Bariatric Betty's inspirations

Inspiration comes from many directions. I was thinking yesterday about a woman who inspired me when I was in college.  Her name was Deirdre Taylor, and she was a wonderfully fun, enthusiastic, and beautiful obese woman.  She traveled as a Chapter Consultant for my sorority - Phi Mu.  Phi Mu was founded in Georgia, and we were used to women coming to visit and work with us in Ohio having southern accents, charisma, and being perfect size 2s.  Deirdre shattered that last stereotype for me and many others. 

I was overweight (although probably not obese) at that point, and felt welcomed in my sorority.  Unlike the generalizations that sororities are intolerant of differences, there was never any pressure to look a certain way, or lose weight, and my sisters were always there with a compliment when I looked extra nice.  Even so, I was surprised when Deirdre showed up my Junior year to work with us on leadership, risk management, and other training.  Our national officers had picked her to represent our sorority nationally; to be the face of Phi Mu to thousands of women she would meet over her year term.  As I got to know Deirdre it made perfect sense.  Her intelligence, poise and beauty were evident to everyone who met her, and her weight was merely one part of her. 

As I talked more and more with her, I became very interested in her position.  Working with collegiate women and helping them have positive, supportive, and successful experiences in college.  Improving study habits and GPAs, raising money for Children's Miracle Network, presenting themselves well for recruitment (and future interviews), and enjoying the friendship and bonds of their sisters.  I was inspired to apply to be a Chapter Consultant myself, and was selected to travel around the country for Phi Mu for the year after I graduated.  That experience ended up being one of the formative experiences of my life.  I learned I could arrive in any city, set up a temporary home and within hours be ready to meet with college administrators, lead workshops, and help women who were struggling with various situations.  My confidence went through the roof!  It led to my next position - being a Clinical Trial coordinator for a Prostate Cancer Prevention Trial. 

I was applying at The Ohio State University Medical Center for numerous positions - with my chemistry degree and enjoying the medical field, the location being hours away from my family, yet I had friends nearby... it was a good fit.  When I heard about the position I was asked "Do you think you could feel comfortable talking to older and elderly gentlemen about their prostates, urinary and sexual functioning?"  I didn't even miss a beat - "Sure!  I can talk about anything."  I had a two day window to learn everything I could about prostate cancer and make a presentation to the doctor who was the lead investigator.  Nailed it.  This was the beginning of my career ( until I became a full-time mom).  It was also where I met my husband. 

All of this because I saw a woman do something I had previously assumed wasn't appropriate for me.  She was a great example of how to not limit myself and my opportunities based on how I looked.  That carries on even now that I'm no longer obese.  Just last night I was jogging in preparation for my first 5k this weekend, and was joined on the track by 5 lovely middle-school/ high school girls.  Seriously, am I the only one who thinks 14 year olds look at least 18 these days???  When I jog, I try not to feel self concious about my appearance, but I am aware that there is a lot of jiggling and wiggling going on.  So last night as I jogged next to these young women I thought about Deirdre and about how these women probably didn't expect to find a middle-aged mom with more sagging and flapping parts than most joggers have jogging along with them.  And I thought "I'm proud to be here, jiggles and all.  I didn't even start to perspire until I was finishing my third mile.  And these girls can hope that they can jog a 5k when they're an "old mom" like me!" Then when I finished my workout I ended up talking to two older sisters who were trying the track for the first time and were interested in bariatric surgery.  It was a good night.

Today my hips and knees are a little sore, but I've got plenty of time to recover before the race Saturday.  Today my major accomplishment was throwing out the extra frosting after decorating the gingerbread for our tree instead of being tempted to eat it.  One day at a time...

Bariatric Betty's a shadow of her former self - PICS!

I'm blown away.  After seeing some pictures people had taken of them "wearing" a pair of pants they used to fit in pre-surgery by fitting both legs into 1 leg of the pants, I decided to try it.  So yesterday I dug through my old clothes and couldn't find any of my old size 20 pants - I donated a lot of clothes right after surgery.  But, I did find a pair of size 18 jeans and tried it.  It worked!  The funniest thing was that they were tightest around my calves and ankles, the THIGHS fit in easily.  So when I went to visit my father-in-law with my boys I had a documenting session.  This is the picture my son Justin took of me!

Seriously?  Holey cow. 

So, the second part of my documenting was the body tracing.  Flashback: the weekend before my surgery, my younger son Ian and I were talking and I realized that even though I thought I had explained the surgery really well to him, he thought I would be coming home from the hospital skinny, or at least signifigantly smaller!  So, in an effort to explain the reality, I laid down on a piece of posterboard and had him trace my torso.  Then I filled in some of the internal organs involved in red (a little hard for you to see on the pink posterboard, but it worked for him and that's who I made it for).  Then I used a blue marker to show where the cuts would be made on my skin, and what the surgeon would do on the inside.  Then I explained that when I got home, the outline of my body would still be the same, that is would take months of my new eating and exercise for it to get smaller.   I ended up cutting it out yesterday and laid it against a blue background.

About 5 months post-op I was curious to see how my "new" body would compare to the old one, so I laid down on the pink posterboard again and had my son trace me again.  That's the smaller outline you can see inside.  I was surprised (and pleased) to see that it had changed that much at that point.  Then I decided that when I had reached my equivalent of "goal weight" (my doctor never set a number, but I had suggested being in the 150s and he thought that was great) I would do it again.  That evolved into thinking that I would have my son trace me again on a different piece of posterboard and cut it out so I could lay it over the old me. 

Now I'm in the 140s (never really thought that could happen 8 months ago) and my guess is this is pretty close to my final weight.  I'm down to 28.3 % body fat I would like to see that go down a little (healthy is considered 25), but I think that will be more turning fat into muscle, so the scale won't change that much.  95 pounds down from my initial weight.  So, time for the tracing! 

OK, I have to say that my son's tracing must have angled in under my muffin top, my chest, and the rest of me, and apparently when I lay down my bat wings go underneath the rest of my arm.  I considered having him retrace me and tell him to try to make sure the chalk went straight down - there were a couple spots that his tracing seemed to have two different tracks (I cut on the larger one).  But then I decided no - he had done all the other tracings of me without directions like that - he might have been angling those as well.  So you can see from my picture at the top that my arms are not stick-like - so take this as more as a perspective, not reality - but WOW!

So after I spent a while wrapping my head around THIS I realized something else.  I lost 30 pounds BEFORE the pink one was made.  My pink self could have been BIGGER.

This shows me as literally a shadow of my former self.  But I don't see myself as a shadow.  I see myself as distilled, or concentrated.  The essence of me, with the excess and unneccesary boiled away by walking, jogging, swimming.  I am distilled.  I am high proof. 

Bariatric Betty starts the school year with pics and a plan

First I want to brag - I jogged 30 minutes straight on Monday, hitting the final goal of Couch to 5k.  I would love to show you a picture of me "crossing the line" but my camera's battery died right before my son tried to take the pic.  Here's a (blurry) but triumphant pic taken with my phone a few minutes later:

My sons haven't gotten up to jogging that long yet.  My older son has started football, so for now he's off the program as he is getting PLENTY of exercise.  My younger son was really struggling to get past the 3 minute mark before he started wheezing.  At first his pediatrician and I thought it was exercise induced asthma and he tried an inhaler for a couple weeks.  It seemed to make a small difference at first, but then there was an incident in which my older son provoked my younger son and the wheezing started up at only 1 1/2 minutes into a jog.  Hmmm.  After seeing the doc again and him having us induce the wheezing by jogging around his office, his opinion (and mine) is that this is anxiety related, not asthma.  Anxiety runs in the family (as does depression) and he has long had fears that have impacted his functioning to some degree (not wanting to be alone in a room, not wanting to go up or downstairs by himself, fear of loud noises, etc). 

The pediatrician came up with a great plan to keep Ian exercising but reduce the anxiety and make this a positive experience for him.  Ian will only run for 30 seconds at a time, and then walk for 2 minutes, alternating back and forth for 30 minutes 3 times a week.  Then the next week, we shorten the 2 minutes to 1 minute 45 seconds, but keep the running at just 30 seconds each time.  He'll jog more times, increasing his aerobic activity while making it seem like he's not jogging any longer.  We'll keep subtracting 15 seconds away from the walking time and monitor how it goes.  We've done it 4 times now and Ian is responding really well. The first time he couldn't believe how easy it was, and said "This is FUN!" - yes!!!  Here's the boys celebrating my 30 minute jog with me.

Unfortunately, once we left the 2 minute walk zone (the approximate time it takes me to lap him jogging while he's walking) it meant that our workouts aren't very compatible, so I'm doing extra workouts with him and changing up my routine.

School started this week, and with it my return to working as a lunch/ recess monitor.  I love this job for two reasons: I get paid (a little) to walk around for 2 1/2 hours and I get to interact with kids (including my 3rd grader) and know what's really going on at the school.   I'm getting in 5000 - 7000 steps a day during those 2 1/2 hours.  I'm also trying to break my dog into Pooch to 5k so that I can jog with him in the morning. 

Couch to 5k would have me do 30 minute jogs 3 times a week for another week before I would be considered complete.  Between my son, my dog, and my work this is what I'm doing:  1 30 minute jog on the weekend.  Daily 40 minute walk/ jog alternating 90 second jog and 3 minute walk with my dog.  Monday through Friday 2 1/2 hours walking at work.  And 3 times a week, 30 minute walk/ jog alternating with my son.  This doesn't prepare me to jog a 5 k, but it's definitely a LOT of exercise and works with my family.

I had a lot of fun going back to school on the first day for another reason - the compliments!  I had lots of people telling me how wonderful I looked, which was fun.  I have been very open about the surgery, so everyone already knows about it and the only questions I've gotten coming back to the school now are "How much have you lost now?" and "Are you trying to lose anymore?".  I happily responded to the first by saying "90 pounds!" and to the second by saying "I'm not really worrying about trying to drop any more weight, but change more fat into muscle." 

My plan is to eventually get to something like this: jog 1-2 miles a day with my dog, walk 2 1/2 hours a day Monday through Friday, walk/ jog 30 minutes three times a week with my son, and weight/ strength training 2-3 times a week.  That might be a little ambitious, but it's my current plan.

I've been adding more fruits and vegetables to my diet when I have room.  The other night I had 1/2 serving of steamed broccoli and 1/4 of a baked potato after my protein!  Woo-hoo - living the high life!  I'm still getting in 75 - 80 grams of protein a day, so there's not much room for much other stuff, but it does make getting fruits and veggies feel like a treat. 

Bariatric Betty feels shame and pride

I'm coming up on my 6 month post-op visit in a couple days, but first I had my 9 year old son's annual check-up.  That was difficult.

My son has been struggling with his weight pretty much his whole life.  He is in the 99% for height for his age as well.  When he was 2 years old he had an incredible weight gain of 10 pounds in something like 3 months, and we requested a consult with a nutritionist after lab work ruled out thyroid problems and diabetes.  We kept a food log for a month and other than cutting out one serving of OJ a day (he used to have 2 because he didn't drink milk, so we got calcium added OJ), the nutritionist said we were doing a great job.  She wished that most of the kids she saw ate as healthy as him.

For the last 5 years we cut out juice altogether (unless it's a "treat" - like instead a bag of chips or dessert if we're eating out).  We've also paid close attention to serving sizes, making protein the priority, and helping him figure out if he is really hungry or just bored.

We've worked hard to keep him active; in addition to loving to ride his bike, play in the pool and on playgrounds, he's done over 4 years of karate and played community soccer for the last 3 years.  This summer we added baseball and the couch-2-5k training.  Last year his pediatrician said this was very important - that he's always going to be a big kid, but that we want to slow his weight gain as he grows and help him have a healthier lifestyle.  Our previous pediatrician (before me moved) had said the same thing, and had said that she would expect an average weight gain of 10 pounds or less a year for a kid like him.  I thought we did really well (especially since my surgery), and suspected he had gained less than 5 pounds in the past year.

First, the good news.  He only gained 4 pounds, so I was right about that.  But, I was wrong about how much he had grown.  I was just SURE he was 5 feet now, but it turns out that he's still under at 4 ft. 10 inches.  He only grew 1 3/4 inches this past year.  That's not a problem, because he's still the tallest kid in his grade!  What was a problem was that I was using the wrong number at home when I was calculating his BMI.  My using his incorrect height of 5 feet meant that he was overweight and had a decreasing BMI.  The correct height means that his BMI is 30.1, and he is officially obese. 

That crushed me.  My son is following in my footsteps in the last way I would want him to - to obesity.  After experiencing the joy of watching my own BMI drop from (morbidly obese) 43 to it's current (overweight) 27.8, seeing that he is just over the border into "obese" just about broke my heart.  I try to teach my kids so many good things, but he learned the lesson of overeating from me. 

His BMI is decreasing.  After I got home I realized I didn't know what his BMI was at his annual physical last year, so I calculated it.  31.2!  So in one year he has gone down 1.1 in BMI - a definite improvement.  And he's now on the border of obesity, instead of sitting solidly inside the category.  He's stretching out, can wear the same size as last year, and is definitely more active.  But that didn't stop that crushing feeling of shame; knowing I failed him by being the unhealthy role model I was for most of the first 9 years of his life. 

I am proud of the changes that I've made, and the ones I've helped my family make in the last 6 months.  I feed them healthier food, and we are all more active.  I know that he is absorbing the hard work he sees me doing, and listens to me talking about how much better I feel.  I feel that I have stopped the trend of increasing BMI and started to reverse it in him.  I knew he was overweight, and I had been trying to help him keep on the right path before I knew he was obese.  He didn't become obese at this visit, he became obese over a year ago, I just didn't know it.  Knowledge is power.  I didn't know how much I was hurting my body until I was diagnosed as a diabetic.  I didn't know I could live the rest of my life on a modified diet until I had to with diabetes, and the success I had in lowering my blood sugar gave me the confidence that I can change my life with the weight loss surgery and my new lifestyle.  I knew that even following the diabetic plan my life would be shorter and have a lower quality of life, and that meant the risks and sacrifices involved with weight loss surgery and living post-bariatric bypass were more than worth it. 


So now I will try to let go of the shame, and focus on the pride I have in the changes I have made in the last 6 months.  And the knowledge that he is almost NOT obese will be a great motivator to keep us all running, to keep me on my plan and be a good role model for him.  Because these are the lessons I want him to learn from me - that if you work hard, you can make good things happen.  You can be healthy, and find out that you're able to do things you've never done before.  The unimaginable becomes possible.

Bariatric Betty gets Vanity Sized

Before I had surgery, my mentor JoJo said "Oh, you're going to be just tiny!" and bet me I would be wearing size 10s or less.  I told her that was not possible.  I've only worn size 10 jeans once, and that was during my high school flirt with aneroxia.  I had started out dieting somewhat sensibly but as I hit plateau and after plateau I ate less, exercised more, and ended up skipping meals for days at a time.  When I got to the point that I was getting dizzy and starting to pass out when I stood up something clicked (Thank God) and I started eating normal meals again.   Then of course, I started eating more than normal size meals and became overweight and then obese again.

I have no intention of going down to that weight again (according to bmi charts I was at about 20), so I thought "Heavens, no!   There is no way I will wear size 10 jeans again." even though JoJo reminded me that today's size 10s aren't the same as yesterday's size 10s.  Then yesterday I went jean shopping after finding out that my size 12 jeans were getting loose.  I ended up buying a pair of 10 petite jeans at Talbot's Outlet. 

What the heck?!?  OK people, I got quite the buzz off of that, I'm not going to lie.  However, my BMI is 30.4 today, I weigh 58 pounds more on the same height I had back then, not to mention I've had kids, so my hips bones aren't even the same configuration any more.   For those of you not used to the BMI numbers - I'm still officially OBESE (for about 6 more pounds) and I'm wearing size 10 jeans. 

Lies.   Lies lies lies lies lies.  Lies we tell ourselves; "just a couple bites of that won't hurt my diet", lies we are told; "school lunch 'tossed salad' = 1/4 cup of shredded iceberg lettuce", lies the fashion industry tells us; "you are a size 10!"  Lets get real, people!  None of this is helping - it's part of the reason that we are becoming an increasingly obese society.  

Because a middle aged woman can gain over 50 pounds of excess weight and find herself buying the same "size" clothes she used to buy.   Why do we even bother with ladies sizes?  Because we don't want to got by waist and chest measurements like men?  I remember reading multiple times that Marilyn Monroes was a size 12.  Right, I believe that, but to say that implies that she would wear a size 12 today.  Uh uh.  The last time I was my current weight I was getting married (15 years ago).  Now the pounds have moved around somewhat, but I think I was a size 14 in my jeans.  So in 15 years the sizes have moved that much:  14 then = 10 now.  Go back to high school and that's 23 years.  I'm guessing that the 16 year old me wore a today's 4 or 6.

The wedding dress industry may be a little more honest in the measurement department.  15 years ago I was told to order a size 20 wedding dress.  Ouch.  I had heard that "wedding dresses run small" and the size 20 was the right size for my chest, but it's still not fun to hear.  They took in the waist and took up the hem, and it looked great.  I expect that now a days current brides get a much larger shock than I did.  I was watching "Say Yes to the Dress" the other day and a bridesmaid ordered a size 6 dress instead of the 12 that was suggested because she was so upset that they would suggest that she wore a size 12!  I can understand that feeling, but believe me, even after dieting she POURED herself into that dress. 

New York City just made the headlines because they might be banning serving drinks in glasses larger than 16 ounces.  Why?  Because sugary beverages are a leading contributor to our expanding waistlines, and we should be aware of how much we are taking in.  That 44 ounce Coke at the movie theater has over 500 calories - which is 1/3 of the total calories an average woman should be consuming for the day.  (I won't even TALK about the popcorn. Mmmmm popcorn.....)  So get a refill of your 12 or 16 ounces, but know that you're asking for more than 1 serving - make a conscious choice.  I know some people will be yelling "Nannystate" at NYC, but really - if we didn't need reminders, we wouldn't be doubling our obesity rates, would we?


I want to give a shout out to the recent series of anti-smoking ads that have been played on television.  The ones with real past smokers talking about caring for their stoma, or amputated limbs, or living after a heart attack.  They have apparently resulted in a real increase in smoking cessation program inquiries.  Maybe there should be a series of obesity related ones like that.  Reality checks.  Maybe they could feature WLS patients...

Bariatric Betty 99 days post op; Joy, Pride, and Fitbit!

I went to my 3 month post-op visit this week and got great news!  Since my operation I have lost 40 pounds, which is 46% of my excess weight on the day of surgery. 70 pounds since the beginning of my blog.  The doctor was thrilled and called me a "model patient".  I felt like my teacher just gave me a big gold star, and couldn't stop smiling all day - even when my labs where being drawn.  I also enjoyed wearing my new size 12 shorts that day. 

I got a Fitbit this month, kind of a pedometer on steroids.  It not only tracks steps taken and distance traveled, but flights of stairs climbed, calories burned based on your profile, and has a motivating graphic of a flower that grows taller the more active you have been in the past 3 hours.  I have been LOVING my Fitbit, and the fact that it downloads the info wirelessly to the website, which then communicates my exercise information to www.myfitnesspal.com (where I log my food) automatically - which really simplifies my activity logging.  I've also found  that it motivates me to push myself farther - so I can reach the 10 flights of stairs, or so I can hit a new "record" for steps taken in a day, etc. 

I clip my Fitbit on every morning, and the morning I had my follow-up appointment was no different.  What was different was that by the time I was at my surgeon's office I realized it wasn't clipped on any longer.  I lost my Fitbit.  I back-tracked my errands that morning and have been unable to find it, so I contacted support@fitbit.com and asked them if I could purchase another unit but without the charging base (and therefore hopefully cutting down the replacement cost).  To my surprise, after giving them the information about where I purchased it, on what date, and what email address it was registered under, they offered to send me a new one FOR FREE!  Are you kidding me?  I can't say enough about their customer service.  Their product didn't break - this was all on me and they are sending me a new one. 

So I'm sending a shout-out to the folks at Fitbit today, and it's just part of the reason I'm smiling so much this week.

Here's another.  I've lost two pounds in the last two days.  Huh?  Yeah, we all know that our weight fluctuates daily.  So a one day one pound difference is normal, and I tend to lose 1-2 pounds a week right now.  The weird part is, I was already down 1.5 pounds for this week - and now I lost another 2.  So I found myself grinning as I walked around the neighborhood with my dog this morning.  It's important not to become dependent on seeing weight loss on the scale all the time - I have gone for 5 days or so without seeing a drop, and those are the days that I have to remind myself that my body will go at it's own pace but continue to get healthier as long as I follow the program.  I remind myself that I will have plateaus in the future - real ones that last weeks, not days.  But to not do anything different and lose 3.5 pounds this week instead of 1-2... yeah, baby!

After my appointment, I had another class with the nutritionist.  I explained that I was concerned about trying bread and pasta - both because they could be triggers, and because I was worried about dumping.  She encouraged me to try some small low carb options.  I tried making cheese pizza on Flatout Lite Italian and could only eat about 2/3 of it.  It didn't make me sick, but the bread felt like a rock in my pouch - not really painful but uncomfortable.  I have no interest in trying it again any time soon - no trigger there.  Then last night I tried eating half a small pita bread as a cheese sandwich with provolone, lettuce, and avocado.  It tasted great, but I got that same pouch-full-of-setting-cement feeling after a couple bites.  So I know I CAN eat these grains in moderation without dumping, or having them get stuck.  But I don't WANT to.  Avocado, on the other hand, I think I could eat daily (yum!) if only it was a protein source ;) 

I'm really proud of myself and feel certain that I will get to my personal goal (140-150 pounds).  The surgeon expects that I might be around 150 at my 6 month follow-up! 

I'm preparing for the end of the school year.  I will enjoy spending more time with my sons (most of the time, anyway) and not going to work.  However, I will be losing the paychecks and guaranteed extra 5000-7000 steps M-F that I have been getting as a school monitor.  So, I'm preparing to start Couch to 5K training with my boys.  My goal is for all three of us to be able to jog one as a team by the end of the summer.  I've never liked running, and don't have the best knees in the world, but after hearing about the successes of other WLS patients with this program, I'm really excited to try.  That, walking the dog, and swimming will be my exercise staples over break, supplemented by the elliptical on bad weather days.  We are also planning for our upcoming trip to Williamsburg and some weddings of friends. 

Hoping all my readers have one of these can't-stop-smiling days soon.  Happy Friday!

Bariatric Betty Talks Truth, Lies, and Money

I am three months out from surgery, and VERY happy with the results.  In addition to no longer being diabetic, I have lost 36 pounds since surgery, for a total of 66 pounds lost.  I have my 3 month checkup next week, and feel confident that they will be pleased.  They told me that the average person loses 50% of their excess weight by 6 months post-op.  I am 3 months out and have lost 40% of my excess weight (from time of surgery).  Yippee!!!  My energy is super high, my mood is improved, and I have the ability to do things I couldn't have done a few months ago.  I look forward to getting my labs done and making sure I'm doing well with my vitamins - I will be honest and say that I have forgotten to take them a few times (but only a few) and want to make sure my levels are good.

One thing about being three months out from surgery - all of the claims have been submitted, processed, and paid (as much as they will be) by my insurance company.  Watching this (and paying the remainders) has been very interesting.

For those of you who may not have been reading my blog since the beginning, I will suggest you take a look at my first few posts - probably starting with Bariatric Betty Gets Sucker Punched, and the ones immediately following.  To summarize, I will say that the first hospital's bariatric program (Hospital A) gave poor/ false information in their information session and after I was all psyched to begin my journey I found out the costs were more than DOUBLE what I had been told.  I then attended information sessions at Hospital B and Hospital C - eventually choosing Hospital C in part because of it's relative affordability, and partially because I was so impressed with the warmth of it's surgeon and staff, and it's low complication rates. 

The truth is two-fold.  The warmth and skill of Hospital C was genuine and fabulous.  The costs they estimated were not.  Did they knowingly give me false information?  I don't know.  I'm dissappointed that they didn't give me correct information - and given the extraordinary care I have received and continued to receive I prefer to guess that they don't know what really gets billed.  That leads me to think that perhaps I should think less harshly of Hospital A and their mistakes.   Maybe I would have found the same thing at Hospital B if I had gone there.  It really makes you wonder: DO DOCTORS AND STAFF AT HOSPITALS HAVE ANY IDEA WHAT THEIR PATIENTS ARE BILLED?  At least in Northeast Ohio, I would guess the answer is No. 

Hospital C told me that for my surgery (RNY Gastric Bypass, laproscopic) and the typical hospital stay (two nights, three days) I should expect that the total bill of about $22,000 - not including anesthesiology (which for some reason, none of the hospitals bills for - it's all billed seperately by the anesthesiologists).  I was told that the average anesthesiology bill for my surgery would probably be a couple thousand by my patient care coordinator, but since she doesn't work for the anesthesiology groups, that was the best she could do.  They also estimated (based on past experience with my insurance and this surgery) that I would need to pay about $3000 out of pocket all said and done, and took a deposit for that amount during pre-admission testing. 

Ready for reality?  I had 10 bills between preadmission testing and surgery.  Radiologists, labs, the hospital, the surgeon, the anesthesiologist, the doctor who check in on me before I was discharged.  Total bills?  $54,539.30!  Yup. 

Now, once my insurance calculated what was "allowable" under their contracts (this was all in network and pre-certified) the total recalculated amount to be paid was $19,946.26 (big difference).  My insurance paid $17,464.24 and I was responsible for $2482.02.  Of course, I have had to pay for the bills not directly through the hospital out of my pocket and have to wait another month or so to get my refund of the remainder of the deposit - so as of right now I have paid about $3600, but I should be getting over $1100 back (eventually).  And yes - all of these numbers included anesthesiology: it was originally billed at $2800 for the surgery and an additional $100 for post-op pain relief (a bargain) and was negotiated to just under $1300 total under contract). 

So why the discrepancies?  I can only figure that the person I talked to who does the billing to the insurance was looking at the negotiated rates when she gave me the quote of $22,000 (plus anesth.) even though I asked her what the difference was between the billed amount and the contracted costs - she only had one set of figures and gave me the impression it was the billed amount.  I ended up paying less than they anticipated out of pocket for as perfect an experience as I could have hoped for.  It's hard to be mad.  But it does make me ache for everyone who doesn't know how to read Explanation of Benefits (I used to do that as part of my job in my former life), and it did give me some stress during my recovery (like watching the amount billed and then PRAYING that the allowable amount would be signifigantly lower). 

As I watched things "in process" and "approved" and bills come in I knew I would want to blog about this when it was all done.  Why can't hospitals tell us all the costs?  Why can't they bill the contracted amount instead of inflated figures?  Why can't we understand the real cost of healthcare BEFORE it's given?  We need to be educated consumers, and I thought I was.  Still, I was surprised.  I know I was lucky - so many people want this surgery and don't have any insurance (or no coverage for bariatric procedures, specifically).  People in Canada routinely wait 6 months - 2 years for their free procedures - I started this journey only 9 months ago and had excellent teaching and guidance (part of which was mandated by my insurance). 

I don't have a solution for what's wrong with healthcare in America.  I do know it needs to be available to and affordable for everyone, and it is neither.  I know my insurance company (and myself ) will likely save tens of thousands of dollars now that I am not a diabetic.  I am worlds healthier and will live years longer than I would have without the surgery.  I pray that everyone else gets the opportunity to have life changing operations like I did if they need them. 

Bariatric Betty wrestles with Head Hunger and takes a leap of faith

Head Hunger - the feeling you have when your brain is telling you that you are hungry, but you are not.  You might be thirsty, you might have just seen or smelled something that awakened a craving, or you might have just stumbled upon a trigger that used to cause you to eat (emotional stress, a time of day, a social situation..) 

Real hunger isn't something that my stomach can feel yet - it will probably be 12-18 months post-op before I feel that again.  That's part of why this is called the "honeymoon" period. 

So this week has been enlightening in several ways.  First - head hunger.  I have experienced this numerous times before this week and dealt with it OK; drinking more fluids, sucking on a cashew, distracting myself.  This week I experienced a stronger feeling, about 1 1/2 hours after dinner.  I felt hungry.  Not thirsty, but like I didn't have enough to eat.  So, given that I had eaten 1/3 cup of cooked lentils with a couple tablespoons of greek yogurt for dinner, I thought "OK, I'll get a little more lentils.".  Note - not craving something "bad" - head hunger can be sneaky!  I got another 1/4 cup of lentils and started chewing slowly.  After two bites, the "Uh oh" feeling hit, and I went and threw them up.  Yuck.  I cuddled up with blanket I thought about the other head hunger episodes I've experienced and realized that evening time is a trigger for me.  A couple hours after dinner (about the time the kids start saying "can I have a snack") my head is trying to get me into my old habit of having a snack.  I can distract myself, drink more fluids, etc, but it is still trying to fight me.  Weird talking about your brain as if it's another person.  Anyway, I decided the best thing I can do is put it out there.  My kids (and sweet hubby) are never happy to listen to me get sick - so when I said "Hey guys, I just realized I should NEVER eat after dinner.  It will only make me sick.  Drinking and sugar free popsicles are OK, but no food" they listened and I knew I would be held accountable.  Hah!  Take that sneaky head hunger!

I made need an intervention in the future about my consumption of sugar-free popsicles, but for now I will let it slide.

So, a couple of fun things this week.  I have been struggling with what I will wear to my son's first communion and my best friend's wedding reception.  All of my dresses in my closet are too large.  I went online and found an adorable cotton & silk dress that I thought would work for both, and I was going to order my current size, when I realized that the next size down would be $15 cheaper.  We will discuss my rage issues regarding the overpricing of plus-sized clothing another day.  ;)  Hmmmm.  Given that I'm losing about 2 pounds a week right now and my friend's reception is about 45 days away... I ordered the smaller size.  So, that's my little leap of faith - that I will fit into smaller dress size in 45 days.  At my heaviest I was a size 22 dress, now I'm down to feeling like a 18 is roomy.  And a 16 is on it's way to my house! 

My other fun thing happened yesterday - after getting my hair done my curiosity got the better of me as I passed by a Talbot's outlet store.  Oooooo, nice clothes...  Talbot's is a store I haven't set foot in for over a decade.  Too expensive, and my body wasn't Talbot's size.  But the big posters in the window saying "Additional 75% off already reduced prices" lured me in and boy was I in for a surprise!  First of all - Talbot's has plus sizes!  I don't know when that started - I don't remember seeing plus sizes in other stores in the past - it might be just because it's an outlet store.  But for all of you who might wear plus sizes now - check out Talbot's!   Second of all - I don't NEED to wear the plus sizes!   I fit very nicely into several pairs of shorts and pants (size 14) and actually narrowed down my choices based on what looked BEST.  Huh, enough things that fit that I could say "I prefer the way this one looks to that one."  Best of all - sale prices!  I got a wonderful plum corduroy blazer, two pairs of shorts, and four blouses for under $40.  SWEET. 

My last thought - Passover.  For those of you who don't know me personally, my religous background is confusing and I have not ever formally been a part of any religion or congregation.  However, my faith is very strong and I have found a lot of comfort praying Hebrew prayers and celebrating the high holy days for the last decade.  Someday I might make the step to conversion, but right now I have quite enough converting going on in my body and mind (thank you very much).  My family is very supportive - my husband was raised Catholic but fits more into a Zen-buddist Catholic mindset than anything, and since I didn't have a strong religious background to raise our children in, they have been raised in a similar open-minded, inclusive Catholicism.  So this is the first Passover in quite some time that I'm not participating in a Seder (either my own mini-one or one thrown by friends) and while I'm not having anything leavened/ hametz that is more part of my medical journey than spiritual one.  It feels strange.  And my kids miss the matzah!  One step at a time.  But my prayers are just as strong (or stronger) and I know they are heard.

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.

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. 

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!

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! 

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!

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...

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.

The Decision, and The Call

OK, so if you're a Weight Loss Surgery person, you know what "The Call" is and can skip the next paragraph.  If not, here you go.

I got two days of The Call.  The first one was yesterday, 1/30/2012, about 6 months after I went to my first information session about baritric surgery.  It was my patient care coordinator, Diane, from hospital C calling to tell me that my insurance company had finally pre-approved my surgery!  This is the call I've been waiting for - I finished my 90 days of multidisciplinary supervised dieting a month ago, and needed them to review all the documentation and say "Yes, she's compliant and fulfilled our requirements for pre-approval".  The second part happened today, 1/31/2012 about 15 minutes ago.  Sabrina, the scheduler called and said that they actually have an opening in the surgical schedule for Feb. 16th! 

So now that I have a surgery date, I'll call Feb. 16th my new Valentine's Day.  The one where I and my whole family say "You are worth this, we love you and want you to live a long healthy life".  I'll be honest, when I got the call about the insurance company approving me I broke down and cried.  In my car in the parking lot of the grocery store.  Several times.  It took me until my fourth phone call to family to stop crying each time I told them.  So the scheduler was supposed to call me in the next couple days, but they needed to make sure I understood that I would need to pay the $350 program fee and the $3000 deposit (because my insurance caps it's bariatric benefits below the cost of the operation) when I come in for pre-admission testing.  OK, I've been preparing for that.

I was so overwhelmed, I almost got in a car accident on the way home.  By the time it was dinner, I think I felt like a kid at the end of Christmas day.  Dazed, so happy to have gotten just what I wanted, but exhausted from the emotions of it all.

The scheduler called today, and I'm going in for blood work, EKG and counseling with the inpatient care doctor and nutritionist all day on Thursday.  Deal!  Can I pay the program fee and deposit in just two days?  If they take credit cards, I can!  (The answer was yes). 

So now things are clipping right along, and I'm going to be working like crazy to get everything prepared.  Coverage for the kids (my husband and mom will be helping), grocery shopping for them ahead of time - grocery shopping for my liquid diet post-op (noting NOT to overbuy - especially on things like broth, thank you guys for your blogs), and cleaning the house so my mom doesn't put EVERYTHING away where I can't find it when she comes to help.  Pre-op pictures - check.  The list is a living, evolving thing.  Suggestions are welcome!

I'm so excited!  And everyone I know is so excited for me.  I am blessed. 

Bariatric Betty says "What are we doing to our kids?"

Those of you who have read my blog before know that my children are a large part of the reason that I want to have this surgery.  I don't want them to grow up without a mom, or with a blind mom, or with a disabled mom if there is anything I can do to help it.  Being morbidly obese (actually now just "obese" with the pre-op diet) and diabetic means that those conditions are in my future - it's just a matter of when. 

It's also because I don't want my kids feeling like they have to defend or protect me.  When I hear that my kids have heard someone call me fat, or laugh at me, it breaks my heart.  It's never fun to be insulted or the butt of someone's joke.  But the big thing is that kids aren't supposed to defend and protect their parents - their suppposed to be protected and defended BY us. 

Then there's the fact that I want my children to be healthier than I am.  Having parents that always struggled with their weight and body issues, I want to be a good example.  I don't want to just say "go outside, play some basketball/ soccer/ run around.." - I want them to see me DOING that stuff.  To know that I will have the energy to join them and inspire them to be more active.  To see me eating healthy, and have healthy food for them to eat as well.  To know that a great way to have one-on-one time with me is to go biking, or swimming, etc. - not just cuddling up on the couch. 

My kids are overweight.  Not obese, but overweight.  One of them was in great shape until about 1 1/2 years ago, when we moved.  He is a black belt in Tai Kwon Do and was incredibly active.  No matter what he ate - he burned it off.  Now that he's just moderately active, it has started to accumulate.  My other son has always been heavy, in addition to have developmental delays and low tone.  We have always gotten them into community sports, and started taking them to the gym twice a week 5 months ago - and it's making a difference.  My husband has taken the brunt of that - he committed to getting them there no matter what - and it's rare that they miss a Tuesday or Thursday.  Their clothes fit differently, and the scale shows that they've leveled off.  Our pediatrician said that he would like them to be active and work on "stretching" their bodies out - getting taller without gaining much, not putting them on a diet.  But we have cut change their preference to graze to having defined snacks, and my personal battlefront has been serving size.  My 8 year old now knows serving sizes of many of his favorite snack foods.  He double checks the amount of Cheerios or pretzels he puts in a bowl with me.  He knows that he can have 5 crackers with his cheese.  It's still hard though - because there are times he just WHINES about wanting to eat more.  I usually don't give in.  He still gets treats - just not everyday, and when he does get them, they replace a snack.  That's important I think, because I want him to learn moderation.  I don't want him to end up like me. 

So this morning while I was working out I watched Toddlers & Tiaras.  It's easy to feel morally superior and snarky when you watch an editted "reality" show like that.  Usually when I watch it I cheer for the underdogs and girls who actually seem nice, and hope everyone else finds a good therapist some day.  Today, my heart hurt as I watched.  A big thrust of the episode was about the girls' weight.  As the pagent director put it "girls who aren't really pretty or are a little chubby should just find another hobby".  OK, I think all of the girls there should find another hobby, and a small percentage actually enjoy what they're doing, but it was the overall message she was giving that blew me away. 

The girls she was talking about were under 10.  Most were 4-7.  Choosing a girl as "most beautiful" from a group is one issue.  Telling girls that young that they are not pretty enough or too heavy to even be IN the competition appalls me.  Most of the pagent directors in other episodes talk about "building up girls' self  confidence" and "being proud of yourself".  This director from Arkansas held up no such illusion.  "These girls should look like Barbie". 

If I was a reporter, I would now insert several links to studies that show how young girls body images are damaged by dolls like Barbie, or reference other articles about how a woman actually built "like Barbie" would be incredibly unhealthy, almost grotesque to look at, or at women who have had dozens of plastic surgeries to approximate that "Barbie" look.  But I'm just an opinionated mom, not a reporter, and you can look those things up if you haven't heard of them.  And I think that if I had a girl I would let her have Barbies, I would just also make sure to point out how weird their proportions are, and make sure she had other dolls as well. 

Perhaps even harder was listening to moms who put their daughters on diets.  At 5 and 7 years old.  These children were not overweight, let alone obese, but they were going to "eat lots of salads" so they would look better in their beautywear.  One mom who was hyper about it, ended up having her daughter's beautywear dress be TOO LOOSE because she had lost more weight than she thought.  Think about that.  A 7 year old who probably weighed 60-70 pounds to start lost about 10 pounds to prepare for a pagent.  And then the judges ended up deducting points because her dress was too loose.  Or the 10 year old girl who won the Ultimate Grand Supreme (translation: the biggest prize) who stood in front of a mirror, probably weighing 65 pounds in this beautiful dress and said to herself "This dress makes me look big". 

The United States has a big problem with obesity.  And the kids are starting to catch up with the grown-ups.  The government just finally changed the school lunch programs to say our kids have to be offered a fruit AND a vegetable at each meal.  However, they also caved to lobbyists and said that pizza can continue to be counted as a vegetable.  Read that last line again, I'll wait.

I heard about a contest that Disney is running where you submit pictures to show changes your family is making to try to improve their health.  LOVE IT.  Way to go, Disney!  The grand prize winners get all expense paid trips for 4 to their new Hawaiian resort.  I told my kids that I'm bringing my camera to the gym tonight to take pictures to show how well they're doing and submit it for the contest.  I'm telling you about it because I would love for everybody in the world to know about it.  Tell your friends, tell your neighbors.  Because even if it increases the number of entries ten fold and decreases our chances of winning, it increases our children's chance at healthy lives.  And they deserve that.