Five-Month Surgiversary

Whoa, Nelly - I am a slacker when it comes to updating this blog. I have been spending the last few months adjusting to my new lifestyle. The last time I checked in I weighed 265 lbs and I am happy to report that I am now around 225-227 lbs. The weight loss has slowed down, but it hasn't stopped and that's what matters. I am able to eat 800-1,000 calories a day which is the goal for now. 
I still suck at not drinking before, during and after meals...but I am getting better at it. I am finding that I don't have much restriction to what I can and can't eat, though I don't push the limits either. I don't test the limits on sugar and therefore, I have not experienced the dread dumping syndrome as of yet. 
I did walk my first 5k this past April. My parents joined me and it was so much fun!!! I hope to do many more and maybe someday, actually be able to run the 5k. I started using the "Couch to 5k" app at the gym and I was able to complete the first week on the treadmill. Now that it's nicer out, I am going to work on this outside...I tried to do it today and ugh, I sucked. Running outside, way harder than on a treadmill. However, it's a work in progress. 

My mom, me and my dad before the race

Dad, mom and I after the race - woot woot, we did it! And we weren't last!

Photo Credit: MLive.com, Jeff Schrier

Also, more exciting news - Bob graduated from nursing school!!! He was working towards this for 5 years, so it's a huge relief for both of us that he is done. Now he is just waiting to take his boards and find a job in his new career. Life is good, friends, life is good.

Statistics:

Surgery 12/8/2015

Highest weight (HW): 310 lbs

Surgery Weight (SW): 290 lbs

Current Weight (CW): 227.8 lbs

Goal Weight (GW): 175 lbs (first goal)

Post-Op: Week 5 update

Well, it's been 5 weeks since I had the gastric bypass surgery. As I have stated before, it has truly been a learning experience. When the dietician tells you before surgery that it will be hard to get in 60 grams of protein AND 64 ounces of water, she wasn't lying. However, when you stomach is a giant stretched out football, the prospect of eating protein and drinking water doesn't seem all that difficult because your able to fit in 60 grams of protein, 64 ounces of water and other greasy, sugary foods as well.
After surgery, however, this is a tough task. I am lucky to get in the protein and water. I feel uncomfortably full after about 1/4-1/2 cup of food. And water, I can only sip, which means I have to sip all day long. Plus, the biggest struggle -  I have to stop drinking 30-60 minutes before meals and 30-60 after meals.
The struggle is real. 
I think what has been the most amazing thing is how much I can eat. Or how little, rather...It's very different because my head still wants to finish that meal. When I feel full I have little "tells"...I either get chest pain, hiccup or my nose starts to run. If one of these 3 things happens, I have to tell myself to stop. Otherwise, food can get stuck. I also have to chew everything into a paste consistency...or food will get stuck. I also have to eat SLOW. I have had a couple of meals now, where I ate too fast and it caused extreme discomfort and I threw up. 
Below, are some examples of how much I can eat...before surgery, I could eat everything on my plate and then some. 

PROTEIN FIRST!

I have not had caffeine or sweets since November 28th. I have not had any fast food in weeks. The control I feel right now feels good, and I hope as I continue on this journey, that I remember this feeling.

Back to work next week and time to start exercising!

Statistics:

Surgery 12/8/2015

Highest weight (HW): 310 lbs

Surgery Weight (SW): 290 lbs

Current Weight (CW): 265.5 lbs

Goal Weight (GW): 175 lbs (first goal)

post-op life

Well, it's been about 3 weeks since the big surgery. The first couple of weeks, I was feeling pretty sore, especially on my left side. Bending and twisting has been especially difficult. My biggest battle is getting my 60 grams of protein in. It is very difficult because I am soooooo full after one shake, which is only 30 grams. This has definitely been an interesting experience. It is very exciting to be given a second chance at eating. It sounds weird to say but it really is a second chance. You have to relearn how to eat and learn how to look at food differently than you did before. It's very exciting, yet very challenging. Some foods sit absolutely fine, some foods make me nauseated and some foods run straight through - if you catch my drift. There are some days when a fart can NOT be trusted. 
My only real set-backs have been some muscle strains and pain. I have pushed some limits too soon and I think I might have torn or strained some of my abdominal muscles. Even actions like sneezing or coughing, cause severe pain and burning under some of my incisions. 
The month of December has been busy and overwhelming at times. The week after my surgery, Bob had his final exams and completed his second to last nursing school semester - only one more to go! The next week, his dad was admitted and we found out that he would need to have open heart surgery after the first of the year. Needless to say, we are ending a busy and decent year on a sour note. Luckily, his dad was able to come home for the holidays and has been doing well. 
More updates soon...

Tomorrow's the big day...

I haven't updated recently and it's because life has been hectic. I am working on finishing my master's degree, so that has kept me pretty busy along with work and getting ready for surgery...which is tomorrow!
Yikes.
I have been on an a pre-op diet since Saturday, 11/28. So yes, I was able to eat a delicious Thanksgiving dinner before the horrible pre-op diet. The diet consists of:
Days 1-5:  A protein shake for breakfast, lunch and dinner Up to 3 servings of 1/2 cup cottage cheese or 8 oz fat free yogurt 1 serving of 1 cup of vegetables (non-starchy) Unlimited clear broths, sugar free jello and popsicles
Days 6-10: All of the above EXCEPT the cottage cheese, yogurt and vegetable
I have lost 22 lbs in 10 days. Whoa.

Surprisingly though, I feel good. My energy level has not really decreased. I didn't experience any dizziness. And I read a lot of discussion boards and Facebook pages and found that sooooo many people cheat on their pre-op diet. I can happily say that I did not cheat once. I stayed true to the diet and I am very proud to say that. 

So, tomorrow at 5:45 am I have to check into the hospital for surgery, which should take place at 8am.  I am very nervous, but I am trying to stay optimistic and calm. Obviously, since it is almost 10 pm and I have to be up at 5am, I can't sleep- which means I am too nervous to sleep. But this is a big step...I am making the decision to be a healthier me. A decision I really never thought I would make; that decision being having weight loss surgery. I am excited for this journey though.

I will try to post as this process continues on. School will be OVER this week and I can't wait! I will have so much more time to do things that I want to do. 

Update

Yikes. It's been a hot minute since I updated. 
Back in September, I had my EGD, which is a scope that went down my esophagus and looked at my stomach. This is a standard test prior to having gastric bypass. The surgeon looked for ulcers, strictures or any other problems that he wouldn't want to encounter during surgery. Fortunately, the test went well and everything came back normal. I had some mild inflammation, which he said isn't a huge deal.
The final two tests included an EKG and a chest x-ray, which are done. I have my 6-month appointment with the surgeon next Tuesday and then all the paperwork can be submitted to insurance for approval. Once approved, I will have a surgery date. He said we can definitely get this done by the end of the year - eeeeeek! I am nervous and excited. What a crazy ride this has been so far...I can't imagine what the next phase will be like. I will keep you all posted...
And no, I haven't started drinking diet coke again. But I do still miss it.

An education on vitamins...a vita-cation.

At my last appointment with my dietician we discussed vitamins. After weight loss surgery, patients must commit to taking vitamin and mineral supplements for the rest of their lives or unwanted complications could occur. Patients who have these surgeries eat less food and consume fewer calories, therefore the body gets few nutrients. This is especially true for patients who have had the gastric bypass (Roux-en-Y) which is the procedure that I am looking into. 
My current vitamin regime includes: 2 chewable multivitamins 1000 mg Calcium 4000 IU Vitamin D 5000 mcg Biotin 50,000 IU Vitamin A
These vitamins were recommended by my surgeon after I had all of my labs drawn and deficiencies were noted in Vitamin D & A, which isn't able normal for those of us who live in Michigan. Almost all Michiganders are Vitamin D deficient. Anyways, my typical dosing included taking all the vitamins with breakfast. At my appointment, I learned that this is not the correct method of taking vitamins. 

First, all multivitamins (MVI) have iron. Calcium can not be taken with multivitamins because the iron won't all the calcium to absorb. MVI's and Calcium supplements should be taken at least 2 hours apart. Also, the calcium and vitamin D supplements should be divided because the body can only absorb so much at a time. Therefore, my new vitamin regime is:
Breakfast Calcium 500 mg (1/2 dose) Vitamin D 2000 IU (1/2 dose) Biotin 5000 mcg
Lunch Multivitamin
Dinner Calcium 500 mg (2nd 1/2 dose) Vitamin D 2000 IU (2nd 1/2 dose) Vitamin A 50,000 IU
My next challenge is to find all of these vitamins in a chewable form - not gummy, but chewable. Liquid form is okay to. Any suggestions? My first stop will likely be the Vitamin Shoppe.  At my appointment, I learned that I have lost around 7 lbs since this process started. My highest weight (HW) was 310 lbs. I am currently 303.2 lb. However, this was before we ate a ton of food at the Grand Hotel. I am still off Diet Coke however, which is a huge accomplishment. Over a month and going strong. 

The psych evaluation that almost made me crazy.

Yesterday I went for my psychological evaluation, which is required by my insurance company for approval for weight loss surgery. I promise I'm not crazy. At least, I don't think I am...
Anyways, the experience was sub-par to say the least. First, I called to set this appointment up back in June when I first learned that it was a requirement. I gave my information to the receptionist over the phone and was told that the doctor would call me to set up the appointment. Weeks later, I still had heard nothing. So, I called back. I was told that they were still working on figuring out my insurance and what would be due the day of the appointment. A day or so later, I received a phone call because they lost all the information that I had given them over the phone previously.
I should have taken this as a sign of things to come.
Finally, they called me and told me that I hadn't met my deductible for the year, so the appointment would cost me around $250. I was told that I had to pay that amount the day of the appointment or they wouldn't send the report to my surgeon. Ok, fair enough. The psychologist finally calls me and we set an appointment for July 29th.
Since I work Monday through Friday, I made the appointment during my lunch hour yesterday. I leave and go to the appointment. I check in at the front desk and the receptionist tells me she has no record that I have an appointment. After shuffling the same papers about 15 times, she tells me the appointment is scheduled in the computer for September 29th. Uhm...no, it was CLEARLY scheduled for July, as I have to have this done ASAP. So, she gives me paperwork to fill out and has me sit down. Twenty minutes later, I walk back up to find out what I am supposed to do (I'm pretty sure she forgot I was even there) - stay or make an appointment for a different day. She calls the doctor and tells me "Yep, you're appointment is for today." Yeah, no crap.
I go back to be interviewed by the psychologist. This takes about 20 minutes. She asks me the usual questions about my support system, why I decided to have surgery, what my ultimate goal and expectations are following surgery, what changes I have made to get ready for my new lifestyle, and questions related to my overall mental health. That was easy...I think I am done at this point, which would have been perfect because I had to get back to work.
I was dead wrong. She tells me I now have to take a test. It is a true and false test. You read statements and you put if the statement is true for you or false. Easy peasy, right? NOT. It was 567 questions. Yeah...FIVE HUNDRED AND FREAKING SIXTY-SEVEN true or false statements. This took FOREVER. The actual name for this is the Minnesota Multiphase Personality Inventory (MMPI) Test. It s a psychological test that assesses personality traits and psychopathology. It is primarily intended to test people who are suspected of having mental health or other clinical issues...or I am hoping to rule out mental health disorders. 
I am a little nervous. Some questions were weird...like "I am not frightened by blood or the thought of bleeding"...well, this is true. I'm an ER nurse so...blood doesn't bother me. But on this test, I am likely to come across as a psychopath. Plus, by the end or somewhere around question 275, I was losing interest quickly and probably didn't answer accurately. I guess we will see if I turn out to be schizophrenic or something.

So anyways, after I fill out this ridiculously LONG test, I go to check out. The lady says they will send me a bill, which contradicts everything I was told before. So, I tell her what I was told about needing to pay today so the report can be sent to my surgeon. She blinks at me for what seems like forever and calls someone. She tells me I owe $450. $450 to fill out 567 true/false statements? NOT happening. After arguing for a few minutes she tells me they will look into it and call me. I tell her they better send that report over to my surgeon ASAP, since they have been yanking me around all afternoon.
If this is what the mental health system is like, then I am not surprised people are nuts. 
End Psych Eval.  And another hoop jumpeth through.

Sweet treats...

I want something sweet. I think specifically, I am craving ice cream or cake or something of that nature. My dietician told me that every time I have a craving I need to stop and consider where I am and what my triggers are. Well, I am sitting in my family room watching TV. What is the trigger? I don't have any idea. I am on my period, during which I often crave sweets. We ate dinner so I shouldn't be hungry...but inside, I feel hungry. I could eat a whole other meal. Why do I have these cravings? Why is my appetite never satisfied? It is a very frustrating feeling.
I wish I didn't have cravings. I wish that I go one day without wanting to fill my body with crap that isn't good for me. This process is so incredibly hard. I know that everything that I go through will be worth it in the end. I want to be able to walk short distances without getting winded. I want to be able to cross my legs. I want to be able to reach my toes so I can paint them. I want to be able to run...to ride my bike long distances. I want to be able to go to a restaurant and not have to scope out the size of the booths to make sure I can fit. I need to keep reminding myself of these reasons, because these are the reasons that I am not running out to get ice cream. These are the reason that I am not drinking Diet Coke. These are the reasons that I need to remember.

still, no more diet coke.

It has been almost 2 weeks since I have had a Diet Coke. I haven't had any carbonated drinks actually, which is a complete change for me. My drinks have consisted of water, coffee (when I have a caffeine withdrawal headache coming on) and lemonade. Eventually, the lemonade will have to go as well because of the sugar content, however I need something to get me through the first little bit of my post-Diet Coke life.  Oh, what I wouldn't give to have a drink of something carbonated. I'm not sure why. Is it because I am used to have a carbonated beverage every day? I don't know, but I know the cravings come and go. I am sick of water. Why is it we need food and water for survival, but yet it becomes such a big part of our lives? Social events all include drinks and food. Anyways, I am rambling. My next series of pre-op hoops have been set up. My psychological evaluation is July 29th, my second dietician appointment is August 6, my EGD is set-up for September 4th and my September surgeon appointment is September 16th. October will be the official 6th month mark and after I have an appointment that month all the paperwork can be submitted to the insurance company. This process is actually going by pretty quickly. Also, in August my husband and I will have a fun weekend away - I can't wait! Lots of things to look forward too.

Dear Diet Coke...

Dear Diet Coke: I will miss you.
Today was day one of my diet coke cleanse. I can not lie...this is difficult. However, it has to be done. Not drinking Diet Coke will be my biggest challenge and therefore, is going to be the first one. It can only get easier...right?
Symptoms: headache, neck ache and overall I am feeling tired and run down. I also find that I am craving sweets, which could just be a coping mechanism. None the less, the craving is there.
I have tried other forms of caffeine, however it isn't helping curb the headaches. I think all that will help is time and avoiding drinking any pop.

The holiday and the dietician

I hope everyone had a great 4th of July weekend - I know I did!! I got to spend quality time with my family and enjoy the great outdoors. It has been a few years since I was able to spend time in the lake - since the weather has been so cold, it hasn't warmed up enough. This year we were finally able to enjoy it again!

Anyways, before I ventured up north for the weekend I met with my dietician for the first time. It was very enlightening. The appointment started with her asking me quite a few questions, which led to me having to say all of my bad habits out loud in a matter of 10 minutes. Talk about a stomach punch.
However, this is a very necessary part of the process. I have bad habits, which has led to me being overweight. I am a snacker. I eat too much fast food. I don't stop eating when I am full. Plus many more. It was an overall great appointment, I learned quite a bit. Some tips she shared with me included:
1. Only eat at a table. Even if it is a snack. If you aren't hungry enough, you likely won't eat at the table unless it is time for a meal.
2. Avoid routes on the way home that take you by fast food places so you will be less tempted.
3. Stop eating when you are full. It takes 20 minutes for your brain to catch up to your stomach.
She also set nutritional goals for me to start working on now, which will overall help when I have surgery:
1. Eat 3 meals per day and eliminate snacks 2. 64 ounces of water each day 3. Remove beverages from meals 4. Eat 60 grams of protein per day 5. Keep a food diary 6. Use measuring cups and spoons 7. Remove trigger foods from home 8. Exercise plan: 3-4 times per week 20-30 minutes 9. Avoid pop and juices
So, my first goal is to cut out pop completely. My second is to clean out my kitchen and start meal planning every Sunday. I meet with the surgeon again tomorrow. Stay tuned...

Decisions, decisions...

Well, as you read in my previous entry I have decided to have weight loss surgery. Which procedure has yet to be determined. The surgeon I have decided to work with provides three options:
1. Lap Band - which I do NOT want. I have been witness to way too many complications as a nurse in the ER. I don't like that a foreign object is wrapped around my stomach, which in a lot of cases, ends up eroded into the stomach tissue. Plus, the success rates for this surgery are very slim and most insurance companies will not cover the costs of your band revisions. So...take this one right off the list!
2. Gastric sleeve - Otherwise known as the laparoscopic vertical sleeve gastrectomy. This is the surgery I was the most sold on until I went to the bariatric seminar and have research more. This surgery involves permanently removing 75% of the stomach, which limits the amount of food you can eat and helps you feel full sooner. This is becoming the gold standard and has increased in popularity. The problem I am finding is that most patients complain of severe gastric reflux and the long-term results are not as good as the bypass. Quite a few patients re-stretch their stomach and can back the weight- which can happen with the bypass, but not as easily.
3. Roux-en-Y - Otherwise known as gastric bypass involves creating a small pouch out of the top of the stomach and rerouting the intestines to create a restrictive and malabsorptive component. Patients lose approximately 80% of their excess weight and the long-term effects are well documented. The risk is relatively the same as the sleeve. I am leaning toward this procedure, but I am still deciding.
However, I have time. Lots of time. The testing and time and energy that goes into this process is plentiful. So far I have had a gamut of labs drawn, which led to me being placed on 4 vitamins: Vitamin d, Vitamin A, Calcium, and a multivitamin. I also had to have an exercise screening and an upper GI to test for reflux. I am in the process of trying to schedule a psychological evaluation. I have a meeting with a nutritionist on Thursday and I go back to the surgeon on Monday to find out what is next on my list of pre-op work. 
I am anxious to find out what the nutritionist has to say. This is very exciting, and yet terrifying, at the same time. I appreciate everyone joining me on this journey. My family and friends have been nothing but supportive. It will be a long road and I am excited to share the journey with you all.

Food controls my life.

A big focus of this blog was supposed to be weight loss and the struggle I have losing and keeping off weight. Well, for a lack of a better phrase - the struggle is real. People - men, women, young, old - have trouble with their weight. With all the processed foods and fast food options it isn't surprising the problems people have. 
First off, some honesty. I have lost weight, a significant amount in fact. I lost over 60 pounds in 2008. I gained it back...and then some. My highest weight (at the time) was in 2008 and that was approximately 280 pounds. As of Tuesday, I weight 307 pounds. It has been a gradual increase over the past seven years, however my weight has gotten out of control. Food controls my life. Food is supposed to be nourishing and be used to sustain life. It shouldn't control your life. Food shouldn't be constantly craved and sought after. 

Me, in 2008 after losing close to 62 pounds

Food controls my life.
This was a hard realization. It caught me off guard - to realize how much I loved food and how much I didn't want to give it up. The next realization? I am 30 years old and my body is tired. My back hurts. My knees ache. When I walk short distances, they feel long to me. My ankles swell and my feet hurt. I am carrying around another whole person with me. My body is carrying an extra 150 pound person. If I don't make changes, and soon, it could be too late.

My husband, Bob and step-daughter, Chelsea and me at her graduation a couple of weeks ago; at my highest weight of 307lbs

Once these realizations hit me full force, I had a melt down. In my doctor's office. He told me it's time to consider bariatric surgery. My instinct with weight loss surgery has always been to say "HELL NO". He convinced me to at least research it and since I am a graduate student, research is my forte, so research I did. 
My initial thoughts on bariatric surgery were: This is the easy way out. I can lose weight, I have done it. The problem? Keeping it off. Weight loss surgery to me appeared to be the easy way out for those who couldn't control themselves. I was wrong. Weight loss surgery is not the easy way out. It is easy to assume that because you have surgery and lose weight very quickly, that it is a magical, wonderfully painless solution to become thin and beautiful quickly. It isn't. It is a long and hard road. The decision itself to do it - not easy. Choosing which procedure is best for you? Difficult. Learning to eat a bariatric, liquid diet - I have yet to even fathom what that will be like. The tests that you have to do before you can even be cleared to have a procedure? Plentiful. Words can't even express how hard this process will be. 
But you know what? It's time to take my life back.