5 months out, 50 pounds down

I can't believe it's already been over 5 months since my surgery. Honestly, most days I can't even tell that I had surgery because I am so adjusted to the new normal. I don't feel the restriction of my new smaller stomach much either, perhaps because it has stretched out some already but also because I naturally serve myself smaller portions now.  In the grand scheme of things, it really is the portion size that is the most significant difference than before surgery.  I still allow myself treats sometimes just like before and mostly that feels right, though I have to fight off the temptation of junky treats (yes, twizzlers, I am talking about you!) and save the calories for the really worthwhile stuff (fresh avocado, high quality dark chocolate.)

I am still losing weight but much more slowly now. It frustrates me but it makes sense intellectually. I would like to lose another 30 pounds, which at this rate will probably take me 6 more months, at least. I never could have lost anywhere close to 51 pounds on my own and so I am hopefully that if I follow the "rules" my surgeon gave me I will get to my goal eventually.  I have a 6-month check up with the surgeon in a couple of weeks and I will get the results of extensive blood work they did recently- I am hoping that will be very affirming and show that I have already improved my health.

Four weeks since surgery

Yesterday was my 4 week anniversary! I am feeling much more normal than I did during the first few weeks. I still tire easily but that's not a big surprise given how little I am eating, how much stress I am under, and how hot it is outside. I am totally sick of my puréed diet but am allowed to advance to the next stage- soft foods- on Thursday. I have started a bit early by experimenting with some finely chopped egg salad and smoked salmon salad (two separate things.) so far so good.  The only things forbidden on the next stage are raw fruits and veggies and nuts and seeds but many people find there are other things they just can't tolerate yet. (Still no caffeine, added sugar, carbonation or alcohol as well.) The rule is to always eat protein first, then veggies, and only fruit or starch if you still have room.  This helps the healing process and helps the body choose to lose fat rather than muscle mass. Since I don't eat meat or poultry or shellfish, I will be eating a lot of fish, eggs, and dairy products.  Beans are hard to digest at this stage but very well-cooked beans in small amounts may be ok. My hope is that I can get enough protein from my meals and snacks to go down to one protein shake a day, which would be great because I am super sick of them. As of today I have lost 25 pounds, which feels awesome!

Back to Work and Purée Experimentation Phase

Tomorrow will be two weeks since my surgery and my first day back at work full-time.  I feel ready- my pain is almost gone at this point, I am sleeping well at night, and as long as I get enough protein and liquids are don't go too long without eating my energy is not bad. I still have some activity restrictions- lifting greater than 10 pounds, swimming, heavy exercise, but otherwise I am free to go about my day normally except for the special diet.  The diet is ok- I graduated from the liquid diet to the purée stage, which will last for 3 weeks. Basically everything I eat has to be the consistency of stage 1 or 2 baby food, which means completely smooth and quite runny.  I also need to get in a minimum of 60 grams of protein per day, which is quite a challenge with the very small stomach capacity.  At this point, I usually have room for about 1/4 cup of food per meal.  For whatever reasons, certain foods are much easier to tolerate than others, which seems to have little rhyme or reason.  Here's what I have tried so far and how it worked out for me:
Cottage cheese mixed with stage 1 baby apples sprinkled with cinnamon- good
Runny mashed potatoes mixed with "chicken" broth flavored protein powder- so/so
Runny cream of wheat mixed with vanilla protein powder- good
Cottage cheese mixed with baby squash- couldn't get it down at all
Plain Greek yogurt mixed with baby apples- good
Runny mashed potatoes mixed with unflavored protein powder- good
Sugar free dark chocolate pudding mixed with plain Greek yogurt, creamy peanut butter, PB2, and milk- good
Low-fat ricotta mixed with tomato sauce, heated- good
Butternut squash soup mixed with unflavored protein powder- couldn't get it down

Not the world's most interesting diet but it works!

5 Days Post-Op and Getting Better Bit by Bit

I can't believe it's already been five days since my surgery.  Overall it's really been an easier recovery than I expected.  I am quite sore in and around my incisions but the pain is getting easier to tolerate each day.  I'm on a liquid diet and tolerating protein shakes and diluted smooth soups pretty well as long as I go slow.  I came home from the hospital really swollen and actually didn't get back to my day of surgery weight until this morning because of all the IV fluids.  I can't drive yet so I am sticking close to home resting a lot, playing online and checking in with my June 30th surgery buddies on www.bariatricpal.com and watching season one of Veep, my newest favorite!

Cranky lady

Came home from the hospital a couple of hours ago.  I am feeling torn between the blog post I feel I SHOULD write about how blessed I am because my surgery went so smoothly and my first day of recovery has been pretty darn easy from a medical standpoint... but unfortunately the honest truth at this moment is that I am feeling really cranky and annoyed at the world, including my cellphone, which randomly completely died yesterday and has been total unresponsive to my attempts at resuscitation, the nurse who misinformed me of the hospital pharmacy's closing time so it was already closed when my mom went to get my medication. After visiting 2 other pharmacies and calling 4 others and striking out every time, I finally gave up and called my surgeon's office and the answering service paged the doctor. He called me immediately (love him!) and was very sweet and he called in a different, more readily available medication, which my mom is out picking up now.  I can't seem to find a comfortable position to rest in and my autistic son is having a really, really hard time with the changes to his routine that are necessary this week.  Our plan that my mom would take care of me so my partner could take care of our son sounded reasonable in advance but is proving far more complicated for a variety of reasons. The most comfortable chair in our house happens to be the cat's favorite too and no matter how many times I shoo her away she keeps trying to climb back into my (very sore) lap. Did I mention there was also an explosive diarrhea episode (my son's, not mine) which my poor partner had to deal with all on her own because I am definitely not up to scrubbing the soiled carpet? We all just need to get through the next hour and then we can hopefully all get some much neded sleep. The bus will pick my son up tomorrow around 8am and I am so looking forward to having time to rest and relax while he is at camp.

Surgery is Over

Well I had my surgery yesterday and so far I am doing pretty well.  I had a lot of pain when I first woke up from anesthesia but they gave me medication in my IV that gave me major relief quickly.  Since then I have mostly felt crampy and sore, which ranges from quite mild to fairly uncomfortable, but I have asked for more pain meds when it gets stronger (about every 3-4 hours) and they work quite well.  I have been up walking around doing laps on my hospital floor and it feels good to move. They gave me my first meal a few minutes ago- broth, jello, and lemon flavored water.  I tried a tiny spoonful of the broth but it smelled yucky and I decided against having any more of it.  The jello tastes good and I have had about 3 spoons full, which has felt fine. I have been very fortunate and haven't had much nausea, which is great.  The doctor should be by in a few hours and then I should get to go home. I am a little worried about the pain getting worse at home without the iv meds option but I think it will be ok.

The final countdown!

My surgery is in less than 48 hours!  I'm feeling calmer than I expected- definitely somewhat nervous but not so much that I am questioning my decision to do this thing.  I continue to feel a lot of relief that I will no longer be so overwhelmed by my struggle with obesity because I will have the powerful tool of the sleeve, the support of my surgeon and his team, the awesome community of fellow sleevers I am discovering online, especially on www.bariatricpal.com, and lots of friends, family and co-workers cheering me on.  Of course I am worried about pain and how difficult the first few weeks (months?) of recovery will be, but this still seems like the smartest choice and investment in myself I've ever made.

17 Days Until Surgery

Well folks this is starting to feel quite real!  I've started shopping for my pre and post surgery needs (lots of protein shakes and broth) and I am busy finishing things up at work because I will be out for two weeks as I recover.  Monday I see the surgeon for the pre-op appointment so hopefully I will get a better sense of what to expect.  I got a really funny fortune at the Chinese Restaurant today: "As long as you don't sign up for anything new, you'll do fine."  Not exactly the message I was looking for but I guess getting most of your stomach removed isn't really something "new."

Support Group

Went to my first bariatric support group meeting last night.  I was totally expecting a room full of people sitting in a circle and talking about what struggles they are having.  Nope- this was a totally different thing. Turns out the "support group" is actually just an informational meeting and there is a different guest speaker each month who gives a presentation and then there's a Q & A question.  This month's presenter was a plastic surgeon (Dr. Long's website) who talked about surgical skin removal options after "massive" weight loss.  Here's what I learned:

1. Insurance companies don't care if you have tons of extra skin that looks and feels gross- there's almost no chance they will cover surgery for skin removal unless you are getting very severe infections and rashes that will not respond to other treatments. 
2. Recovery from plastic surgery can be very painful, especially from tummy tucks since it involves tightening the muscles as well as removing skin and fat.  
3. There's no way to predict whether your excess skin following weight loss will be mild or severe and there's basically nothing you can do about it.  It's a mystery combo of genetics, age, degree of obesity, and luck.  
4. Plastic surgery is expensive!  The doc wasn't exactly sure of his rates but it sounded like patients who want to address multiple body parts (like tummy tuck and breast list) pay $20,000+.  Many patients go back for more surgery later on.  There was a short testimonial from a sweet older woman who lost 115 pounds and had her "bat wings" removed and a breast lift, then a year later got a tummy tuck. I must say she looked great.  

I am going to try not to worry about how loose and hangy my skin might get- I've lost a lot of weight before and I didn't have a major problem with excess skin so hopefully I won't this time around either.  

Got my surgery date!

Today was a big day- I got my surgery date!  It is June 30, which is exactly 8 weeks from today.  I have a few final preparatory steps I need to complete between now and then: blood work to see if my vitamin levels are back up to normal (I was very low in vitamin D, B-12, and iron so I've been taking lots of supplements), a follow up appointment with the pulmonary doc to find out the results of my sleep study, attendance at the monthly bariatric surgery support group, and a full day of pre-surgical tests and information sessions two weeks before surgery. The main thing I'm nervous about at this moment is the requirement that I don't gain any weight or they will cancel my surgery.  It's a standard rule- I think they figure that if you are non-compliant before surgery, you are more likely to be so after surgery, which can lead to complications.  It makes sense, but preparing for weight loss surgery brings up a lot of feelings and not stuffing them down with food is challenging.  It's easy to tell yourself that this will be your last opportunity to eat freely and so you should indulge now while you can. If I do that, I will gain weight! The idea that I'm giving up certain foods forever is not actually true because most sleeve patients can actually eat almost anything once they are fully healed but just not in large quantities.  So I'm trying to follow the pre-surgery eating guidelines they gave me: wean off caffeine, eat little to no sugar, practice eating slowly, and always eat protein first (to fill you up.)  They also recommend starting to exercise.  This morning I took a short walk before work, which was actually a really nice way to start the day.  I also ate several cookies that someone brought to work- not terrible but also not as disciplined as would be ideal.  Tomorrow is a new day.

Welcome to my new blog!

Thank you for checking out my new blog about my weight loss journey and the gastric sleeve!  I've been in the process of getting ready for my surgery for about 4 months.  My insurance approval just came through and so I should be getting my surgery date very soon!

How I got to here: I have struggled with my weight and yo-yo dieting my entire life.  I don't even remember a time when I didn't need to think about what was ok to eat (vs. what was fattening) or when I didn't feel pressure to eat less than I wanted to eat.  Obesity runs in my family and it has always felt like I'm running towards it or away from it at every moment.  Food and overeating have been my best friends and my worst enemies- the things I turn to when I'm sad and often the reason why I'm sad. I've been on every diet under the sun and successfully lost a lot of weight multiple times, always to gain it all back and then some.  I've spent years in therapy trying to understand why my relationship with food and eating and weight is so difficult and intellectually I totally "get it", but changing my behavior in a sustainable way has always been just too hard.  I think of my inability to gain control over my emotional overeating as my biggest failure and it is a source of great shame and pain for me.  Currently at my all-time highest weight, my feelings of shame and frustration are coupled by major concern about my long-term health and the dangers the extra pounds can pose.

Last October, I did something that I rarely do- I asked for help.  I told my endocrinologist that I had lost faith in my ability to lose weight and re-gain my health on my own and asked her to prescribe whatever medication could help me achieve my goals.  Her answer surprised me- she said that all of the medicines out there for obesity are lousy and have terrible side effects and that if I was really serious about losing weight, I should consider bariatric surgery, especially now that the "new" gastric sleeve surgery option was available.

Surgery?  I had never considered it.  Isn't it dangerous?  Doesn't it cost thousands of dollars? Wouldn't it lead to a lifetime of serious digestive problems?  In her office and the weeks that followed I learned that all of my assumptions had been wrong.  Bariatric surgery performed by an experienced surgeon on a mostly healthy patient is actually quite safe.  Most insurance covers it.  For people who are obese but not extremely obese, sleeve gastrectomy is a great option with lower complication rates and MUCH fewer long-term side effects because they don't touch your intestines.  The more I researched, the more I began to believe the the sleeve might be a tool that could help me reach my goals and maintain them and that I owed it myself to seriously consider it.  And that, my blog friends, was the beginning of this journey.