Disappointing Pre-Op Appt

Yesterday kinda sucked.

I had what I was told would be my last appointment with the surgeon before my GBP surgery. Turned out that it wasn't.

Woke up at 7 AM (normally, an hour BEFORE my bedtime!) for my 9 AM appt. Met my mom at the clinic and headed up to the office.

The doctor doesn't have people skills. I'd forgotten that since I saw him last in April. It would have gone better had I remembered and been prepared.

He asked me when I'd had caffeine last. I was honest and said I'd had some sips of mom's the other day, but I'm basically off it completely. He began to scold me about how one sip was too much and that's how people fail their weight loss surgery.

As I said, I wasn't prepared for his scolding and took it a little hard. Also, because I am awesome, I'd missed a few of my anti-anxiety pills and I was tired, so I was far more easily upset.
Finally, all of my other appointments have had nothing but praise from the rest of the pre-op team, so the negative reaction was unexpected.

The doc said he would have to review what the rest of the team reported, but he didn't think there would be any reason to deny me the surgery. Once he reviewed everything, he would submit to
my insurance that he feels I qualify. Once he hears back from them that they also approve, I'll get a call and schedule a surgery date.

As far as I understood, by the time of yesterday's appointment, all of the reviewing and approving should have been done and I was going to schedule my surgery at the appointment. I was, I think, understandably upset. All the doc did was yell at me and poke at my stomach, so
it felt like a waste of time being there.

Now, I sit and wait for a call or letter saying I was approved, which will probably take another week. Then, I schedule the surgery and, THEN, I see the surgeon once again in his office a
few days before going under the knife.

I'm just so tired of this dragging on. I want to move forward, get past the surgery, and get on with my life. Meh.

SV and an NSV

Scale Victory:

As of the beginning of tonight's work shift, I've lost 26.4 lbs.

I never wrote it down, but my personal mini goal was always to hit a loss of 25 lbs. I'd be at 23 or 24, but couldn't quite hit my goal. Tonight, I hit it was 1.4 lbs to spare. :)

Non-Scale Victory:

Besides hitting the 25 pound mark, I finished all of my group therapy appointments for my GB pre-op program. Can't even express how happy I am about that.

Those appointments should have taken 12 weeks. Honestly, I think it took me more like 18-20 to finish because I missed so many, due to either being so tired from working a 12 hour shift or
because I worked the night of the meeting. I thought they'd never end!

The meetings themselves were good. Getting to know other people going through what I am going through was beneficial. The people, especially the ones near the end, were fantastic to
talk to. We could laugh and joke and then also get serious when we needed to. Between the people and the material covered, I learned a lot. It was just the time of day that sucked and made it so hard for me to get there.

Now, I can sleep until a decent time on Wednesdays-- 5 PM, preferably. This makes me very happy. 3rd shift people need their sleep too!

Time to own up...

I'm not doing so good with keeping myself on track with my surgery pre-op program lately.

1) I've been off my thyroid med for two weeks. Until it is stable, I can't have the surgery. It'll take me a few months to get my levels stable again.

2) I had a massive migraine for three days this week, beginning Monday. I didn't even look at my appointment calendar, because I couldn't deal with trying to call people anyway. I wasn't
sure I had any appointments to begin with. Turns out, I had three. Now, I have to call and explain the situation and, hopefully, this won't derail me too much--in the past, it has taken me a month to get in with the Nutritionist.

3) My attendance at my Learn meetings has been sporadic. I'm required to attend 12 of them. I've made it to 2. Some missed meetings were due to work--legitimate reason. Others, it's because they're at a time that's horrible for me and I oversleep. Not legitimate.

These issues aren't stopping me from having the surgery. They're just creating frustrating delays. The thyroid issue will put me out into November for the surgery, and that's if the level is perfect after just a few months. Sometimes it takes longer after a slip up. The appointments can be rescheduled and I have plans to call on Monday. The learn meetings, well, by the end of August I should have 7 done. I can try to schedule individual Learns, but, otherwise I should be done Oct 19th.

I guess I'm just mad at myself because these delays were preventable. I don't want my surgery so close to the holidays, but I do want it done before 2012 (already met my insurance deductible
for 2011).

What's done is done. All I can do is continue moving forward from here, right? I think part of it was that I was getting burned out from all of the stuff I needed to do for this. Well, I've had a break, so it's time to recommit and that's exactly what I plan to do. :)

Am I Winning or Just Sick?

It's really hard for me to believe my ongoing success at losing weight and becoming healthier. So much so that, when I think about the fact that I've actually lost 17 pounds, I wonder if something isn't medically wrong with me causing it. <--how sad is that?!

I keep thinking about my mom and how she lost a bunch of weight before she was diagnosed as diabetic. I just had vials upon vials of blood drawn for the plethora of tests the Internist ran.
All the tests came up perfect except my white blood cell count, which was a bit high. The doc said that I seem to run high, so he wasn't concerned about that. He says I'm healthy.

That funky WBC leaves me a place to worry though, and take away from my victory of losing more weight than I've ever intentionally lost before.

I believe Dr. H that I'm healthy...99% of the time. It's that 1% that I'm making a choice to work on. My new mantras will be:

I am in charge of my weight loss or
gain.

I am making healthier food
selections.

I am increasing my activity level.

I am succeeding.

A Small Rant

I'm not losing weight lately. In fact, I've gained a pound. This is starting to irk me.

The problem is that, after I lost a few pounds, I started to obsess about food, thinking about it all the time.

Same thing happened around 2002, when I dropped 30 pounds without really trying. As soon as I realized that I had lost weight, then I started worrying about keeping it off and the foods I
should and shouldn't eat. If I'm thinking about it, then I want to eat it.

I'm not so sure how to get over this.

If I have WLS, I have to pay close attention to my food--far closer than I am now. Will that just make me gain more, making the WLS a huge waste of money and a totally unnecessary risk?

I do know that part of my current problem is that I'm off my anxiety/depression meds. I become more obsessive about things without the meds and I also get down on myself, which leads to
mood eating.

Bah! I wish weight loss wasn't such a psychological pain in my ass.

Holding Strong

I joined MFP on April 1st (the fool part was not doing it sooner) and weight prior to joining was 317 lbs. By April 16, I'd lost 5 lbs. At my weigh-in on May 2nd, I'd gained back 0.6 lbs, putting
at 312.6. I weighed myself tonight again and I'm still at 312.6.

I could be upset that, in two weeks, I haven't lost any weight, but I'm making a choice not to be. For someone of my pumpkin-like stature, holding steady/not gaining is a victory in itself. Don't
misunderstand me--I'm not thrilled, but I'm not going to beat myself up over it. Instead of being upset, I made better choices tonight about my food and beverages.

My honey, who is only slightly overweight, was looking at a BMI chart and said "man, if I ever hit 250 pounds, that's it. There will be some major changes There's no way I'll allow myself to go any higher than that." I did my best not to be hurt by that, since I'm 62 pounds over his limit.

He didn't realize that, to someone who is emotionally sensitive anyway and off her anxiety/depression medication, that what he said could be taken as "you were lazy and allowed this to happen. Your weight is beyond unacceptable." That's not what he said or
what he meant, but that's how my wacky brain wanted to take it. Thank goodness, on this occasion, logic won out over emotional irrationality.

I'm holding strong on my weight and I'm emotionally stronger than I thought I'd be in the situation with my honey. I'd say that's not a bad place to be for now.

1st Nutritionist Visit

Today was my first visit with the nutritionist. One would think that would be an easy visit, but, damn, it wasn't. As someone who has been overweight my whole life, my food intake is a seriously sensitive subject. I admit I got a little emotional at one point. Just once thought, then I bucked up and we got through it. :)

She asked me to walk her through my meals on an average day. Pfft. Like I freakin' know. If there was any sort of "average", I'd probably be able to maintain my weight and not gain so much, but it fluxuates, just like the pounds on my thighs. Automatically, I started to give her my food intake from the last day I worked, which I know is much lower than days I have off (12 hour shifts in the E.R. do not leave much time for eating).

She was pretty happy to hear I was already keeping a food journal. She was planning on having me keep one, but she said to just continue with MFP and print them off for the next time I see her. That'll give me two to three weeks of days to bring in.

Next up, the psychologist! I'm seeing a psychologist after being off my crazy meds for several weeks. That ought to be fun (not even a little).

The psychologist will have me walk through my reasons for wanting the WL surgery, my known eating triggers, mental health history, and then set me up with the group therapy program that I have to complete. That whole visit will be one big emotional suck-fest, I figure, but, it has to be done and I will make it through.

First Appt with Surgeon

Yesterday was my first consult with the bariatric surgeon. I'm still reeling a bit.

I am a candidate for the surgery. In fact, it could be done as soon as four months from now, which freaks me out a bit since I didn't expect anything until early or mid-2012. If I find that I feel things are moving too fast for me to be comfortable, I will drag my feet a bit. There's no way I'm going to go through this feeling like it's being rushed.

The appointment left me emotionally raw. Having my weight issue discussed so clinically is rough. Clinical discussions tend to not have the harsh edges buffered. The doc and his staff were not mean or anything. In fact, they were very nice, but it's still hard to hear some
things, even if I already know them.

In the next month or so, I have many appointments. Off the top of my head...there's a nutritionist, physiologist, psychologist, internal medicine. Plus, I have to go to 12 weeks of group
therapy sessions for pre-op patients.

Because I'm having this procedure done through my employer (I work for a major health care organization) and the company self-insures the employees, there are a lot of hoops that I don't have to jump through to get my health insurance to pay. No physician supervised diet and no
1 year waiting period, to name a couple.

My medical problems are nearly all managed without medication at the moment. So, the only medical condition that could hold things up if it gets out of control is my thyroid. I'm in the midst of adjusting my dose, which can take several months. Once I find a dose and have multiple months of blood work showing correct and stable TSH levels, I'll be good on that front.

I left the appointment with the surgeon feeling like it was a success. However, as the day went on, I realized how worn out it made me feel. They gave me this large binder of info to read through and to add papers to from all my appointments. When I got home, I just set it
aside. I haven't made myself look at it yet. I think I need a couple days to emotionally recuperate before I dive into the info.

Five pounds down!

I'm so excited--I've lost five pounds!

In the grand scheme of what I need to lose, it's not much. It's only about 3% of what I need to lose to even be 150 pounds (at 5'1", that's still overweight). However, it's awesome to see that I CAN lose weight. For so long, it's felt like that wasn't even a possibility.

As I state in my blog title, this is a journey. Journeys don't always go the same speed. Sometimes you fall behind or even get lost. Right now, my path is clear and seems to be going along at a good clip. When things get tough, I can look back at this and remind myself that the path is still there--it may be covered in the wrappers of the candy bars I consoled myself with when I was lost and felt like I should give up--I just need to work hard to see it and keep moving forward.
I can't say enough about how helpful MFP (MyFitnessPal.com) has been.

I am a person that needs notes and reminders to keep my life in order. If it's not written down, it isn't going to happen. Being able to plug in my food/exercise and have it right there for me to see has made this so much easier.

I started using the diary has a way to get a baseline of what I normally eat. I didn't intend to modify my eating habits yet, but I have, somewhat. It's too easy to lie to one's self when things aren't on paper (or, in this case, on webpage) and having my food intake shown in black and white has made a world of difference for me. Hell, I've barely exercised, but I'm still losing weight.

I make choices about quality and quantity that I wouldn't have even thought about a few weeks ago, because I felt overwhelmed by trying to figure things out manually. The MFP diaries made
things much simpler and allowed me to take my first steps toward being at a healthier weight. Being accountable with the right tools gives me control where I use to feel I had none. I'm so thankful that I friend mentioned this website. Truly.

Absolute Failure or Rousing Success for Getting My Butt Moving?

Wow, I'm not sure if the experience I just had with an exercise video severely depresses me or is spurring me on. A little of both, I think.

Yesterday, I received my copy of The Biggest Loser Power Walk from Amazon. Once my honey
went to sleep this morning, I decided to test it out. Holy shit, I lasted only a half mile.

Saying I lasted a half mile sounds way better than saying that I quit 7 minutes into
the video. Seven-frackin'-minutes!!

I'm reminding myself that I am not a fit person by any means and I also have multiple medical problems that make exercising more difficult. I'm also trying not to let those reminders turn into excuses for not getting my butt up and exercising.

I am a big time asthmatic, yes. I do have knee problems, yes. I do have a serious back problem, yes. Those issues will be greatly helped if I keep trying to exercise--yes, very much!

As I write this, I've come up with a strategy. I have to accept that I currently have limitations-- I can't seem to handle more than a half mile (fine, 7 minutes :P) at a time-- but I can try to work with them and try to change them. So, I will do seven minutes at least once a day. If my medical problems aren't giving me too much trouble, I will go for a second round of at least a half mile later on that day.

Whether I call the exercise "brisk walk" or "low impact aerobics", MFP shows I burned 73 calories in those few minutes. To me, it is sad that was all I could manage. However, I'm going to think positively about this and remember it is 73 calories that I didn't even try to burn yesterday.

Now, excuse me, I need my inhaler... *lung squeak*

So, the Scale isn't **Completly** Evil

For years, I've avoided the scale. It has been my enemy. The numbers kept creeping up until I decided that I didn't want to see it anymore. Today, however, was different, because it showed that I lost two pounds!

No, 2 lbs isn't much, but it's a start, right? :)

I've been using a website called My Fitness Pal, which has a food and exercise diary, which can fill in the calories (+/-, based on intake and activity). I've been trying to be pretty honest and keep on top of it. Since I've lost a couple pounds since I last saw my doc, I guess it's working.

Eventually, I'll have to start getting more exercise. I need to start getting ANY exercise. To say I'm sedentary would be an understatement, I admit. I'm taking one thing at a time though. First, get a handle on my food intake, then, on to adding exercise. If I change too much at once, I'm afraid I'll feel overwhelmed and quit.

Joined MFP

As I've said before, I'm rather craptastic about knowing portion size and such. In an effort to work on fixing that, I joined My Fitness Pal.

It's an interesting little website that calculates caloric intake someone needs to maintain or lose weight, based on current height and weight. Along with the site's food diary, which

The Secret Dreams of a Chunky Chick

I have secret dreams about the results of losing a bunch of pounds--things that I've never told to anyone. They're things that I think most "normal" size women can do or experience.

 

I'm trying to be more open and stop bottling thoughts and feelings up about my weight, so, here's my list for the whole world to read:

 

• Wear one of my boyfriend's t-shirts. This may be a chick-flick induced wish, but it's something I've never even had the option of doing. I have always outweighed him.
• Fit comfortably in an airplane seat. I have completely avoided flying since my trip to Vegas 10 years ago. The seats were snug then and I'm bigger now. I have this fear that I'll get on the plane and the staff will make a big, public spectacle about saying that I need to buy a second seat.
• Not have to check the weight-limit on items I'm considering purchasing. I've had to do this for folding chairs (wrecked a few, much to my humiliation), exercise equipment, a hammock I've been eyeing for years, etc.

 

I'm sure that there is more, but this is all I can come up with right now.

 

What I can say is that, while my weight has had a huge impact on my life, it hasn't ruined my life. I have great friends, family, a wonderful fiance, and a job and a home to go to each day. I try to maintain a positive attitude, even when life makes it tough, and remember that it could always be worse. Life, no matter it's limitations, is a gift.

One step closer

Well, I officially have an appointment to meet the surgeon and see what I need to do to move forward.

I spoke with the doctor's assistant, "D". He told me that he received my referral from my PCP, but he would have to wait until he verified approval from my health insurance company before he scheduled me to see the surgeon, because it would be a waste of my time and money if the insurance company had no intention of paying. He said he would know in 7 to 10 days.

I work for the same healthcare organization that I am seeking this procedure through. Since they're self-insured, when I mentioned my insurance company name, he said "oh, well, then we can go ahead and set up that appointment right away!" 

The first opening wasn't until April 22. I'm glad I didn't have to wait to schedule or I'd probably be waiting until May to get in.

So, now I wait some more, but I still see this as progress. Things are happening, even if it is 3 weeks(!) away. D is sending me a packet in the mail. At least I'll have some info before my appointment.

The appointment will include a 45 minute video about bariatric surgery (both the program at the hospital and the specifics of the procedure itself) and then a 45 minute consult with the surgeon.

I have to say, my first experience talking to someone in that department was really good. D made me feel comfortable when discussing something that can be a very sensitive subject for me. Hopefully, it's a fair representation of things to come. :)

Today's the first day of the rest of my life, right?

I'm starting a journey here. I'm scared, because it isn't a journey with any end--it's life long. I'm taking a path that will, with hard work and some help along the way, take me from fat to fabulous.

I've been overweight for most of my life. According to my mom, it started around early grade school. It's been a constant struggle for me.

Weights that come to mind:
5th-6th grade -- 170 lbs
12th grade -- 190 lbs
26 years old -- 265 lbs
31 years old (today) -- 317 lbs

Until recently, I was sure this weight would stay with me for the rest of my life, along with the many health issues it has and would bring.

In the past, I have tried dieting. Believe me, I didn't get to this weight because I ignored the problem.

I remember a physician monitored diet around 6th grade where I was to take in 1200 calories a day. The coaching/help received from the doc was in the form of a two page document that explained what I should eat for each meal. That's it. No help with understanding portions. No explanations of what healthy foods could be substituted for less healthy ones. Really, it was all no help.

The next year, I remember my mom trying to bribe me to lose weight. "Robyn, if you lose 20 pounds, I will buy you that jacket you want". Again, there was no teaching me how to realistically modify my eating habits, just a carrot (pun!) dangled up too high to get.

Please, don't get me wrong, my mom was doing the best she could. She just didn't have the tools to help me. No one had ever shown her what was a proper portion size or anything of that nature. She didn't need it because she'd always been a person who is always moving, burning calories. Plus, as a single mother, she was working long hours to pay bills. She couldn't be everywhere at once.

In high school, I thought I was so freakin' fat. Now, I'd give anything to weigh 180/190 pounds.

There are several reasons I need and want to finally lose weight.

1. I have a birth defect--a malformed vertebrae (L5) that causes my spine to have a 33 degree curve. It can be very painful, as I can hurt the muscles of my lower back very easily, since they're attached differently than they are designed. One day, I'll have to have surgery to fuse my tailbone to my L5 to my L4. Excess weight, especially as much as I am carrying now, would make the success of that surgery very questionable and the recovery time will be harder and longer.
2. I have asthma that is exacerbated by the extra pounds.
3. My knees have started to hurt a lot within the last few months
4. I want to have a baby. At my current weight, I am less fertile, I would have a high risk pregnancy (gestational diabetes, high blood pressure, etc.), and my back would be a huge problem with adding pregnancy pounds to it's burden. If I had a child right now, I wouldn't have the energy to be a proper parent.
5. My mom is diabetic, creating a greater risk for me of becoming diabetic myself.

After years of trying to lose weight, I feel defeated whenever I think about trying again. Thirty years of failures does not inspire my confidence.

About two years ago, I began to seriously consider bariatric surgery. My mom was very supportive, but my fiance wasn't. Without his support, there would be very little chance of success. So, I gave up that idea.

Things have changed though. My fiance (a.k.a. my "undocumented husband" or "UH") came home a few weeks ago and asked me if I'd ever considered gastric bypass (he forgets previous conversations a lot. Love him, not his memory ;) ) I wondered where that question had come from and he said that one of his coworkers had the surgery and told him all about his experience. I reminded my UH that we had talked about this before and his unwillingness to support me had put an end to my considering the procedure.

We had a long talk, during which I explained why I felt it was something I could benefit from and that I didn't see the surgery as a cure, but more of a helping hand. By the end of the convo, my UH said that he would completely support me now that he'd been able to talk to someone who had experienced it first hand.

I mulled this conversation over in my head for a couple weeks and, finally, today, I had an appointment with my primary care provider (a.k.a. my doctor/ my "PCP") to talk about it and to get a referral to begin the process of finding out if I am a candidate.

PCP she believes I should qualify as a candidate. She said that now is a good time, because I am still pretty healthy for a person with my body mass index. She said that, by the time I am 35 in four short years, I won't be so health -- I'll very likely, at minimum, be a diabetic. I was given a referral to see a bariatric surgeon.

This does not mean the surgery is for sure and, even if I do have it, it may be a year before I get there. For insurance and protocol to make sure I'm truly a candidate -- both physically and psychologically -- there are several hoops for me to jump through.

Per PCP, who I just found out had the surgery herself, I will likely have to do another physician managed diet to satisfy the insurance company. Also, each candidate needs to attend several individual and group therapy sessions for pre-op patients to sort out the person's relationship with food (emotional eaters, etc.), how to break any unhealthy food associations, and whether a person can mentally handle the life long change they're considering. No doubt, there's even more that I'm forgetting.

No word yet on how soon I can get into see the surgeon and begin all of this. The office is going to call me in the next couple days.

In my first paragraph, I said that I was scared about this. My fear is not enough to stop me from considering this procedure, but I think it is healthy to recognise what I'm worried about.

1. I know people who have had the surgery and had great results, but I also know people who had complications, someone that gained the weight back, and a person who died from complications years later. There are risks with any surgery, but DAMN, that last one scares me quite a lot.
2. I have a fear that I won't be able to handle to food restrictions after surgery. I really love ice cream. Really. <-- with this one, I think about it, but I know that I will follow through the best of my ability if I go so far as to have my stomach cut up and rerouted to lose weights.
3. Everything I read says that this surgery is safe for the long term, but I still worry that I'm going to have trouble when I'm in my twilight years because of this. I've yet to hear about an elderly person who had gastric bypass.
4. The idea of having my stomach Frankensteined freaks me out.

I do believe that the risks and my fears are outweighed (ha!) by the benefits. I don't think that the surgery is a cure-all. It's just a help that will make initial weight loss easier, by making my stomach very small, but the new stomach does stretch. Long term, I will have to continue to exercise and watch my diet.

With the goal of just being healthier, not necessarily "skinny", I'm committed and excited for what may come.