Finally at 229 - 5 pounds from surgery weight

Finally!  Finally!  Finally! 

As of yesterday, I dropped another pound to put me within range to complete the pre-surgery "written test".  This test is required by Northern CA Kaiser to show that we've read the informational binder, and we know the inherent risks and major lifestyle changes associated with surgery. And we know what to do to get and keep the weight off and what behaviors will put the weight back on even with a smaller stomach. I mailed my completed test yesterday and will hopefully hear from them later this week or early next week to schedule the psych evaluation.  The psych eval is required  to make sure we know that surgery by itself won't take the weight off or keep the weight off. There are lifestyle changes, challenges, and they want to make sure we are aware that we will have to follow the vitamin and eating regimen forever. Anyway, I'm thrilled to be within 5 pounds of my surgery weight!!! I know they're backlogged for psych evaluations, but I'm still hoping to have mine in September or October and hopefully have surgery in November! 

Tonight is yoga. I'm hoping to find time for some cardio so I can burn more calories.  Since I may not have time to hit the gym, I will try for a short walk after yoga.


Update:  Just talked to Nancy, the Bariatric Coordinator at Kaiser Fremont...I'm officially on the waiting list for a psych eval.  She said that one of their psychologists had to quit abruptly because her husband was abruptly transferred out of the country.  She said that a replacement psychologist has been hired, but it might be September before I can get an appointment.  I asked her if I could go to another location for the psych eval, and she said she'll call Sacramento to see if they can get me in for an eval there. Fingers crossed.  I also asked her to remove my request for a December surgery from the record.  I want the surgery ASAP and will take a cancellation. :D

C'mon 229...and then 224 not far after...

I'm doing everything I can to get down to 229 so I can call in my weight, send in my test, and get scheduled for psych eval.

I'm making really good food choices.  I'm moving.  I'm drinking LOTS of water.  And I'm losing inches.  A couple of my tops now come down lower than they used to, so I'm guessing that my chest and tummy have gone down some.

I will really have to watch my eating this weekend. Be aware when I start to feel like eating compulsively.  Limit the sodium. And MAKE TIME TO GET TO THE GYM BOTH DAYS!  Sunday, I have a 9 am appointment with a personal trainer at the Crane Court gym.  I plan to get there early and get at least 30 minutes of cardio in.   I have website work to do this weekend too.

Doug and I are going out to dinner and a movie.  Hopefully he'll be ok with Chili's or something similar that has "healthy" food.

Excellent post by a man who is 20 years post-op

http://wlsappeals.com/2094/walters_bariatric_surgery_blog/20-years-bariatric-surgery-patient/

Lessons Learned: Celebrating 20 Years As A Bariatric Surgery Patient

Posted JUN 30 2014 by WALTER LINDSTROM in WALTER'S BLOG

I don’t remember the first day of OJ Simpson’s pre-trial hearing for the murders of Nicole Simpson and Ronald Goldman. I know my wife Kelley does – she watched the whole thing from a waiting room in a hospital in San Diego. Me? I was having surgery. It was June 30, 1994.

Could it really already be 20 years? I guess so. My 9-month old daughter – my living, breathing “A-HA!” moment – is 20 years old and doing a summer abroad in Spain. My 16 year old son – the gift I hadn’t even conceived of yet – is about to get his driver’s license. 20 years goes by in an instant.

Even as fast as the time has passed I dare say I’ve learned things over those 20 years which might help someone else, whether a person exploring the possibilities of surgery – a soon-to-be patient anxiously awaiting their impending surgery silently praying this really is the answer she or he hopes it will be – or people like me in the midst of their wonderful post-operative journey. I even have the audacity to hope these musings will offer something to health care providers offering surgery as a treatment option.

So, in celebration of a very important date in my life, my gift to myself is in writing some reflections, one for every year. It is my sincere hope one or more of these thoughts resonate with someone who might read them and need them. Please share them liberally with anyone who might benefit.

1. Bariatric surgery isn’t for everyone. Sure there are medical reasons which disqualify some people but I’m not talking about that. If you’re exploring it for yourself and decide it isn’t right for you – DON’T let anyone try to shame you, scare you, beg you or otherwise try to convince you to have an operation you’re not fully committed to living with for the rest of your life. Allow yourself the gift to choose another path.

2. “Support” is not a 4-letter word! If someone you care about is having surgery and you’re not comfortable with their decision you’re probably feeling a host of emotions ranging from fear and apprehension to disappointment and anger. DEAL WITH IT! Whether it’s pre-surgery or 20 years later this is really hard on us. It makes it easier when we have people in our corner and not trying to sabotage us.

3. Say it loud! Say it proud! OK – I respect anyone’s decision about privacy and what they wish to share or not share about their lives, especially in this age of social media. But I really hope you can honestly, even proudly, talk openly about your decision to have weight loss surgery. I believe many of us keep it secret because we fear it’s not going to work but I think committing to it out loud strengthens our resolve to succeed more than does a mysterious “gallbladder surgery” which wondrously resulted in a loss of 150 lbs. a year later. Besides, keeping it secret is a disservice to others like us who are often desperate to know “how is she doing it and why can’t I?!?….”

4. Post-op patients should learn to use two words: “FOR ME….” For 20 years I am constantly saddened by the “patient on patient” crime I read on “support” sites. “Only an idiot would have XYZ procedure….” “I’d never go to that doctor….” “If you don’t do ABC then you’re going to fail….” Be supportive of others’ choices. Hostility does nothing to elevate your own choice. Learn to voice things positively: “For me, doing XYZ was the best choice….” Like I said, “support” is not a 4-letter word!

5. Pre-op and Post-op patients should not underestimate the value of being in a well-run support group, especially before surgery and for a good amount of time afterwards. Questions need to be asked and answered about what to expect, what to do and when do to it. Shared experiences and feelings in the early stages of the process are invaluable. Don’t blow them off indiscriminately as too “touchy feely” (and yes fellow MEN – I’m talking to US!). That is a mistake.

6. Just because a surgical option is new that doesn’t necessarily mean it’s better.

7. Just because a surgical option is new that doesn’t necessarily mean it’s worse.

8. There is no Gold Standard! The next time someone, anyone, tells you the “X procedure” is the “gold standard” you might want to remind them we haven’t used the “gold standard” since 1933. That term is really quite useless. Insist a health care provider speak to you in terms of what is the best course of action FOR YOU.
9. Repeat after me: DOCTORS and PATIENTS should make decisions regarding medical treatment and surgery. THERE IS NO PLACE FOR INSURANCE COMPANIES TO SUBSTITUTE THEIR JUDGEMENT FOR THAT OF YOUR DOCTOR AND WHEN THEY TRY TO DO THAT YOU SHOULD FIGHT IT WITH EVERY FIBER OF YOUR BEING!

10. Remember the bathroom scale is non-judgmental. It doesn’t think you’re a “good” patient/person or “bad” patient/person. It gives a number.

11.  Plateaus happen.  When you’re a patient early in your post-op journey please remember that the number on the scale may not move in the direction you’re hoping for every day.  It may not move at all for weeks at a time.  Pretty much that’s normal so don’t stress about it.

12. Reach a balance between using the scale to obtain information so you can assess how you’re managing your chronic disease and stalking it in the hope the number says what you hope/want/need it to say. We patients all have a terrible fear, often unspoken, that we are destined to fail surgery just like every diet we ever tried. We tend to freak out when the number doesn’t go down or – God forbid – it ticks upward.

13. YOU have the power choose how that number on the scale is going to impact how you feel about yourself.  I choose to have that number tell me how I’m doing managing my chronic disease, no different than a hypertensive patient paying attention to blood pressure readings or diabetics looking at HbA1c numbers. Sometimes I manage my disease better than at other times. But FOR ME, knowing the number a couple times a week works better. When I tried managing my disease by consciously deciding I didn’t want to know the number because I didn’t want to be a “slave to my scale” I went by how my clothes fit. That was a mistake.

14. If you’re really concerned about a plateau or weight regain, contact your doctor’s office FIRST – then you can make that social media post. Too many of us post as a substitute for reaching out to our bariatric programs. Sorry but sometimes the “advice” isn’t so good.

15. Don’t make my mistake. If you’re regaining weight after you’ve had surgery, PLEASE do not avoid seeing your surgeon and his/her team because you’re embarrassed or feel like you’ve failed them. I had a revision 9 years after my original surgery. I waited way too long to address it and I see or speak with bariatric surgeons and integrated health professionals around the world every single day! You haven’t failed unless you make the choice to not see someone about what’s going on. Given the chance most quality programs and professionals would be begging you to make an appointment to see what’s going on so they can help. Let them.

16. If you’re a bariatric surgeon, nurse, integrated health professional or office support, PLEASE be doing surgery because you care deeply for patients like us and understand that we have a chronic disease. If we’re struggling after surgery the last thing we need is someone who is supposed to be in our corner being judgmental. What we patients are going through, whether year 1 or year 20, is freaking hard. DO NOT MAKE IT HARDER!

17. Repeat after me: Needing a revision doesn’t mean you’re a failure! Needing a revision doesn’t mean you’re a failure! Needing a revision doesn’t mean you’re a failure!

18. The nature of bariatric surgery support groups invariably changes the further out from surgery you are. My support group no longer meets at the hospital where I had my surgery. My support comes from my family, friends and colleagues and has as much value FOR ME at this stage of my journey as any bariatric in-person or online support group I was part of as a member or which honored me with an invitation to speak and share experiences.

19. Whether you are pre-op or 20 years post, we all need help along the way. Take a minute today to say “Thank You” to someone who is helping you with yours. It feels good. After 20 years I have so many people who helped me that to try and list them by name risks leaving someone important out so I’m not going to take that risk. But I will tell you we as patients owe thanks to a two organizations, their members and their leadership. I joined the American Society of Metabolic and Bariatric Surgery in 1996 and at the time it was closer to a “cult” than it was a major specialty surgical society. ASMBS has grown to help guide and shape important decisions that affect all of us as patients and it has been and will continue to be an important part of my life where I have met many of my closest friends. Equally true is the place Obesity Action Coalition has in my life. Simply stated, there is no other voice out there for us and I’m OK with that because the OAC and its amazing team has achieved things I never dreamed possible when I was being wheeled into the operating room or when I began my new professional life as “The Obesity Law & Advocacy Center.”  If you haven’t joined OAC – please do. We all deserve it.

20. Twenty years is a long time. God willing there’s going to be a lot more. FOR MEmy journey has meant an improvement in health and longevity which allows me to receive the love I get from my daughter Marissa and my son Jared. They honor me every day by growing into truly amazing people and I know in my heart that if I had not had surgery 20 years ago I never would have been around long enough to see that. But most important to me is the need to say thank you to my Hero and love of my life, Kelley. She is my hero because she loved me regardless of how I looked on the outsidewhen my BMI was over 60. She loved me through the scary reality of weight loss surgery, not once but twice, wanting only for me to be healthy. FOR ME Kelley makes possible anything of meaning I experience every day of my journey.  She is my reason to travel this path and I’m blessed by her and because of her.  I’m a very lucky man.

I can only hope some of you can someday be similarly blessed during the journey you’re taking.  Good luck!

Robin Williams, Grateful to be Alive, Getting Real

So I've had a lot of thoughts bouncing around my brain the last few days.

Robin Williams' suicide, and how I very nearly succeeded at ending my life two years ago. There but for the grace of God and a couple good friends, go I.  I'm beyond grateful to still be alive!

Finalizing the logistics for my trip to Washington and Oregon in 3 weeks.

The fact that I learned at a recent weight loss surgery support group that Kaiser Fremont is down to one psych professional for the evals and is currently booking appointments in October so I have to get down to 229 lbs (or below) ASAP so I can get scheduled for psych, and then scheduled for surgery.

Also at the WLS support group, there was a woman who was 5 days post op for the sleeve and drove herself to group.  Amazing! I hope I can drive that soon if not sooner.

My relationship with food, and my compulsive eating of junk, trying to pass it off as "food funerals".  I had a very good chat with Jessica Aycock today.  And I came to realize the following:  those "food funerals" of nearly nightly Taco Bell runs and McDonald's ice cream runs are more accurately called "compulsive eating".  The kind of eating that got me to my highest weight.  The kind of eating that sabotages all my weight loss efforts because a part of me wants to keep this armor of fat.  The kind of eating that surgery will not permit.  I have to build a new relationship with food for the rest of my life because I can no longer use food to "numb out" my feelings or use fat as a shield.

Here's Jessica's response:  "You are so wise and you're ready for this - I know you are. You've been working for this for a long time and you KNOW what has to be done and you're taking steps to do them. It's not easy, but it's not impossible. Treat food as fuel and find something else (healhty & productive) to battle those feelings of inadequacy and fear. You are doing SO amazing!  It's all just a matter of perception - and you're right in the middle of change!"

I know I can do this.  I saw myself in the mirror today and my body just does not match or define who I am.  It's not me.  I may have needed (or thought I needed) to be "insulated" before...but I know my own strength now.

As Jess says, "treat food as fuel" not a way to escape. Oh, and I have to drink more water...I forgot water yesterday at my session with my trainer, and I didn't have anything for the ride to pick up Santa or at the dog park.  By the time I got home, I was dehydrated and was getting a headache.

Oh, and not sure if I mentioned this...I talked with Jessica May before Sacred Web circle last Friday about her stomach amputation comment and how I perceived it as judgement of me/my decision.  She says that she is part of the "size movement" and that's where she was coming from.  Although she does not agree with my decision, she supports that it is MY decision, and when I brought it up in the sharing, she kind of tuned out...which is fine.  I was able to share, but she didn't have to listen...all good.

Also, I talked with Bob last week and told him I'd have to "step away" from the poker group for awhile.  One, it goes too late for me, but I didn't tell him that.  I did tell him that it conflicted with Sacred Web right now, and I am drawn to the spiritual connection more than poker, and I am also having a hard time resisting the candy and desserts at poker, so I have to do step away from poker so that I can continue to lose weight AND for after surgery, when sweets will likely cause dumping.

So....lots of thoughts....I'm making decisions to meet my goals, and getting the support I need too.

Facing the Naysayers

So the other evening, I mentioned to Doug's brother Dennis that I would be having abdominal surgery and if he moved back into the front room, I may have to sleep there for a few nights in the recliner.  He asked what the surgery was for and I told him the truth. He's now made it his mission to help me lose weight without surgery. I really do appreciate his concern, and of course, if he comes up with suggestions that seem feasible I'll try them. That being said, my mind is made up on having the surgery. I've done a lot of research, and talked to several people who have had weight loss surgery, and not one person regrets it. I think it's the best option for me to lose weight, keep it off, and reclaim my health.

Additionally, I'm going to Sacred Web circle tonight and I think it's my first time back there since I first mentioned having the surgery and Jessica called it "amputating your stomach", and I got a bit annoyed at what I perceived to be a judgmental comment.  I'm not saying this is for everyone.  I'm just saying that it's something I need and want to do.  I've done A LOT of research and talked with a lot of people, and for me, the benefits far outweigh the risks and restrictions that I'll have to live with for the rest of my life.

I like what Joy replied, when I mentioned all this on 3FC.  "You don't have to justify yourself to anyone. You are the one in charge of your life. It doesn't matter what they think. Just smile politely and say - thank you for your opinion, however I must do what is best for me."  Amen, girlfriend.  Amen.

I'm reading the stories on the forums, hearing peoples' challenges, and triumph, and seeing the progress photos.  I am SO looking forward to having the surgery.  I really hope to lose the remaining 11 pounds by the end of August because I very much want to have my surgery in early November so that I'm able to travel to Nancy's for Christmas.

No longer full of shit

Okay.    I admit to being a woman of simple pleasures.  Ever since coming down with a violent stomach bug on Tuesday night/Wednesday morning where I spent the entire night puking up every last bit of my stomach contents, I have not had a bowel movement for nearly a week.  I was starting to get concerned.  I wasn't feeling crampy or "plugged", and admittedly I ate pretty light on Wednesday and Thursday.  But I ate normally on Friday, Saturday and Sunday...and this morning...and...nothing???

I had nearly decided to purchase something on the way home to "encourage" movement in that area, and then shit happened!  Wooo Hooo!

Hiking the Pacific Crest Trail - Summer 2015

Okay, so my cousin Sue suggested to our cousins Steve Gray and Lisa Urabe wouldn't it be great to hike the Pacific Crest Trail together.  I asked if I could invite myself along.  She said sure...but to start training now.

I can build up my cardio endurance...but as far as hiking...I'll have to start with walking and build up slowly.  To be honest, I haven't done much walking, mostly because I'm just too afraid of it hurting again (or still).

It sure would be awesome to hike with my cousins.  By then I should be approximately 6 months post-op and hopefully able to walk/hike great distances.

Yesterday was a success!

Given the fact that according to my BMI, I'm "morbidly obese" and I have diabetes...what I accomplished yesterday is something I really need to do every day.  I managed to go the entire day without any kind of ice cream (even low carb/low sugar/low fat ice cream).  I probably have done this several days over the summer, but more often than not, my sugar addiction either steers my car to get an ice cream cone or sundae, or it makes the ice cream jump into my shopping cart at the store.

As I've mentioned, there is a 99% chance that I will not be able to eat ice cream after my bariatric surgery, so I've been trying to curb my addiction now. Anyway, yesterday was day 1 without ice cream.  I'm trying for day 2 today.

I will try making homemade fruit ices (or whatever you call them) like Jessica suggested by putting frozen fruit in a food processor.

Uneasy

I'm not sure why I'm feeling uneasy.  I'm not nervous about the WLS.  I'm hoping to get down to my goal weight and have it done soon, but I know that if I can't get it done around the end of September, I might as well wait until early December to save the two weeks without pay.

I just have to develop some strength and use strategies to deal with my sugar addiction.  I can't keep giving in to ice cream...especially not sundaes at 400 calories each.  And I'm not sure I'll be able to have even low carb ice cream after surgery, so I might as well break the addiction now.

Goddess, please give me strength.

Great blog post on Obesity Help

I found a great blog post on Obesity Help:

http://www.obesityhelp.com/forums/amos/5263894/Tips-for-surviving-your-WLS-from-new-Sleever-whos-11-days/

Tips for surviving your WLS from new Sleever who's 11 days post op.

Emotional Tips;

Protect yourself emotionally: Only tell a few people about the surgery. Your inner circle, and be prepared that many of your closest family and friend will NOT understand. I chose to not disclose my surgery and am so glad I kept it to myself at work and w/ 99 percent of my friends and family.

Set boundaries: I have made it very clear to all, do NOT ask me how much weight I have lost. This is a long journey, there will be ups and downs and I do not need that pressure. I will share with my Sleever support group and Dr. for accountability purposes. You may ask how I am doing, how do I feel. People think they are being supportive and they do not know the pressure it puts on someone to perform.

Make your home a safe haven, especially at the beginning: preop and new post op (3-4 months) is a very fragile time. Physically yes, but the emotional journey is a huge part of the success. No need to make it harder. Make a list of your binge foods. The foods that you just know, if they are in the house I am going to obsess about them, they will call my name. And keep them out of your home. I keep hearing that "it's not fair that my family be deprived/suffer." YES, it is fair. They love you and you need their help. IF they are truly supportive they will eat those items out elsewhere. Maybe have a friend or spouse take the kids to a night out for pizza or whatever while you rest at home. Or have the spouse go out w/ a friend for their burger or Chinese fix. If the food is not in the house it is much more likely that you will not slip and eat it. Protect your sleeve. It is healing for up to a full year.

Make friends online: You need support. Information.  Find folks you click with, but ignore the negative dramatic sort. I like this site as well as FB: Gastric Sleeve support group. but I blocked a lot of folks who were just bringing negativity. I need healthy, positive support and good information. Networking has really helped.

Put away the scale; Weigh once a week. That's max. Post surgery, I'd even encourage you to wait to weigh after two weeks as your body is adjusting. Do not let the scale define your journey. It will mess with your head. it's only a tool for you to use; scientific feedback. Not the be all, end all. Put that scale in it's place.

Remind yourself of the big picture; Look 1-15 years down the road. If you stay on this path, where are you headed? WLS is not for the faint of heart. but what could a fresh start do for your health, for your life? Get that picture firmly placed in your mind. Focus on this being a journey of healing. Moving towards a healthier, more abundant, fulfilling life. Make a list of all the things you want to do that you could if you were not obese. Have a vision of your future. it will sustain you through the rough patches.

Physical tips:

PreOp; Follow your surgeons diet. Everyone has a different one. Do not binge or cheat. Ask your surgeon if you an add some protein (like an egg at breakfast and 3-4 oz of chicken or fish at lunch and dinner.)  I was allowed to do that and it saved me, but every Dr.is different, so do what they say to do. FYI; The day before surgery is clear liquids.

 And careful not to drink after the time they give you, pre-surgery, this is no joke. Had a gal online report she had her surgery cancelled because they found her chewing gum right before surgery. The anesthesiologist said the saliva she produced was enough to cancel it. WOW.

What to take to the hospital; A comfy outfit to change into day two. Your own pillow. An extension cord and charger for your iPhone. Something to read. Your current medications, but ask your surgeon when you are allowed to take oral meds. Chapstick and hand cream. A sleep mask and earplugs.

My worst days were day two and three, as I had a lot of pain from the gas they pump into your abdominal cavity to perform the surgery. Then day four and five, my incisions started to hurt, and I felt like my gut had been punched by a prize fighter. I did not sleep on my side until a week out. Putting pillows up under my knees as I slept on my back really helped. When you start to drink again, go SLOWLY, the ice chips; melt them in your mouth and warm them before you swallow. When you ge****er, drink from a cup and do not gulp. Small sips continuously. Dehydration is a big issue, stay on top of it. In the hospital and when you get home; walk walk walk away the gas pains. Gas x is controversial since it goes into your new stomach which is tender, I did not use it and believe that walking helps more. Rest as much as you can. The pain is tolerable. Remember, you WILL get through this. It is normal to have regrets on day two or three. Day four or five you turn the corner and you will feel better.

The liquid diet and then pureed diets are covered on other pages, but I will say this; GO SLOWLY! When you try anything new take one small bite and swallow. Wait. Wait some more. See how you are tolerating it prior to eating more. Stick CLOSELY and do not deviate at all to the food plan or timeline. Protect your tummy! it needs to heal. Get your protein in. Get your water in. Get your bariatric vitamins in. Take very good care of yourself, esp the first month.

I am eleven days out and I do not regret what I just went through. Rather I feel blessed and hopeful for a new future, an abundant life. All the best to you!- Michelle

Loving Exercise and 9 lbs down so far!

I'm having trouble sticking to a 1,200 calorie/day eating plan.  I'm up around 1,500 usually.  I'm hoping that all the exercise I'm doing (30-60 minutes per day, and sometimes 90 minutes), I'll be burning off the extra calories.

But the great news is I'm down 2 more lbs for a total of 9 since 6/26.  Only 11 more to go until I reach the goal weight set by my surgeon. And only 6 lbs before I can call in and get my psych eval and a date set.  :D  I'm mostly following a 1,200 calorie a day eating plan and working out between 30-60 minutes per day. I'm really enjoying exercising.  Even though I still have difficulty walking very far, I'm focusing on what my body will do for me without pain (exercise bike, water aerobics and yoga) and burning calories that way.

Support Groups - Learning So Much - Serendipity

On Tuesday, July 8, I went to my first Support Group meeting.  This one was at Good Sam.  Kaiser insurance (and doctor) require attendance at support groups prior to having surgery. It was a very welcoming group. Approximately 20 people were there, 5 "pre-ops" and the rest were anywhere from 2 weeks to 10 years post-op. It was very inspiring and educational to hear from the people who have had surgery, the tremendous amount of weight they lost in their first year (typically 80-150lbs for the women), and the regain (which was anywhere from 0-20lbs). People shared their challenges as well as what they're doing successfully, all really good information.

It is helpful to hear from people who have been through it. And I'm so grateful to my friends Annie and Kit for being willing to answer my questions. It seems that the "head stuff" (emotional eating, eating out of boredom, craving for carbs, justifying that one little piece won't hurt)...all that stuff, happens to most patients. As my niece who is a bariatric dietitian says, Weight Loss Surgery is not a cure-all. It's just a tool. It won't keep you from emotional eating. My surgeon explained that all he does is shrink your stomach...nothing changes with the "head stuff" until the patient deals with that.

Some patients rely on "dumping" to keep them from eating high sugar or high fat foods (which honestly is what I'm hoping for), but then again not everyone "dumps". Also different foods agree (or disagree) with different people. Everyone is different so there are no set rules, just guidelines on what to eat, how to eat and beyond that, it's trial and error what each patient can tolerate. At last night's meeting, the members were discussing protein drinks. And most of them commented how some things that were delicious prior to surgery were just disgusting (either in smell or taste) after surgery). No one knows why that changes. It just does in some people.

Also, from all I've read and heard from people, the key "weight loss period" after surgery is the first 12-24 months when the surgery actually inhibits the release of the hormone that makes you hungry. All the post-op patients I've talked to say take advantage of this timeframe to lose the most weight possible, because those hunger hormones come back. And patients who are not careful with their portions do occasionally stretch their stomach pouches.

So that's it. Weight loss surgery is a tool that can help a person eat less and lose weight, but patients that don't commit to a lifestyle of portion-controlled healthy eating and exercise aren't going to have as much success as those that do make the commitment to themselves. My surgeon said that if I didn't try very hard (meaning if I try and "get away" with eating the wrong things or eating too much), I'd probably lose about 50 lbs after surgery, but if I did make the commitment and stick to it, I could lose roughly 100 lbs.

I'm going to another support group tonight.  This one's at El Camino Hospital.   I learned about it last night at the water aerobics class.  Just before class as I was getting in the pool, I got to talking with a woman. She mentioned she'd had surgery 5 weeks ago, but I didn't press for information. Then she mentioned it was gastric bypass surgery. She seemed to want to tell me all about it, and I was eager to listen. We chatted during the entire class, so I got a great workout and lots of good information. It was amazing serendipity that I happened to meet and start up a conversation with a woman who just happened to have had recent bypass surgery.

One thing the woman from water aerobics told me is that during surgery, they fill your insides up with air so it's easier for the surgeon to move around in there.  She said that after surgery, there is pain due to the air, and that if you can burp or pass gas, it will help expel some of the air.  She was unable to for a couple days.  She also said that when she gets full, she feels slight discomfort on her left side, and when she has a bowel movement, she feels discomfort there too rather than in her belly.

So much to learn, but I want to educate myself so I'm as prepared as possible.

My name is Michelle, and I am addicted to sugar

Another moment of clarity yesterday...I absolutely have an addiction to sugar, especially ice cream. I tried to alleviate the cravings by telling myself I have lots of yummy Greek yogurt at home, that is low in calories and high in protein and much better for me. I know it's not the same though. The craving got so bad that I really felt like an addict. I was absolutely "jones-ing" for ice cream.  It really hit me that I have become addicted to sweets. I ended up not stopping for ice cream, and opting for the Greek yogurt when I got home, followed by a bowl of cereal later on. 

Bariatric Surgery Orientation with Surgeon and Dietitian

I learned a lot at the bariatric surgery class yesterday.  The presenter for the class is one of the actual surgeons, and he has 11 years experience doing bariatric surgery.  He really knew his stuff.  The last 1/2 hour of the class was presented by a dietitian explaining what vitamins will need to be taken for the rest of our lives, and also the portion sizes post-surgery. The success rate for the surgery in terms of weight lost and low rate of regaining weight makes it very appealing.  I made an appointment with the surgeon for Monday, which is when I'll learn, among other things, the weight I need to get down to before surgery. They weighed all the class participants yesterday, but the amount of weight we need to lose is based off our highest weight on record at Kaiser over the past year. I asked the surgeon if it's possible (or recommended) to use a meal replacement program (like Opti-Fast) to lose the weight prior to surgery. He said he doesn't recommend it because he wants patients to learn strict portion control, healthy eating and practice chewing each bite very well. I will discuss Opti-Fast again with him on Monday, and in the meantime, I'm still keeping my appointment for with the Opti-Fast physician for Tuesday morning, and I should have an idea about what I decide to do by Tuesday afternoon, right now I'm leaning more toward surgery simply because of the much lower rate of regain.

It's really interesting. One woman in the class mentioned how people were trying to talk her out of surgery, that it was too drastic and the weight could be regained anyway.  The surgeon asked her if the people she spoke to had the surgery.  And it's true...the hesitant comments come from people who have not had the surgery.  People who have had the surgery say that it's the best decision they ever made.

Had some trouble staying on plan today.  Ate too much licorice at work.  I'm taking the remainder of the candy to tonight's poker game.  Other's can fight over the leftovers.  Tomorrow, I'll look through my binder more to get a good sense of the 1,200 calorie eating plan.  I know my portions (especially for cereal) are over the top.  I'm going to probably have to lose around 25 lbs prior to surgery, and I'd like to lose it faster than 1 lb per week.  That's not going to be easy.  So far the food I REALLY like the most that's high in protein and low in calories is Dannon's Greek Yogurt.  Like I said...more research is necessary.

My niece is amazing

I just adore both my nieces!!  I've been in contact with one more than the other lately because she's a dietitian for the same medical group I'm a member of, and she works with bariatric patients all the time. I told her what my friend Mark and his wife said yesterday. They expressed concern that all the people they've known who have done either OptiFast or bariatric surgery have all regained their weight plus extra.   I'm not naive.  I know that it's possible to regain with either method.

So I asked my niece...is it likely that people regain all their weight?  I know it's possible, but is it likely?  To which, she replied, "Just with any weight loss effort there is a possibility to regain weight but that's not a reason not to do it! Based on your commitment to live a healthier lifestyle you will do fine! If someone regains weight above 15-20% after surgery they are really participating in some unhealthy lifestyle behaviors."  Therefore, I'm taking this as I CAN do this.  Whatever I decide, I can succeed and get my health, mobility and life back!  :D

Appointments and more appointments

Well, my week off work (week of June 30-July 4 - due to company shut down) is filling up rapidly. 

The Medical Weight Management (Opti-Fast) group has scheduled me for a physical evaluation on Tuesday morning, which means that between now and Monday afternoon, I have to have fasting bloodwork and an EKG done to show that I'm healthy enough for the meal replacement weight loss program. Next week Wednesday (July 2) is my epidural injection. D will be driving me to that appointment and back home as I will be under very light sedation to relax me, and also have some possible numbness in my legs from the local anesthetic they inject prior to the steroid. 


The bariatric surgery department called to set up my initial evaluation with their team, which is tomorrow (June 26 at 2pm). Sadly, they didn't have any openings for next week, so I have to take tomorrow afternoon off work. 

Oh well, even with all the medical appointments, I still plan to have a fair bit of quality time next week to spend at the beach or at a shady park or redwood grove to read a good book. 

Made My Decision

I've made my decision. I asked my doctor for a referral for bariatric surgery. Once she submits the referral, I'll have an orientation with the dietician and possibly others from the bariatric program staff. At that orientation, my weight will be taken...the starting weight...of which I have to lose 10% before I can have surgery. To lose that 10%, I have signed up for the Medical Weight Management Program (Opti-Fast) which will either start on July 2 or July 16 with complete meal replacement starting a week later (7/9 or 7/23). 

Once I've lost the initial 10%, which will take roughly a month, I'll decide whether to do the surgery or continue with the Opti-Fast. One of the doctors of the Opti-Fast program says that bariatric surgery patients frequently use the Opti-Fast to lose the 10% and then some of them end up cancelling their surgery. I figure by 3-4 weeks into the Opti-Fast, I'll know whether I can do another 3 months of Opti-Fast, or if surgery would be the best option. I've sought out opinions of lots of people and done some soul searching. Yes, it would be preferable to lose weight without having any internal organs altered. 

The question that I keep asking myself is...will I be able to keep my food healthy and portions small if I don't surgically alter my stomach? And honestly, I don't know. 

What I do know is that however I lose the weight, is going to require discipline. Discipline and commitment that I'll need for the rest of my life.

Reality bites

I totally understand about difficulty sticking to a diet program. I almost posted that "I am willing to do ANYTHING" to relieve my back pain, then I caught myself "except stick to a effing eating and exercise plan". So I'm thinking I'll do better with either or both of these two very drastic measures. Sadly, if I don't do Opti-Fast, I'm not even sure I could get off the preliminary 10% that bariatric surgery requires. And it will be dang hard to not eat any solid food for 4 months, and only little bits for several months after that as I transition. I'm not sure when it starts, but there will be summer BBQs, D's father's wedding in August, my vacation in September (which includes a wedding)...during all of these I'll only be able to have my Opti-Fast liquid. As for bariatric surgery, there's really no choice in eating less and avoiding fatty or sugary food because if you don't eat right, you risk "dumping syndrome", which means that if it's overly fatty or sugary or is greater than the size of the new stomach (the size of an egg), it's coming out. 

On June 19,  in the afternoon, I went to an introductory class about weight loss surgery, which was ok. I think I learned one or two things, but mostly it covered things I heard about from friends (thank you, Annie), my niece who is a Dietitian at Kaiser in Southern Cal, and info I found online. Anyway, the class is required as a first step for anyone considering weight loss surgery. The next step is get a referral for surgery from my primary physician and then to take the surgery overview class which is conducted by a dietitian and goes into more details, then to meet with the surgeon, and all that stuff. 

I'm going to wait to ask my doc for a referral until next week, as I'm going to an intro class on Saturday for the "Medical Weight Management Program" (Opti-Fast). 

D really wants me to do Opti-Fast first as he doesn't think it's smart to have surgery to resize and reroute my internal organs without first trying to lose weight by any means (meaning Opti-Fast or any other means) while keeping my body in-tact. I understand his concern. I also know that he has not been with me through my weight loss struggles and increasing pain these past 10 years since I hurt my back. It's a lot to think about. I didn't fall asleep until nearly midnight last night because I was thinking about this.

My sister, who did Opti-Fast successfully and kept nearly 100 lbs off for 3 years (and then gained some of it back), said she'd recommend having surgery over Opti-Fast. Her daughter (my niece) had gastric bypass (RNY) and it saved her life. My niece is no taller than me and was around 300 lbs. I don't know how much my niece lost, but she looks and feels great, and is having a very healthy pregnancy (she's due in a couple weeks). Another difference between Opti-Fast and surgery is that my insurance covers surgery (out of pocket would be around $100, maybe slightly more). My insurance doesn't cover Opti-Fast (out of pocket would be around $4,000 or more). D thinks it doesn't make sense to have organs resized, rerouted and removed to save money. I understand his concern. I am giving this careful and serious consideration...there is so much to think about and research.

So the reality is....

I went to see my primary physician. We didn't even get to talk about my shoulder or my knee. She's quite concerned with my lack of mobility and lack of improvement in my back. She wanted me to get straight over to the hospital's radiology department to get a full set of x-rays, and she scheduled me for an MRI at 8:30 am (so I came into work early, and have to leave soon). I've got an appointment with a spine specialist on Tuesday afternoon.

She said that I absolutely MUST lose weight. If I don't she sees my limited mobility getting worse because of my degenerative discs. She said she wants me to do 30-60 minutes of stretching morning and night, and do some kind of cardio, preferably water aerobics, 5 days per week. She'd like me to do water aerobics or swimming every day if possible, but the recumbent bike at the gym is probably also ok. And she told me that walking is not a good exercise for me right now due to my back problems.

Oddly enough, according to the chiropractor's xrays my cervical spine is more messed up than my lumbar, but I don't really have any intense pain there, just low back, hips and legs. As for how much of the chiropractor costs the insurance covers...zero. I have Kaiser insurance and they don't have any chiropractors in their medical group. But they do have acupuncturists and my doc has referred me to one for an initial evaluation. 

As suspected, the spine specialist confirmed that I have a bulging lumbar disc at L4-L5 which is pinching a nerve, and he said that I have "nerve clumping" in my spinal column. Which is where, in most people, the nerves have plenty of room to flow freely...some of mine are clumped together. I haven't done a lot of research on this yet, but he said that and the pinched nerve were the causes of my pain. He strongly suggested an epideral injection (which is a combination of lidocaine to numb and steroid to relieve the swelling and pain). Over the past year, I have spoken to many people in my physical therapy back class and in water aerobics and they had great relief from the epidural. 

It's just a stop-gap measure. It will wear off in a few months to a year. He said the best think I can do to alleviate my pain is lose a significant amount of weight (same thing my primary physician said). He happens to be one of the two Medical Directors of the Opti-Fast program for my medical group, and he highly recommends it. He said they he has seen tremendous success in both losing weight and keeping it off...including countless people who have lost 100+ lbs. I told him that I was considering it and also considering bariatric surgery. He said that my medical group requires that people lose at least 10% of their body weight prior to bariatric surgery, and many people choose Opti-Fast as a way to do that. In fact he's seen numerous people cancel their bariatric surgery because of the tremendous success they had with Opti-Fast. Opti-Fast also includes weekly group support and frequent blood tests to monitor everything. 

So the good news is that now I have possible ways to help alleviate the pain short-term and long-term. I was talking with B who is disabled due to a cancerous nerve sheath tumor he had removed from his leg nearly a year ago. They had to cut through all the muscle and because he's diabetic the wound still hasn't healed. He told me that I might have to accept that I might have to live with this limited mobility for the rest of my life, and I told him that I'm not willing to go there. His situation is different from mine. None of my muscle tissue has been compromised. The doctors say I'll do better if I lose the weight, so that's what I have to do. 

I'm going to an informational meeting about Opti-Fast on Saturday morning, and I'm trying to get registered for an informational meeting about bariatric surgery. 

I understand these are both extreme measures and I know that they both require drastic lifestyle changes. I've been talking extensively to people who have done both with great success, and I'm aware that unless I stick with proper eating it's very easy to gain it all back. I'm just not willing to live in pain or to have my mobility limited any longer.