Changing HOW I eat is so hard. I mean, I knew it would be hard, but now I'm actually IN it.
I should have been working on it earlier, this frantic eating. Whenever I have food in front of me, it's like I haven't eaten in days, I just frantically shovel food into my mouth. Now that I'm doing purees (and starting soft foods), the same thing is applying - I go into a frenzy when there's food around! It is taking almost everything in me to slow down. In fact, I have had two soft food meals so far in which I over-stuffed myself because I wasn't eating slowly enough. Ugh, that feeling, nauseated and uncomfortable, but also just so so "hungry". In fact, I am still feeling the effects over 24 hours later. I know that it's not real hunger, it's just an automatic reaction to having food around, but it feels so real and keeps me shoving food in my mouth even when I don't want to. I am hoping that I can improve in this area, that I can quiet my food desperation and appetite, but I know it's going to take work and willpower on my side - something I've always had trouble summoning on my behalf.
I have not been doing well with hydration. My skin is dry and flaking and my mouth and eyes are dry. But it's hard to drink water because I feel nauseated and it still kinda hurts my stomach. Waiting 30 minutes before and after food is NOT working out for me - I just can't seem to get enough fluid in! I don't know what to do.
Exercise is also something I'm failing at. I haven't done any form of exercise since I got back from the hospital. Like, what am I thinking? I know this is an important part of my new lifestyle, but I forget (because it wasn't a part of my previous lifestyle) or I just keep telling myself I'm healing and I'm too exhausted from not eating. Or my skating rink is closed, as if that's my only option for exercise. So many excuses.
Other than these things, I do seem to be doing well. My incisions are healing nicely, I really haven't had any intolerances to anything. I'm just falling behind on things and being a bad bariatric patient. I'm working on it, I need to put more into my efforts.
Well, I'm back! The surgery was Wednesday, but they made me stay until today (Friday)... not because I wasn't doing well, but because it is a requirement of the surgeon. I was actually impressing all the nurses with how well I was recovering. I was up and walking within a couple hours, absolutely determined to progress. AND the gas pains were surprising! It's really unfortunate that there isn't really anything they can do to help with the gas pains except encourage walking, but the drugs did a great job with the incision pain.
It was very boring at the hospital - I thought I had loaded my mp3 player with audiobooks, but of course that wasn't working. There was TV, but there was nothing interesting on it. I pretty much sat around staring at nothing for hours, ugh. Eventually, I remembered to text my people to let them know I was alright, and I was able to get some sleeping medication to knock me out. Everyone at the hospital was so nice and incredibly helpful, I felt like I was being taken great care of.
The surgeon said that my liver was HUGE, and that, without weight loss, I'd have cirrhosis within 5 years... yikes! It is a good thing I was able to have the surgery - just another reason that I NEEDED to do something drastic.
I'm getting a little nervous about hydration - 64 oz seems like a lot of liquid now that I can only take in a tiny bit of water at a time. So far, I haven't been able to get down much liquid at all, it feels a little uncomfortable and gets all gurgly, but I will keep trying.
Well, anyways, I'm back and well!
Well, the surgeon said I am a great candidate for the surgery, so we're moving forward!
I am very excited, I was so worried that he wouldn't approve, but it took very little time for him to evaluate me.
Boy, the requirements! Obviously there's the Nutrition appointments and a psych eval, but there's also lots of blood work and X-Rays, a Colonoscopy/Endoscopy, and the dreaded Pap Smear. I will also need to attend a support group, twice. It's fine, though, I am willing to jump through the hoops, I just wish that all of this wasn't so far away - 1 hour drive each way.
The other requirement is: LOSE 20 LBS. From what I've read so far, this is quite a common requirement, but it seems really difficult, since I have been gradually and constantly gaining weight over the last year. In fact, I GAINED 20lbs over the last 6 months, which is incredibly alarming, and was the main reason I even thought I might need the surgery.
I liked the doctor - he seems like a no-nonsense type. The only thing is, we didn't talk about the different types of surgery yet. I suspect he wants to see if I seriously follow his requirements before taking the time, but even so, much of the information in the packet I was sent home with talks about the LAP Band, which is a procedure I most certainly do not want. I know he also performs the sleeve, which is the one I've chosen for myself, so I'm hoping my suspicions are correct and that we discuss surgery types next time we meet.
Anyways, YAY! I'm on the way
I've been watching videos of the VSG surgery, and I am fascinated. It is really helpful for me to actually see what the procedure is, what is involved, what it looks like afterward, and to get a view of the anatomy in the area. I think I would recommend these videos if one isn't squeamish, I think it is good to know what's going to happen to help one make the best decision for oneself.
It is really a big hassle to be having the surgery so far away - it's a 1.25 hour drive each way to my surgeon's office, and I find myself having to make that journey sometimes two days in a row. Not easy on my elderly vehicle, but at least I have audiobooks and podcasts to listen to while I go. I do have to say, before I got this surgeon, my PCP told me I could get a surgeon anywhere in my Northern California area, which could have meant driving 4 hours each way in some cases, so I AM thankful; in fact, I'm pretty sure this is the closest surgeon I could have had.
How hard is it to go to a party when one is on a diet? So difficult. I went to an annual Fried Chicken Day party on Saturday, and, boy, it was hard not to graze. I even made an Apple Cheddar Pie for the occasion, and I had to taste that, of course. I have been steadily losing weight over the last month or so, and I only have 4 more lbs to lose to meet the requirement, but things like this may set me back quite a bit. I need to buckle down. I have a little less than a month to lose that 4 pounds, and I can't keep using special occasions as an excuse.
Boy, I did not realize how much money I was spending on food. Now that I've been on liquids for almost 3 weeks, I haven't spent basically anything. I mean, I was already stocked up on protein and vitamins before the surgery, and I will eventually need to spend money on that.... well, and I will need to start spending money on food this coming Wednesday when I move on to purees.... BUT STILL. I used to eat out every day (and not cheap fast food, but real restaurants), and it's no wonder I was kinda living paycheck to paycheck. But, boy, I did eat some delicious things.
At any rate, that isn't the only thing I've noticed. Sitting around at home and at work, HUNGRY, I've been constantly thinking about food. My relationship with food, my future with food. Pre-surgery I was telling myself and others that eventually I'll be able to eat everything I want again, just smaller portions. Now I am realizing that that would be a complete mistake, that eating like that is why I'm so unhealthy in the first place, and I would be undoing the benefit of this "extreme measure" I took to get healthy. I love to bake, but I'm going to need to be careful now. I'm coming to terms with the fact that I will probably never eat sugar the same way again - I will need to be extremely careful and use low-calorie options whenever possible and avoid candy (which I used to binge-eat); I'm kinda okay with this... I've been addicted to sugar, but my true love is UMAMI (savory flavor). So it will be harder for me to avoid fats like butter and olive oil, gravies, fancy cheese, coconut milk (in its role in Indian food). I am a foodie, and I want big, rich, complicated flavors! Thankfully, there are tons of calorie-free spices and low calorie condiments, but I'm not a good cook yet - something I will now work on, since I have no choice.
So, I am nearly 50 lbs down from my highest weight when I started this journey in June - 14 lbs down since surgery. The power is off in my town, so I went to the city to a spice shop and treated myself to some delicious, aromatic spices. A fancy taco seasoning for the refried beans I'm going to eat on Wednesday (when I start purees), some Garam Masala for when I want to make something that tastes like Indian food, and a couple little tasters of spice blends to experiment with. One of the first non-food rewards... though, maybe it kinda IS a food reward.... but anyways, it doesn't involve calories going into my mouth.
Healing-wise, I'm doing very well. So far, I haven't had anything that disagreed with me, haven't accidentally over-stuffed myself, haven't caused myself much pain. The worst part right now is the itching and scabs at the incision sites, which I have a compulsion to pick at. Thankfully there are still steri-strips there as a physical block to my wandering itch-seeking fingers. I hope to start purees on Wednesday (my 2-week surgiversary), but I might try some very liquidy purees ahead of time. I'm antsy to get started on real food, but I need to make sure I don't injure my healing stomach.
Some friends of mine have been very kind to me - they are elderly people (and very very thin), and they said that they don't know what I'm going through having never struggled with weight, but they care about me and understand that it is going to be a difficult process and wanted to offer me actual money for meeting my goals! I was floored. I told them that that wasn't necessary, but thanks for the thought, but I think they might actually do it, saying that it'll be for my upcoming trip to Germany so I can be healthy and active and ready for anything. What kind, kind friends. AND My pastor and his wife, those dear people, gave me an incredible, thoughtful gift - a weighted blanket! I've always wanted one, I find the weight so soothing and comforting both for my body and for my anxious/depressed brain.
I have been shown so much kindness lately, it has brought me out of the self-pity and has reminded me to be thankful. And I am. I'm also thankful for quick healing and no complications.
Well, it looks like I've met all my requirements! Woooo! I see the surgeon next Thursday, and I'll be ready for him to send all the info off for insurance approval. This is very exciting! I hope that he'll set a date for my surgery at that point...
I'm going to start slowly buying things I know I'm going to need after my surgery; today I ordered a "fancy" scale (which was an affordable off-brand, but which I have read is accurate) and some leggings (since my pants are already falling off me). My biggest problem is that I'll really get into something then GO ALL OUT and buy everything I need for it in one go... and then I'm broke for weeks until I build my finances back up. So I'm working on doing it slowly, just getting one or two things that I can afford within my budget for the week. I am pretty excited about this - it seems like this surgery is not only going to improve my weight, it may also force me into healthy habits that I wasn't expecting, like practicing self-control and discipline. I already feel the improvements, I'm making positive changes in my behavior.
My mother is also obese and would like to have the surgery, but she is now 66 (in a youthful way, though), and I hear that some doctors won't operate on older folks. My surgeon does sometimes take older patients, depending on the patient. I hope my mom gets the help she needs, it would be good for her, a diabetic, to make such a change - I want her to be around a lot longer.
So, I decided to use bariatricpsychevaluations.com for my eval - I was able to find only a few reviews, and they were split down the middle between satisfied people and people whose evaluations never made it to their doctors. I figured I would chance it, and it paid off for me!
I was able to get an evaluation appointment within a week, and the woman I spoke with was very thorough and easy to talk to. For a little more than 2 weeks, though, I was calling my surgeon to see if the report showed up, since it was only supposed to take 72 hours, but it hadn't appeared yet. I decided to call the number on the website, and was able to reach a person (I called on a Monday in the middle of the day), and she was very helpful - it turned out they had the wrong fax number. She went ahead and faxed the report again right away, and that's another requirement crossed off my list!
I needed an evaluation quickly, they were reasonably priced out-of-pocket, and the wrong fax number was my only issue. If one decides to try it, I would recommend writing the correct fax number in the notes section on sign-up and perhaps also giving it to the evaluator.
I met with my surgeon today for my pre-op appointment where he showed me what he would be doing, how long it should take, the risks involved, and the diet to follow. He told me I had lost a total of 32 lbs so far and asked if I wanted to drop out and lose the weight on my own; when I told him I still believe I need the help, he told me he agreed with my decision, and so the countdown begins!
There will be a 5-day liquid pre-op diet (no 2-week liver shrink diet like I feared, thank goodness), and then the regular diet progression of clear liquids - full liquids - purees - soft foods. I'll be "eating" only liquids for a total of almost 3 weeks, and that is what I am looking forward to the least. That seems like such a long time, and I know it's going to be hard. I'm going to be drinking a lot of broth and V8 to break up the sweetness of the protein shakes.
I need a water bottle to help me meet my hydration requirement, but it's hard for me to find what I want. I want a stainless steel bottle, it would be nice to have a sippy straw or lid, but I don't want something that can get moldy, but it would be nice to have a filter bottle, otherwise I need something large because I get squeamish about drinking unfiltered water; It might also be nice to have a bottle that reminds you to drink water, but nothing too expensive. Obviously I can't have all of these in one bottle, so I just don't know. A silly thing to think so much about, haha, but drinking water is going to be my life for a while.
Anyways, I'm getting totally pumped! Starting to tell a few more people about the surgery, making sure I have a good support base and people praying for me. So far, everyone has been supportive - I haven't gotten any back-talk from anyone, which is encouraging. At the moment, I don't care if they are secretly judging me in their hearts, as long as they don't plague me with their opinions. I know I'm doing the right thing, and I don't want to argue about it or have to justify myself to anyone. I'm a bit of a sensitive person, so, even though I won't be changing my mind, I get extremely anxious when there's conflict, and I don't need a hit to my morale at this time. I'm just trying to live my life.
Wow, this was a long and boring entry, but writing this stuff out really does help me, I don't expect people to be as interested in it as I am.
Surgery is the day after tomorrow!
I'm starting to second-guess myself about the surgery - I know it's pre-surgery nerves, but it's still very real. I think the thing that is bothering me the most is that I won't be able to eat like I used to. Like, it's hard for me to imagine being able to be satisfied with just 1/2 cup of food. I am a total foodie. The delight of my life has been delicious, high quality food; I believe that the human sense of taste is one of God's kindest gifts, given for our pleasure. How can I enjoy gourmet meals if I only get a tiny taste? I know this is silly, I'm just used to bigger portions and eating fast as if I haven't eaten in days... once I am able to feel full quickly (imagine, actually being able to feel full?) and when I'm forced to really slow down and savor a meal, a small portion isn't going to be so bad. But I am freaking out a little bit. I just have to tell myself it will be worth it, and it won't be as bad as I think.
At this point, it's hard not to hope (and maybe even expect) that the surgery is going to show results immediately. I'm not going to walk out of the hospital a thinner person, it's going to take maybe a year to get to goal weight, or maybe I'll never even reach my goal weight. This has to be okay with me.
An update about the liquid diet - this is my 4th day on full liquids, and I think I'm doing okay. I can't watch food shows/videos or anything because it's making me crazy and a little depressed, but I am not as hangry as I expected. I am a bit grumpy, no doubt, but I've been able to stave off hunger pangs with protein drinks, soup, and V8. The thing I haven't been able to prevent is migraines - I've got the family curse (it runs in my dad's side of the family). One of my biggest migraine triggers is HUNGER, so I woke up this morning with a migraine; I've been expecting this, and I'm impressed that I haven't had one yet, but it was time for it to pop up. Thankfully, my migraine medication is okay to take, which is helpful even if I can't take any effective pain killers (no blood thinners).
Alright, so, tomorrow - clear liquids and bowel prep; Wednesday, surgery!!
Being an invalid is so boring. I want to go out and do something, but my body isn't ready at all.
Thankfully, I haven't had much pain (other than the gas pains, which, thankfully, I was able to get rid of while still in hospital). Even in the hospital, my pain was relatively minimal, so I'm doing okay without the pain killers so far. I've been able to take my psych meds - most can be broken in half, so I only have to crush one of them. I've started taking my chewable vitamins, and there are no issues with those so far. All-in-all, It looks like I'm doing well!
I'm a bit concerned about getting enough liquids in - I may be trying to push to hard, but every time I take a sip of something, it hurts a little and gurgles. I've tried hot, cold, and lukewarm, salty, sweet, plain water. I'm hoping that this will get better because I don't want to end up in the hospital with dehydration. A bit of me kinda wishes I was still in the hospital for that reason... Not that it was particularly pleasant, but it was nice to know that I wouldn't get dehydrated because I had an IV in. I don't know why dehydration is such a concern for me, perhaps because I've never been good about getting in my fluids.
I haven't felt what I would call real hunger yet, so that is a relief, but I am craving foods that I can't have yet - specifically, refried bean puree spiced with taco seasoning! I don't know why I'm craving that so much, but I'm just really looking forward to it. I'm getting very very bored with clear liquids - I'm not enjoying broth like I thought I would, which is a shame.
I'm feeling pretty down, probably because I'm so bored. Watching TV in the middle of the day makes me so uncomfortable! I'm kinda regretting the decision just a little, but when I remember what the doctor said about how big my liver was and how close I am to having cirrhosis, I know I've made the right choice. I mean, I know I made the right choice, anyways, but thinking about food is getting me down. It's not all about food. I have to remember that, even though my life revolved around food before, it doesn't have to - I can find other ways to be fulfilled.
Looking forward to getting back to roller-skating and eating something with some spices in it!
The day is coming up! A week from this Wednesday! I'm getting nervous, but mostly in a good way. I've told all my close people, and everyone is supportive so far; I've got a few people praying for me (well, mostly for the surgeon and his team), which is a comfort.
I've been having "food funerals", though I'm on the fence about that concept in general... in some ways, it doesn't seem like a good idea to have "one last...." if it means binging on things. That kinda defeats the purpose of the pre-op diet you were on to develop good habits. But I've been doing them. Indian food one last time. Baking one last cake for myself. One last ice cream. I begin my pre-op liquid diet on this coming Friday, so I'm kinda going a little crazy with the last meals, almost on the verge of a binge - though, encouragingly, I've been able to control the urge to binge so far, avoiding situations that would cause that behavior.
Speaking of the 5-day pre-op liquid diet, I think the thing I'm getting most nervous about is being HANGRY for those 5 days before the surgery, but I have to remind myself that it will be worth it, and in doing so, I hope I can keep my attitude from being totally rotten. But BOY do I get hangry.
Last night I went to one of the required Support Group meetings, and I wasn't sure what to expect. Turns out, all the people there were also pre-op, and the group leaders were very encouraging. We talked a lot about the sleeve and it's benefits and some about the band - looks like most of the people getting surgery from Dr. Hanna have the sleeve, which is encouraging because that is the procedure I want; I definitely do not want the band. I mean, what if my insurance runs out? I won't be able to come in for adjustments and would be stuck with a foreign object in me!
At any rate, the best part was... at the end of the meeting they spoke about how hard it has been to get a psych evaluation, and I was presented with other options... so I'm going to get my evaluation done at the beginning of July, which means that all of my requirements will have been met by the end of July! This is such a relief for me.
So I see the surgeon again on Tuesday - can't wait to find out how much weight I've lost and possibly get a tentative surgery date!
I was so so nervous and discouraged about the 1,200 calorie diet the surgeon wanted me to do, but it has turned out to be okay. I go over the calorie limit much of the time, but not by much, and I am able to take it in stride and not beat myself up over it. But lately it has been easier to control my eating (I almost feel like the promise of surgery is bolstering my spirits), but half of the days I still have that deep deep hunger that just won't seem to go away. I'm not sure how long I'd be able to keep up this diet without the eventual help of the surgery, but I seem to be doing okay with it for now. YAY!
In other news... wow, it is hard to get a bariatric psych evaluation. All of the qualified individuals in my provider network are extremely backed-up, and many of them are not taking new clients. It is frustrating because I will be done with all of the other requirements by the end of July, but my psych eval appointment is at the end of October! I can't even get a surgery date set until after I've had the evaluation. I'd rather not have to wait that long, but I don't know of viable alternatives...
...Except I was googling and I saw bariatricpsychevaluations.com - I am not sure what to think about it... if I could get it done more quickly, paying $150 seems like it would be worth it, but is it legit? I was able to find a few reviews, and it seems to be split half-and-half - some people are happy, but other people never got their evaluation sent to their surgeon. Hard to know what to do.
To be safe, I should probably just be patient and wait until October, but I need to have this surgery, and now that I've made up my mind about it, I don't want to wait. I need to be healthy YESTERDAY.
I have always been easily discouraged. I will often not try something because I "know" I will fail at it, or I may do some other self-sabotaging thing. This is a terrible way to live life, and I've only recently started working on it.
This weight loss surgery is something I know I need to do, something I even WANT to do, and I am determined to give it a shot even though I "know" (untrue) it's just another thing I will likely fail at. I'm trying to push past my automatic hide-under-a-rock reaction.
So, keeping in mind my default self-defeating attitude, I am already struggling with this diet. It was only YESTERDAY that the surgeon told me I needed to lose 20 lbs and that I need to keep a food log and try to eat only 1200 calories/day. I guess I'm struggling with the IDEA of the diet. 1200 calories is crazy! I'm HUGE, how am I going to successfully function in day-to-day life on so little sustenance? I'm going to get low-blood-sugar migraines, I'm going to be even tireder than I already am, I'm going to be so so hungry all the time.
The thing is, I have barely even started the diet, but I am already psyching myself out, worrying before it's necessary, my brain is screaming for me to eat a huge amount of whatever I want in protest. Am I strong enough to withstand? I'm not so sure. So then how am I going to be successful with the surgery??
Lots for me to think about. I want this so badly, but I am AFRAID that I won't be successful. Being so full of fear can really squash all the joy from life.
I had my colonoscopy/upper-endoscopy last Thursday, and the prep for that was a struggle - I think my body registered the Miralax solution as a poison because I could not keep it down, and I got a migraine from not eating. But the procedure went fine, except... and this is so embarrassing... I think I ended up singing during it! I know I was all drugged up, but I am so mortified about singing a love song while there was a camera in my colon!
Anyways, ever since then, I have been eating like a crazy person again. Just always feeling that deep, deep hunger, and I'm struggling to control myself. The other day, I ate more than double the amount of calories I was supposed to, ugh. I think it may have to do with the fact that I'm feeling very depressed lately, and I have always tried to use food to comfort myself (like many of us here, I'm sure).
I'm also struggling with the exercise portion of this diet. At the beginning, I took a 30 minute walk, and my lower back seized up after about 10 minutes - and, of course, I had just gone down a steep hill, so I HAD to continue around the loop to get home via a much easier hill. That was very very painful, and I've been afraid to walk more than 10 minutes ever since.
I do, however, go rollerskating twice a week, which is AMAZING exercise, low-impact, and it doesn't hurt as much even when I skate for an hour. But there is a huge fire happening in my area, and the fire department is using the parking lot of my local skating rink, so they're closed for a few weeks. What will I do? I love to skate.
Hopefully I can knock this depression soon and just get on with life. Just wish I could skate it off.
I made a checklist a while back of all the surgery prerequisites, and I have been checking things off - feels so good! Because my blood work showed elevated liver enzymes (this has been the case for me for a while), the surgeon added one more requirement: get a liver ultrasound. Ah, well. But even with this new requirement, I will still be finished with everything by the end of the month! Then he can submit everything to the insurance, and hopefully I'll be able to have the surgery in September!
I've been reading The Emotional First + Aid Kit: A Practical Guide to Life After Bariatric Surgery, and it has proved to be a good resource. Lots of earnest information, honest truths, short stories of success or failures, helpful suggestions, useful activities. I definitely recommend it. A suggestion it gave was to create pros and cons lists, just to get everything out in front of you and to really make you think honestly about your choice to pursue surgery and what it could mean to do it as well as what it would mean NOT to do it. Good stuff. A simple suggestion, but definitely useful.
I just got the call this morning - the insurance had approved the surgery! My surgery date is October 3, 2018, which is a little sooner than I was expecting.
I've been losing weight lately - so far I've lost about 30 lbs since when I started the journey. This brings with it some doubts and waverings... sometimes I think, "Do I really need the surgery?", and for a while I think I'll cancel - I mean, I've been losing weight without it, maybe I can do it myself? But I know that I need the help, I've tried losing weight many times before without being able to sustain the change. I need help, and I think that if this chance is presented to me, I should take it. I know that relying too much on the sleeve to cure my bad habits is not wise or correct, but from what I know about myself, I will be more likely to continue knowing that I have a "help-mate", an actual physical reason to help inspire me. Losing a bunch of weight very fast will help me realize that it is possible and that it is REAL. One of my biggest failings is that I will give up or not even try if I can't "visualize" what the end result would be - this has affected my previous weight loss attempts along with many other aspects of my life. Losing a bunch of weight in a short amount of time will help me get past my hesitations and help me "visualize" success. And I need to succeed, my health and well-being depend on it.
Anyways, I'm very excited! I am going to seize this opportunity! I can't wait to make a fresh start!