Wednesday, June 30, 2010
I don't really feel any sort of restriction at all. I can see how people could be very tempted to push things at this stage. I'm keeping what I'm eating between a cup and a cup and a half per meal, but I feel like I could eat more. So far I have been mostly good about my food choices, except for last night. I ate some leftover fish before heading to our friends' house for dinner, so I wouldn't be ravenous while everyone was eating sliders and chips and corn on the cob. Handled that pretty well, but then it was time for making ice cream in the ice cream balls. By that point I was hungry enough that I caved, and had about a cup, maybe a bit more, of ice cream. It was made with half and half, so it wasn't as bad as say Hagen Daaz or the like. But still, not the choice I would have preferred to make.
Some of the things I've read about "bandster hell" indicate that folks a few weeks out often can eat just like they did before being banded. I have a feeling I fall into that category rather than one of those who PBs and gets stuck early on. At no point have I really felt truly full, though in the first several days of mushies I definitely was feeling satisfied. Not as much now, but I can wing it for another few weeks. It's not like I was satsified in any way from January-May! *laugh*
Monday, June 28, 2010
I'm definitely curious about the weight thing. I'm not sure I can resist stepping on the gym scale whenever I make it over there. But, then again, having a full month's losses surprise me all at once is tempting too. ;)
Probably, I will wait until right before the trip to Chicago, which is the week before my next appointment on July 21.
The social thing is proving a bit weird to me. Last night wasn't too bad, though I had to opt out of ordering Chinese takeout, of course. Mind you, my budget is always on the snug side, so folks are used to me choosing not to be included in some things. I had to completely bypass a birthday thing on Friday because it was dinner and margaritas at a Tex-Mex place, and I just think I would have been kind of miserable watching everyone else eat and drink. The birthday girl and her husband know I was just banded, but no one else there did, so I didn't want to have to explain anything or have anyone think it was money-related and try to buy for me. :\
I think that will get easier once I can eat real food. Maybe. I am a social eater (and drinker) and keeping my portions under control will likely sometimes be difficult.
My birthday shindig is coming up in early August. Sushi, sake, singing, and shiny (SSSS) party!
I'm thinking I'll have to totally forgo the sake, but maybe I can sip on something else and get a little tipsy. The sushi portion will be mostly sashimi, which I don't mind at all. No spider rolls this year!
I'll have to dig through the bins of clothes in the garage for something shiny/sparkly/spectacular in a smaller size. Or buy something. I'd prefer to work with what I have, as I'll still have a ways to go, but if I have to get something else, I can always just add it to the costume bins after and it will get love at some future Burn event from someone else. :D
Oh yeah, I am starting to get hungry, sort of. I'm hungriest right after I eat, oddly enough, so I'm thinking this might be some 'head hunger' working on me rather than actual hunger. I'm only managing to get in about 800 calories per day max, so I should work on upping that a bit somehow. The problem is that with mushies it seems like I can either go the really healthy route (which is what I'm doing now), or add all kinds of not-so-great foods or ingredients. I think I may have to start adding a snack or two of yogurt or cottage cheese or something in there to bump my caloric intake a little bit. The thing is, I'm not hungry between meals. In fact, I keep forgetting to eat later in the day and then my shoulder starts hurting again.
Oh well, it's a learning process.
Sunday, June 27, 2010
It's not producing pus, and it's not pink around the incision itself. But it sure hurts like crazy every time I clean it, and it doesn't seem to be looking any better from day to day. It's so difficult to keep it clean and dry, because, like I said, it's between my belly rolls -- and Texas is HOT.
I'll just keep working on it and see how it goes, I guess.
I took the last dose of the Zithromax for my cough yesterday. Still have the cough, though, and it's still productive. Mostly it's only at night and in the mornings, not during the day. So maybe it's just post-nasal drip. I'll keep an eye on that too, of course.
Tried scrambled egg whites for breakfast this morning, plus 1/2 cup of WW vanilla yogurt. Pretty satisfying. I haven't had any trouble with anything I've eaten or had to drink so far. No regurgitation and no "stuck" feelings. Hopefully this will continue to be the case, as it seems pretty common that people have at least one episode within the first couple of weeks.
Saturday, June 26, 2010
Day before yesterday, I woke up feeling good, as usual, but no shoulder pain!
Considering that this has been the worst part of the whole process so far for me, I'm thrilled that it seems to be going away. I'd read on LBT that it never really goes away for some people, and that was going to be a HUGE downside to this if that was the case for me.
Yesterday it kept feeling like it was sort of *thinking* about hurting again, but it didn't really manifest into anything until evening time. It's too early to tell, but it might be something that shows up when I'm hungry. I've read that some folks who still get it get when they overeat, but so far for me it's come out of nowhere a couple of times when I've waited too long to eat.
More testing on that is in order, though.
The incision is still healing OK, I think.
I had the single incision through my belly button, so there isn't really much TO heal. It's hard to keep it dry and clean, so I've been alternating between leaving it exposed and taping a gauze pad around the edges to act as sort of a filter. Still hard to keep it dry, though -- it IS Texas in June, and unless I'm in the A/C, my belly button is just going to be sweaty.
Here's a couple of photos I took today -- 11 days post-op:
I circled the incision in the first pic. The scar/hole above it is from my navel ring. Dr. Ganta did a great job cutting UNDER those holes, so I should be able to get my ring back in when it's all healed up. :)
Man, I didn't realize I had that many stretch marks. At least they're all silvery, I don't think they show too badly when not showcased by the wonders of flash photography. heheh
Whodathunk that once upon a time I had a smooth, flat belly --- even at nearly 200#!
Two kids and some serious yo-yo dieting for the past decade or two have definitely taken their toll. I don't know if I'll have the guts (so to speak) to go for a tummy tuck and breast lift after all's said and done. My brain and vanity say yes; my fear of surgery, and my budget, say no.
Wednesday, June 23, 2010
Lost about 5 pounds, bringing me to 219. Yay!
I have to say, the wait time in that office is getting ridiculous. I waited over an hour at my pre-op appointment on the 10th, and my post-op was only slightly better, waiting 45 minutes for a 10 minute visit. I think they're just overbooking too many people for each time slot. Either way, I had to haul ass out of there to get my Bean to her ortho appointment -- 5 minutes late. I was so wrapped up in being in a hurry by that point that the questions I had about the coughing I've had for the last couple of days, and about other ways to deal with the shoulder pain -- well, those questions flew right out of my head. grrr.
My incision is healing well, and Dr. Ganta gave me the go ahead to skip to the pureed foods stage for the next 4 weeks. Essentially I can eat anything I don't have to chew. I don't have a huge appetite yet, but I did try some zucchini marscapone soup and some WW vanilla yogurt yesterday, and I added Soy Slender to one of my protein shakes. Nice change!
I think I'll probably stick with at least 1-2 protein shakes per day for a while to make sure I get in all my protein. Had cottage cheese for breakfast today. I think one of the hardest habits for me to break is going to be the drinking during and after meals thing. I am SO accustomed to having water with my meals.
I scheduled my next appointment for July 21, at which point I will have my first adjustment (fill). I'm not sure whether to look forward to it or not!
I'm still in debate whether I want to buy a new scale any time soon. Mine broke a couple of weeks before surgery, and I don't know whether or not I want to replace it yet. On one hand, it might be good to make sure I'm staying on track; on the other hand, it's kind of fun waiting a long time between weigh-ins and getting a big result at the end of the wait. hrmmmm....
Going to back-post later today with my surgery story, just so I get it in here. :)
Tuesday, June 22, 2010
Anyways, my husband M and I got to the hospital a bit late, after dropping our older daughter off for her day at camp. One of my dearest lifelong friends also was getting banded this morning by Dr. Ganta, and her housemate and her mom were outside, and told us that she had just gone in. So it turns out we were right on time. M and I waited for less than 5 minutes in the waiting room before we were taken back to the outpatient surgical area. At Seton, this section is divided into pods, and I guess the one we were in was a pre-op pod. I was weighed, and given a gown, PANTS (woot!), and slipper socks to change into.
M and I waited around a bit after I changed, and a great nurse came in and did some basic checks on me and I think a phlebotomist started my IV. I met the anesthesiologist (very nice guy!) and discussed some of the things on my history, all pretty normal stuff. Dr. Ganta and his assisting surgeon came in and talked with me, and I joked (well, sort of) about changing my original goal weight. See, Dr. Ganta is pretty conservative, and doesn't want his patients setting potentially unrealistic goals for themselves. So, the goal weight we'd set for me back when I'd had my original consult was 198. Now, I'd just weighed in at 224. Getting surgery to lose 26 pounds would be sort of silly. So he gets to calculating a new goal (155 or below, btw). I was only half-serious about it right then, but I get the feeling he's not the joking type. Fantastic surgeon, though, which is what matters. heh
A bit more waiting, and they come and get me and wheel me back. I only have vague recollections from here, but I remember being sad about them taking off my PANTS! and getting very nervous as they had both my arms out to either side. Then I guess they gave me the juice, because the next thing, I was waking up in recovery.
My recovery nurse was also awesome. Seton has a great staff, I felt like I mattered every step of the way. A feeling of heaviness in my chest, so I focused on getting my breathing deeper and more regular. I was a little bit cold, but not crazy shivery like the last couple of times I'd been under general anethesia. The nurse brought me some blankets and chatted with me a bit here and there. There were a couple of other patients in the recovery area having a bad time of it, so it was definitely interesting in there.
After a bit, someone else (also very nice!), came and got me to take me to radiology (I think) to do the contrast medium swallow. They were really backed up in there, and it took a bit to get me settled. My friend apparently had been waiting there for over an hour, as I'd caught up to her at this point! I'm guessing I waited there for close to another 30-40 minutes before they came and took her, then me to do the swallow. Man, that contrast medium stuff is FOUL!!
But, the radiologist(?) was very complementary about Dr. Ganta's skills, and says he always does very clean work. Yay!
Back to the holding/waiting room. The nurse or whoever they had manning this room was the only person at Seton with whom I was somewhat underwhelmed. He was obviously training someone else and didn't even really look at the patients. I did catch his attention at one point and got him to adjust the bed for me so I could talk with my friend for a bit. Eventually they came and got my friend, and then a bit later, me.
Back to the pods area, where I get out of bed and try to pee. Fail.
I come back into the room, and my bed is gone, and they settle me into a recliner. I get to start sipping on water (yay!), and give me some Phenergan for a touch of nausea I've got. Of course, this makes me sleepy and I doze a bit. I'm blind anyways, as M had to leave to pick up our daughter from camp dropoff, and he took my glasses with him. They show up while I'm all snoozy and hang in my little room with me. Linda from bariatrics (another great Seton person) comes by and gives me my post-op info packet.
Throughout the rest of the afternoon and into the evening is the I.MUST.PEE parade. Warm water peri bottle helps? Nope. Pushing (gently) on my bladder? Nope. Running water? Nope. Walking? Nope. I even attempt pushing on my urethra from inside my vaginal canal. I FEEL like I have to pee, but I just can't get it out. argh.
Finally, the nurse brings out a sonogram device that measures how much fluid is in my bladder. 436cc. I go back in the bathroom. She calls Dr. Ganta, who gives the word that if I can't go soon, I'll have to be catheterized before I can go home. Oh. Hell. No.
I've had that joyous experience once before, and that was enough.
One more round walking through the outpatient area, a new bathroom (with the sink in it) with my peri bottle, warm water running in the sink. I spray myself with the bottle, push on my way lower belly, and lo! a trickle of urine! I've convinced my reluctant urethra to let go with a combination of tricks and dire threats.
A repeat bladder sonogram thing reveals only 134cc remain. I went enough to go home! I'm pretty sure I'm the very last patient in the post-op for the day at this point, and I'm sure my nurse was glad to be able to start wrapping up her day. I get disconnected from the IV and the BP machine, get dressed, and get outta dodge.
My abdomen is a touch sore, but not bad, and the left shoulder pain has started to kick in. I have what appears to be a piece of gauze under a sealed clear plastic wrap sort of adhesive.
Once home, I immediately realize that the bed is a no-go, and get settled in to the reclining part of the sofa for the night.
Monday, June 21, 2010
My past is a study in yo-yo dieting and rollercoaster weight gains and losses. Starting in the 4th grade, at 138 pounds, I made my debut into the world of dieting. I remember wearing a size 9 in the 5th grade, and by the time I was 13, I was about 170.
I battled daily with ridicule and the social stigma that comes with being a plump child and pre-teen. One cold November morning, I was crossing the schoolyard, slipped and fell on the icy ground, and the entire population of my K-8 school roared in laughter at the chubby butt of school jokes sprawled on the ground.
I took a bus home, and never went back.
Fortunately, my family moved from Colorado to Texas less than 6 months later, and I had a chance at a fresh start. Unfortunately, we lived in a Holiday Inn for several months while my parents searched for a house. We lived on restaurant food and takeout, and I gained at least 30 pounds, to enter high school at over 200 pounds, with no signs of slowing.
I did manage to keep the gaining under some control through high school, and only gained another 20 pounds over the 4 years. I also gained friends and self-confidence, despite my weight. After high school, I went on the Rotation Diet (a low-carb plan) and Quick Weight Loss (a shakes/food combo plan). I dropped back down to 170, and managed to maintain this for a couple of years. Out of my parents’ home, on a shoestring budget, I did not gain weight, but I was certainly not eating in a healthy way.
At age 21, I entered college and moved to Austin. Living in student housing, with 24-hour access to all-you-can-eat food, the weight began to creep back on. 180,190,200,210…. I tried diet pills, liquid diets, etc. I would lose 10-15 pounds, only to become frustrated and give up. The weight returned, of course, with more on top every time.
I met my future husband a couple of years later, and he was a ‘perfect’ match. Perfect in that our impulsive eating styles meshed very well. We could, and did, go out often to buffets and for pizza. We cooked steaks and pasta at home. We both ate very large quantities and very quickly. We both started to gain weight, but not too fast, as we were both young and fairly active.
At least once a year, we would embark on another attempt to lose weight. Atkins, personal trainers, gym memberships, Jenny Craig, and more. Every time, one or the other of us would fall off the wagon, and the other wasn’t far behind. The weight continued to creep upward for me, to fall off and then pile back on for him.
I knew that someday we wanted to have children. And that I did NOT want to start my pregnancy fat. So I struggled and worked for almost 2 years to bring my weight down. I got down from 260 to 215, and got pregnant before I actually intended to do so. I immediately quit smoking.
I changed my eating habits to some extent during this pregnancy. I introduced whole foods into my diet. No more white bread, only whole wheat. All whole wheat pasta, brown rice, barley, and whole wheat couscous became staple starches. Fish, lean pork, and chicken replaced the steaks, ribs, and cheese. I switched to plain non-fat yogurt, and low or non-fat dairy all the way around. I craved fruit and made vegetables a standard at every meal. And I was ravenous.
I had made the changes in WHAT I was eating, but not in HOW MUCH. I gained up to almost 280 pounds during that pregnancy, and fudged to my midwives about it so they wouldn’t reject me or put me on a special diet. My blood pressure and blood sugar remained good throughout the pregnancy, and I had a healthy natural delivery without complications.
Over the next 3 years, I struggled to get the baby weight off. Every day, I battled the increase in appetite that breastfeeding brought on, and I watched, counted, and measured everything that I ate using Weight Watchers POINTS plan.
I was losing weight, very slowly, and I was miserable.
Every moment was consumed by the obsession of what I was eating, and by how hungry I was. Every time I nursed my daughter, all I wanted to do was eat. Sometimes I gave in, but I wanted to get pregnant again, so I slogged along with the very slow progress. I switched to Weight Watchers CORE plan in hopes of combating my overpowering hunger and appetite, only to gain weight due to my inability to control my portions.
I got pregnant again, 3 years after my first daughter was born. I managed to maintain reasonably well through this pregnancy, and was 254 at my second daughter’s birth.
Now, more than 2 years later, I am well over 265, and I feel so discouraged by my inability to master my own impulses. I still work out 3-5 times per week, we eat in a whole foods way, and I am still gaining weight. I am hungry all the time, and the thought of putting myself through years of hunger and deprivation for miniscule results is daunting, to say the least.
The idea of Lap-Band surgery, for me, is a last resort. I have seen my blood pressure start to creep up over the last couple of years, and I know that hypertension awaits me in the near future if I cannot manage to take off this excess weight.
The frustration of being thwarted daily by my own inability to control my portions angers me. I have made so many changes in the right direction. I eat the right foods, and have been teaching my children good eating habits. Our family has made the choice to eliminate junk food and takeout long ago, and we try to include activity and exercise in our daily lives. But this last, so essential, stage eludes me. I find myself at the table, eating far too much of our healthy fare because I am still hungry well after the healthy portion size has been consumed. It is so difficult to present a good role model for my daughters when I feel like what I say and what they see are so different. My older daughter already has been asking questions about why I am fat if what we eat is supposedly so good for us. She doesn’t understand why some of her friends get to eat loads of candy, chips, and cookies, and their parents aren’t fat, but her mommy is. I want to be able to show her that the way we are choosing to eat makes us healthy inside AND out.
I feel that the Lap-Band would be a tool to aid me in making this final change. Ideally, it would help me to manage my portion sizes without me always feeling hungry and desperate.
Thank you for taking the time to read this, and for considering approving me for Lap-Band surgery.
Sunday, June 20, 2010
Like many, I succeeded in taking off much of my excess weight, dropping from just under 270 at my highest, to 244 when I started WW, to finally about 190. This took me a total of about 3 years. Then I got pregnant again, and my weight went up to about 255. After pregnancy, I managed to drop down to about 235. I fluctuated back and forth for a year and a half or so between 225 and 235, and then the weight started creeping steadily upward again.
By December 2009, I was back up to 268# and miserable.
The idea of going through another 3 years (and MORE) of being hungry, every single day, was so daunting it brought me to tears. I am tired of trying, succeeding, and then getting so sick of deprivation and hunger that I just throw in the towel... and back it all comes, with more.
So, after much deliberation, I decided to look into something that I had previously discounted as the "easy" way out, as a cop-out and something I would NEVER do.
Weight Loss Surgery.
Now, I made the changes a long time ago to eat mostly healthy choices. I decided this not only for myself, but for my children. And it's worked. My girls love veggies, lean meats, whole grains, and are willing to try all kinds of foods. They are generally great at limiting themselves on portions (my weakness).
However, even the best foods can cause weight gain if the portions are oversized. So even with this high *quality* diet, I was gaining. Because my portions continued to be out of whack.
With my husband's new insurance, I could consider WLS options with most of the surgery being covered by insurance. I started researching and decided that the best option for me would be gastric banding. I didn't need or want the more extreme bypass options, and the band would help me with the final hurdle I had been unable to conquer on my own -- portions.
Now, I certainly didn't decide that I was definitely going to do this right away. The insurance had a lot of requirements, and it would take time to meet them all. I had the BMI down -- at 268# I was just shy of 43 BMI. I did/do not have an comorbidities. I'm pretty healthy, just fat. I would be required to follow a 3 month multidisciplinary medically supervised weight loss progam. I needed 2 years of medical history showing my weight at over 40 BMI. I had to undergo a psychological evaluation.
I did not have the 2 years medical history, at least not the way I thought they wanted it. I was heavy at the end of both my pregnancies, but had lost weight before both of them. I had been uninsured for years as a self-employed person and had not had regular physicals. I had both my kids with midwives and did not have records throughout both pregnancies. I was 239# at my 2008 physical (not heavy enough) and 260# at my 2009 physical. Just a general mish-mash of vague records, and I was sure that if I submitted that I would have to appeal.
So, I decided to start the 3-month program and see where things went from there. As I was both unsure of my approval likelihood and undecided about whether or not I was even willing to go through with the surgery, I really buckled down during this time. I limited my portions to what I understood to be post-band sizes, and limited my calorie intake to under 1100 calories per day, usually between 900-1000. And it worked.
Between January 6, 2010 and April 7, 2010, I lost 28 pounds, going from 268# to 240#.
After that, my surgeon, Dr. Sashi Ganta of Austin Institute of Bariatrics and Laparoscopy (AIBL), submitted my application to the insurance company, along with a letter (which I will post separately) that I wrote pleading my case. I was, surprisingly, approved.
I continued following the program on my own up until the day before I went to Florida on vacation with my family, May 12, and dropped from #240 to #227.
I enjoyed myself in Florida, and kept my portions under control for at least the first part of the trip. I kind of started to lose it near the end, and by the last day I was back to eating however much I wanted. oops. We got back from FL, and we were home for a few days. I thought about getting back on track, but never managed to do so. I went in on May 21 for all the testing I would need if I chose to go through with the tentatively scheduled June 15 surgery date. Over Memorial Day and surrounding days, my husband and I went out for an annual 6-day camping event. I packed light, food-wise, and managed to keep myself fairly sane over this trip.
I also came to the decision during the first week of June that I was going to go through with the surgery. After looking at photos and videos with my family of myself over the last couple of years, I simply decided that I just couldn't do this any more. No more ups and downs. No more being hungry all the time. I wanted the tool that the Lap-Band could provide me. I wanted something to help me stop WANTING to eat so much all the time.
So, on June 10, I went in for my pre-op visit with Dr. Ganta. Weight : 224#
We finalized surgery plans for the 15th, and I went home to try to continue sticking to the pre-op diet. I did so-so on that, but didn't have any big "food funerals" or anything.
One of my nearest and dearest girl friends for life also had been seeing Dr. Ganta for Lap-Band surgery, and she was ALSO scheduled for June 15, right before me! We both told him he'd better have a VERY good day that day. ;)
On June 15, 2010, I went in to Seton hospital in Austin for Trans-umbilical Gastric banding (TUGB). This is a Single Incision Laparoscopic Surgery (SILS), that was all done entirely through my belly button / navel, for no visible scars. I was very happy to have found a surgeon who not only could do this surgery, but is considered one of the pioneers of the technique.
More to come!