Pressing the reset button on life

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I am just over 2 weeks post-partial nephrectomy and starting to feel like a human again. I think getting back into a routine has been helpful. The past two months have been a blur full of so many emotions.

So let’s get the drama out of the way. I had my post-surgical appointment with my surgeon at UCSF on Monday (gosh, that was just a few days ago but feels like forever!). She walks in the exam room all smiles and hands me the pathology report and she says, “I have great news! It wasn’t cancer!” Imagine my dumbfounded look.  I have spent the last two months waiting to have a cancerous tumor removed from my kidney, so this was the best possible news, yet it’s still sinking in.  In my last post (almost a month ago), I mentioned that there was a 75% chance that my kidney mass was renal cell carcinoma, just like it said on my MRI report. Turns out after the pathology, it was something called an angiomyolipoma, which is a benign tumor made up of vascular, muscle, and fat cells. The short story is I didn’t have cancer, I don’t need to be monitored for cancer, and I’m basically done with anything over at UCSF!

I did, however, have a chunk of my kidney removed, so I still have a bit of recovery to do from that. No lifting anything more than 10 pounds until after September 3 (6 weeks post-surgery), so my workouts are on hold. The whole experience was a bit traumatic. The hospitalization was difficult. I was in so much pain, even for a few days after I was released, and then the pain meds made me dizzy and nauseous, so I discontinued those as soon as I could. I’ll spare the details but let me just say I no longer take the simple act of peeing for granted. Ugh.

So here’s the path forward: I’m still on leave from work for one more week but have been logging a few hours a day to catch up and figure out what I missed. I’ve been dealing with migraines for the last 10 days which has been a bitch, so I am off to my primary care doctor to see what’s up with that (since I’m out of my meds that I only get 12 of per month!). I have been working my way up to walking a couple of miles a day on the treadmill. I was so exhausted and realized I needed to push myself a bit to get my stamina back. It’s amazing how quickly you can lose it! I’m a bit out of sorts with food. Nothing has been sounding awesome and I’ve been slacking on food prep (I have an excuse, I think), so this week I will be doing some planning to get back into that routine too.

There’s so many lessons to come out of this ordeal. Believe me, I know how lucky I am and will never forget that. 

The master plan

I am the queen of the “stay tuned” post with no follow up. Of course maintaining 2 blogs, 3 Instagram accounts, 2 twitter accounts and Facebook may have something to do with it. I forget where I have made my updates. 

I feel like I have pulled myself together a bit. My consult in San Francisco definitely put my mind at ease to a certain extent. I loved the surgeon and her staff, I got my two pages of questions answered and I got scheduled for surgery. It’s next week. Yikes. 

Fun fact. I have beautiful kidneys. The surgeon pulled up my CT scan and walked us through the slices to show me where the mass was located. It’s on the top front of my right kidney. That’s when she remarked I had beautiful kidneys. It does not appear that the mass has gone into any of the collection systems of the kidney so it looks like it can be removed cleanly without impacting kidney function. Good news. 

They won’t be able to confirm Stage and grade until after surgery. At this point she says it’s a 75% chance it is clear cell renal cell carcinoma. There are a few other type of RCC and a few non-malignant things it could be but she feels pretty sure of what she will find. Hopefully the pathology comes back quickly. 

The plan is that she will do the surgery with the Da Vinci robot which will be minimally invasive and a faster healing time. I should be in the hospital for 2-3 days. However, since I have a history of adhesions from my 2 prior abdominal surgeries, there is a chance it may be an open surgery. I won’t know for sure until I wake up. Yikes. 

Knowing I will be at UCSF is a relief. That place just inspires confidence. And the services they offer are amazing. The consult I had with the oncology nutrition department was really interesting. That’s just a free service they provide that will be available to me now that I am a patient. The good news is I don’t have to change much. I eat really well in general and I have started the shift towards plant based. The dietician basically said she didn’t have a lot of suggestions of things to change and that I would be in great shape for recovery. She did offer a few suggestions. 

  • Go whole food plant based. So not necessarily 100% vegan, but reduce the amount of animal products and focus on non-processed whole food fruits and veggies and grains to the extent I can with the Bariatric diet. ✅
  • Reduce sodium. They recommend this for all their cancer patients but controlling blood pressure is important with compromised kidneys. My hope is I don’t lose any function with a partial nephrectomy, but I do have to take good care of them. I never ever ever want to be on dialysis.  My blood pressure pretty much runs low and with the lack of most processed food in my diet, I should be good. ✅
  • Add pre-biotic food and lots of veggies for probiotics. Gut health is still kind of a mystery to me too. Must do more research. She recommended additional flax seeds to my protein ✅ and adding food with live active cultures like fermented foods and yogurt. So kim chi, sauerkraut, kefir, yogurt, etc. And eat more cruciferous vegetables to the extent I can with my protein first rules and tiny tummy. ✅ She also recommended a probiotic called VSL#3. Need to research. May add that down the line. 
  • Keep the protein supplements going and stay at the high side of the 60-80 gram Bariatric requirement. ✅

It’s comforting to know I don’t have to change much and since it’s anticipated that surgery and removing the mass will be the cure for me with no follow-up treatment, life should continue as normal after I recover. They will follow me for 5 years which is typically the timeframe for recurrence. There’s a 5% recurrence rate based on what the surgeon told me — much better than the 80% I’ve read from the National Kidney Cancer association. Stupid Google. 

So it’s all good. I just want to put this surgery behind me. It’s going to be a long recovery. So I’m putting together my Netflix and Hulu playlists and nesting in the house. The worst of it will be over in a few weeks. 

Thursday we get to go down to SF for all of my pre-surgery tests and meeting with the anesthesia team. Those peeps need to be my friends. So another crack of dawn drive to the beautiful bay is in store in a couple days. Have I mentioned how amazing my husband is?

So there you go. Now I am off to make lists. 

The waiting is the hardest part

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Tomorrow is my consult with the urologic oncologist at UC San Francisco. I found out on June 6 I have kidney cancer, on June 7 that I was being referred to UCSF, and on June 19 that the appointment would be tomorrow. Waiting almost 3 weeks knowing you have an evil entity inside you is not fun. I’ve spent way too much time being angry about the wait, and even worse, looking up stuff on Google.

The good part of that is there is a lot of information, and much of it comes from authoritative sources. The bad part is I have some unique things in my health history that I have questions about and I’m just not going to find the answers online.

For example, the post-nephrectomy diet seems to be in direct conflict with the post-gastric bypass diet.  I have a consult with the UCSF nutritionist on 7/7, so I am sure I will get my questions answered, but am hoping I don’t have to do a lot to reconcile the differences with the nutritionist in my surgeon’s office. Some of the recommendations I have seen are really similar to the renal diet my dad was on with his dialysis. The irony of it all! It leaves me wondering what I can eat if I can’t have most of the things that are currently staples in my diet. Again…I just have to wait.

In the meantime, I have been making a move towards a more plant-based diet. I’d say 85% plant based.  Most nutrition recommendations I have seen lean towards an inflammatory diet, which is probably what all of us should be eating anyways. I’m sticking with my bariatric protein and following my doctor’s nutrition program.

My appetite has pretty much sucked but I have been eating enough to maintain at the low end of my goal range.  I lost 4 pounds that first week I found out, but that seems to have leveled off.

I worked from home all of last week, mostly due to the heat, and partially due to pain in my side which is either completely psychosomatic, a muscle strain, or stress.  I don’t know if my tumor is big enough to cause pain, but I guess I will find out that too.  I think the heat may have had something to do with it too.  I also took the week off of Kaia, as it just hurt too much.  My body was telling me to rest (which I did with plenty of naps!).

My plan is to get the whole story tomorrow, and then go from there.  My guess is it will take me some time to get scheduled for surgery, so I plan to go back to work to try to be a productive member of society and save my leave time.

I feel like today will be a long day but I am filling it with lovely things like laundry, journaling, meditation and some movement. And gratitude. I am so grateful to my friends and family who have been checking in and offering prayers and help.

Updates to follow…

Moving forward – an update

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I have a bit of an update. I am scheduled for a consult at UCSF next Monday. I’m glad to just have a date. I am completely nerding out about being sent to a facility that has modern technology: full access to my chart, all patient forms can be filled out online, I watch a 30 minute patient orientation video, and I have been sent probably over 200 pages of information to review before my appointment. I was also able to generate a list of questions for the doctor from another online app they referred me to. I have no doubt that the standard of care at UCSF is going to be beyond anything I’ve experienced so far.  Here’s hoping.

I plan to provide updates here from time to time and am still thinking about using Facebook groups to get info out to everyone (family and close friends).  Stay tuned as I work through all this…

Thanks to everyone for the overwhelming support so far.

Just call me #asskicker

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I am many things.

I am a rule follower.

I am a complete nerd.

I am a worrier.

I am a hard worker.

I am a wife.

I am a dog mom.

I am a sister, an auntie, and cousin.  And all the rest of those things.

I am a writer(ish).

I am a Kaia girl.

I am a gastric bypass patient, and therefore an obesity #asskicker.

Last week, I became something else when I learned that I have renal cell carcinoma.

I became a warrior cancer #asskicker.

Well, that all sounds super good and brave and kick ass, but the truth is I am terrified of what’s next.  And I am waiting to find out what that is.  I have been referred to the urologic oncology department at UC San Francisco and waiting to get scheduled.  And like Tom Petty says, the waiting is the hardest part.

So this blog started as my weight loss journey story, and I guess in a way, this is all part of the journey.  Had I not had gastric bypass, and my little complication in September, this would have never been caught. Or at least not until it was too late.  I am hopeful this was caught early enough that they can just remove it and I can move on. I have a bit of a rough road ahead but I am positive I will come out of this even stronger.

Meanwhile, if you see me crying in the corner, it’s nothing personal.

All denominational prayers are gladly accepted. I will be counting my blessings while waiting for the path forward.

Love to all.

And in the words of Syrio Forel (Game of Thrones), I say “Not Today.”

 

Practicing self-care through grief

One of the drivers for my recent lifestyle transformation journey was the death of my father on June 9, 2015. The minute the calendar changed to June, all of the feelings came rushing back. I’m in a funk. 

There’s nothing like facing some scary medical stuff that makes you realize your parents are gone. I think it’s an innate thing to want your mommy when you are sick. And since my mom has been gone almost 17 years (wow), I’ve instinctively always called my dad when I needed support. 

I’ve been thinking about him a lot lately, and what it would be like if I had known then what I know now. 

Self-care is something I did not understand until after my dad passed. I always put everyone’s needs in front of my own and I did not take care of myself. The last six months of my dad’s life, he was in and out of the ICU, I took weeks off from work at a time, and I completely fell apart. My nutrition was the worst ever. I have no idea what I ate during that time and I felt like crap. Comfort foods I imagine. I had major anxiety and couldn’t be around people.

I was constantly taking care of something whether it was medical appointments, grocery shopping, emergency room visits, wrangling caregivers, fielding complaints about him from his assisted living facility. Uh. Non-stop. 

After he died, I struggled with severe depression and anxiety. I was just not myself. I was stuck. It wasn’t until I was referred initially for weight loss surgery that I started researching life after surgery and the some of the methods for dealing with some of the emotional sides of this process. 

Journaling became a great outlet for all of these feelings and keeping a daily gratitude journal really helped to turn things around.  I have talked about all of my tactics for maintaining positivity. I am taking time this weekend to breakout that list and take care of myself through these next few weeks. I have more medical tests, doctors appointments and an ortho consult on the horizon. And I can’t call my mommy, but thankfully my brothers entertain me on the group text we have had going since June 2015.  

Peace and Love. 

Listening to Sgt. Pepper’s Lonely Hearts Club Band, which like me, is 50. 🎵🎶

How do you feel now?

I am loving how the IIN Integrative Nutrition Health Coach program aligns perfectly with my own personal journey. I would imagine that’s the case for a lot of people. So many of the exercises and assignments are introspective and focused around personal goals and intentions, as you’ve heard. 

This week, there was a section called Simple Ways to Optimize Your Life. So many of them have become ingrained in my life already since I started making changes around this time last year in anticipation of my gastric bypass surgery. My gratitude practice is likely the one that has made the most impact. For this program, I have increased my daily gratitude acknowledgments from 3 to 5. And I’ve begun to articulate them to others, as well as in my journal. I have been particularly grateful to the coaches at Kaia Fit for helping me stay active and making modifications to workouts for my current knee situation. Just spent 20 minutes in a magnetic tube today and hope to have some answers soon about next steps for my knee. I am so fortunate to have people who look out for me. 

Another part of this section has to do with being in tune to how your body feels after eating a certain way or specific foods. This is something that came up in our weight loss surgery support group a few months back, aiming to help people connect with their emotional attachments to food. 

I feel like I have worked through my emotional eating issues since my primary cause of emotional eating was triggered by my dad. I have come to terms with so much of that since he passed, coming up on 2 years as of June 9. Heavy sigh. The fact that my appetite and cravings have been well controlled with gastric bypass is a big part of having this urge under control. But I have also practiced mindfulness in this area too. I took to heart the instructions about focusing on the taste and texture of food and listening to fullness signals after my surgery. I really do try to focus when I am eating. I enjoy my food and don’t pick anything that is just okay since I get so little of it. 

This week I have two things going on. One, I am experimenting with going more plant based in my diet. I have met some very passionate vegans who have been very helpful in identifying plant based sources of protein. I need to find a way to ensure I am absorbing sufficient nutrients because of my altered digestive system. I even asked my surgeon about it. I’m curious in general because there’s very little literature about vegan RNY patients and if I plan to be a health coach for WLS patients, I feel like I need more data. My surgeon said there is a medical grade plant based protein made by Unjury, but since the vegan diet is missing several essential amino acids, supplementation is also required in addition. 

I have been doing research about the inflammation caused by dairy and animal products and am seriously thinking I need to make some changes to see if they help with my arthritis and digestion in general.

So I signed up for Peel’d this week at Kaia, and will get soups, salads, juices, smoothies and quinoa bowls for next week. I will need to add whey protein shakes on top of that to get my recommended supplementation in, but otherwise will be trying to stick to plant based all week. I’ll be journaling throughout the process to document how I am feeling, whether inflammation and bloat are decreased, and my overall energy levels. It’s a great experiment and it ties in with my school assignments. I’ll be adding tempeh, fruits and veggies if I get too hungry. 

I am really starting to believe in the body’s capacity to heal itself if given the chance and using food as medicine. What better way to learn than through your own experience. 

So stay tuned for my food and mood report. 

The Good Life

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I just completed the first module of my first week as a student in the Health Coach Training Program through Institute for Integrative Nutrition. I have to confess the whole thing is quite intimidating. There are people from all over the world, many of whom already have their own businesses up and running with perfect blogs and Instagram accounts, and clever names, and videos of them cooking perfect food in their perfect kitchen. Quite honestly, our 1974 Harvest Gold electric stove top has one working burner (yes, getting a new stove is on a really long list of things we need to do). Frequently heard in the kitchen, “Are you going to be using the burner, or can I?” Makes for some fun collaborative dinners.

This week’s assignments included working on a mind map for our big goal and an intention statement. The good thing is that I know that this program will help me refine my intention paragraph to be a bit more concise and focused, but I already know my niche – to work with other bariatric surgery patients to help support them on their journeys by sharing my experiences and knowledge. I hope to one day be able to articulately talk about so many of the concepts we’re learning.  It’s week one. I am cutting myself some slack.

One of the exercises was to find a creative outlet to document the school journey and to help process the new information we’re learning.  Hence, blog. I also have my journal, planner, and a variety of notebooks for my lists and notes and random finds.

I’ve found one person who is also interested in working with bariatric patients, and one who had a gastric bypass as well, so it’s great to be among people who know and understand and don’t judge.

Side note: I am ruminating on the power of intention this week and the law of attraction.

  1. Create daily affirmations for what you desire.
  2. Feel the emotion of having already received it.
  3. Let go and trust the universe will deliver.

There it is. Right there. I’m digging in and the universe will deliver its abundance.

I know that I am starting to say things like this and people are looking at me like I am some kind of hippy freak. But really, positivity attracts positivity. It’s true. My life has improved so dramatically with the changes I am making.

Another exercise was to think of words and feelings associated with my intentions.

The last one was to great a Good Life Jar. This entails making a list of the things that I think make a good life. So far my list includes loving, learning, relaxing, connecting, moving, and listening. Each week I will create an activity associated with each of these words so I can actively experience each one. I think this will be a fun thing to do on a weekly basis, just to stay connected to how good this life really is.

The goal is to coach myself this year. Make myself the best Marilyn, no matter how unraveled I become. The more I put into it, the more rewarding it will be.

I have embraced

The next time someone in my weight loss surgery support groups mentions how much they hate their loose skin, or their bat wings, or deflated boobs, I am going to tell them to watch the documentary Embrace

Watch the trailer here:

We have to learn to be more forgiving of our imperfections. Yes, embrace them. 

New Goal: Happy and Healthy

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I have been overweight for a long, long time. Actually since I was 11, I have been aware of my weight, on some kind of diet, with various results, only to gain it back. Bariatric surgery has changed that. I’ve been spending the last five months frustrated with being in a stall, holding fast at 135-138 since January. This week following a visit with my surgeon, we decided I’ve arrived.  I’m a good healthy weight, and with all of the exercise I have done with Kaia Fit and weight lifting, I’ve put on a good amount of muscle.  So, while my BMI of 27 still says I am overweight, I’m comfortable enough in my skin to say Fuck You, BMI!

So, I have declared my goal weight 136 and will work to maintain within a 2 pound range of that for now.

So the mindset of not trying to lose weight is completely different than how I have spent the last 40 years. Logically in my head, I know that being at goal for a bariatric patient doesn’t really mean that much. I am pretty much going to eat the same way the rest of my life. My target calories are 1000-1100, 50 grams of carbs, and 80-120 gm of protein with plenty of healthy fats. But now it’s going to get interesting. Let the games begin.

I am starting my program at Institute for Integrative Nutrition next Monday, so I have been immersing myself in learning more about how important nutrition is to overall health and about eliminating (or crowding out) toxins from my life.

This weekend I was also lucky enough to go on a tour of Nugget Market in Woodland with my Kaia Fit group. Nugget has an amazing selection of organic produce and specialty foods, so they walked us through the store pointing out where all of the ingredients for most of our cookbook recipes are.  It was awesome! We got a lot of samples and gifty type stuff to take away.

So I am learning about superfoods (and there’s so much more to learn).

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This morning I made a chia pudding with the Spectrum Warrior Vitality mix of chia seeds, maca, and cacao nibs. I mixed some pumpkin pie spice protein powder with almond milk and 2 tablespoons of this amazing stuff.  It was way more filling than my normal breakfasts and full of fiber and protein too.

I also decided to more or less follow the Kaia detox week plan of having smoothies, soups and salads this week.  I’ve been having a bit of stomach pain the past few weeks, which may be gastritis, so I’m taking carafate and omeprazole to get this under control, but also backing off on the crunchy raw vegetables for a while.  I had been adding raw red cabbage and shredded carrots to my kale salads and I think that may have been a bit much for my tiny tummy to handle. So I will be doing my green smoothies before Kaia (supergreens, almond milk, maca to replace flax I was using, frozen blueberries and protein powder), soup for lunch, and salads for dinner.  Kaia’s recipes are pretty much vegan so I will be supplementing my protein with protein powder or eggs, chicken, and string cheese. I also got some sauerkraut, which while raw, is a probiotic and should be good for gut health. I am pairing those with chicken sausages for dinners too. I’m not quite ready to go vegan, mostly because I worry about getting the protein I need from food sources and keeping my carbs low, but I am adding in some vegan foods like tempeh for some variety.

I made this Curried Cauliflower Stew out of the Kaia cookbook, which should serve 4, but for me will be 12 servings. I used all organic ingredients, and it was vegan until I added some chicken stock to thin it out a bit. I actually decided to hit it with the immersion blender which made it like a chunky puree (not photogenic, but very tasty). The carb content on this is pretty high, so the serving size is 1/2 cup, but that’s perfect for my pouch. I’m going to pair with eggs and chicken this week. I will probably end up freezing half of this since I don’t think there’s any way I can get through all of it.

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So I’m looking forward to this new life of maintenances and wrapping my head around that whole concept.  In the meantime, working towards happy and healthy, getting my stomach pain under control, and eating some nutritious and delicious detox food this week.