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.
Sunday, June 29, 2014
Friday, June 27, 2014
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.
Thursday, June 26, 2014
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
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
Wednesday, June 25, 2014
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.
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.
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.
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.
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.
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