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

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

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

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

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

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

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

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

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

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...

Pre-admission day

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

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

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

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

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

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

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

Bariatric Betty gets shrunk

Well, this week I took my MMPI.  I told one of my friends before hand that I hope it didn't show that I was any crazier than I already knew I am! That was no joke - with my depression and PTSD, I don't expect a totally clean report.  I did joke with her that I was hoping my other 15 personalities kept quiet enough for me to focus on the test.  She said if they spoke up, just promise them a donut to keep quiet.  I love having a friend who's already had bariatric surgery.  She can say something like that and I KNOW that she is totally behind me. 

Before I started the test, my designated psychologist for the insurance documentation collected my co-pay.  He told me to take my time, and I assumed it would take about 2 hours.  Instead, 1 hour and 567 true and false questions later I was done.  If any of you have not yet taken the MMPI, it's alternatingly funny and sad.  It has statements like "I believe that spirits and/or demons control me" immediately followed by "I would like to be a singer".  Several times I read questions that made me wonder.  For instance when comparing "I would enjoy covering the theater as a journalist" and "I would enjoy covering sports as a journalist", what exactly are they differentiating?  Is there a condition that excludes theater appreciation?  Or is sports counter-indicative of another? 

When they ask "I sometimes lie to others" - don't you feel like it's a trap?  Who hasn't told at least a white lie to spare someone's feelings?  So you answer yes.  Unless you are a pathologically liar, in which case you would answer no.  Unless you are also an attention seeker - which I would imagine most pathological liars are - so you would answer yes. 

Here's what I think.  I think they should add two more questions. First, "I spent time thinking about possible reasons for different responses to these questions while taking this test".  Then, "I skipped at least one question accidentally and had to go back and correct my answers".  Hmmmmm, maybe my results will indicate I'm borderline obsessive compulsive? 

When I finished, the psychologist said "OK, so it will take me a couple weeks to write up a report, and then I'll send it to Diane at Hospital C".  Fine.  So I asked "When should I come back?" and he looked at me blankly for a moment before saying "Well, you don't have to.  Unless you want to come back?"  Huh.  I guess this guy is not part of my new lifetime commitment to a bariatric program - luckily Hospital C has their own that I can consult with forever if needed, I guess.  I ended up telling him that maybe after he reviewed the results if he felt that there was anything that would be useful for me to know from the results he could let me know and I would make an appointment.  No wonder he collects the co-pays up front - he doesn't think he's going to see you again! 

I also discovered something wonderful this past week.  Facebook has private groups for weight loss surgery patients and veterans.  Some of these veterans have over 10 years and hundreds of pounds lost under ther belt!  So I joined two lists and can ask other questions without all of my friends seeing them.  I also found several other blogs of current and past bariatric patients that I really enjoy.  Seeing the pictures of before and after is just amazing.  It inspires me to see that so many have taken this tool and used it to change their lives so completely. 

I have told several friends about my plans to have bariatric surgery, but I still feel hesitant to make it common knowledge.  It's hard enough to discuss it with friends who don't understand the committment involved, let alone having people I haven't seen since high school or relatives that I have nothing in common with question me.  They can ask when they see me in a few years and wonder why I look so good! 

This week should be fun!  I have my first meeting with my physical trainer, my first pre-op support group/ education session, and my first meeting with my surgeon and his team!!!  I guess I'm a little excited - too many exclamation marks :)