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)

2015 Reflection

2016. Where the hell did 2015 go?! I know it's four days in, however, I never did write an obligatory "New Years Eve Post". Overall, 2015 was a good year. 

2015 brought many challenges, emotional decisions and a lot of fun. I never thought at the beginning of the year that I would make the decision to have weight loss surgery. At the beginning of the year, I was planning for my husband to start his nursing clinicals and I was entering my final year of my master's program. I was also preparing to go to Florida to spend time with my aunt, brother and husband and the Detroit Tigers (spring training!!!!). 

2015 took me to Phoenix, Arizona for a geriatric trauma conference. I climbed into a "Hole in Rock" while at my highest weight of 310 pounds. It makes me now wonder, what can I do, once I have lost weight? Only time will tell. At the conference I got to spend time with a great friend. It was a work trip, but it was fun!

2015 also took me to Florida. Wisconsin (another work trip, also a great time with some great people!). The upper peninsula for a fun getaway with my husband. We got to spend an awesome night in the Grand Hotel, a once in a lifetime experience!

2015 taught me a lot about myself, nutrition, and becoming healthier. I kicked my 15 year habit of drinking Diet Coke. I had my first major surgery. I witnessed my best friend getting married. 

And, I graduated from school! One of my lifetime goals was to have a master's degree. Check!

The thing to remember is that every year will bring happiness and struggles. It is how you deal with those struggles that help you grow. Was 2015 perfect? No. We struggled to make ends meat, with Bob in school full-time and working less. We had family members have health scares. Friends with health scares. 365 days will never all be happy and perfect. There will fights, tears, laughter, smiles, etc. 

So, was 2015 was a good year? Yes. 

I hope that 2016 is just as good, or better!

Happy new year to you all! I am excited to continue my health journey with you on this blog!

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...

Post-Op, Days 1-2

Well, it's over. I remember going to the seminar in early June and thinking that six months of testing and nutritional counseling would go by slowly and really, it flew by. I also realized how grateful I am that I had six months to mentally prepare myself. Once I made the decision to go through with weight-loss surgery, I was ready to jump in and get it over with. However, after going through the entire process, I am happy that I was able to prepare my body physically and mentally. There is definitely a method to the madness of the insurance companies and bariatric programs here in the United States. If I could make a recommendation to anyone considering having a weight loss surgical procedure, I would say to do at least six months of preparation even if you have the choice to just do it. In the long run, it will help you be successful.
Day of Surgery: Tuesday, 12/8
I had to check in at the hospital at 5:45 am (yuck...). I had to shower the night before and the morning of, cleansing with an antibacterial soap like Dial. Of course, I didn't sleep well the night before because I was nervous, excited, scared, happy...and so many other emotions that I can not possibly explain. After checking in, I was taken into what I call a "pre" pre-op area where I changed into a gown, reviewed my medical history, had some labs drawn and was asked to wipe myself down with chlorahexadine wipes. During this time, my husband was able to sit with me, which was a relief because I was so nervous. At around 6:45 am, I was moved into the pre-op area which meant I was now alone and without my husband. Luckily, the pre-op staff was amazing and nice. The nurse put in my IV and gave me some pre-op medications (Lovenox, which is a blood thinner and zofran, which is to control nausea). The anesthesiologist and the surgeon both came to speak with me and gave me a chance to ask questions. After I signed consents and spoke with the doctors, the nurse gave me some Versed (a benzo to help control anxiety and relax me before going into the operating room).

Me, in the "pre" pre-op area - scared and nervous!

The Versed must have knocked my ass out good, because the next thing I remember is being moved into the OR and moving myself onto the operating table. Next, a mask with oxygen was put over my face. Then suddenly, I am being woken up. My first memory is feeling like I had swallowed something and I was not able to cough it back up. I am guessing this memory occurred when they woke me up while I was intubated, which they do to make sure that I will be able to maintain my airway. 
After this, I remember waking up and being able to thank the OR staff for taking care of me. I think I also mumbled some weird things to the CRNA, but I can't be sure that this happened or if I was imagining it. Once I was done in the OR, I was taken to the post-op area when the nursing staff monitored my vital signs and made sure I was stable enough to go to my room. Once I was stable and I had a room assigned, I was moved into a private suite which is where I stayed until yesterday afternoon. 
The day of surgery is pretty much a blur. When I came out of surgery, I was able to move myself from the OR stretcher to the bed...I remember the nurse calling me a "rockstar" because I was able and willing to do the moving by myself. I had terrible epigastric pain, which I was told is from the gas they used to inflate my abdominal cavity to see during surgery. I was quickly hooked up to a pain pump (PCA) which gave me a dose of Dilaudid every 10 minutes if I needed it. Basically, when I needed pain medicine, I could push a button and the machine would administer it to me. Not going to lie - I pushed that button every 10 minutes. I am happy I did because the pain never truly went away, but the medication made it way more tolerable. So, my second piece of advice - stay on top of that pain medication because once it is out of control, it takes longer to get it back down to a tolerable level.
I came out of surgery with a Foley catheter, which is tube that was in my bladder and drained my urine into a collection bag. This allowed the nurses to watch my urine output and ensure that my kidney's were functioning properly. It also let me rest in bed without having to get up to pee, which would have been often because they gave me quite a few fluids during the procedure. I also had a Jackson-Pratt (JP) drain in place, which allowed the staff to watch for any stomach content leaking, which is a potential complication of the Roux-en-Y surgery. The JP drain is a small tube that was by my stomach and came across my epigastric area (internally) and exited around my right mid abdominal area. I was also hooked up to IV fluids and the pain pump. On my legs, I had white TED hose and SCD's, which helped make sure that my blood continuously flowed to help prevent blood clots from forming.  My husband and parents spent most of the afternoon with me, which was awesome especially since I was pretty much in and out of sleep the entire time. I walked a couple times the first day, which was painful and I got a little nauseated, however it was necessary to get the healing process going as soon as possible. Ambulating helps prevent many surgical complications like blood clots, pneumonia and it helps get the gas moving.
Other than the fact that I had just had surgery and I had drains and tubes, plus 5-7 small incisions on my abdomen, I didn't feel like anything had changed inside. It sounds weird...I'm not entirely sure what I expected to feel. But I felt like nothing had changed. Of course, the day of surgery, I was kept NPO which meant nothing by mouth so I wasn't able to actually test out the new pouch and re-routed intestines. It was just weird to think about the fact that my stomach was now the size of the tops of my two thumbs and my intestines were moved around. 
Post-Op, Day One: Wednesday, 12/9
Early in the morning on the day after surgery, I was able to have the Foley catheter removed. I admit, I was pretty concerned about having a catheter in the first place because I know all about catheter associated infections and other complications associated with having a catheter. However, it was nice to be able to rest all night and not have to worry about getting up to pee 100 times...because that's exactly what would have happened. After the catheter was removed, I went for a couple of walks, up and down the hallway to keep the CO2 gas moving out (which was put in during surgery and causes quite a bit of pain when it just sits in your belly). That's my third piece of advice - walk, walk, walk...because that gas pain does hurt!
At about 8am, I was taken down to have an upper GI performed to check again for leaks. The upper GI is an x-ray. I had to drink 60 mL's of contrast and have multiple x-rays done to see if there was any leaking at the internal suture lines. That test was all good, so I was given the green light to start drinking fluids. I had to drink 30 mL's over an hour, for six hours. Once I was able to do that without feeling pain or nausea, I could move onto clear liquids which was 30 mL's every 15 minutes. I have been very lucky, because I have not had any nausea since the day of surgery, which is likely from the anesthesia and pain meds. I was able to take in some sips of water and some sips of chicken broth. Fortunately, I was able to tolerate this without any issues as well. After lunch time, the PCA pump was turned off and I was started on oral pain medications.
Later that night, I developed a low grade fever. This had me somewhat freaked out. The nurse reassured me that this is often normal after abdominal surgery and I needed to cough and deep breathe more often. I did just that and by the morning, my fever was gone. Bob came and stayed the night with me, which was awesome because I was scared I was going to have a complication and not do as well.  
Post-Op, Day Two: Thursday, 12/10
Discharge day - yay! I had 3 requirements to meet: pain control on oral medications, pass gas and be able to hold down fluids. I passed all the tests and was able to be discharged late afternoon. Prior to discharge, I had to have the JP drain removed. Talk about a weird feeling - I seriously felt the drain pull across my abdomen and out. I had some chest pain immediately after and for a couple of minutes. It was the weirdest feeling. Luckily, the sensation went away pretty quickly and I got to go home!
Whew, this was a long entry and I am exhausted, so more on the post-op experience to come... :) Thank you everyone for our love and support. The amount of messages, visitors, texts and phone calls from everyone has been overwhelming and so appreciated. 

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.