Bariatric Betty Breaks down a bit, plus a new pic

I saw my primary care physician for the first time since surgery this week.  She was thrilled with my success and there were a lot of fun "Oh my goodness, I almost don't recognize you!" compliments.  She asked a lot of questions and was thrilled with my exercise routine.  She also seemed surprisingly knowledgeable about blood tests that need to be watched.  But, there were some not fun things as well. 

If you remember my birthday post, I talked about how my birthday was wonderful with the exception of some poison ivy on my face and neck.  I ended up getting both an injection of steroids and later being put on an oral dose pack as well.  About halfway through the itchy mess of that, I noticed a sore itchiness around my waist on my right side.  At first I assumed that I had spread the poison ivy there in my sleep.  Later as it spread around my back, I began to think it might be something different.  It felt uncomfortable for fabric to touch it, and it wasn't as itchy as the poison ivy.  I rubbed some topical cortizone cream on it a couple of times a day.  I started wondering if I was experiencing the skin infections/ rashes that some WLS patients get under the folds of their skin.  My rash seemed to be on top and under the flap of skin, but I thought I would get my primary care physician's opinion.  I haven't thought I would want plastic surgery unless there was a medical necessity.  On the other hand, if my skin was going to itch and sting like this off and on for the rest of my life - that might push me towards it, and I better start getting it documented.

So as I described it, she said she would take a look - we were doing my annual exam, so she was going to be looking at everything anyway.  It only took her a couple seconds of looking for her to inform me that it was not poison ivy.  It was shingles!  In a lucky coincidence, I erupted into shingles while I was being treated for poison ivy, so all the steroids I was taking for the later helped the shingles not be so horrible.    What a strange silver lining!

Next she felt my hips - I had told her about sleeping on my stomach with a pillow under my abdomen to alleviate discomfort from my hip bones on my skin.  She felt them and said "Oh my, you are bony there!"  Bony?  Never in my life would I ever dream I would be called bony ANYWHERE.  But one thing you learn about major weight loss is that you don't lose it evenly, and certainly not in any order of preference of location.  Then she felt my left hip where I have been feeling some pain especially when I'm walking/ jogging and announced that I have some bursitis.  She would have prescribed anti-inflammatories, but knew I can't take them as a WLS patient.  She said if the tylenol stops working, she can prescribe injections of anti-inflammatories, which I can take. They also suggest you stop the repetitive motion that is aggravating the bursa and causing it to be inflamed.  Yeah.  Well, I can't stop walking, and I don't want to stop jogging.  For now the tylenol works fine.  But there might come a time when I will need to change my exercise routine because of it.  Isn't bursitis like an old-person-thing?  I guess it goes with my old-person-loose-skin now.

Last borders on TMI, but she also found that the unusual pressure I have been feeling at times is due to a rectocele.  A rectocele is kind of a hernia of the colon.  In my case it isn't causing actually pain, and returns to it's proper position when there's no straining involved.  She said that there's no risk to my health involved right now but that if the pain or retraction changes we'll have to look into surgery.  Apparently obesity is a big risk factor in rectoceles.  I suspect I might have had it for a while but didn't notice it until my diet changed into 90% protein and therefore made me more prone to constipation.  So I will continue to work on packing fiber in. 

Two weeks into my new workout program results... my dog and I can both now jog North/South Roundhead circle. That means that except for a 5 minute warm up walk and 5 minute cool down walk, we are now jogging his entire walk! Boy, that was quicker that I imagined it would be. There are several advantages to this. First and foremost, I get his walk done in 25 minutes instead of 45. Extra time is a serious advantage. Second, it kicks up my exercise a notch, increasing the intensity and calories burned. I'm still not loving jogging itself, but I'm enjoying the benefits.

I'm doing the alternating walking/ jogging with my son three evenings a week, so on those days I'm just walking Perseus in the morning. Then I'm walking during my monitor shift. Last Thursday I got over 20,000 steps in a day according to my Fitbit! Even cooler, I found out that since I got it on Mother's Day I have walked over 1,000,000 steps. One million.  How wild is that???

Then there is the mental part of my work-in-progress life.  Last weekend I had a scary reminder of how easy it is to get off track.  We were holding a sleepover and I went to go make the traditional post-no-sleep-over breakfast of pancakes.  Out of Heart Healthy Bisquick.  So I got out my cookbook and made some batter from scratch, but it didn't look or cook right.  I tasted it, and realized I had forgotten to put in the melted butter.  Remixed it and tasted it again -ahhh, much better.  I made the pancakes but found myself wiping off the batter drippings with my finger (and then licking the finger).  Yum.  Uh oh.  I love to bake, and have been very good since surgery not to eat anything I bake (which has been pretty easy).  However, for some reason I have always liked the unbaked stuff (cookie dough, batter, etc.) as much or more.  Here I let down my guard and find myself slipping into old habits.  No no no no!  It's a reminder that I need to be vigilant.  I probably tasted less than a tablespoon of batter, so I didn't dump.  I did, however, crave carbs more than usual for the next couple of days.  This weekend we had another sleepover, another pancake breakfast, and I was careful not to let one drop of batter reach my lips. 

I also caught myself chain eating salted cashews when they are left out on the table.  Cashews aren't a bad snack if I haven't gotten all my protein in - but when you find yourself taking three or four nuts every time you pass the table you aren't eating to live.  You're grazing.  Away go the cashews.  Out of site, out of mind.

All of this leads up to my losing it over some innocent choices my husband made for my son and officially inducts me into the food-nazi society, I guess.  After a tough football game that my son played in a soaking rain, my family split up for the trip home.  My husband got my football-player son a bottle of "Gatorade: Recovery".  And a bottle of regular gatorade.  I found out about the first on the phone and was like "Why??? It's only 10am?  He had 20grams of protein at breakfast, he doesn't need the 16 grams of protein now when he's going to come home and eat lunch (and more protein) in one hour!  And it has a lot of sugar, too.  He doesn't need that.  He's going to get high blood sugar and then crash as the insulin kicks in and feel horrible."  The when they got home I saw a second bottle of regular gatorade being consumed on top of the first one and just took it from him and threw it out.  "Did you know that the American Academy of Pediatrics recently said that NO STUDENT ATHLETES WILL BENEFIT FROM SPORTS DRINKS?  That basically it's like giving them sugar water or pop.  The only gatorade they should get is the low cal one, and even then it's unnecessary.  Water is best.  If they want to drink one of these for treat - like instead of an Icee, that's OK, but this is not helping him!"  Add in that they stopped at GameStop on the way home so he could blow his allowance when his brother also wanted to go there, and I was beyond irritable. 

It didn't help that I was tired, having to get up at 6am on Saturday to get him to the pre-game warm-up and meeting.  Or that I hadn't gotten my usual morning walk/ jog in with the resulting endorphins.  But I think mostly it was feeling overwhelmed.  Pushing myself to keep up with my exercise, work, finding out about the shingles/ bursitis/ rectocele, and the normal daily struggling with the kids about homework/ cleaning up/ etc.  I just lost it.  My poor husband. 

So the last couple weeks have been a little shaky, but I'm leaving them behind and climbing back out of that place.  I went to a baby shower yesterday at a beautiful restaurant and drank water through the whole thing.  I really enjoyed seeing a lot of extended family, and really liked most of the compliments I got as well.  The only exception being the one surprised "You look really pretty!" that was then amended to "Oh, not that you weren't pretty before."  Yeah, it's OK, I understand.  And the spirit it was intended in was nice, and they're right I do look a lot better.  I did have to spend about 15 minutes explaining why Visalus would NOT be a good choice post bariatric surgery.  Does anyone else feel like that's a pyramid scheme?  Oi vey.  Anyway, it was fun for the most part, and I brought the take-home goodies back for my boys.  Here's a picture.

 

Bariatric Betty's body and mind - new pics

I'm coming up on my 6 month post-op point and so much has changed.  Many things, but not everything.

I am no longer diabetic!!!  That will always deserve first billing and multiple exclamation points.  I know that not everybody who has WLS has their diabetes go into remission, and that it can return, but so far I am among the lucky ones and hope to stay that way.  I was just talking to my 9 year old about it yesterday.  That I can assume I will live to see my kids grow up and maybe see grandkids or even great-grandkids some day is something I could not presume before. 

My body continues to morph into a previously unknown thing.  I wrote months ago about the bizarre feeling of realizing that my hips were holding up my pants (instead of my belly).  The first step in that particular revelation was understanding that those two bumps on my front that were feeling pressure from jeans, were in fact, bones.  Bones that I had never before noticed, but had always been there.  These bones weren't visible, but were noticeable for the first time because of the decrease in the fat pad that laid over them.

Recently I have experienced the surfacing of other underlying structures - bones, tendons, etc.  These are not always fun - they are sometimes startling.  I am reminded of an article I read several years ago where a formerly obese woman suddenly notice the prominence of her shoulder blades and thought she might be deformed. 

Lying on my side, the excess skin and fat redistributing down with gravity leaves my hip and pelvis remarkably exposed.  I find myself squeezing them, poking them, and outlining them as I get to know this new "normal" for me.  A few times I have asked my husband to feel them as well, and let me feel his bones to compare and reassure myself that these are indeed, normal.  You mean average people feel these things every time they lay down?  Weird. 

The Anterior Superior Iliac Spine.  Yeah, I looked it up.  Those bumps that help hold my pants up are now painful at times.  Not when active, nothing like arthritis.  They hurt when I lay down on my stomach - my preferred sleeping position.  I think it is more accurate to say that my skin hurts. Having less padding between the bones and skin has apparently made me very sensitive to the pressure.  I frequently find myself putting a pillow under my pelvis (in addition to the thick mattress pad we also have) to give a little extra cushioning. 

I also have lower back pain - a common complaint in WLS patients.  Our center of gravity has changed, and our core muscles are having trouble adjusting to the redistribution.  In my case, my large chest has always caused some back pain, and now that weight is leaving other parts of my body much more than my chest, that increased ratio has resulted in increased pain.  Just leaning forward when brushing my teeth can be fine 20 times, but the 21st and I look like the stereotypical old man, hunched over with a hand on their back.  Most frequently the pain comes when I'm getting up from a lying down position.

I enjoy seeing muscle definition in my legs and shoulders.  I think seeing definition in my clavicles and shoulder blades is attractive!  I never carried much of my weight in my legs, but the jogging has reshaped them anyway.  Feeling the steely tendons around my knees is fun.  Which brings me to a LACK of pain in my knees.  Many morbidly obese people have significant orthopedic issues, hip pain and knee pain being very common.  I was lucky not to have those.  However, I have always had "bad" knees, and even when just "overweight" would have problems where my knees occasionally "popped" out of alignment when I was running or climbing.  That would result in my being on crutches for a week or two at a time.  It didn't happen when I was a morbidly obese adult because I wasn't doing high impact exercise. 

When I started Couch-to-5k training I was very nervous about how my knees would react.  I found that if I opened up my stride and ran it hurt my knees almost immediately, but if I ran short strides low to the ground I stayed pain free.  Having my muscles and tendons tighter than they've probably ever been has given me more support, and I haven't had one incidence of "popping".  Yesterday I actually jogged 25 minutes and felt fine (although really tired) when I was done.  This is a picture of me from last Friday when I finished my first 22 minute jog.

A little hot, a little sweaty, tired and thirsty - but happy.  I can't say I ENJOY jogging, but I find it very rewarding when I'm done.  In two weeks I should be jogging 30 minutes at a time - that is supposed to be the equivalent of a 5k!  When I have completed that challenge, my goal is to 1) choose a 5k to actually run in and 2) Start training my dog in the Pooch-to-5k so that we can change our morning walk to a morning jog.  Next goal - Tackle the Tower  - a stair climbing challenge to climb the Terminal Tower in Cleveland. 

However, parts of my mind remain stubbornly unchanged.  I find myself choosing sedentary things - being online (like now), watching TV, reading - more often than active ones.  I can and do join my kids when they go swimming, play ball, etc for a while, but then often grab a book while they continue to play.  My fitbit calls me active, burning lots of calories and getting over 10,000 steps a day, but I have long periods between active times when I sit - and I don't have a desk job.  I hope those periods start to decrease.  I know once the school year starts I will be standing and walking 2 1/2 more hours a day M-F again.  The head-work continues to be the hardest part of this journey.

Looking forward to my 6 month post-op checkup on my 42nd birthday next week.  I'll be sure to post again then.