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…

Feeling Bloggy

 

I got called out on Instagram for my lack of blogginess. So today, I feel bloggy. There’s currently a photo challenge for the month of February and I’ve been focused on doing daily posts. My life has been occupied with working out, sleeping, working, planning meals, focusing on good things — I guess I just wasn’t feeling the urge.

I am totally in. This should be fun! #Repost @mrmuleman with @repostapp ・・・ Mondays could use all the added umpf they can get, so I'm releasing the preview of this year's @MrMuleMan's #WLSFeb17PhotoChallenge today. Mark your calendars, repost, tag your friends, and spread the word. The idea is the same as last year's challenge, to share ideas, tips, strategies, questions and answers about topics related to weight loss transformation, getting healthy, weight loss surgery, and fitness in general. You do not have to have already had WLS to participate, this challenge is open to anyone interested in slimming down and getting healthier. Just post something on each daily topic, and don't forget to use the #WLSFeb17PhotoChallenge tag. New this year will be a prize pack that will go to one lucky winner, filled with snacks and health & fitness items. Look for the rules post to see how to get entered. Questions? Contact @MrMuleMan Start planning your posts and let's see how huge we can grow this challenge this year! #Wls #weightloss #weightlosssurgery #wlscommunity #vsg #vsgbro #gastricsleeve #rny #gastricbypass #weightlossmotivation #weightlosstransformation #weightlossinspiration #changeyourlife #fitnessrevolution #wlsrunner #gethealthy #getfit #wlsphotochallenge

A post shared by Marilyn (@marilyn_unraveled) on

So there it is — check out my account to see my take on the theme of the day.

The one for today that I wanted to post, but then didn’t is here. The theme was skin. The truth is that I am not that upset about loose skin. I don’t have it that bad, but it’s still a trip.  The wrinkly bunched up skin shows up most when I am doing push-up.  It hangs forward on my arms. It hangs from my stomach and back, and my thighs. I’ve said it before – it’s like a badge of honor. My skin has been along with me on this journey from beginning to end.

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My entry for Day 10 of the #WLSFeb2017PhotoChallenge: Skin

So what else?

I just finished a 6-week long session of Kaia Fit.  It’s interesting that my weight loss completely stopped since I started working out fairly intensely, but my body composition is changing and I’m certainly getting more compact, not matter how slowly that’s happening.

I think people are noticing the changes more than I am. I’ve had people tell me I don’t need to lose anymore, or ask me what my secret is.  For the most part I have been pretty open about my surgery, but I don’t really share with people I am not that close to. I know a lot of people in my support groups on Facebook are extraordinarily private. I was too, in the beginning. This week must just be the one where everyone decided to complement me.  Maybe it’s all of my new super cute LulaRoe clothes.  Have I mentioned that? I have become a LulaRoe addict. I have a few pix posted over on Instagram of some of my new things. I am trying to figure out what my style is — outside of jeans and sweatshirts which is what you will typically find me on on the weekends.  It’s been fun dressing up a little more, even though I don’t have to.

I somehow think that my focus on being positive is somehow making me more approachable where people will say something to me. Whatever it is, I like it! I’m making new friends through Kaia Fit, I feel more social and all of this is good since I lowered all of my anti-anxiety and anti-depressant meds.

While it seems like my little life is perfect, it’s a constant struggle. I have to work hard to keep my head in this place. I have to fight the negative self-talk and self-doubt. I have to live day to day and not focus on weight as a number or the fact that the scale isn’t moving. I actually think I am done losing weight. Or maybe my body wants to just sit here for a while until it realizes that we haven’t entered an apocalyptic ice age and it needs to store every calorie.  I still know my metabolism is moving at snail’s pace, meaning every calorie I take in needs to be of the highest quality. I still can only eat about 1/2 cup at a time, and I need really good protein to keep me feeling full and to fuel my muscles from all of these workouts.  I don’t really have the desire to eat crap, but since my intake is so low, it has to feel worthwhile.

I don’t want to be that person who starts a blog to talk about their weight loss surgery journey and then stops.  Those were all the blogs I was finding while I was researching surgery.  I wanted to know more about how life was post surgery. I guess what it will be is…well, life. We’ll see! I’m enjoying the ride!

And Kellye — I am open to topics. Maybe like the photo challenge I need some blog prompts! Keep me honest!

 

Tales from the NUT

It drives me nuts that all my of my weight loss surgery forums use abbreviations. I’m still a little old school that way. When texting became a thing and people were substituting 2 for “to” and 4 for “for” and U for “you” — it was a pet peeve. So of course now I start doing it. 

NUT = nutritionist

WLS = weight loss surgery

RNY = roux en y (gastric bypass)

NSV = non-scale victory

There’s a bunch of others, but I digress. Back to the NUT. 

In my last post I talked about going to see the nutritionist and going to support group. Apparently support group is cancelled for November and December, honestly the time where patients probably need it most! And that was one of the things on my mind for my visit. How the heck do you do Thanksgiving?

Here’s what I got out of my visit:

  • I talked about my new found hunger and tracking that I am more hungry on running days. Found out I could have increased my portions to 1/2 cup a while ago. And I can have snacks if I am hungry. See…rulefollower strikes again! The book says do not advance past 1/4 cup until being directed to do so. And it also says 1/4 cup should satisfy you up to six months without snacking. So I didn’t snack. 
  • Thanksgiving. It’s basically the same rules. Protein first, then vegetable. My plan is turkey and Brussels sprouts. That should be fine. And I might bring a sugar free desert (pumpkin cheesecake or crustless pumpkin pie). I am NOT a baker so I may need to call in my wonderful husband for help. Growing up with a diabetic mom pretty much guarantees not learning how to bake for realz. 
  • I talked about my goal weight. I am still shooting for 120 but I told her I want to see what that looks like. I don’t want to look sickly. And I don’t want to set something I won’t be able to maintain. It’s not that far out of reach and it blows my mind. 

So…I left there knowing I could eat more food and I could eat more often if needed. 

And you know what happened?

This did! The next chapter: 130s.

Pardon the lack of pedicure. Since I added more food, I’ve budged the scale. 

The other thing is that now that I know I can have more food, I am less hungry. There really is an off-switch with a tiny stomach. You just have to listen to it. 

We are expecting that goal for me will happen around February at this rate. I am doing about a pound or so a week most weeks. 

Next month I get my vitamin levels checked and in January I get to see the doctor again for my 6 month visit. 

So there you have it…tales from the NUT.