Monthly Archives: May 2012

Last Supper Syndrome and Yes There Is More Than One Food Group

So, I was only going to write only about something called the Last Supper Syndrome, but I had to write a quick note about my recent chicken experience.

I am really feeling overwhelmed by chicken today.  Maybe that’s because when I went grocery shopping, everything I bought revolved the chicken and the chicken soup I was planning on making.  No breakfast or lunch meals were planned for.  Yes, I spent $60 at the store on chicken dinners.  As a result, I’ve had to eat something with chicken in it every single meal, most of them revolving around chicken and rice/noodle/potato soups, chicken and veggie stir-fry, raw veggies with a spicy shredded chicken dip.

I am definitely ready to expand my palate because I am definitely chickened-out.  Anyway, on to our regularly scheduled post.

When I last saw my nutrionist she gave me a lot of information about what to expect both before and after surgery.  One of the topics was something called Last Supper Syndrome, which is the act of making sure you try all of your favorite foods before surgery, making sure you get one last taste for a while or maybe forever.  I laughed as soon as she said it and exclaimed, “Oh yeah, I totally have that!”

The nutritionist explained that this is a point of stress for many people.  I have been having fun with it making mental notes of things I have to try one last time, so she kind of surprised me.  Maybe I’m OK with saying good-bye to some foods because I am really tired of food in some ways.  And maybe I’m OK with it because I’ve kind of been down this road before. 

It was maybe 2002-ish when I found out that I had a whole host of crazy, extreme food allergies.  I kept ending up in the emergency room with strange swellings all over me.  My hands or feet.  My lips.  My eyes swelled shut once.  I went to my primary care doctor and they had no clue what was causing this.  I was tested for everything from Lupus to MS.  Finally, a friend of mine showed up at my house when my eyes swelled shut and took me to urgent care.  I told the doctor everything I had eaten, the medicine I was taking, the household products I had used.  Everything.  Finally, she said, stop taking the penicillan immediately, you’re having an allergic reaction.  Then she quizzed me on the other times I experienced this and she was like, yeah, girl go see an allergist.  So, I did. 

The allergist completely shattered my world.  I’m allergic to milk, tomatoes, peanuts, shellfish, and corn just to name a few.  Think of all the food made from these foods.  Pizza, ice cream, peanut butter.  And medications like iodine.  They tried desensitizing me.  Didn’t work.  So, I had to completely elimnate these foods from my diet.  It was the hardest thing I have ever done.  But you know what?  My world did not come to a complete end.  I have learned a lot about cooking and how to make tasty foods without those allergens. 

It is not easy.  I still struggle with craving different foods.  Sometimes it is very hard for me to walk past the frozen pizzas in the grocery store or sit the the same room with someone who has just ordered a pie of zaaaaa.  I have found myself many a time trying to justify buying a pizza.  Just one.  A small one.  Just a slice. I have benedryl. I’ll be fine.  Then I force myself to remember the time during the desensitizing phase, I was in the emergency room after eating pizza arguing with the doctor because I would not let him put a tube down my throat just in case the swelling became so bad I stopped breathing.  I know that is a possibility and yet the desire to eat pizza is strong enough that I have to tear myself away from pizza section.  Or force myself to leave the room if someone orders it.  

I know my struggle with food will not end the day of the surgery, but I also know if I can walk away from pizza, ice cream, lasagna, cheesecake, etc over and over again, I can handle anything.  I do not plan to completely gorge myself.  I have not so far, but I am going to enjoy tasting some of my favorite foods and saying “good bye” even if it just might be “see ya later!”

 

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Sleep Study & Nutrition Counseling

Today I am going to share my experience with the sleep study and nutrition counselor.

Sleep Study

The sleep study was an odyssey.  I have been three times to the sleep center.  The first visit was a complete disaster.  I read, I watched TV.  I stayed in bed trying to be very still with my eyes closed.  Here’s the one thing I did not do:  sleep.  

I was so frustrated.  And the more I tried to sleep, the more stressed I became.  It is very difficult though to relax in that setting.  Granted, the center had a big comfy bed.  Lots of fluffy, comfy pillows.  A ceiling fan and they allowed me to set the room temperature to a comfortable level.  The setting was perfect for promoting sleep. What could be the problem.  Well, I will tell you.

Wires.  They glued wires to every part of my body it seems.  My legs, arms neck, nose, and scalp. So uncomfortable.  And to top it off, I had an allergic reaction to the adhesive they used to stick the electrodes to my skin.  I was itchy for days afterward.

They finally just sent me home around 5am.  They cannot really measure how I sleep if I do not sleep.  So, I had to reschedule and come back.

The second visit went much better.  Same comfy bed and pillows.  Nice cool room.  I took a Benadryl to counter the effects of the allergic reaction to the adhesive.  Not to mention the added benefit of knocking me out.  I slept all night, thankfully.  The results were horrific however.

It turns out, I stop breathing 44 times per night and my oxygen absorption level ranged from 62-89.  Oxygen absorption is supposed to be over 90 at all times.  This is very dangerous and puts a lot of strain on the heart.  So, they immediately scheduled the next appointment, which was to have me sleep with a c-pap machine.

That actually went OK.  I hate the c-pap machine, but it does help me sleep better.  I had to be hooked up the the wires again, but I apparently slept all night and did not stop breathing once.   

It is apparently important that I be able to breathe.  I will have to use the machine in the hospital.  Because of the anesthesia, if I stop breathing, it could be really bad.  So, I will use the c-pap machine until further notice. 

What is a c-pap machine you ask?  It is a machine that blows air into you nose and/or mouth.  The flow of air keeps your air passages open and clear so that you do not stop breathing.  The machine is small and barely makes any noise.  You can add water to it so that you do not get dehydrated during the night.  The mask is a little uncomfortable.  But I have learned to live with it.  I am hoping it is a temporary thing as often sleep apnea is cleared up after the weight loss is achieved.

Nutrition Counseling

I was a bit apprehensive about the nutrition counseling, I have to admit.  I do not know why.  My nutritionist is the nicest person.  She is very sweet. Nonetheless, I did not know this going in.  I had to write down my eating habits, which is a source of stress for me.  Obviously, I struggle with food.  And I with my food allergies, I have really struggled.  So, it is kind of a big step for me to talk to a nutrition counselor and I put it off as long as possible.

The truth is, this was a very liberating experience for me.  I was nervous, but my nutritionist was super nice.  She talked to me about my diet, steps I could take to improve what I eat.  Most of which I already know.  She encouraged me to keep a journal of my eating habits, which I still have yet to do.  She also gave me some other options that are low in salt, heart-healthy, allergy-free ways to improve my diet.  She was not so interested in restricting my diet as she was with giving me healthier options to choose from.

A major part of our nutrition conversation revolved around what eating will be like after the surgery.  And she gave me steps I am going to have to take now to prepare.  It is no simple task.  I cannot drink 30 minutes prior to eating, during eating, nor 30 minutes after eating.  I have to chew my food to the consistency of apple sauce.  And worst of all.  I have to ween myself off coffee!  WTF?  I mean seriously, I’m a writer.  I’m not sure how I am going to function without my daily cup of joe.  But somehow, I will learn to manage.  

I have another appointment with the nutritionist this week.  I guess my next tasks should be to create a food journal.  And contact the psychiatrist.

The First Steps

The first steps to planning for a gastric by-pass surgery are obvious.  You make an appointment and meet with the doctor.  Explore the different procedures available and choose the one that you and your doctor feel will fit your needs best.  What?  You say.  There’s more than one procedure? Yes, there are several.  I did not know this going in.  I thought there was just the gastric by-pass and the lap band.  Turns out there are several procedures.  Wiki has a great entry on gastric bypass procedures.

Once you have decided on a procedure, then the real work begins.  

Unless you are paying with cash or on credit, you are probably, like me, relying on your health insurance company to pick up the tab.  Most insurance companies have a few requirements you must meet.  You have to have a bmi over a certain limit.  This can vary depending on your insurance.  They also have a mandatory waiting period and nutrition counseling.  My insurance company requires six months of nutrition counseling.  A bit draconian?  I thought so until I realized what else is required.

The doctor and/or the insurance company may also require a sleep study to test for and treat sleep apnea, clearance from your primary care physician and possibly a heart doctor if you see one, a psychological review, tests done by an endocrinologists, and any other medical tests they feel are necessary based on the general health of the patient involved..

Seems like a lot, huh?  It is.  This is a big surgery.  A life altering surgery.  If the doctors and insurance companies do not make sure a patient can handle it, they would not be being fair to the patient.  The surgery also changes forever your relationship to food, your body shape, and can affect your self image.  You go into the surgery thinking this is exactly what you want.  The reality is, it can be much more of change than you are mentally prepared to handle.  Many patients suffer depression for months, sometimes years after the surgery.

So, where am I in this process? 

I have visited the sleep center three times already.  I have been doing the nutrition counseling.  Trust me, none of this is particularly easy.  I have not done the psychological evaluation yet, but that is next on my list.  I also had my yearly physical.  Once I have finished the nutrition counseling and complete the psychiatric evaluation, I have to contact the bariatric doctor’s office again and find out what else they want me to do.  It took me longer than I had planned to get started on some of these things, but I should be ready to start planning for the surgery by the end of the year.

A New Choice A New Direction

I have struggled with my weight all of my life.  The struggle began long before I was overweight.  In grade school and high school I was not fat, but I felt that I was.  Worst of all, many of the people in my life told me that I was, just reinforced my already out-of-wack self perspective.  When I look back at my childhood pictures, I wonder not only why I felt that way, but why anyone would tell me something that was so patently untrue.

Throughout my teen years, my weight fluctuated between 120-135.  When I went to college, I think I weighed about 130.  When I left college, I weighed 160-180.  By my mid-twenties I was over 200.  

Recently, I weighed in at 298.  Wow.  I have tried losing weight, oh I don’t know…every day of my life?  Yeah, that sounds about right.  Part of me thinks that if I had never been so weight obsessed that I never would have gained as much as I did.  

Now I am beginning to feel some of he negative effects of being obese more than I ever have before.  I have high blood pressure, asthma, food allergies, and back problems.  Walking is difficult, standing in one place is excruciating, and I am very concerned about overall health in general.

I have spent the past two years really struggling to get my weight and health under control, I do not seem to be making much headway.  

November of last year, my sister came to me to tell me about a girl she works with.  This girl experienced extreme weight loss over the course of a year or so.  My sister finally asked her co-worker how she did it.  Her friend was surprisingly open about what she did.  

Apparently, she had something called a lap-band procedure done.  She had a small band placed around part of her stomach and part of her stomach removed.  And she exercised like a madwoman.  My sister wanted me to have this done.  I was wary, but with the health problems I had been having, I was pretty open to nearly any idea.  I talked to this girl and went to her doctor.  

I made the mistake of going to this doctor by myself.  I should have waited until my sister, a friend, or someone else could go with me.  But, I did not wait.  The people at the office were very nice.  But I left there feeling somewhat uncomfortable.  I was excited about the thought of doing something to help with my weight problem, but I did not really connect with the doctors at this office.  I felt as if they were more interested in selling me a particular program, and not so much interested in finding the right solution for me.  I felt as if I was being pushed into choosing the most expensive, most invasive, least healthy procedure they offered.

Now, I know several people who have either had a gastric by-pass or a lap band procedure done.  All of them are very happy they made the decision and say that they have no regrets.  One of the women even tried gently nudging me in that direction a few years ago, but I was not ready to consider it as an option.

After leaving that first office, I went to my primary care doctor.  I set up an appointment with her specifically to discuss my options.  She made a couple of recommendations of doctors nearby that I could talk to.  I still had concerns thought.  You see, they were connected to the hospital in my neighborhood.  I had a bad experience there recently and really did not want to go back there for any reason, especially an invasive, life changing surgery.  I’m sure the doctors she recommended were just fine, but I was wary.

Over the next few days, I thought about my options  I was sitting in my bosses office one day when a girl from a different department walked into his office and sat next to me.  I had been thinking of her recently because I knew she had the gastric by-pass surgery.  She now worked from home and came into the office very rarely, so I hadn’t had a chance to talk to her.

I don’t know how she felt inside, but I know that outside, she looked great.  She had lost a lot of weight, which was part of it.  But honestly, now she had a happy glow about her.  So, when she sat down, I stopped what I was saying to my boss and turned to her and said, “I’m glad you’re here.  I need to talk to you.  It’s kind of personal, so feel free to tell me to shut up if you don’t want to talk about it.”

Obviously, she knew what I was talking about right away with that kind of an intro and she just looked at me and said, “Ask me anything.  Nothing’s personal anymore.”

So, I told her everything I had been through recently and my thoughts and reservations and I asked what she had done.  She told me what procedure she had done, who was her doctor, and how she felt.  She gave me the name and number of her doctor and told me that I must go see him.  She loves him and everyone in his office.  She said they are the nicest people and absolutely changed her life.  She had no regrets and would do it again.  She was also honest about some of the problems she had experienced after the surgery and how she managed.

I went to see her doctor and my experience was exactly as she described hers.  They were very friendly and basically held my hand through all of the options and helped me pick what they feel would be the best procedure.  Of course, its the procedure this particular doctor specializes in, but I didn’t feel the hard-sell like I did at the other office.  But I also feel as if I would have chosen this procedure over any other because it negated many of the concerns I have about gastric by-pass surgery.  It is invasive, but less drastic than several of the other procedures I have looked at and, best of all, if I have serious complications, it is reversible.  

So, I have come to a decision.  I decided to have the gastric by-pass procedure done.  This was not an easy choice.  Nor is it an easy process.  What I have been going through is nothing like I thought it would be.  You don’t just meet with the doctor one week and prep for surgery the next. There are many steps and it is rather complicated.

I have decided to blog about my experience to help me explore some of the feelings I am having and to basically discuss the process I am going through.  I have not had the surgery yet, and probably won’t until closer to the end of the year.  In the mean time, I have a lot of preparation that I did not expect to have to do.  It is going to be a long journey from where I am now to surgery, weight-loss, and good health.  I hope you will join me.