to try.  They are technically on my doctor’s list of acceptable protein, but they don’t have whey isolate, they are whey concentrate.  So many rules!  Just thought I would mix it up for a week or so, because boredom leads to all kinds of bad habits!

A friend suggested that I have Adam Levine deliver my food to spice it up.  If only…

Some serious scratch

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Anyone want to guess what my little adventure cost me a few weeks ago?

Surgery and hospital stay was $31K — all covered by insurance.

Ambulance $4,114 — none of it covered by insurance, unless the ambulance company provides them with my patient transfer report.  They better do that.  Sounds like I need to give my insurance company a call.  Should be covered from one hospital to another, especially since I was all doped up on morphine at the time.

Ugh.

It’s none of your business…

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…but it’s time for me to say something.

This whole post will surely be one doozy of a HIPAA violation — although technically I’m divulging my own information, so maybe that’s not really true.

My emotions about this surgery run rampant. Maybe it’s the hormones.  Well, that’s a good place to start.

I alluded to medical issues in an earlier post. I have a number of conditions that create the perfect storm of hormonal wackiness. I’ve had a pituitary tumor since 2003 (managed medically).  I have a low functioning thyroid. I have a bunch of girl issues that sometimes throw things out of whack. Since my dad died I have been struggling with pretty severe depression and anxiety. And stress. I’ve had a lot of personal and work stress. All of these things together not only require medications that have their own side effects, but they also create some hormonal imbalances that may impact my ability to lose and maintain weight.

My metabolism is sluggish.  Some people may say it’s very efficient, since my body tends to store everything I eat for the zombie apocalypse. And math? My body doesn’t know math.  You know, that formula calories in must be less than calories out? Well that one doesn’t work for me.  The math just doesn’t add up. I ran half marathons and trained daily and continued to gain weight, even with severely limited calories.  Before surgery, I actually lost weight more easily without exercise, or with very moderate exercise.

In anticipating all the reactions people will have when I come clean about this surgery, I feel like I need to justify why I didn’t just do it the hard way with diet and exercise.  Why I took the easy way out. My response — there’s nothing easy about it. My justification? Several physicians and my surgeon determined and documented medical necessity. That should be enough. So far everyone I have told has been very supportive. There will be no negativity allowed.

I wrote this post over the course of 4 days.  I hope it makes sense.

Goodbye Grumpy

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This is my Grumpy tank that has served as my sleepy-time garb for many a hot night over the past 15 years.  Bought this at Disney World when my little brother got married.  I love this shirt, but you know…it just doesn’t stay on. So it’s time to say goodbye to Grumpy. Maybe it will serve someone else just as well for another 15 years. Into the donate pile you go.

It’s complicated

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There are numerous Facebook “support” groups for weight loss surgery patients and they are full of people who have been given no rules, who are asking when they get to eat pizza again, and who are clearly not appreciating the benefits of surgery having gone through dramatic altering of their digestive system. You usually hear about these people ending up in the ER with dehydration or damage to their new delicate pouches or sleeves. I have had such smooth sailing in my recovery, I resolved myself to believe Rule Followers don’t get complications. 

But I changed my mind on that. 

One week ago from today I found myself in the ER doubled over with severe intestinal pain that started the day before. I couldn’t eat, I couldn’t drink — I knew something was wrong. I called my surgeon (note: call your surgeon, don’t consult Dr. Google) and she had me take my leftover pain meds overnight, but said I should go to the ER if it got worse. I spoke with her several times in the morning and decided the ER was my best bet. I went into the ER where they did blood tests and I got a bit of judginess from one of the nurses about “being talked into that procedure.”  I had heard stories of bias against weight loss surgery patients in the ER so I was dreading going in. I was seen really quickly, put on IV fluids and major pain meds. MAJOR. I had to do a contrast CT scan which required me to drink some nasty stuff over the course of 2-3 hours before they could do the tests. Morphine was wearing off in 2 hours so they bumped me up to dilaudid. It was crazy pain. 

About 6 hours later…a few hours after the CT scan, some nurse I hasn’t seen asked me if the surgeon had been in to see me. I was like “SURGEON???? WTF?”

My original nurse, Joaquin, who I thought was going to be a dick, turned out to be my biggest advocate. No one had come to tell me what was going on so he told me the CT scan revealed an internal hernia and twisting of intestines. They were trying to find a surgeon and I told him I only wanted my surgeon. He took all of her contact info and gave it to the ER docs and it took them another hour to figure it out, but my surgeon had them arrange for an ambulance to take me to her hospital for surgery. The general surgeon came in to talks to me in the ER and said he had done ONE gastric bypass in residency 10 years ago so they were happy to send me to her. I was pretty freaked out at this point but the pain meds were definitely taking the edge off. 

I got to the other hospital after a 40 minute ride with possibly the dumbest ambulance guy and was put in a room on the floor where they take care of bariatric patients. People who understand what was going on. My surgeon came to see me within the hour to tell me what she saw on the scan and told me I get a gold star for being her first patient to get one of these so early in my recovery. There were two cases in the ER before me, so my surgery was going to be at midnight. I was so out of it and in pain and thirsty  and going on 2 days of not eating I didn’t care. 

So out of surgery at 2:00 am Saturday, I find out I had a tiny piece of scar tissue that caused the spiraling of my intestines and all she needed to do was snip that and everything unraveled (hence the name of this blog). She explained that I had lost so much internal fat leaving spaces in the area where she did the bypass which allowed things to move around. She said she put in several permanent stitches to hold everything in place and I should be good to go. I could immediately tell that the pain I had been feeling was gone. Now I just had surgery pain. And I had to start over with my food progression. Liquids for a few days, then onto purées and then solids as tolerated. Still working on getting past puréed food a week later. 

I had to stay over night and had to meet all of the requirements to leave. 

  • Walking laps around the floor
  • Breathing exercises 10 x an hour (the anesthesia was a bitch and I still feel like I am catching my breath)
  • Drinking progressively more for several hours, 30 ml, 60, 90, 120. It’s hard to do but I wanted to go home. 

The nurses were awesome. I made sure to be extra nice and self sufficient so I could be their favorite patient. I even saw one of my favorite nurses from my surgery back in July. I’ve lost about 35 pounds so far and they were all so encouraging about how well I am doing. 

Anyhow…took the week off to recover and it is so much easier and faster than the original surgery. I’ve been doing some work from home so I know I will be ready to get back. 

So, I am a rule follower who had a fairly rare complication early on and I consider myself very lucky. 

Knocking on wood this is the last of it. 

Rules for Rule Followers

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I need rules. When I have rules, I can be successful. That’s a big part of why I chose the Roux-en-Y gastric bypass over other procedures. 

One of the rules for gastric bypass patients is that you cannot eat anything with processed sugar (pretty much anything sweet like a jar of Nutella, birthday cake, or the crap they bring to work on Fridays) or fried or fatty foods. Eating these foods can cause what is called Dumping Syndrome, which sounds horrifying without knowing what it is. Sweating, nausea,vomiting, cramping, etc. Sounds like fun — not! I liked that there is a consequence for doing bad things, but that also means I need to be careful of people who say, “just this once,” “just a little,” “in moderation.” I don’t need saboteurs. 

Here’s some more rules:

  • Protein first
  • Don’t drink at the same time as eating
  • Wait 30 minutes after drinking before eating
  • Meals should take 30 minutes to eat
  • Wait 30 minutes after eating before drinking again
  • No drinking with straws
  • No caffiene
  • No gum
  • No NSAIDs – ever!
  • No soda or anything with bubbles
  • No alcohol
  • No bread, rice, pasta and other obvious processed carbs
  • Goals every day are for 60-80 grams of protein from supplement every day
  • Minimum of 64 ounces of fluid
  • 3 meals a day 2 ounces or 1/4 cup each
  • Exercise 30-60 minutes 6 days a week
  • Bariatric formulated vitamins every day

It’s a lot of things to think about, and I am sure I am leaving something out. But it is structure. It is totally overwhelming the first few weeks because it’s so hard to do. My teeny tiny stomach holds about 2 ounces, so in the beginning when everything is still healing and swollen, it can take an hour to drink a protein shake. Everything took forever. Over time, all of 3 months so far, it’s become more of a routine and isn’t quite so overwhelming. 

But there is more. Since my surgery, I have never been hungry. Like ever. I can go for days without eating I have discovered (more on that later), so I have forgotten to eat. Especially since I went back to work. I set timers on my watch to remind me to eat and drink because there is no real physiological trigger. Apparently this goes away at some point, so I am trying to get the most out of this “honeymoon” phase. 

Other surprises since waking up from surgery:

  • I can’t tolerate anything sweet
  • I’m a spice wuss. I hope this gets better for sure. 
  • The thought, sight, or smell of chocolate completely nauseates me. This is the saddest one, but definitely is playing into my goals. 

These are rules for life. Forever. This is a giant lifestyle change. And worth every sacrifice.