Saturday, March 31, 2012

Bariatric Betty firsts at 6 weeks out

So this has been a relatively quiet week, but I wanted to share a couple of firsts that happened this week.  First of all, I have made it to transitional foods.  I can enjoy small amounts of iceberg lettuce now, so salad has come back into my life (YAY!), and I also found that I can tolerate a hard taco shell.  Better than regular taco shells, I found these mini ones by Taco Bell that come 24 to a box (instead of 12 or 18).  They're tiny, and when I filled 2 of them with some beans, cheddar cheese, a little lettuce, salsa and bit of greek yogurt - DELICIOUS.  As long as I chew them to death ;)

I also am off physical restrictions - so I can now lift more than 10 pounds and I can do any cardio exercise that I want.  So far I've gotten back on the elliptical for the first time in addition to walking, and I'm hoping to swim later today!  Still can't do any weight training because I don't consume enough calories to build muscle.  But not having to worry about how much groceries or laundry weighs is liberating.  And the elliptical felt really good.

I also wore my first size 14 pants this week (followed by my second, third and fourth - thank you budget bin!) and that was wonderful.  I realized I haven't been this weight for about 13 years.  That's a really weird thought.  I haven't seen my weight go down by much this week, but I couldn't fit into these jeans 2 weeks ago, so it's ALL good. 

Here's a funny thing I experienced for the first time.  I was wearing one of my size 14s and walking my dog, and felt this funny pressure on my front in two spots.  Not discomfort, but pressure.  My pants weren't sagging (which happened ALL the time when I was a larger size) off my backside, and I realized that SOMETHING was holding them up.  Not my stomach.  Usually when I had pants that didn't sag, it was because they were cinched so tight around my waist (in the belly button region) that it would start to hurt after an hour.  But that wasn't happening.  My stomach felt comfortable, and the waistband was below the belly button region, anyway.  There was a gentle pressure on each side... the jeans were being held up by something firm... HUH - Hipbones!  I do not mean that my hipbones are protuding, even lying down on my back I have to press into a 1" good cushion of padding to FIND my hipbones.  But, what it means is that the hipbones WITH the padding are now supporting the weight of my pants and holding them up!  OK - for my friends/ readers who have never been obese you are probably going "Ummmm, yeah?" but you need to understand that this is a brand new thing.  I'm an apple shape, and have no easily definable waist for the most part.  Even now as my stomach is decreasing in size, the apron of skin that is growing from shedding the fat is taking it's place as a new type of spare tire.  But it's more movable and compressable, so my jeans have found something new to hang onto - hips.  Huh.  Cool.  And much more comfortable. 

I also enjoyed celebrating my son's 9th birthday last week.  It was great, and since I'm allergic to chocolate I had no tempation with his choice of desserts for the parties (chocolate chip cookies and brownies).  Most fun of all, I got lots of compliments from my friends who saw me.  Talk about getting a swelled head!  I'm looking forward to baking things that are a greater challenge for me to resist and then celebrating my restraint in a couple of months.

Friday, March 23, 2012

Bariatric Betty - 5 weeks out, new totals, new job!

So today is day 36, and tomorrow I get to start trying transitional foods.  That means very small amounts of super-toasted bread products (the crunchier, the better) and things like a bite or two of iceberg lettuce.  Woo-hoo!  Chewing continues to become more and more important as I eat more things that won't just slide out the tiny opening in my stomach.  I've had several reminders to CHEW MORE like two unchewed lentils stuck together blocking that opening and causing pain and vomitting.  Once it was a shredded piece of cheese.  The new crunchier foods increase that risk if I don't chew well.  I continue to feel uneasy about eating in front of others outside my immediate family because of this, but I'll keep working through it.  My best friend was sweet enough to not only give me the entire menu for her wedding reception, but to tell me the restaurant that's catering it, so I can try things ahead of time if I want.  I'll still need to eat protein I pack, but I could at least taste some palak paneer!

So lots of good news this week.  As of today, I actually weigh the weight on my driver's license!  That is very exciting, and again makes me wonder why they don't actually have us stand on a scale (without our seeing the weight) that would automatically enter the weight in the computer at the DMV (and not put it on the driver's license for the world to see).  After all, if I had disappeared a year ago, they would have been looking for someone that weighed 52 pounds less than I did - how would that have helped them find me? I have actually imagined that heaven forbid I had been murdered and they found my body, them saying "Nope, this can't be that girl, she's much more obese."  HELLO - how many of the people getting license give their correct weight?  I'm guessing even those who have never been obese fudge a little.

Yup, 52 pounds!  My BMI has gone from 42.1 down to 33.9.  I'm losing 1 to 2 pounds a week, which is right on target for now.  It will slow further as I have less to lose.    I'm very excited about achieving my next goal - no longer being obese.  When my BMI gets to 29.9, I will be overweight, but not obese.  Celebrating being overweight sounds oxymoronic, but when you started out being Morbidly Obese, it's a real milestone. 

So yesterday I brought a pizza party to my son's classroom to celebrate his birthday.  I suggested that instead of cupcakes or cookies, because I figure by giving them a lunch of cheese pizza, grapes, and water they were probably eating the same number of calories they would normally get at lunch, but it felt like a huge treat.  The kids had a blast - and funny enough I didn't have the slightest craving for the pizza.  I didn't even want to lick my fingers as I plated all 24 servings.  I used to love pizza. 

So after lunch I stopped by to chat with the principal and let her know that I will be all healed up and off restrictions after our spring break, so if she needed anyone to sub as a monitor (watching the kids for lunch and recess) I would be available.  She had offered to hire me fulltime (2.5 hours a day M-F) last fall after I had applied as a sub, but I had told her that with the planned surgery I would be out a couple months in the winter/ spring, and didn't think it would be fair to them.  Her response was "How did you know?  Did you know?  That I just got two resignations this morning?  They're on my desk right now!"  So, I'm hired "fulltime" as of 4/16!  The pay isn't great, but I will only be working when my kids are in school, I'll have a really good idea of what's really going on in the elementary school, and hopefully I can help keep the peace.  Given my strong sense of fairness and sense that school should be a safe place for children, I hope neither the principal nor I regret this!

The interesting thing is I realize now that I probably couldn't have done this last fall when I applied.  You see, you constantly stand and walk for 2 1/2 hours.  While I was walking 2 miles a day, doing the elliptical for 1/2 hour (5 miles) and other active things, just standing for an hour used to make me sweat.  I remember volunteering at the bookfair and walking around a small room helping kids for 1 1/2 hours and being sweaty and exhausted.  Because when you are morbidly obese, your body works really hard just STANDING for a long period.  It was easier to do 5 miles on the elliptical than stand/ walk a little for 1 1/2 hours.  

So I'm going to start increasing the lengths or my walk with my dog now to make sure I build up my endurance a bit more before starting my job in April.  I know my body is totally different now, and I'm not as limited as I was, but I'm still obese and at my current approx. 600 calories a day, my energy level isn't sky high by any means.  At least I know I will be guaranteed a lot of walking (in addition to walking my dog) for the rest of the school year.  Once summer starts, I'm looking at starting Couch To 5k training with the whole family.  Now that will be interesting. 

Friday, March 16, 2012

Bariatric Betty at 1 month post op with pics

Wow, what a month!  Full of emotional highs and lows.  Some "it can't be this easy" moments and some "why have I not lost weight for the past few days" ones.  All in all, I have been pretty complication-free!

At 3 weeks I had my first post-op follow-up first where they said I had already lost the average excess weight (16%) they see in RNY patients at one month.  Good thing, because I've only lost another pound and a half since then.  Part of that is because of my journey with pureed foods and then recently soft foods (no blenders!).  You defintely lose slower once you are actually eating.  I have also slowed my eating, and now take 20-30 minutes to eat a meal (vs. that too-fast black bean soup puree moment).

Here a picture of me I took today

Most people say they can see the change since surgery most in my face.  I also have to show this other picture I took of my new furry friend, "Bearyatric Betty" - a great recovery gift from my friend and WLS mentor, Jo.

Jo's the best - other than the fact that reading Bearyatric Betty's name made me laugh so hard it pulled my stitches. 

So, I had a little scare last week when I worried I was becoming intolerant to dairy.  Being ovo-lacto vegetarian, that was concerning.  I get 1/3 - 1/2 of my protein daily from dairy.  After 2 rough stomachs with Greek Yogurt and 1 horrible one with pureed cottage cheese,  I tried to take Lactaid with dairy and that seemed to help.  In fact, it helped so well a couple times, I started to wonder whether I even had a problem.  So I stopped taking the Lactaid, and what do you know  - I'm fine with dairy!  Huh.  Don't know what happened, but I am glad it stopped!

I went to our community garage sale yesterday and got a bunch of things.  I needed some size 16 pants (my 18s are starting to fall off) - so I got two pairs of jeans, 1 white tailored blouse and 1 pair of shorts that fit right now for a total of $17.  I also bought some khakis that will fit in another 10-15 pounds, ditto 2 skirts, and then two blazers I can wear with pant/ shorts or skirts when I'm down another 20.  I'm going back Tuesday for "bag day" - when you can get anything you can fit in one of their good size bags for $5 - and stocking up on lots of shirts and shorts for the summer in various sizes. 

So I started my "soft foods" the other day!!!  So far I've enjoyed 2 ounces of fresh mozzarella with a slice of tomato, 1/2 cups of scrambled egg beaters with 1/4 cup shredded cheddar, 1/2 cup of morningstar veggie crumbles with a little spaghetti sauce and 1/4 cup shredded mozzarella, 1/2 cup of low fat cottage cheese with unsweetened mandarin orange slices - all with no dumping, no overeating, and chewing well. Then came lunch today.  I thought I would try the morningstar veggie meatballs with spaghetti sauce and mozzarella (similar to the crumbles).  Unfortunately, on my second bite, I didn't chew long enough and got a piece about 1/3 inch long stuck in my pouch.  OWWWWWWW!  First came the drooling, then the pain - kind of angina-like.  I tried to swallow some water to see if it would push through - I FELT it move up and then wedge right back in there.  Owwww. So I spent the next 15 minutes trying to throw it up - finally did, whew.  I know I'm lucky that I haven't had to throw up since surgery until now - and it wasn't that bad since I've had all this time to heal - but I'm in NO HURRY to experience anything like that again.  Latest lesson - THINK about the chewing EVERY bite.

During a spell where there wasn't any change going on with the numbers on the scale, I measured myself.  This was very cool - because I hadn't measured myself since November.  In November I was halfway through my pre-op 90 day medically monitored diet, and since then I have lost 5 inches in my waist, about 4 in my hips, and about 3 in the band around my chest.  I also lost 1 inch off my biceps, and almost an inch off my thigh.  I'm pretty happy with all of that.  My only disappointments is that some of my weight has come off my butt - which was fairly small to begin with, and that none of it seems to be coming off my cup size.  I know that I will have less "sagging" pants moments when I have a more defined waist, and that will come.  I also expected that my bountiful chest wouldn't reduce much (if at all) based on past weight loss, but I was holding out hope.  Maybe it will change later, but probably not. 

This brings up the ghosts of discomfort of being looked at like I'm a waitress at Hooters... but I will deal with that if/ when it comes.  At least I won't be dealing with diabetes and morbid obesity at the same time.  It's hard when people assume that the only reason you have a large chest is because you WANT that type of attention, and that it must be implants.  As the rest of my body gets smaller, they become more apparent.  But, right now, I have enough to focus on with sticking to the plan.  Tomorrow will bring what it will.  And I'll do my best with whatever that is.

One last thing - I now live in Onederland!  Translation for those who have never struggled with their weight - I'm under 200 pounds.  I actually got there a while ago but was nervous about announcing it.  Not because I thought I would gain it back (NO way), but because for many WLS patients, it takes a year or several to reached this promised land.  By the time I had surgery I was only at 213, so I didn't have that much to lose to get there.  It definitely doesn't compare to the achievements of those who started much heavier, and I didn't feel right about "bragging" about it because it could make some of my fellow WLS patients feel like I was diminishing their accomplishments.  So I haven't announced it on my private facebook groups, but I figured if you are reading my blog, first of all THANK YOU, and second of all - you probably know me well enough by now to know that I'm not comparing this landmark of mine to anyone else's.  Everyone takes their own journey.  But I'm not going to hide successes or setbacks on this blog - so there it is!

Wednesday, March 7, 2012

Bariatric Betty's 3 week check up - doing great, BUT...

So yesterday (actually day 19) I had my three week check-up with my surgeon's office.  They were very pleased with my weight, the amount of fluid I'm getting in, the amount of protein I'm getting in, and my walking.  According to their scales I've lost 15 lbs since surgery, which was 17% of my excess weight.  They said that the average lost at one month post op is 16% of excess weight, so I'm already ahead at less than 3 weeks.  She also mentioned that they would anticipate that I will have lost 50% of my excess weight at 6 months post-op.  That would mean I would lose 30 more pounds in the next 5 months - sounds great to me.  So that's the good news.

They were concerned about a couple of things.  First - I haven't been taking long enough to eat.  I found that out myself the night before when I ate my black bean soup in about 10 minutes and was in pain for about the next hour and a half.  That was the FIRST TIME I had even had any discomfort from my pouch.  I was almost happy that it happened, because I was starting to wonder when I would get some pouch "feedback".  So I had already resolved to take a lot more time eating.  I've been getting a lot of volume in my pouch for being 3 weeks out.  I was getting almost a cup in most meals, and they said that eating that quickly means that 1) I probably have been having my puree too thin so it's exiting the pouch too quickly and 2) I'm a quick healer and not very swollen at this point.  They said that I will be able to eat less as my food gets more solid.

Second, I was asking about being allowed to exercise more.  I wanted to start some lightweight free weight training for my arms/ shoulders, and maybe gentle walking on the elliptical.  As my fat is decreasing my arms are starting to get flabby, and I miss the endorphin rush I get working out.  Plus, I keep on reading and hearing others being warned not to waste their window of opportunity/ honeymoon period.  I want to make the most of mine.  This appointment burst a few bubbles.  I was told very bluntly that I'm not consuming enough calories yet to build any muscle, and that if I start working out now, it's possible I could destroy my existing muscle tissue, and then it wouldn't come back.  Whoa.  When I asked about the elliptical I was told "No, because even that will use your abdominal muscles more, and if the stitches in your abdominal muscles don't heal well then you could have permanent weakness in spots."  Oh.  So I said "OK, so just keep walking, you know walking my dog..." and she almost choked.  "You're walking your dog?!?"  I tried to explain that I've come up with strategies if he starts to pull (like standing on the leash) so I don't stabilize with my abs, but that he usually doesn't pull, he just walks at my side.  But, she was still worried.  I tried to explain that my dog HAS to go out at least once during the time that my kids and husband are away during the day, and that I have made sure that I take all the precautions I can.  So I'm not arguing about weight training or using my elliptical - I totally get it.  And I'm going to be very careful walking my dog, but I have to walk everyday and so does he. 

So one of the funnier moments of the visit was with the surgeon's assistant who was talking about how I'll be on regular food before I see them again.  So she says, "Breakfast, talk to me about cereal and milk..." and looked at me.  Huh?  I think I can only say I had a confused deer-in-headlights look.  "C'mon, what do you think about cereal and milk for breakfast?"  Ummmmm.  I don't.  I don't think of cereal and milk for breakfast.  I've been a diabetic for the previous year and a half.  Too many carbs, too low protein, etc.  "No, no.  Think about your rules, would milk and cereal make a good breakfast?  No.  Protein is way too low, right, but it is also a lot of LIQUID calories.  You aren't supposed to have liquid calories.  And it will wash the cereal right out of your pouch - it's like drinking with a meal!"  Oh.  OK.  Right.  But I had a whole nutrition class with one of their nutritionists after the appointment and she felt really confident that I understand the rules.  It was just being asked like that, my brain froze and went "Whaaaaaaaaahhhhhht?"

I had the nutrition class with Orlando, a fellow RNY patient that I met in the hospital.  He's doing really well, too.  I have to say, the support of fellow patients as well as the amazing staff at the hospital means so much.  I talked to them about me attending my local support group vs. the one at the hospital because they're on the same night each month.  The surgeon's office said that was fine - yippee!  And pretty soon I get to start having TVP (texturized vegetable protein) - a staple in most vegetarians' diet. 

Yesterday I also got the formal invite to my best friend's wedding reception in May.  And promptly got anxious about it.  A dinner reception - eating in front of non-family members.  What if my pouch throws a fit and I vomit?  Will there be anything I can eat?  OMG, I've never been anxious like this, but I calmed down and started working through it like a challenge.  OK, I'll ask my friend exactly what is on the menu, then I can see what I might be able to eat.  If there is anything appropriate for me to eat, I can try making it at home a few times before the surgery so that I can see if my pouch will tolerate it.  And I will pack a source of protein that I can eat - maybe cheese cubes, I'll be on normal food by then.  That way I can have a ready protein I can eat out of my purse before I try a bite of anything else.  OK, that will work. 

So I have a bunch of social things coming up.  My son turns 9 this month, and is making his first communion next month.  Then my friend's wedding reception in May, and a family vacation in June.  I need to have clothes that will fit for all these occasions.  The birthday is fine - at a bowling alley, I can get away with loose jeans and shirts.  The first communion will need something dressy, and I will be too small for anything I currently own.  Ditto on the wedding.  And I will need summer clothes for vacation...  Luckily, there is a local community garage sale in about 10 days where they usually have really nice clothing.  I will be all over that sale.  Once my weight stabilizes I will save up and buy some new nice clothes for myself - but it doesn't make sense to waste money on clothes I may only wear a couple times while I'm shrinking. 

I hinted to my family that maybe in 6-9 months they could nominate me for "What Not to Wear" so I could get professional advice on how to dress my new body, as well as a gift card to pay for it.  The response?  "Ummm, they would need you to be in New York for like a week, right?  We'll just save money up for you to shop here."  It is nice to needed. And the poor guys did just do without me for three days and they still don't have me back in full form yet.   Maybe What Not To Wear will decide to make a stop in Cleveland someday :)  I can't complain - not with all the blessings in my life.  My family, my friends, and my pouch.

Saturday, March 3, 2012

Bariatric Betty; an ice cube with NSVs

NSVs?  That's short-hand for Non-scale victories.  Something that shows you are doing well on your weight loss other than watching the number on the scales go down.  They are important, because sometimes the number on the scale stops changing, sometimes for weeks at a time, and you need to have something telling you that what you are doing is working. 

My first NSV is that I have become a human ice cube.  Morbidly obese people who lose a lot of weight (through bariatric surgery or otherwise) tend to become cold.  Permanently.  That's OK, really, because as a morbidly obese person, we used to be permanently hot.  And sweaty.  At least when you are cold you can bundle up.  When you're hot, there are only so many layers you can take off and still be legal in public, and even less layers you can take off and feel comfortable about how you're dressed - so you just end up sweating a lot, which is embarassing.  So it's day 16 and three days ago I started to realized not only am I not feeling hot anymore, I'm cold.  Especially after walking my dog outside (well bundled up) in 35 - 40 degree weather.  I have to come home, take a hot shower, get dressed warmly and then bundle up with blankets to get warmer.  Woo-hoo!  I feel like I've crossed a border into a different country.  After surgery I was still at least constantly warm, and was wondering when I would get my chill on - and it finally happened!

Second NSV:  my raincoat.  I have a beautiful magenta trenchcoat and it has been raining a lot this week.  We haven't had a lot of snow this winter, and now the rain is setting in.  The neat thing was that I hadn't worn my raincoat for a couple months, and when I put it on I realized how loose it was!   Loose like, after I buttoned it I realized I had about 6 extra inches of fabric that I used to fill.  Even greater comparison - last spring it was TIGHT. 

Third NSV:  my (perceived) mood.  My husband is thrilled, because he says I'm in such a great mood every time he comes home now.  He said it's wonderful, that he can't believe how even-keeled I am.  I laughed the first time he said it, because it's not how I've been feeling.  I explained that I'm still feeling emotional and easily irritated, but I've been trying to make sure I don't bite anyone's head off because they won't stop making that knocking sound, etc.  So I guess my NSV is that I'm better at controlling my reactions, and my husband appreciates it.

My biggest challenge this week has probably been the idea of being with people other than my family.  I went to my son's school for the first time in a couple months yesterday and really had to take a moment before I went in to prepare myself.  I expected people would notice a difference in how I looked, and they did.  I got several complements, which was nice.  But I was preparing myself for the potential negatives: the reaction that some people have when they hear someone had bariatric surgery.  The "Oh, you cheated" look or comments.  I do not have a problem with confrontation, and I anticipate that I will be educating a LOT of people over the next years about how hard it is, not just committing yourself to the surgery but the how you have to live for the rest of your life after the surgery.  My goal is to do this nicely (i.e. without telling people they are ignorant and cruel for making negative comments) and without going on for a half an hour ;)  But now that I'm starting to see people other than my neighbors and immediate family I know that it will happen.  Luckily, it didn't happen yesterday :)   I also had a very strong reaction because my husband's extended family wanted to invite us over for lunch this weekend.  Lunch?  As in eating?  I can't DO that.  I don't eat real food yet.  And even if I brought my own food, I don't know how I would react to the smell of everyone else's cooked food (let us not forget my sudden nausea at the smell of edamame cooking with soy sauce, ewwww).  And then the definite possibility of getting the "foamies" (a pre-curser to vomitting that happens to WLS patients when their pouch decided not to respond positively to whatever they're trying to consume and they start to salivate quickly).  I don't want them to see that.  I'm not ready for people to watch me eat (other than my immediate family, that is).  Getting a sense of the anxiety that started to build up?  I'm sure I sounded like a babbling fool as I tried to deal with an invite politely over the phone, and eventually said "I don't know if that would work, maybe we could stop by after lunch".    Yeah, that's it.  Now if I could get rid of all the stuff before that, it sounds perfectly fine, right?

So I go in to my surgeon's office for my 3 week post-op appointment next week, and I'm excited.  I think I'm doing pretty well sticking to the plan, and my weight loss is now about 15 pounds since surgery, about 45 pounds since the beginning.  I'm hoping I can get permission/ blessings to start using my elliptical a little, and maybe do some lightweight free-weight training for my upper body.  I still get some pulling from my stitches, but it's a lot better and less frequent now.  I'm not supposed to be doing real exercising until 6 weeks post-op, but I feel like I'm wasting an opportunity, and I'm watching my arms starting to shrink and droop skin and I know that toning would help.  This next week I will also be switching to more puree/ less protein shake supplements.  The rule is that if I can get down 50 grams of protein or more from my purees I should stop drinking the shakes.  I'm planning on making that happen by adding unflavored whey protein to some of the purees to boost the protein levels.  I will also be beginning the rule that will apply for the rest of my life:  no drinking with meals.  I will not be drinking liquid 15 minutes before and 60 minutes after meals so that when my 1/4-to-1/2 cup of meals are in my stomach they are not washed through, thus making me hungry again sooner.  Other than helping us feel "full" it also gives our body the chance to start to absorb the nutrients better.  Since we can only sip (not gulp) liquids now, we need to consciously try to sip frequently in all of our allowed time slots to prevent dehydration.  Whew - big week ahead!