Monthly Archives: September 2012

Back to Business

Now that I have the hard emotional post out of the way, it is time to get back to the business of discussing my preparation for the gastric by-pass surgery.

These are the tests, etc that I have to complete before surgery.

  • More blood work – the list of blood work tests they gave me is very long.
  • Urinary test.
  • Chest X-Ray.
  • Sonogram of gall bladder
  • PFT test – Pulmonary Function Test.
  • Another EKG.
  • Pulmonary consult and clearance.
  • Bariatric education class at hospital.
  • Nurse interview at hospital.
  • GI Consult.
  • EGD – that’s where they stick a camera down your throat all the way to your stomach to take a peek inside.  Fortunately, I will be unconscious for this.
  • Last pre-op visit with Surgeon’s office the week before the surgery.

Here is what I have done so far.

  • GI Consult.
  • Nurse interview at hospital.
  • Bariatric education class at hospital.

This is stuff I am getting done this week.

Wednesday:

  • Blood work.
  • EKG
  • Pulmonary consult and clearance.
  • Urinary test.
  • PFT test – Pulmonary Function Test.

Friday:

  • EGD.
  • Colonoscopy.

What I still have left to do before the surgery:

  • Chest x-ray.
  • Sonogram of stomach, gall bladder.
  • Last pre-op visit with surgeon’s office and appointment with their nutrition counselor.

Fortunately, my primary care doctor is a pulmonary care doctor, so I can get the pft and pulmonary clearance done right there in the office.  I can also get the EKG done there.  They will also do all of the blood work, etc.  The GI doctor that I saw is also going to do a test for Celiac Disease.  My sister has it and the doctor thought it would be prudent to see if I have it as well.  I insist that I do not, but we shall see.

I am waiting to do the chest x-ray and the sonogram of my gall bladder until after I see my primary doctor.  I want to make sure that they give me recommendations for those tests as well as the EGD and colonoscopy, which is scheduled for Friday, so that they can get clearance from my insurance company.

Oh the hoops I have to jump through.

The bariatric/nutrition class at the hospital was very informative, if not a little bit scary.  The nutrition part of this class was actually very interesting.  The nutritionist reaffirmed many of the things that I’ve already learned, plus she talked specifically about what we will be eating.  A lot of the diet isn’t going to work for me.  Mostly because of the dominance of milk-based products.  I am allergic to milk, so I am not going to be able to follow that part of it.  Fortunately, she did say that there are many alternate choices for me.  I will have to work with the nutritionist at the surgeon’s office to create something specifically for me.

I think the heavy reliance of milk-based products is because milk is a great source of protein, which is very important after surgery..  Milk is also a food that can be found in many soft forms, yogurt, cottage cheese, soft cheeses.  Soft, gentle foods are also important in the immediate first eight weeks after surgery.  With that in mind, milk products are great.  They offer the double punch of being soft and packed with protein.  Excellent food choice for post bariatric surgery.

Not for me.  I have to find alternate sources of soft, protein rich foods.

The scary part came when the bariatric nurse gave her talk.  She was terrific.  She is a tall beautiful blonde-haired woman with a delightful eastern european accent.  I think she said she was from Ukraine.  She was also tough as nails and did not hold back at all.  She was very specific about what life will be like the few days immediately following the surgery.  She talked about the pain levels we should expect.  She told us that some of us may have feelings of regret in the first days after the surgery.  She also said that some of us may need to give ourselves pain shots after we get home.

She basically tried to paint a very real picture of life immediately after the surgery, plus what we should expect for the first eight weeks.  She stressed the importance of following the diet and the doctor’s orders.  Basically, she put it out there that if you were having doubts at all and did not think you can handle what is coming, now is the time to talk to your surgeon and perhaps reconsider.  This surgery is not for the faint of heart.  It is not easy.  She also made it clear that this surgery is not the answer.  It is only a tool.  It is up to use to use that tool to make more substantive changes to our lives to see the best results.

I definitely left there with a more clear picture of what to expect.  I am definitely not turning back.  Yes, I was a bit scared about the possibility of giving myself shots.  I really do not think that I can do that.  I will somehow manage to muddle through.

Yes, the pain of the surgery does scare me.  The things I may have to do in the immediate aftermath of the surgery scare me as well.  The pain I feel every day, whether it is excruciating back pain, agonizing foot pain, both of which are almost constant, or the difficulty I have breathing are so much worse to me.  I am willing to face a little bit of short-term extra pain and difficulty to   experience long-term positive health benefits.  In short, I want to take my life back from my obesity and I’m not going to let the short-term pain of surgery stop me.

Today’s cat is Milo.  My sister adopted two abandoned kittens.  One was a girl, which we named Oscar.  The boy kitten was Milo.  She took both kittens so that they would not be tossed into a dumpster.  She intended to keep Oscar and find Milo a home.  She did eventually find Milo a home, but not before he left his mark on Oscar.  She had a little of four adorable kittens, all of them found a loving home.  Then she had Oscar fixed.  Nonetheless, we loved Milo.  He is a beautiful cat.

Searching for the Skinny Girl Inside

Where the heck have I been?  I know, I know I have not updated my progress for a while.  I have been trying to frantically prepare for my upcoming surgery.  Emphasis on frantically.

First thing’s first.  My surgery date has been moved to October 24.  I must have an endoscopy and a colonoscopy.  The soonest I could get an appointment for that was Friday, October 5.  The results from those tests will not be back in time for me to have the surgery on October 9.  In addition, if I have any bacteria in my system, I will have to be on antibiotics for two weeks.  So, the surgeon’s office thought it prudent to put off the surgery until later in the month.  So long as there are no further complications, there should be no further delays in the surgery.

I have to admit, I am relieved that the date was put off.   I know, reading my blog, one might be under the impression that I am really ready for the surgery, that I have am mentally prepared for the changes  the surgery will bring.  Allow me to disabuse you of that notion.  The truth is, I am an absolute mess.

This is how I have been feeling lately:

The past couple of weeks, I have been dealing with a lot of pretty difficult stuff.  I am very nervous about the surgery itself.  I think that goes without saying.  Everyone who has ever had any kind of surgery is usually nervous before the surgery.  That is not what has really been the cause of my stress recently.

The immediacy of the surgery has me thinking a lot about my life, my health, my weight, my relationship with food, and many other problems.  I have spent a lot of time analyzing why I eat, how I became so obese, why I have allowed other people’s words, what they think of me, and their  behavior affect how I feel about myself, and the life I feel I’ve lost because of my obesity.

I have been looking at pictures of myself from high school and college when I was much, much thinner.  In most of the pictures, I was not even a little bit overweight.  Nonetheless, many people around me, people I loved and trusted, did not hesitate to tell me how fat I was.  Everything I ate was analyzed and criticized publicly by them.  I was often told that I had such a pretty face, and what a shame it was that I was fat.  As I looked back, I became angry.  I was angry at every person that ever called me fat when I clearly was not.  I was angry remembering every time others tried to shut me down by telling me I was fat and ugly as a way to deny me of my voice, self-confidence, opinion, or to make them feel better about themselves.  But mostly, I was angry at myself for believing them.  I could not see that I was not fat even when I only weighed …. pounds.  I could not see that I was pretty or cute when they called me ugly.  I was angry at myself for not having a thicker skin or the sense to realize that their words said more about the kind of people they are than about the kind of person I am.

Then there is the whole food issue.  I know that I have written before that I am sure saying good-bye or even see ya later to some of my favorite foods will be something that I can deal with.  I am still certain that I can but that has not stopped me from freaking out. As my surgery date looms in the immediate future, I have been stressing out over every single meal.  I have kind of over done it with some of my favorite dishes.  I cannot lie.  And I have experienced great anxiety over not being able to eat the kinds of foods I have grown accustomed to and love.  Food has been a great friend and comfort to me over the years when people have not.  Food is always there.  While people may treat me like I am nothing, not worthy of being friends with, not worthy of dating, food does not.

I am also a good cook.  I love to cook, actually.  I love delicious food.  I love experimenting with recipes, spices, flavors, sauces to make food even more delicious.  I love eating something at a restaurant or a friend’s house and going home to try to re-create the dish.  When someone tells me they are allergic to or cannot have a certain food they previously enjoyed, I love experimenting with ways to make that food so that they can eat it.  I can make my favorite dishes and feel a sense of completeness and satisfaction that I have trouble finding in other aspects of my life.  I can share the food I make with others and I find an acceptance I do not often find in my relationships with people in general.  I am almost always complimented on the food I make.  I am rarely complimented on clothes or how I look.

Changing my relationship with food is scary.  I recognize that it is necessary, but that does not mitigate the stress I have experienced recently.   

This has all caused a lot of anxiety, depression, and stress that has been almost paralyzing.   I find that I become unreasonably stressed out over the smallest things.  I had to go to a four-hour nutrition class this week.  The class was held at Inova Fair Oaks hospital, which is twenty miles from where I live.  I do not have a car.  My sister was meeting me there. She lives almost thirty miles from me.  The hospital is between us.

I took a bus and the metro to get there.  Well, actually, the route required that I take three buses and the metro.  And there is a good deal of walking involved.  Because of my weight, I have a lot of pain and difficulty walking.  That caused me a lot of stress.  I was afraid that if i missed anyone of the buses I would be late or miss the class.  I also did not know where one of the bus stops was located.  As a result of the stress I experienced over this, I was up most of the night before.  I only had three hours of sleep.  Nonetheless, I managed to get up on time and on my way.  I talked to my sister most of the way during my journey to the hospital.  Thank God for cell phones.

When I got off the second bus, I was lost.  The directions that I printed off of the metro website were confusing.  The directions read like, “walk a short distance and turn left onto Stringfellow road.  Walk a short distance and turn right onto Lee Jackson Highway.” The problem was, I was already standing on Lee Jackson Highway.  If I turned left onto Stringfellow, that would have taken me away from Lee Jackson.  I was explaining this to my sister.  She had just pulled into the hospital.  I read the directions to her and she was also confused.  I was standing at a major intersection on a highway and had no idea where to go.  Finally, she told me to stay where I was and she came to me.  It turns out, I was two lights from the hospital.  I made it to the class on time.  Everything worked out OK.

Oh and the bus stop?  Turns out, it was across the street from where I had been standing.  I was unreasonably stressed out for no reason.

That is just one example.  I have thousands more and many of them much more mundane.  I have fought to overcome my fear and stress each time and most of the time I have been successful.  Certainly, when it counts, I have been successful in overcoming the fear and managing my anxiety.

I am lucky though.  I have the world’s greatest sisters.  I have talked through everything I am going through with them.  They are both so supportive and they are both my biggest cheerleaders.  My youngest sister, especially really seems to understand my tortured relationship with food.  We have had some very frank conversations about food.

I do not want to leave you with the impression that I have been sitting around all day, every day crying under the covers.  Some days maybe, but not all of the time.  Yes I am afraid of the surgery, terrified in fact.  I am afraid of the changes that are about to happen to me.  I am worried about not being able to eat some of the things I love.

Mostly though, I fear remaining a prisoner of my obesity and health problems.  I fear not being able to do the things that I love to do because I am too fat or unhealthy to do them.  I already live that every day and I do not want to any more.  In order to move forward and have a different life, I need to make different choices.  That is why I am having the surgery.

I know that I can do this.  As difficult as the past few weeks have been, I feel it will all be worth it.  So, please forgive my short hiatus.  I promise there will be more good posts to come.  So, I will leave you with this adorable cat picture.  I do not have any specific cat stories to share with you, so this will have to do for now:

 

 

 

 

 

The Surgeon Appointment Part 2

Don’t look for Part 1 for this post.  It does not exist.  This was simply my second visit with the surgeon’s office.

Before I could see the surgeon a second time, I had to do these things to qualify for that appointment:

  • Psych Review.
  • Nutrition Counseling.
  • EKG
  • Pre-op clearance from my doctor.
  • Sleep Study followed up with C-Pap machine.

Now that I have completed all of these, I have to get more tests!

  • More blood work – the list of blood work tests they gave me is very long.
  • Urinary test.
  • Chest X-Ray.
  • PFT test – Pulmonary Function Test.
  • Another EKG.
  • Pulmonary consult and clearance.
  • Bariatric education class at hospital.
  • Nurse interview at hospital.
  • GI Consult.
  • EGD – that’s where they stick a camera down your throat all the way to your stomach to take a peek inside.  Fortunately, I will be unconscious for this.
  • Last pre-op visit with Surgeon’s office the week before the surgery.

I can do all of the blood work, urinary test, EKG, PFT, and the pulmonary consult with my primary care doctor.  Since I have asthma and pulmonary obstructive disease, I chose as my primary doctor one who specializes in pulmonary illnesses.  So, that will make part of the tests easier.  I also just had a PFT test when I met with my doctor for the pre-op appointment.  I might be able to use those results.

I think I can do the Bariatric class and the nurse consult at the hospital on the same day.  And I might be able to do the GI Consult and EGD at the same time, but I’m not sure.  I have the last pre-op with surgeon’s office already scheduled for October 3.

This is an intense process.  The nurse I met with today at the surgeon’s office told me they want to make sure that I am as healthy as possible before the surgery.  This way, if there are any issues, they can be addressed and fixed before the surgery.  Also, I’m sure it covers them if there are complications.  They can say, we worked hard to make sure she was a good candidate for the surgery and medically able to handle it ahead of time.  This is a good policy as far as I’m concerned.

I would rather have everything checked than to have him open me up only to find a problem.

So, back to my doctor I go with a list of new tests in hand.  Goody-goody.  Wish me luck.

Today’s kitty-cat picture is one of my sister’s former cats.  Her cat had four gorgeous kittens, as evidenced in my previous post where she was seen nursing said kittens.  I took two, Yoda and Veruca Salt.  She kept her cat, Oscar, and also kept a kitten called Mogwai.  He is just beautiful.

So, why is he her former cat? Well, let me tell you.  She was living with a boyfriend at the time.  He kept calling Mogwai his.  He fed the poor kitty fresh turkey slices every day as a treat and the cat loved him.  My sister’s cat.  Loved the boyfriend.  When they broke up, she moved out and took both the cats.  He then called her every day crying about her taking his cat.  The cat in turn, destroyed everything and cried every  day.

Now this is funny because before she moved in with him, he was an avowed cat-hater.  He complained every day that she brought cats into his house.  Needless to say, she was confused on the insistence for the cat when they split.

She had to go visit him one day to pick up the last of her stuff.  She took Mogwai with her to prove to him the cat loved her best.  She walked into the house and Mogwai jumped out of her arms and ran to the boyfriend.  The cat sat on his lap and scowled at my sister.  He had made his choice.  She just looked at him and said, “I guess he’s your cat.”

So, here he is.  One of the last pictures she ever took of Mogwai…my sister’s ex-boyfriend’s cat.

 

 

Countdown

As of today, my gastric by-pass surgery is 35 days away.  OMG!

I know I have been planning for this all year, but now I am really starting to get nervous.  I think in part because it is starting to feel very real.

Every meal I eat, I find that I am looking at it and thinking, “A month from now, I will not be able to eat this.”  I have to admit, that is freaking me out a little bit.  I am OK with these changes, and I won’t let my anxieties keep me from having the surgery, but I have been thinking about it a lot recently.

I mean let’s face it, my choices are clear.  Take a chance and make some really big sacrifices to attain good health and potentially a longer, more fulfilled life, or keep going as I have been and risk continued health problems and potentially an early death due to those problems.  Faced with bad health, continued problems, and an early grave, I choose better health.

Things have been seriously bad for me.  I really struggle every day and I hate it.  I just want to regain my previous independence.  I want to be able to walk everywhere I want or need to walk.  I want to be able to do a lot of things I could do before that I cannot do now.  I want to have a long, healthy, vibrant, fulfilled, vital life.  And I never want to be where I am now ever again.  Ever.

So, every time I have doubts or concerns about whether or not I’m doing the right thing; every time I freak out about how my eating patterns will change; every time I wonder about the potential risks that accompany this surgery, I think about where I am now,  what I want to do in life, and what I am missing out on if I do nothing.

So, 35 days before my new life begins.  I have to say it, despite my concerns, I am very excited!  🙂

Here is a picture of me from college.  I was 21.  I’m not sure how much I weighed, maybe 135-140. Yes, my friends and I had been drinking a little at the time, but in my defense, I worked at an amusement park and had just finished my shift.

Approval and a Date Change

I heard from the surgeon’s office today.  The surgery has been approved by my insurance company.  Just like they said, they were able to get the insurance company to reverse their position.  Also, because of the delay, my surgery date has been changed to October 9, 2012. Yay!

Now I have a follow-up appointment with the surgeon.  At that time, I have to pay their fee, which is $200.00. This will not be a problem as I have money on my flex-spending card for that.  Then they give me a whole new list of orders I have to do.  Here are some of the things I may need to do:

  • More blood work.
  • Another EKG.
  • Maybe a stress test.
  • Four hour nutrition class.
  • Buy supplements and protein drinks for after surgery.

I am not looking forward to a stress test, but I guess it is better safe than sorry.

On completely separate topic, I have become strangely nostalgic.  I’ve been looking at all of these old pictures of myself.  I am surprised by how thin I was in some of them.  The whole time, I thought that I was horribly fat.  In many of them, I was not.

It is funny what your brain makes you think about how you look, especially after a lifetime of being told that you are fat.  I guess if you hear something long enough, you just believe it too.  I am going to add a few pictures here of what I used to look like and what I hope to resemble as I lose weight.

OK, so I know there’s no chance I will ever look like this again, but darn wasn’t I cute? I think this was my first day of Kindergarten.

Here are a couple of high school pictures.  I think this first one I was in my sophomore year.  The last ones were from my graduation.

These next three were after I gained some weight.  I weighed around 200 plus pounds.

And for good measure, here is a picture of my sister’s cat just after she had her kittens: