Tuesday, February 28, 2012

Bariatric Betty: pickle-licker

Before anything else, let me say that my heart and prayers go out to the students and families in Chardon, Ohio after the school shooting yesterday.  May we learn something from this tragedy that helps prevent things like this from happening in the future.  Please remember the families involved in your prayers.

Day 12 (starting counting from the day after surgery when I started fluids) and it's been pretty good so far considering.  I was on full liquids for Day 2-10 and then on Day 11 (yesterday) I got to start thin purees.  Just in time, too, because on Day 10 I found myself licking a slice of pickle!  C'mon, licking a pickle - that's liquid-ish, right? 

I have been lucky to find a protein supplement that I think is pretty good.  I use the Syntrax Nectar Fuzzy Navel.  23 grams of protein and 0 carbs, 0 fat.  I like it because it doesn't have that thick creamy taste that so many protein shakes have (and that I can't stand).  It's Whey protein, so it digests easily in my pouch.  Fuzzy Navel kind of tastes like Tang to me.  And I drink it out of a water bottle with a small opening so I don't smell the "protein smell".  No, I'm not receiving any compensation from Syntrax ;) 

Since Day three I've been able to drink three servings of the protein shakes a day, which has really helped my recovery.  The one incision that was still bandaged and having "ooze" when I was discharged scabbed over 2 days ago.  They said it can take up to two weeks, but that the amount of protein you are getting in makes a difference.  Cha-ching! 

The only downside of having fuzzy navel/ tang taste three times a day (in addition to water and Crystal Light) is that you get very tired of citrus/ fruit flavors.  Hence the pickle-licking incident.  I miss salty, savory flavors!  So yesterday was a banner day.  I made two different purees and alternated during the day.  First up was Low Fat Ricotta cheese, Mids Meatless spaghetti sauce, garlic salt and water.  Yummmmmm.  Think cheese ravioli minus the pasta.  Second was Fat Free Refried Beans, Pace Picante (Mild) and water. Think mexican bean dip without the chips.  Also good.  Both went down easily, no "stuck" feelings.  I had a little more burping than I've had with drinking liquids, but otherwise it didn't feel very different.  I ate 1 cup over the day, split into 4 servings. 

I kept waiting to feel that "full" feeling.  I didn't get it.  I also didn't get any discomfort or anything else associated with eating too quickly or too much.  Later in the day I actually felt hungry.  Hungry?  I'm not supposed to feel hunger now.  Is it "head hunger" - where I'm not really hungry but my brain is confused?  I remembered something I've heard at support groups and on my Weight Loss Surgery FB groups - sometimes you will confuse being thirsty with being hungry.  So, I drank 24 ounces of Crystal Light over the next 30 minutes and felt somewhat better.  Then I had my last 8 ounces of protein shake for the day and the "hunger" was gone.

I wish I was able to identify "full".  Not yet.  I have discovered "thirsty" (which masquerades as "hungry"), and "not hungry".  I only experience discomfort if I drink too fast - sometimes I forget that two swallows in a row is my apparent limit.  If I swallow a third without a pause, it splashes right back.  Then it's fine and I can swallow again.  I don't want to push my luck by eating normal size bites of food, because who WANTS to feel bad, but sometimes I can't help thinking "is my pouch small enough?" and other crazy things like that. 

So other than eating and drinking being slightly TOO easy, my only frustration is muscle pain in my abdomen.  I'm not supposed to be lifting more than 10 pounds, and I am being very careful with that.  The major difficulty has been with my dog.  I have to be able to take him out several times a day, and while he normally is not a big "puller" when we walk, he can get aggresive towards other dogs.  If it's not one of his canine BFFs and they walk by, he's all "This is my yard/ my pack leader/ I'm a tough dog/ go away!!!"  Usually annoying/ amusing (he's a 30 pound cocker spaniel, so he doesn't seem very threatening).  Now, when he pulls on the leash to bark at a dog, he pulls with more than 10 pounds.  I know, because my abs hurt - especially where my stitches are.  So I usually look out the door carefully before taking him outside, but twice now his LEAST favorite dog in the world has come around the corner right after I have gotten my 8 year old on the bus.  Yesterday I hurried back inside, but not before things got pulled enough that it hurt on and off all day.  This morning, same thing, but this time I had sense enough to hand my leash off to another mom, who held on to him for a minute until he had calmed down.  Better. 

I did take him for one of our regular 1 mile walks yesterday - which we have BOTH been missing.  It was the furthest I've walked since surgery, and he has been desperate for more exercise.  That went fine, his archnemesis was no where in sight. 

Speaking of abdominal stitches, I've decided that the indented spot where my doc sewed some muscles together to prevent a hernia post-op is my "one-pack".  I've never had muscle definition in my abs - honestly I don't know if it's possible.  Even at our lightest, my family has always had "soft stomachs", and now-a-days our kids are diagnosed "low tone" and double-jointed.  So one may be as much muscle definition as I ever see there, but I don't care.  Latest numbers: I'm down 12 pounds since surgery, 42 pounds since this journey started.  Whatever frustration I have, I'm not diabetic anymore and still losing, so I'm happy!

Thursday, February 23, 2012

Bariatric Betty's a Hot Mess

Day 7, which means I had surgery 8 days ago, because in bariatric world, you count the days from the first day you drank liquid.  Things have been going smooth - and it sort of feels like the calm before the storm.  Like when your kids have been playing quietly together in the other room and suddenly you realize that it's TOO quiet and know that they are up to something.  Or I'm paranoid.  Could be either.

I'm drinking at least 64 ounces of fluid a day.  The liquid is mostly water (hot or cold), Crystal Light, and Syntrax Nectar Protein drinks.  Twice I've had hot Cream of Mushroom Soup (strained through a sieve) and it was a nice change.  I'm drinking at least two protein shakes a day, which is actually the goal for the second week, which starts tomorrow.  Cool.  I've lost 6.4 pounds according to my home scale, which I think is friggin' fantastic!  I was prepared to barely lose anything the first week because of all the fluid retention from surgery. 

I'm surprised at how few problems I'm having.  Other than occasionally gulping when there is no room in my pouch for gulps, everything goes down easily.  Nothing I've drank has made my stomach upset - although I did find out that the smell of cooking edamame with soy sauce is NAUSEATING.  My husband has been wonderful, and only went back to work for a full day today.  The boys are helping pitch in, especially my 11 year old.  My eight year old switches between being helpful and being upset that Mommy isn't doing her normal stuff.  If it's his idea to take the dog outside, he's proud to help.  If I ask, he might get ticked and throw a blanket over his head until he says quietly "I don't want to".  He's also been acting out more at school, but change is hard for everyone.  It doesn't mean his acting out is OK, but I know where he's coming from.

Because as much as I am a glowing success physically, I'm a hot mess inside.  What started as weird dreams definitely influenced by my pain control medicine, I realize now is a accurate picture of the psychological landscape inside my head.  My dreams have repeatedly involved someone (a friend, a realtor, etc) pointing out that I've left something a mess - lots of clutter, childhood toys, some things my mom dropped off when she downsized that I had no purpose for.  Sometimes they're in my house, sometimes I have apparently left them at a friend's house sometime in the past, and she's nicely saying "Ummm, you need to come get these out of here.  Now." 

It's fascinating, because as I realized in the middle of the night last night, it's kind of like as my fat is being burned off by my body it's almost like I'm remembering aspects of what made me put it on there in the first place.  Like a beach eroding and showing old trash (maybe treasure?).  Feeling embarrassed - ate extra servings of pasta.  Felt like a failure at keeping the house up - ate some ice cream.  Felt proud of my baking skills - made extra cookie dough to make cookies for friends, but then snacked on the dough.  Felt noticed and unsafe - ate more of anything so that nobody would make advances or threaten me.  These are all real feelings, and ones that I've prepared myself will NOT be hidden under fat anymore, and the weird thing is, I'm not feeling them now.  I'm feeling the MEMORIES of them, and they're coming out in my dreams. 

Of course, in the middle of the last night, I didn't FEEL like that.  I felt miserable.  I wrote all of the above like it was about some other person - clinical, removed - but it's about MY past, which affects my current feelings.  My current feelings include feeling proud of doing exactly what the doctors said - liking stepping on the scale.  Being impressed with myself for getting all my fluids and protein in - telling people how well I'm doing.  But it also includes feeling guilty because I can't take my dog for long walks like we used to. Can't even do short ones, really, because when he pulls on the leash it could affect my stitches and cause a hernia.  So I have his sad eyes (and bored chewing teeth) looking at me all day (and destroying every pen or marker her can find).  Feeling guilty because I can't empty the trash, or have enough energy to even just go with the family to the Rec Center (just sitting once we get there).  Feeling impotent as a mom, because I have to keep myself off the painkillers all day to be able to drive to the store to get some fresh fruits and vegetables for the rest of the family.  Then being too sore to lay down and cuddle my son goodnight.  And while housekeeping isn't normally my greatest stregth, knowing that I can't take a load of laundry downstairs to get it started, or bring one up yet means that I'm watching the laundry pile grow. 

Luckily, I've got my husband, who patiently listens to me in the middle of the night while I explain these feelings.  While I tell him that I feel super hormonal like PMS brought a friend, and that it's only by sheer willpower that I'm not biting people's heads off when I'm slightly irritated.  And that I know that some of these over-emotional mood swings are normal for post-ops, because THANK GOD I've been reading posts from so many others who have had he surgery over the past 5 months.  So I know I'm not really going crazy (crazier).  I know it's temporary.  And I know that if I keep doing what I'm supposed to do, I will stabilize and continue my success. 

I'm so thankful my husband and friends are willing to listen (especially my husband who loses sleep doing it).  Because talking is helpful, at least for that moment.  It let's me get back to sleep.  Or stop feeling like crying.  And get back to work following the Rules, working the plan.  And blogging all about this, because it is feeling cathartic, too.

I want to start working out, and maximizing this "window of opportunity".  I won't until the doctors clear me, but I think about it A LOT.  I want to stop taking any painkillers, but I know that if I push myself too hard I end up hurting and unable to do anything.  So I'm praying for patience.  I'm asking my kids for understanding.  And I'm looking at my dog and telling him I love him even thought he's not getting the exercise he needs, and giving him a new chew toy.  This too shall pass.  I'm thankful for the gift of this tool, for my family, for my friends, and for all the prayers that have been said for me.  I look forward to paying it forward.

Monday, February 20, 2012

Bariatric Betty's Gastric Bypass

I was admitted to the hospital at 6:30 am on 2/16/12, very excited and nervous that something would go wrong and we would have to reschedule.  I had so many people praying for me, and had done so much research I don't think I was that worried about something bad happening/ complications, just what I would do if something made me reschedule.  There wasn't room for my husband back in pre-op, so as soon as I changed I kissed him goodbye, and told him I loved him, and I would be alright.  I had hoped that Dr. Ben Meir would meet up with us before then so he could meet my husband, and maybe I could get a picture with him, but as long as the surgery was on, I could pass on the photo op!

I can't say enough about the nurses, techs, and doctors at the hospital.  Everyone reviewed my information every single time they came in contact with me, and took the time to encourage me as well.  "You're making a great choice", "You are going to do so well".  Just after my IV was placed in my dehydrated veins (that magnesium citrate worked a little too well, and had me voiding water right until I left the house), and I got some anti-anxiety meds,, Dr. Ben Meir came back.  He was all smiles and told me that he was very excited for me, and was glad I was excited to have the operation.  I asked him if he would mind going to the waiting room to introduce himself to my husband before the operation, and he said "Of course!".  Next thing I knew, he brought my husband back in and let him take a picture of Dr. Ben Meir and me.  Plus I got an extra kiss from my hubby!  I told Dr. Ben Meir he is going into the family album.  That's the last thing I remember.

The next thing I know, I was waking up in recovery and they were telling me that it was all over, and that I did great!  Later I found out that the surgery had been delayed an hour, then gone the 3 hours they predicted, and by the time I got into my own room it was about 2pm.  My husband was right there waiting for me with a big smile on his face and a hug.  I was super tired, and super thirsty but knew I couldn't even have ice chips until the upper GI xrays showed my pouch could pass fluids without leaking the next morning.  God bless the nurses and techs - not only did they come check on me frequently, they brought mouth swabs!  I wasn't even producing my own spit, so those things were like a dream come true.  I dutifully spit out any liquid in my mouth after swabbing it so nothing would go wrong, and they would keep bringing me more :) 

My mom and sons got to the hospital later and brought me a family picture to look at from my bed - best hospital present ever.  I started walking the halls with the nurse that day, and it wasn't as bad as I feared.  My incisions didn't seem to hurt too much, and I was more tired and achey than anything.  I got four walks in that night and was allowed to go solo after the first two.  Best thing I found - having other bariatric patients on the floor!  One I knew from pre-admission testing.  The other I just met while I was there.  We would say hi from the doorway as we walked passed each other's rooms and invite them to join us.  We compared pain levels and talked about how excited we were. 

The next morning I was taken down to radiology where I swallowed some foul dye several time and they took a series of x-rays.  I was worried the first time I swallowed 7ml.  What if it couldn't get through the stoma, the pouch or the Y junction?  But it went down so quickly and easily, it even surprised the x-ray tech.  Bonus: the tech had already have gastric sleeve bypass herself a year ago!  She talked about it being the best decision of her life and looked wonderful! 

The only hard part of my day was the next 1 1/2 hours.  I was tired and wanted to go to my room so I could get ice chips (yummmmm, ice chips!!!!).  But, the radiologist was backed up and it took another 1/2 hour before he even got to my films.  By the time that he read them and signed off, it turned out that my surgeon had already reviewed them himself online and ordered the ice and water for me!  Then I waited the next hour for transport.  That was painful.  My mouth was sore from being so dehydrated, my muscles were sore from already sitting up so long, and I watched other patients being brought down and taken back up from radiology while I just sat there in the hall.  The tech felt so sad for me - she brought me a pillow and backed me against the wall so I could rest my head.  Twice transport came and took away empty beds and wheelchairs.  I was about at my wits end when transport finally came for me, and tried not to be mad as she took me back to my room.  I thanked her for coming to get me - there must have been a problem in dispatch, I don't think it was her fault.  But by the time I got to my room, the tears were flowing.  I got into my bed and ate my first ice chips, loving each one, but it took a while for my tears to stop.  More pain meds helped, and so did a little rest. Probably also helpful was that I was able to start my anti-depressants again.

I did at least 10 walks around the hall that day, and started having more gas pain (now that I actually was swallowing stuff, my intestines were befuddled).  Still, walking seemed to help.  That night I actually slept for 3 hours at a time, which was a big improvement over the previous night.  Unfortunately, each time those three hours allowed gas to build up.  Unlike my fellow post-ops, my lower intestines didn't start up until after I went home, and the only way gas could vent was by burping.  Early the next morning I was trying to walk some of it loose when the pains got so bad I started crying in the hall.  My sweet nurse helped me back to the room and told me I could lay back down for a bit before sitting up again.  I asked her to double check that none of the pain I had was near an incision cite, and they weren't.  Fear backed off, and I knew it was just gas.  They didn't want to put me on Gas-x/ simethicone at the hospital, but tried a suppository and a bowel stimulant to get stuff woken up down there.  About a day later, it finally let some gas out - yay!

Removing the drain was weird - I imagined it was much shorter, but I had 9-12 inches of tubing in me.  It didn't hurt coming out at all, and then I got to take a shower and be discharged.  Getting home was wonderful.  My mom drove me home and my husband and kids had the place all ready for me.  It took me a couple days to be able to sleep comfortably enough in the bed to make it worth sitting up from lying down flat with a sore stomach, but walking continues to help.  I haven't had any problems keeping fluids down.  I even got two protein shakes down yesterday - I was only planning on one, but when I was doing so well and still fours hours from bedtime, I figured "What the heck, I'll try another".

Best news of all  -when I was discharged I was off all my diabetes medicine.  They checked my blood sugar every four hours post-op and it kept going down: 131, 126, 118, 110, 104... Since I've gotten home it's been even lower!  Looks like my diabetes has already gone into remission, just as I hoped it would.  My mom is going home today, and my ever supportive husband is taking another day off to stay with me tomorrow, but I'm starting to feel like myself again.  A gassy, bloated, liquid-only self, but still...  My only new advice to share with pre-ops: I found that the Syntrax Nectar protein shakes are much better than the vanilla creamy ones post-op, and don't watch America's Funniest Home Videos the first week after surgery (it feels great to laugh, but hurts!). 

I came home to dozens of messages and cards from friends and family, and am so grateful for their support.  I "came out of the pantry" to my facebook friends about having the surgery before I went in to the hospital, and received only positive comments.  My friends and family support has been the greatest gift and biggest source of strength through all of this.  Now on with the journey towards health...

Saturday, February 11, 2012

Bariatric Betty 5 days before Surgery

So, here it comes.  The big day is less than a week away, and I'm tying up lose ends.  I've labeled where lots of things are kept in the house for the benefit of my family and my mom who will be coming over to help for 5 days.  I've done extra grocery shopping, made lists of food suggestions that the kids like, written down how they like things prepared.  I've written just-in-case notes to my husband, kids, and sent emails to the kids' teachers letting them know what is happening just in case they see behavior changes in the kids because of anxiety or anything.  I'm continuing to go over the plans for the day before surgery (now called "Poop Day" by my boys), surgery, discharge, and when I first get home with everyone.  I've bought all of the suggested post-op supplies and meds the bariatric center suggested and set up my little "liquid protein station" complete with shakes, whey powders, blender, and a sieve.  I've bought some books I'm looking forward to reading on my kindle.  I've set up some post-op playdates for the kids. 

All of that stuff is logical and healthy.  Now here's the other side - I've been enjoying my farewells to carbs. In the last week I've had a small serving of ice cream and a medium size fro-yo.  I've been choosing my meals to include some of my favorites that I won't eat the same again (or modified for a long time) - pasta, pizza, calzones, eggplant paremesean, and big salads (OK, that's a healthy one, but still).  I haven't been binging or going outside my calorie allowances, but my total carbs per day have definitely gone up.  My blood sugar is still fine.  But it's still part of giving up loving to eat to become healthy - the mind change that I have to make that the scapel doesn't touch.  I've asked my son to let me make chocolate chip cookies for his birthday in March instead of the cake balls he wanted - because I hate chocolate chip cookes, and love cake balls, and don't want to be faced with temptation too early.

I think that in all my previous diets there was this feeling that "after I make goal I can eat like a normal person again" and a big difference here is that I am choosing that I will never be normal, and I'm OK with that.  That it's worth it.  That this change will be permanent.  That I will NEVER get an ice cream cone again.  Not because I couldn't, but because I will choose to follow the RULES, and the RULES say no liquid calories.  Will I ever indulge in a taste of something?  Yes, but not for the first or maybe even second year and then it will be something solid so it gives me statiety.  I've heard from the vets and know that the more you let carbs in, the harder it is.  So I'm going to think like I did when I was feeding my kids their first solid foods.  Start with vegetables not fruits. Focus on protein.  It's easier to like fruits, so hold off on them until later.  I want to re-program my taste buds during my honeymoon period.  I would LOVE it if I no longer wanted chewy bread and pizza crusts, or sweet/ salty carbs.  So I will stay away from them.  Protein and fluids, protein and fluids....

I wonder what things I might enjoy post-op when I can eat normal food that I don't like now.  Could I learn to like squash or cooked cauliflower?  Kale?  Tomato soup?  I wonder what size I will be in 6 months.  In a year.  I pray that I will no longer be diabetic by the time I am discharged.

We're planning an extended family trip to Williamsburg, VA in a few months, and I gingerly explained to my parents that I won't be comfortable eating with some of their friends who live nearby at that point.  They totally heard me and said they understand that my dietary restrictions will be tough and that I will still be working through what stays down and what won't (which could change on any given day).  They also made sure that the place we're staying at is a condo with a full kitchen, so I don't have to depend on food from a restaurant.  I have to say, my parents are being really supportive.  My mom has totally taken my request for positive-only comments to heart, and has become my biggest cheerleader (well, maybe second to my husband). 

I've also been getting a lot of support online from my WLS surgery friends - which means so much.  My traditional friends have been taking me out, writing me emails of encouragment, and offering to help with the kids - which is all VERY much appreciated.  But my WLS friends know where I am because they've been there, and they know where I'm going.  They are able to handle my panicky questions, like "If I dump after surgery from having too much carbs, I'll have pretty much have the same symptoms as when I become hypoglycemic as a diabetic - but I won't go into a coma and die, like I could now, RIGHT?"  They know my personal brand of crazy, because they've have it to.  It's still there, just in remission.

Everyone has a different story, a different outcome.  All I know is that whatever my best possible outcome is will only happen if I do the best following my surgeon's guidelines.  I trust my surgeon, and I trust God.  How I use this tool, this gift, is up to me.

Friday, February 3, 2012

Pre-admission day

So yesterday I spent 8 hours at hospital C.  The first 1 1/2 hours were waiting for my pre-admission testing orders to show up :(  They had a packet from the Center for Bariatric Surgery (CBS) for me, but for some reason I wasn't yet registered in the computer, showing up with a surgery date, or with orders for my tests.  That was a little nerve wracking, but I figured it would get worked out, and it did.  Better now than on the day of my surgery!

I had 7 tubes of blood drawn, an EKG, a health history, a pulmonary functioning test, and an exam and medicine review by one of the center doctors who handles in-patients.  Then we had 1 1/2 hours of group classes with the nutritionist and the nurse.  The rest of the time was spent waiting for our turns with the various techs, nurses, and doctors.  We also had a taste-test for protein products that we could purchase at the CBS or elsewhere.   Not anything I'll ever crave, but several were tolerable. 

I was very lucky - all of my tests came back fine.  I was the last one of my group of 7 other bariatric patients to have the pulmonary testing, and she said "Ah, my first normal all day!"  Others came back with other problems - one has to have three iron treatments by IV in the next week to treat her PREVIOUSLY UNKNOWN severe anemia - Yikes.  At least know she knows part of the reason she's been so tired - it's not just the weight.  Some have to get clearance for things like their blood pressure from their primary care doctors, and everyone other than me has to give themselves blood-thinning injections before surgery, because of risks for clots.  At least one person had to go on a two week Opti-Fast diet before surgery, to lose some weight and shrink her liver.  The nurses and doctor all kept saying "Oh, you're the easy one!" when it was my turn.  I almost felt guilty, because everyone else was having so many issues come up. 

It quickly became apparent that my health was not the only difference.  As a group of 7 women about to have surgery for morbid obesity, we were all ready to spill our guts, share, and bond in our little conference room.  Over and over questions came up that I have read about on the Facebook groups I'm a member of, or in the local support group that I started attending as a pre-op.  Sometimes I volunteered what I knew, other times I said "I think that's something we should ask the nurse/ doctor/ nutritionist". 

I can not tell you how much more prepared I felt than most of the women in the room.  Emotionally, mentally, physically.  I heard comments like "You know, they make low-carb ice cream with protein in it now" and winced.  I tried to explain that while we might have an occasional bite of a treat after we're in maintenance, they really want us to stay away from liquid calories as much as possible.  That anything we eat (after the first 6 weeks, of course) should stay in our pouch as a solid so that we feel satiety.  Went right over their heads; "Well we're not talking about a big bowl of ice cream, just a little one".  Or the woman who wanted the dietician to say it was OK to put Cool Whip on her cappucino protein shake during the liquid phase.  She kept asking in different ways, and the dietician kept saying "Cool Whip doesn't give you anything.  You can add skim milk..." and finally I just said "I think what she is saying is NO."  The inquiring patient was disappointed, because she said she wanted to "pretend it was like regular cappucino".  Ummm.  Missing the point. 

Don't get me wrong, I don't feel better than ANY of those women.  I just feel that I have already asked those kinds of questions, heard the sad answers and started to wrap my head around them.  I feel like I got a head start because of my virtual online and local in person support group.  I know I will come up with crazy ideas, too.  But that's why I'm so glad to have connected with so many vets already - including self-declared "food nazis".

13 days until surgery, and I've got a lot of organizing, planning and shopping to do.  Plus, some local moms are taking me out to dinner and a movie tomorrow before I'm laid up :)  I'm very blessed to be in my situation, and grateful (SO GRATEFUL) for all of the support I've received already.