I realize it has been quite a while since I've provided an update.  The fall is an extremely busy time for me at work, and this fall has also been full of wonderful social events, which I have thrown myself into with gusto.  In the past, I would say no to road trips, formal parties, anything to do with strangers, because I didn't feel comfortable with myself.  Ten weeks out of surgery, though, I am having a grand time.

First, the numbers:  as of this morning, I am down 52 pounds.  When I think of this, I am stunned.  I had hoped, though thought it was unrealistic, that I might hit the 50 pound mark by Christmas. 

I am off metformin, which I took for several years for Type II diabetes; my blood sugar hovers between 89 and 102. Anything under 120 is considered normal.

My blood pressure is also within the normal range, so my cardiologist has cut my meds in half.  The plan is to come off them entirely if my blood pressure remains stable.

I am averaging 6500 steps a day.  Still not the 10,000 I am shooting for, but so much better than before surgery.  I regularly choose the parking spot furthest away from any door I enter, and at work park on the third level of the parking deck, and use the stairs to go up and down.  I don't do drive-throughs any more; if I want coffee at Dunkin Donuts, I go in.  And instead of using the phone or email, I walk around my building to talk with people, or schedule meetings in offices other than mine.  Again, I am amazed by this.  I even get cranky if Piper wants to cut our nightly walks short.

My greater struggle is with my closet -- I was not prepared for my clothes to not fit this early on, and have gone to work some days looking like a kid playing dress-up.  On the other hand, I have found some items in my closet that I hadn't worn in forever, or had even forgotten buying.  There was even one dress that I never wore -- it was too small when I bought it, and now is too big.  Honestly, though, it is a nice problem to have.

This would also be a very dangerous time, if I was just dieting without the help of surgery.  I feel terrific, and don't look so bad.  I am able to do things that I wasn't even able to dream of two months ago.  This is the point when I would get weak, or fall back on bad habits.  Start eating badly again, making poor choices, getting lazy, and the weight would slowly creep back.  And before I knew it, I would end up in a downward spiral, even heavier than I was before.

This process has not been easy.  And all I can think about right now are cupcakes, pizza and wine.  And ice cream.  Fortunately, my new stomach cannot handle these foods, so I can't self sabotage.  So my journey to better health will continue.  And for that, I am extremely grateful.

 

Me, two months out.

Me on my birthday, July 15.

Back to LIfe, Back to Reality (Almost)

I survived my first week back at work.

It was actually pretty nice to be back.  I love my job.  Just in case you don't know what I do -- I run the Affinity Federal Credit Union Foundation, which is the philanthropic arm of Affinity Federal Credit Union.  With 135,000 members, $2.3 billion in assets under management, and over 400 employees, we are the largest credit union headquartered in New Jersey.  Affinity is regularly voted among the best places to work in NJ -- last year we came in at #15.  Affinity takes great care of its employees.  In addition to the Cadillac of health plans, its generous leave policy made it possible for me to have weight loss surgery and take the time I needed to heal without causing a financial hardship.  In fact, it cost me virtually nothing (just my regular $20 co-pay for doctor's visits).

So I was excited to get back to work, back to my amazing team, and back to a more normal routine (though I did enjoy sleeping late, taking naps on the screen porch, and breathing in that refreshing sea air).  What I was not excited about, however, was food (I know, who would have ever thought those words would come out of my mouth!).

I really struggled with both the pre- and post-surgical liquid diets.  Moving to soft foods gave me more options, and wasn't bad when I was down the shore, and could eat or drink at my own pace.  I started reintroducing regular foods the same time I went back to work.  Regular for me, though, has a new definition -- mostly lean proteins in the form of fish, chicken, reduced fat cheeses, and eggs.  I have also discovered turkey jerky, which tastes great and has 13 grams of protein per ounce, though it is really hard to eat an entire ounce (another thing I would never had thought I would say!).

That is the crux of the challenge for me now -- getting in enough food to hit my daily protein goal of 60+ grams.  I can only manage to eat 2 - 2.5 ounces of food at a time.  Pushing it to 3 finds me running to the nearest ladies' room.  Same with drinking water too quickly, or too soon after I ate.  Fortunately, when something needs to come up, it is mostly liquid with just a tiny bit of food.  Unfortunately, I get very little warning, so I am becoming quite adept at choosing a seat closets to the door during meetings so that I can make a quick exit.  And of course this only happens when I am with other people.  Good thing I have great, understanding co-workers.

I don't really miss anything.  I haven't had tea or coffee since surgery, though as the weather starts to cool I think I might find myself yearning for a nice cuppa Irish tea.  My tummy has so little room in it that I am unwilling to waste it on any food that does not contain large amounts of protein.  Though I did have a moment yesterday, while I was in the grocery store. 

As I worked my way through the deli department looking for low-fat feta, I rain across a wheel of St. Andre -- a beautiful triple crème cow's milks cheese that is a little more intense, a little more buttery, and a little softer than brie.  I discovered this cheese during a visit to Seattle.  It pairs beautifully with smoked salmon, a warm crusty baguette, and a nice cold oaky chardonnay -- one of my favorite Friday evening meals, especially after a particularly busy week.  In that moment, I was sad.

But then I remembered how well I am doing.  As of today I am down 33.6 pounds, and my blood sugar is hovering between 116 and 121 -- almost normal!  I am able to walk with relative ease, even choosing parking spots that are further away from the entrance of whatever building I am going to.  I am regularly walking over 5,000 steps a day -- not the recommended 10,000, but given that less than a month ago a couldn't walk from here to there without getting winded, I am pretty proud of myself.

Finding a New Normal

Sorry for not getting an update sooner -- I have been working primarily off my mobile phone, which I find challenging for longer projects such as this.  I have finally gotten my Surface Pro 3 to work (an aside -- it is way too much technology for me, so I struggle with it regularly), so here I am.

To answer the most pressing question everyone seems to be asking, yes I am feeling better, although today has not been terrific.  Once I got past the clear liquid phase, and was able to have yogurt, it helped.  I saw my doctor on day 6, at which point he gave me permission to advance to cheese and tofu, so I have spent most of the past week living on that.  Whipped cottage cheese has 15 grams of protein per 1/4 cup, and tofu has 2 grams of protein per ounce, so it has been fairly easy to get my 50 grams of protein a day in.  As for liquids, I am relying on crystal light lemonade, low sodium V8 juice and water, and most days get close to the 64 ounces I need.

Interestingly, my sense of smell has become incredibly heightened, which has turned out to not be a good thing.  As many of you know, I have always been sensitive to smells; I can't wear perfume or use certain soaps and shampoos because they give me migraines,  while other scents send me running to the bathroom to vomit.  I find it even worse now, as things that never bothered me before send my tummy into an uproar.  I am never sure when I will find myself overwhelmed by something no one else can smell.

Foods I loved in the past may have the same impact on me.  Already I am finding things to be super-sweet.  I used to love Gold Peak Diet Iced tea.  I love all my tea sweet (I sweeten it with Splenda).  Not any more.  I feel as if I can taste the chemicals in the artificial sweeteners.  I not only have no desire for coffee, but I am turned off by its smell.  A tuna salad sub from Mike's here in Belmar used to be may favorite.  I decided to get some of the tuna without the sub yesterday.  Three times I ate it, three times I experienced "dumping syndrome" (sort of a very rapid evacuation of the food in your system, accompanied by hot flashes and cramps), so that s no longer an option.

These challenges I was prepared for.  Everyone -- friends who have had this surgery, doctors and other healthcare providers, online resources -- all advise of the changes in how your body reacts to and processes food.  In fact, one of the reasons the surgeon recommends staying out of work for at least two weeks is to give you time to adjust and figure out how to manage food.

In fact, other than the food issues, which I will figure out, I am feeling really good.  I am down 27 pounds, and can easily walk around the block without getting tired or out of breath.  Each day I am trying to add more steps and more activity into my routine.  Tomorrow, I am going to try yoga.

So, do I regret the surgery?  I don't think so.  As I am still recovering at the Jersey Shore, I feel like I am still in a bit of a bubble, so the jury is kind of out until I get back to my real life.  Juggling food at work will be challenging, s I easily get distracted, forget to eat, and then gulp down whatever I can find.  Clearly, that is going to need to change.  Same with liquids; I will need to make a conscious effort to stay hydrated throughout the day, instead of drinking water non-stop from the time I get home until I go to bed.  One of the benefits of spreading my liquids out throughout the day is that I no longer find myself getting up to go to the bathroom five or six times a night, which means I am sleeping much better.

So overall, yes, I am better off now than before surgery.  I just need to find my new normal.

I call bullshit (sorry, mom)!

I did a lot of research before I had my sleeve. I joined online forums. I talked to people. Everyone said it was great. They made it sounds as if they sprang from the operating table and started running marathons, with no pain, no problems eating. 

I call bullshit.

Two days before I was scheduled for surgery, I had stopped taking in any calories at all. Just the thought of food, in any form, made me want to vomit. I still hadn't received insurance approval, and began to think that I was doing all of this for naught.  I yelled at the woman in the surgeon's office.  I had a crying jag at my desk. I was ready to call it all off.  Not because I was afraid of the surgery, but because I was afraid I would never be able to think about eating without vomiting again. I searched all the forums; no one wrote about this, no one complained about it.  So I figured, it would pass.

Hah.

I finally got insurance approval Tuesday morning.  Later that afternoon I received the call that I needed to be at the hospital by 11:30.  So I packed up my clothes, my books, my pup, and drove down to Belmar, where I planned to spend my recuperation period.  After a fairly sleepless night, I got up, and we headed to the hospital, where I was quickly checked in, given a gown, slippers, and lovely hair net, assigned a bed, and sat. And sat.  And sat.  Apparently, I was #7 on the docket, so it was after 5 p.m. when I finally went into surgery.  When I woke up in recovery, I was in terrible pain.  My throat was on fire, I couldn't speak, and my chest was so full of gas all I wanted to do was cry. 

After what seemed like hours, I was finally brought to a room.  As I was getting settled, there were two small children right outside my door, screaming and running all over the place.  My head was pounding, my body ached, and I was done being nice. I asked the nurse to make them leave and close my door.  Unfortunately, they belonged to the woman who was admitted to the bed next to me.  I wanted to scream.  A dose of morphine took care of that.

The following morning, I was feeling pretty good (regular doses of IV pain medicine), and walked around the floor a bit .  I was told walking would help with gas, but I walked to keep my mind off how thirsty I was.  I was going on 34 hours since my last sip of water, as I waited for my "leak test." They give you a few ounces of a very thick, awful tasting liquid, and then take x-rays to make sure it goes down the way it should without leaking or any blockages.  I passed, and my reward was diet lemonade, sugar free orange ice, and discharge.

When we got back to Belmar, I was greeted by my nephew, Alex, three dogs -- Piper, Lola and Brooklyn. It was nice to be "home."  Trying to be the good patient, I made a protein shake with diet decaf iced tea and plant-based protein, and nearly threw up all over the place.  There was no way I was going to be able to drink any of that.  I decided to give up on protein for the night, sip some water, and try again the next day.

Every sip of water that I took resulted in a terrible pressure down my chest, as the water flowed to my stomach.  My throat was still sore, gas was building up, and all the pain meds had worn off.  An allergy to codeine left me without any pain meds at all. My first day at home ended with dry heaves. Not an auspicious beginning.

The next morning, I tried a few sips of Isopure clear liquid protein drink in coconut; it cam right back up.  The  pain in my belly was getting worse, and even water was making me nauseous.  I was really worried there was something wrong with me; no one else had talked about these issues.  Once I asked the questions directly, though, I found that this was pretty common, and decided to just power through it.  I decided I would not try to get any proteins in, and would just focus on liquids.  Crystal light lemonade became my go-to.  For variety, I mixed it with diet decaf iced tea.  On the third day, I started drinking V8 juice, and celebrated keeping everything down.

Today is day 4. I was able to have a chocolate-banana protein shake (though it took me almost 2 hours to finish it).  I seem to have mastered sipping, and can even get water down again.  I've been able to swallow my BP pill (crushing it and trying to take it with jello led to more nausea).  And I've been able to walk about 1/4 mile with relative ease.

Am I glad I did this?  I honestly don't know yet.  I am down 20 pounds from my heaviest, 10 since surgery four days ago.  I am feeling better than I did, but am constantly concerned that the next thing I put in my mouth will make me vomit. 

I am pissed, though, at all those people who  made this process seem like sunshine and roses, because it isn't.  I wish had known how hard it would be, because then I would have been able to be better prepared mentally. 

It doesn't suck -- at least not the way I thought it would.

As I sit here writing, I am eating a low-sugar coconut ice pop, hoping it will settle my stomach, as nothing else has worked.

I am on day three of my pre-op liquid diet.  Before I started, I was worried that I would be hungry all the time, that my stomach would be constantly rumbling, and I would be constantly distracted thinking about food.  I was very, very wrong.

I am not hungry, although I do crave certain foods.  For instance, Friday nights were typically spent on the deck with my pup, enjoying a good book and a nice glass of chardonnay.  Dinner was either some nice, crusty bread and a soft cheese, or pepperoni pizza.  As I move onto the next stage of my journey toward the sleeve and beyond, I will need to create some new rituals that are not based on food.

That said, my tummy is constantly grumbling.  It is not happy with the shakes I am supposed to be subsisting on now.  I have never been much a milk drinker; in fact, I rarely have milk in the house.  Now, I am expected to drink three milk-based drinks a day.  The result has been a near-constant state of nauseousness (is that a word?).  I am using lactose-free milk and lactaid, to no avail.

Today, I ditched the milk-based protein shakes for an apple-melon clear protein drink.  It didn't suck, but I cannot imagine once this is all over that it will become a staple in my fridge.  Unsweetened Iced Tea helped a bit, but when it came to eat again (120 calories would not sustain me for the day), I just couldn't bear the thought of a shake.  So I made the conscious decision to cheat, a little.

I bought large container of egg-drop soup and ate the whole thing.  My caloric intake will still be under 500, and I am hoping the protein in the eggs will outweigh the "solidity" (again, probably not a word) of the egg itself.

The weekend will be a challenge, as we celebrate my niece's high school graduation and wish her well on her journey to college.  There will be food everywhere, and another ritual that will need changing -- one of my favorites.  After each family gathering, my sister and I sit at the bar in her kitchen -- her on a high stool, me on the other side on a dining room chair, share a bottle of wine, and talk.  The guests are gone, the kids in their rooms, and the dogs are fighting over the dog bed.  I love this time.

But I remember that the reason I am doing this, having this surgery, is to have more time like this with her -- more years of these late-night talks about everything and nothing.

Where the rubber meets the road

Tomorrow I begin the all-liquid phase of surgery prep.  From tomorrow through August 11, I can have just three, milk-based protein shakes a day.  I can supplement this with tea or coffee, other no-calorie drinks, chicken or beef broth, sugar-free Jell-o and sugar-free ice pops.  And all the water I want.  For the first time in this process, I am scared.

Let's be honest here -- if I was any good at limiting what I eat, I would not be in the situation I am in, nor would I be undergoing such extreme measures to lose weight.  What if I try this and fail?  And if I can't maintain control for this week, what does that mean for me post-surgery?

Different people prepare for this step in different ways.  Some taper their shake-intake.  That had been my plan, and for the most part, I have been having a shake most days for breakfast.  I had hoped to increase that to two shakes a day this past week, but I decided to have a food funeral instead.  So for the last week, I've chosen foods that I love and have lived on, and enjoyed them one last time.

Interestingly, I found that I didn't love the foods as much as I thought.  I had a Big Mac and fries; I can live without them.  Sesame chicken, a staple, actually gave me an upset stomach.  The falafel sandwich I had been dreaming about didn't taste nearly as good as I remembered.  And I think I have had my fill of pizza for a long, long time.  My birthday burger and cosmo where great, but they were special occasion foods, so I am pretty okay with not having them again any time soon.

I am hoping that post-surgery, when I can go back to solid foods (about four weeks out), that I will be able to tolerate other foods I love, which are much healthier -- fish, eggs, vegetables.  I've never been a big red meat or pork eater, and I only eat chicken if someone else cooks it -- and even then there are no promises.  It does mean that I will need to plan better, make sure I have healthy food in the house, which can be cooked quickly.  I will need to remember to snack in the afternoon, so that I am not ravenous when I get home from work.

Focusing on the positives will help, starting with walking my dog.  Piper gets so excited whenever I pick up her leash -- she actually starts dancing!  And doing things, without wondering about whether or not I can get from the car to my final destination without huffing and puffing and sweating like a pig.  One of the things that I hope will keep me distracted during the difficult times is to create a list of things I want to do.  Some will be small -- walking to the library or going to the shore.  Others, more adventurous, including a possible 5K in some really fun location, or going to Nashville with my sister and my mom.  And then there are the experiences on my bucket list, which I had given up on -- traveling to South Africa and going on safari, going exploring in the Galapagos.

But for now, I am scared. 

Bump in the road

It's a good ting I used to be a long distance runner.  The patience, strength and endurance I gained from that has been a great help through the WLS process. 

Let me start by saying that I know I am extremely lucky.  I work for a company that values my health, and provides me with the Cadillac of health insurances, for an extremely small co-pay.  When all is said and done, I will likely be out of packet less than $200 for the surgery and all the pre-op prep.  And there is a lot of pre-op prep -- 19 separate doctor's appointments: three with the surgeon, one psych, one nutritionist, one full physical with my GP, two appointments with the gastroenterologist, an endoscopy, an appointment with the pulmonologist, a breathing test, a sleep apnea test, a pre-op educational session, pre-admission testing, and four cardiology visits, including two for a nuclear stress test.  It was the latter where the most recent bump in the road arose.

After arriving at the appointment 30 minutes late due to road closures and a lack of detour signs, I waited another 45 minutes to see the cardiologist.  It was Friday, it had been a long week, I was tired and already on edge.  I just wanted this part over with, so I could have my ultrasound, do my preadmission testing, and get on with my surgery and my life.  Silly me for thinking it would be that easy.

After telling me that my heart muscle was very strong (likely due to all those years of running), the cardiologist told me that there was a "shadow" on my stress test that was if concern.  He explained something I already knew, but normal-sized people don't ever have to worry about.  Because of the excess fat I carry, it can be difficult to get clear pictures of internal organs.  That, coupled with the placement of my heart under my breast, which is also on the larger side, the images from the stress test were not clear, and showed a possible blockage in my coronary artery.  To know precisely what the issue is, I need to undergo cardiac catheterization.

During this process, the doctor will snake a thin, hollow tube from my wrist into my coronary artery.  He will inject a contrast dye through the catheter into my arteries, and take x-rays to determine if there are any blockages.  In the best case scenario, there is no blockage, the catheter comes out, and I go home.

If there is a blockage, the first step would be to insert a metal stent to open the artery, and put me on blood thinners for four weeks.  This would require pushing my surgery date back, at least five weeks from the date of the catheterization, to give time for the blood thinners to do their job, and then wean me off them so I don't bleed out during surgery. Of course, if there is a truly severe blockage, then the intervention would likely be more complex, and I would have other things to worry about.

While the doctor seems to think it is most likely that they will find this is just a shadow, and will not require stenting, we won't know until the procedure is actually done.

So now, I am waiting until the scheduler is back in the office on Monday, to see when we can get the procedure scheduled.  Then I need to try to get my pre-admission testing moved up as well, as it needs to be done to clear me for the catheterization.

Did I happen to mention that I work?  Full-time?  And I commute almost an hour each way to work?  And that my doctors, and the hospital, are all about an hour in the opposite direction?  What had been a very carefully orchestrated schedule, designed to minimize the disruption to my work schedule, has been blown to pieces.  I am trying frantically to get this latest procedure scheduled for next week, so that regardless of the outcome, I can be back to work by July 27, as I am running a major fundraising event on July 30.  My sleeve surgery was scheduled specifically so that I would be back to work in time for our October Casino Night -- the second biggest fundraiser on our calendar.  There is a real chance that I may not be able to get this all done before then, in which case I would likely need to start all over again from the beginning, as the pre-op testing cannot be more than 60 days old.

So I spent yesterday in bed, feeling sorry for myself.  I finally decided to do something about the situation I had gotten myself in, and there is a chance it might not happen.  So I am upset and emotional.  I do not want to be social.  I do not want to deal with food, and clothing that doesn't fit and in which I am uncomfortable.  

And I am so darn tired. I find driving absolutely exhausting, and seem to be in the car constantly. 

Bu today I am getting in the shower, shaving my legs, and going shopping.  I am going to get fruit, fish and fresh veggies, and I am going to plow on, in the belief that this will all work out.  Maybe if I believe hard enough, it will come true.