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.”

 

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. 

151 Days

151 Days. That’s how long it took. For what? For me to really find out how much my stomach can hold. 

I’ve definitely felt full before — got that tight feeling in the middle of my chest, then stopped eating to let it pass. Some food goes down easier but some takes time. Might be a texture thing. Might be just the mood of my bicycleta (the South Park-inspired name for my pouch). My bicycleta was feeling angry I think. 

Last night I decided to make a big batch of roasted Brussels sprouts to have with leftover crockpot chicken that Mike made. We had the chicken Friday and it was awesome. Chicken thighs with fresh rosemary and thyme. Very tender. Didn’t anticipate any issues. 

I noticed that full feeling halfway through my leftover meal. Did half of the chicken first (protein first rule), then had a few Brussels sprouts. Felt immediately full. I stopped. Waiting for it to pass. I sat at the table making pained sounds for about 15 minutes while Mike made his dinner. It was hurting more and more. Waited some more. Decided to pack the rest into a container, then I realized just how big the portion was. I figured the Brussels would be okay…maybe they were denser than I thought. (Note to self: yes, you are good at ball parking portions, but stop that now!)

I set my 30 minute timer to wait before liquids, thinking I could make some peppermint tea and that would help. Skip ahead 45 minutes. As I went to make the tea, the felt a familiar feeling. I was sure I was going to hurl. I stood over the sink and that feeling passed. I went into the living room to watch TV and another 30 minutes later, I made a mad dash to the bathroom and threw up for the first time since surgery. It was scary because I don’t actually know where my stomach is and how that would work since it’s like a straight path through to the intestines. I’ll spare you the details, but it’s pretty much what you might expect. I definitely felt better afterwards. Came back to the living room and after a little while, I took a sip of tea and made the mad dash to the bathroom again and this time barely made it. The tea I drank came out first but I think I expelled whatever was causing my distress the 2nd time around. 

Not sure what the heck happened. Could be the reheated chicken had too much of a texture change, or the volume of food. One thing I know for sure is that I do not want that to happen again.

Today’s going to be a protein-yogurt-soup kind of day, just to give my bicycleta a break. 

Again, another example of me thinking something would never happen to me. Another lesson learned. Good times. 

The cat is out of the bag…

Well, I did it. I told my story on Facebook to my 500+ friends, some of whom I actually know, some just virtual acquaintances. The response was remarkably better than I expected. I know I was looking for support, but I als felt like if someone could learn something from what I am going through, I’d want to help them. 

This is the picture I shared, which is dramatic enough to begin with. 


And here is the post. 

Thanks to everyone for the overwhelmingly supportive comments on my new profile picture. I have written this post in my head a million times, and even needed to start a blog to figure out how to start. So I’ll just do this: on July 5, I had gastric bypass surgery. There’s a growing number of my friends and family that know, and with a couple of exceptions, the support has been amazing. Weight loss surgery patients commonly hear comments like, “you took the easy way out” or “couldn’t you just do it with diet and exercise?” Well let me tell you, nothing about this has been easy, and no — my body doesn’t understand diet and exercise. It was defending a weight and would do everything to stay there.  

Those of you who have known me for a while know that I have struggled with my weight for my whole life. In 2009, I did a medically supervised weight loss program and lost 75 pounds and was able to maintain a good chunk of that weight loss for about 5 years. Various medical issues like a pituitary tumor, sluggish thyroid, medications, stress, lack of sleep, depression and anxiety, and a range of metabolic issues made it an uphill battle to maintain, let alone lose. My metabolism is shut down. I was referred for weight loss surgery in November of last year, right before Thanksgiving. I was upset, embarrassed and felt like a failure.
I did months of research, stepped through a lot of hoops with the insurance company, and talked to friends who had the procedure and decided that this was the best option for me. I’m about 2/3 of the way to my goal, and it’s very slow, but that’s okay. It’s a huge lifestyle change and there’s a lot of rules. But hey — I am a rule follower. I’ve had great support from friends (and my bosses) at work. But you can read more about that on my blog, and follow the rest of my journey. Visit marilynunraveled.com.
The pictures here are from a trip to Mexico in 2008, 3 days before my surgery, and then today. It’s been a long road, and there’s more to go, but I invite you all along with me.

In addition to the supportive comments, I’ve also received a few private messages of encouragement and of thanks. People who were at a crossroads in their own journeys who may have needed a push. 

I feel a sense of relief now that this is out there. Since privacy settings in Facebook and Instagram are so unpredictable, more and more people were solving the mystery of why I eat 1/4 cup of food at a time. 

Feeling supported, grateful, and a little bit teary eyed. I have some amazing people in my life. 

Mirror, mirror…in the backyard

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I have spent many years avoiding mirrors. And even when I am not avoiding them, I’m not very kind to myself. So, we don’t have a full length mirror in our house.

As I get closer to my goal, I find myself doing a double take when I catch my reflection in a storefront or see myself in a full length mirror. I don’t recognize myself. That’s why I’m taking weekly pictures — it allows me to let my mind catch up with the changes that are happening with my body. So much of this journey is mental, and my mind is a trickster.

Yesterday, while out with the dogs in the backyard, I caught myself in the reflection of our woodshed and decided I needed a picture to see what I was really seeing. I still don’t think this is me.

Going mirror shopping today. I have to learn to like that person.

Dressing Room Drama

The last time I went shopping with my husband I cried in the dressing room because I had to go back to Plus sizes after being a size 14 for many years. It was heartbreaking and I felt like a failure.

I think that may have been the last time I tried on clothes as I resumed shopping plus sizes from Old Navy online.

Fast forward 2 years. Today, I went to the Gap for their Friends & Family 50% sale (code FFSALE if you are interest, through tomorrow).

I don’t know what kind of clothes I should wear. The don’t know how to shop. The whole thing stresses me out.

I picked up a couple of size S sweaters, waiting for some salesperson to give me the evil eye, then picked up a few pairs of size 10 pants. Anxiously in the dressing room, those pants just went right on. No crying at all!

Again, the sizes are a trip. I can wear anything across multiple sizes depending on who makes them. The LOFT makes me feel good with their vanity sizing.

Today, I felt like a normal person.

I asked Mike if I look like a normal sized person and he rolled his eyes and said “yes baby.”  Seriously. It’s a trip.

Now I have 3 pairs of pants I can wear to work without them falling down. Progress.

“Support” Group 

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! 

It’s complicated

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

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.