Monday, November 29, 2010

Link to VSG / Gastric Sleeve Surgery

Hmm, this isn't for the faint of heart, but I did find a link to an excellent overview of a VSG surgery - and an actual surgery being performed, eep!

Gastric Sleeve Surgery video

Marry Me!

ROFLMAO, I have just re-read through a few blog entries and I realize what a catch I am! Divorced, over 40 (well, I *am* 40, but that changes soon enough), 3 young kids, morbidly obese, herpes, and, in my own words "am bloaty and gassy all the time."

Yes, marry me! I am your heart's one true desire. ;) I guess I can just cut and paste this blog over to my match.com profile, haha!

Phhhblllttt. Hey, come next summer I'll be rocking my new hot body, and will be so busy putting it through its paces! Just like a new car, you've got to get it running and see what it can do. I am greatly looking forward to it. I have a feeling life is going to take many turns for the positive in 2011.

Sunday, November 28, 2010

CPAP = Claustrophobia, Pester, Aggravate, Peeve

I feel ashamed of such a lame acronym, but that's all I have for you tonight. I've been attempting to bond with my CPAP for a little over a month now. I hate it.

It doesn't help that I know I have very mild sleep problems and won't need the machine for long after my surgery, or after I lose any amount of weight. That makes it even more of an annoying invasion of my nights.

When I first put it on, it seems good. Ahh, yes, I think, that seems good. A little push of air. Not disruptive, not bothersome. Mask fits well, hose doesn't get in my way. All is well.

At some point during the night, it becomes INTENSELY annoying to me. I don't think I've slept through the night once since I got the darned thing. Not on the nights I've used it, anyway. There have been several nights that I have not used it.

I have a history of this sort of thing. I'm a terrible jaw-clencher and teeth-grinder. I have a nightguard, and I can humor myself and put it in before bed. I rarely will wake up with it in, however. My subconscious self decides at some point during the night to do away with it: tucking it in the medicine cabinet, throwing it on the floor, hiding it under my pillow.

Same with the CPAP. I generally find I am getting up to go to the bathroom (something I do not normally do) and "forgetting" to put it back on. Then awaking in the morning a little surprised that I'm not wearing it.

Oh, I hate that thing. I know it's supposed to be good for me, but it is good for me in a terribly unpleasant way. I will be so happy to bid it adieu!

Spell Checker

Oh my goodness, I had no idea that I've been spelling 'acupuncture' and 'acupuncturist' wrong all this time! I guess I was going a little overboard with my Cs! And I was just arrogant enough to think that the highlighted 'accupuncturist,' signifying a spelling error, was some sort of mistake on blogger.com's part, not mine, haha. But it finally puzzled me enough to check into it - and wah-lah! Poor spelling on my part.

Not that it's the first or last time you'll see a) mistakes or b) foolish arrogance on this blog. Bear with me. :)

Goofball

My accupuncturist reaaalllllllyyyy wants me to stop eating gluten. I am a stubborn one, though, and have not yet taken the plunge. Her reasons make sense, and I would be well-served to give it a try.

- My low levels of iron, vitamin D and vitamin B. She says this is exactly what you'd expect to see in someone with malabsorption problems, likely due to gluten intolerance.
- My ethnicity as 1/4 Alaskan Native (here, I always say "eskimo" but I am told that it is now an offensive term. Not to me or my family, haha, but I'll yield to the PC-gods, nonetheless.) My accupuncturist says "Alaska Natives" are notoriously gluten-intolerant because it simply was not part of their natural diet.
- She's been gluten-free for several years and swears by it. She's a big nutrition/healthy eating fan.

Okay, I already know I am lactose intolerant. That in itself makes me cranky. :) Give up wheat and dairy?? (This statement implies that I've actually given up dairy, which I have not. I've simply learned not to overindulge quite as often, and when I do, while I am retching into the wastebasket whilst sitting on the toilet with horrificly painful diarrea - well, at least I understand that I did it to myself. Dope.)

Years ago, I did have my doctor do a celiac blood work panel on me. It came back fine. However, my accupuncturist says the initial panel they usually do has a high false negative rate: there is some more involved test that yields better results. Now, I trust my doctor, but I have to say - after my initial iron test was "fine" and my follow-up panel ordered by the sleep doctor was so miserable...well, let's just say I'm open to the follow-up testing.

The reason I requested the celiac panel was because of the Starbucks Eight-Grain Roll. I'm not much for sweets in the morning, and I had taken to eating these rolls. And it took me a little while to figure out that I was getting a miserable stomach ache and being gassy and bloaty after "enjoying" them. Oh! It was when I made the rolls at home that I really made the connection. I found a similar recipe, made delicious rolls at home, and paid the price. I started wondering if I was gluten-intolerant, or even had celiac disease.

My doctor poo-poo'd me right from the start. As a morbidly obese woman, he said I obviously was not having troubles absorbing food. (He didn't say it that callously, but I'm just cutting to the chase.) My accupuncturist says the opposite is true - obesity can indicate poor nutrient absorption, too.

The easy thing to do would be to stop eating gluten, even temporarily. However, I'm spoiled. Without a diagnose, some professional confirmation that I am gluten intolerant...well, it's easier to keep eating it. Doh.

And I'm intolerant, I can tell you for sure. I am always gassy and bloated feeling! This is real! I used to think it was because I drank so much pop: but when I didn't drink pop, I felt the same way.

Give. up. the. gluten. I have done this for a short time in the past. It is not hard, it is just not fun. I have read online resources and borrowed books from the library on the subject.

As my accupuncturist says, now it's just on me to make the decision.

Saturday, November 27, 2010

Ex-Smoker

Happy six weeks smoke free to me! Hurray! I am happy to say that I feel confident in my non-smoking status. Generally, I don't think too much about it. When I quit smoking (twice) earlier this year for three weeks each time, I started up again when I was having a hard time with the kids. The stress just got to me. I think I've been doing much better wrangling my three young'uns, and I haven't wanted to turn back to cigarettes. On Thanksgiving, I went to my parents' house. They both smoke - the elusive "light smokers" who have no more than a few cigarettes a day. Anyway, they went outside after dinner to smoke...and that was the first time that I thought, "yes, I'd like one, too." I didn't even go outside with them to chat: I found something to keep myself busy, and the urge was fleeting, anyway.

I will have to be careful, though. Cigarettes sound good when I drink, and they have always been a crutch for me when I am stressed. When I quit in 1998 or thereabouts, I did well as a non-smoker. However, I was getting ready to have children, so I was very committed to it and had finite goal(s) in mind.

I started smoking again, briefly, in 2004. I had to have an MRI for an upcoming back surgery. In the MRI machine, I had a complete and utter claustrophobic meltdown! Oh man, did I ever hate that. I left the lab in tears and went across the street and bought a pack of cigarettes. I sat on the stairs of the store and cried and smoked. Eep. MRIs = nasty. Anyway, I was a basket case over the impending surgery, and I smoked for several months leading up to the surgery, then quit right before it.

Also, this week I had a couple dreams about smoking. This isn't unusual - I've had dreams about smoking every time I've quit. These dreams were humorous, though. In the first, I found a half-pack of cigarettes and lit one, without thinking. After I had smoked it, I chastised myself for "forgetting" that I am a non-smoker. Then I realized it was a dream, and I felt relieved that it wasn't really happening. I laughed about it when I woke up. However, the next time I fell asleep, I dreamed I was smoking: this time I was pissed off because I *knew* I wasn't dreaming (of course, I really was)! Oh, I was so mad at myself in that dream...and still a happy non-smoker when I woke up. Oh, crazy psyche...

So...I will always have to watch myself with cigarettes. They are a big time stress "go to" for me. But today, I am six weeks smoke free, I am proud of myself and have no urge to pick up the habit again. Yay, me!

The original quit smoking meter I was using on the blog doesn't seem to be working. This one is okay - but shows some odd currency sign instead of the $ sign. However, the math still checks out. Over 600 cigarettes foregone! And over $300 saved! (Where in the heck is this money, though??)

Bariatric Surgery Support Group

I went to my second support group meeting today. I'm so glad I went! A couple observations on the makeup of the group:

- most of the people there are significantly older than me (55+, I'd say). There was one girl there who is 20 - she had lap-band surgery two years ago.

- most of the people there had gastric bypass, roux-en-y surgery. Two had lap band, two or three had gastric sleeve, as I plan to have.

- more women than men.

All are so nice. Two of the women strike me as a little kooky. Interestingly, both of them were also the ones who seemed overly stressed about the amount of food they are only able to eat. One spoke of being molested frequently in the past, of not trusting men, etc. These topics were not par for the course for the meeting.

Lap band surgery is not nearly as effective as gastric bypass or gastric sleeve. The two people there: the 20-year-old girl and the 50-something man, have not lost very much weight. She has lost 37 pounds in two years, he has lost about that in the 10 months since his surgery. They both have quite a bit more weight to lose, but not so much that you would think they need gastric bypass surgery. She expressed some disappointment in her weight loss, but acknowledged it has not been a priority for her. I pointed out that at least she wasn't gaining weight. I was about as overweight as she is at her age, and if I had been able to curb the weight gain, life would be very different for me now, perhaps.

There were three people there, two women and a man, who were eleven days post-op for gastric bypass surgery. That was primarily why I was so glad I went! They all looked wonderful. Good color, healthy, happy. All said they experienced no pain from the surgery, only discomfort. All said they stopped using pain meds in the hospital. I was very pleased to see how well they looked so soon after the operation. It has been one of my biggest concerns with the operation. Post-surgery, my life will continue at its normal fast pace. My kids' dad will take them for a couple weeks following surgery, and I will take a couple weeks off work. But I want, and need, to be back on my game as soon as possible. Seeing these three made me feel good.

One of the recent surgery patients was one of the women who was stressed about how much she could only eat. She is eleven days post-op and she wanted to be eating more variety, eating regular foods. She said that she did eat a small portion of regular Thanksgiving dinner. It was a little disconcerting: it illustrated how the food addiction does not disappear with surgery. However, most people report that immediately after surgery, the hunger disappears, for the most part. I am wondering if the two women who seemed a little more...hmm...what is the word I'm looking for? A little less mentally stable (although they weren't *unstable* by any means) were also the ones who seemed to struggle with the loss of food more.

One man has lost 132 pounds since his bypass surgery in February. He was really quite inspirational. He talked about the emotional difficulties following surgery. He said for the first couple months after surgery, he was pleased with his weight loss but could only described his emotional state as feeling deprived. He said it was hard, but he focused his energy on all the many benefits of the surgery and weight loss. He said, again, at Thanksgiving - such a food-based holiday, it was a little hard. But he has so much more going on for himself than a year ago, it was only a feeling of minor loss. He is really cool. His wife was there (not obese) and they talked about changing priorities: he used as an example milestones he set for himself post-op. He said it was very hard at first to think of non-food celebrations to look forward to when he met his milestones. :) I liked them both immensely. He works out regularly now: twice a week with the physical therapist, more at home.

For my part, I shared that I am planning the gastric sleeve operation in January. I quit smoking about a month and a half ago, and have struggled with weight gain since. I am nervous, but excited about the surgery. I loved seeing people look so healthy immediately after the surgery, and I loved hearing their success stories. I am stressed about missing time from work, since I have exhausted all my paid leave. They are such a nice, supportive group, it really boosted my spirits.

I've got another post or two in mind, I've got some errands to run but will be back later!

Monday, November 22, 2010

Iron-y

I'm a couple weeks out from my second iron infusion, and I have to say...wow! I think I am feeling much better! I have noticed that I am waking up before the alarm in the morning, and actually getting up. Pre-iron, I would hit the snooze button a million times and finally drag myself out of bed at the last possible minute.

Also, I'm not so tired in the evening. I'm getting more things done and not collapsing into bed at the earliest possible moment.

Finally - I am not so irritable. This is really quite remarkable, as it's hard for me to recognize irritability as a valid side effect of low iron. But also, I haven't understood why I'm so damn irritable without good reason. And lately...well, I'm just not. Sure, I'm still bitchy and overwhelmed sometimes, but largely, I think the difference in my mood is pretty darn noticeable.

I've also taken three of my weekly 50,000 IUI vitamin D capsules. Three? Hmm, I'll have to check. I got the prescription a week and a half or so ago...maybe I've only taken it twice. Anyway, between the iron and the vitamin D...well, I daresay I am feeling human again!!

I get my blood levels checked on Wednesday afternoon. I am very interested to see where everything stands. Also, I find it interesting that I stopped taking antidepressants in late July. I have to say that all these months later...I don't miss them. I would say I feel the same or better as I did when I was on the antidepressants. When my moods are blue or even bleak, they are the same blueness or bleakness as when I was on the antidepressant. When I am feeling good, which is generally most times...I feel as good or better as when I was taking the antidepressant. And I don't have to deal with all the yucky side effects.

Tuesday, November 16, 2010

Costco's Protein Drink and More Thoughts on the Surgery

Really, that's the best one of the bunch, I suppose. It looks like the brand is "Premier Nutrition," but mostly, it just says "Protein" in big letters down the front of the box. It's 3 grams of fat and 30 grams of protein. Tastes yummy. Sells for pretty cheap at Costco.

My ranty post yesterday about deciding to have the surgery was purely for my benefit. I am blessed with friends who support my decision, but not blindly: asking the same questions I am asking myself, coaxing me to think through the things I need to resolve. I don't want to second guess my decision after the surgery, so I need to make my peace with it before the big day! And it is a struggle for me. By nature, I am very, very hard on myself and my perceived failings. My weight, my body, my health - I have a lot of regrets and recriminations about it. So, the last thing I want to be doing after the surgery is kicking myself for having it. I know me: I have to work through all my feelings, so when I'm recovering and need my gallbladder out, while I'm standing there holding fistfuls of my own hair...well, I need to know that I thought it all through and made peace with my decision.

(Hopefully, this scenario won't play out! Instead, I'll be rocking my ever-shrinking body and bouncing off the walls with all my newfound freedom and energy.)

Monday, November 15, 2010

Biggest Loser Previous Winners



I borrowed this picture from another site. I haven't followed the Biggest Loser (see future posts RE: self-loathing, what-I-hate-about-you-is-what-I-hate-most-about-myself). Clearly, though, the photo demonstrates that weight challenges continue to be a very personal, very difficult struggle, even with all the resources and media spotlights. But Oprah would be the first to admit that, too.

Thoughts on Obesity and Aging

This isn't the sort of blog where I ruminate deeply over posts, drafting and editing and revising and finally publishing. Nope, these are my actual thoughts as I have them, haha.

I was thinking about WLS last week. Really, it's all I think about. I am reluctant to have it. I don't want to introduce new side effects into my life: hair loss, heartburn, gallbladder problems, etc.

But...what's the trade-off? And really, what am I adding? Several months ago, I *did* have to go to the doctor for gallbladder pain. I had an ultrasound that did not show any stones, but I didn't have the more conclusive follow-up test. We skipped that, because by then I was no longer having the pain (and haven't had it since).

But the reality is that I am female, fat and forty. It is not out of the realm of possibilities - heck, it is even *likely* that I'll have gallbladder problems. And post-surgery, my doctor puts you on some gallstone resistance medication for a few months. Maybe I won't have problems. And if I did? Really, it's not the end of the world.

As far as hair loss goes, well, one of the reasons I dread that potential side effect is because I already suffer from it. Twice over recent years, I've taken a migraine medication (Topamax) that can cause hair loss. For me, both times, it did. And it takes MONTHS after stopping the medication to stop the hair loss. It's creepy. I have been off that medication for quite awhile now, and I am still losing a lot of hair. I don't know if it's from the med, or stress, or the Natural Instincts hair color I'm using. But, I'm surviving. It is annoying, and it creeps me out, but it is not the end of the world.

Pain. Pain is another side effect. Uh, hello, I had three babies without a bit of pain medication. Sure, I cheated on that third guy and adopted him - but I was there when he was born and his delivery did not hurt me one bit! But with my second, he was in there sunny side up (WHAT IS THE MEDICAL TERM FOR THIS) and crooked, and at one point in the delivery I got up and said I was going home, so tired and frustrated I was...but no pain medication. Sure, I was at the midwife's house and the most she had on hand was probably Tylenol, but I did it!

I also had an L5-S1 spinal fusion in 2004, and you don't know pain until you've had a spinal fusion, I think. Ouch. So I can handle five little laproscopic incisions and some stomach pain.

But what I was really thinking about was getting old. I was telling a friend that I *want* to believe I can take the weight off without surgery. But I am forty, and I don't want to spend the rest of my life in a life and death battle with my weight. And life and death is exactly what it's become.

You don't see elderly obese people. I told my friend I finally realized it is not because they all figure out how to beat the weight as they age. It's because they die. And I'm not even talking "elderly" as 70 or above: you don't see many 60 year old obese people.

There is a woman I worked with in the building here. She was super morbidly obese. She ended up in one of those motorized scooters. When our employer started covering WLS surgery a couple years ago, she said she was the first person to sign up. First, she had to do something - maybe it was lose a little weight. We're not close, and I don't see her often, so I don't know the details. All I know was that I continued to see her around the building in that motorized scooter...until I didn't.

Now, it is possible that she had the surgery and lost so much weight, I just don't even recognize her when I pass her in the building. But I think it's just as likely that she died. I don't know, and it's not important, because this is about me and *my* struggles with obesity, not hers. I don't want to die of obesity. As a single mom to young kids, I can't say that I am always completely enamored of my life. It's exhausting. But eating myself to death is not a road I'd like to take.

I get inspired by these women who take off tremendous amounts of weight without surgery. Their discoveries, struggles and victories are very inspiring and thought-provoking. But I always wonder about their future. Do they keep it off? Once all the challenge of losing it is gone - do they maintain it? I am as competitive as hell, so I can get engaged in a good battle to lose. But, then? When the challenge is gone, so am I. What about all these Biggest Loser contestants? I think there's good reason they don't do many "Where are they now?" stories. My guess is most of them are right back where they started. I know this game. I've played it my entire life. In the past, I've been a "pull yourself up by your bootstraps" success story, too. I've lost 70 pounds more than once through sheer willpower and determination alone. And even 70 pounds lighter - I faced all the same struggles and challenges I do now. But I repeatedly gained the weight back, and more.

I don't have room in my life for "more." If I keep pushing my weight upwards, as I've done this month with quitting smoking, I will kill myself. I've reached maximum capacity, I'm afraid.

So, while I'm not thrilled at the prospect of surgery to overcome my weaknesses...well, I can live with it. *Want* to live with it.

I've got a new perspective on "taking the easy way out" with surgery. I've never been one to take the easy way out. I got my first "real" job the moment I was legally able, I worked full-time during my senior year, I earned my associates, then bachelor's, then master's degrees while I worked full-time. I had three kids without pain medication, I fought hard to save my marriage and threw my husband out on his butt in the middle of the night when I realized I was the only one fighting for it.

I don't cop out, I don't take the easy road. It's ridiculous that I would continue to be so hard on myself over this decision. I am trying to save my life. I am trying to HAVE a life. I'm having that freaking surgery and I don't give a damn what anyone thinks or says about it, or me.

ROAR!!!

Going in the Wrong Direction

My little web counter at the top of the page says it's been over four weeks since I quit smoking. Yay, me!! However, I can really feel it in my clothing. The jeans that had gotten so baggy they were really pretty inappropriate for work? Well, they're snug now. :(

On the good side, I have played "Just Dance 2" several times, including for a good 4-5 songs last night. It may not be a strict exercise regime, but it is a work out, and it is something, anyway.

Also, did I mention I'm a NON-SMOKER?? This, in itself, is very good news. And except for those first couple days, I didn't even really struggle much with it. It was time. However, as usual, when I've quit, my sweet tooth comes roaring to life with a vengeance.

Now that I'll be one month smoke-free tomorrow, it's time to reign that monster in. If I continue to gain weight, my insurance company may decide that I am not a good candidate for weight loss surgery (WLS). And it's mid-November! The new year is creeping up on me quickly - and so is the potential surgery date.

Friday, November 12, 2010

IV Iron Infusion - Good News Follow-Up!

Happy news! Unexpected, too. I have a voice mail on my phone from the hematologist: my ferritin levels are normal! This, before my second IV infusion, even, as they took the blood to test when they got my infusion going on Wednesday. I've got a call into their office, I'm not sure what my number is (nor exactly what it would mean if I *did* know, haha). I know that per his testing, my ferritin level was 3 before the first infusion, and he wanted to get it above 50.

They had scheduled me for a third IV for next week, but the message was to cancel that appointment. Instead, I'll go back during Thanksgiving week to have my blood drawn again to see where the level has stabilized after the second infusion.

I heard back from the doctor's office: my ferritin level is at 48, as tested on Wednesday before my second infusion. So, my level is probably even higher now. The target was to get it above 50, so we're in like Flynn! (was going to say, 'so Bob's your uncle!' here, but decided to go with a slightly less obscure exclamation.)

This is very interesting, because it means my blood is getting back to where it should be, and I should be reaping the rewards!

Also, the hematologist called in a prescription for Vitamin D for me. He does not like those levels, either, and wants to get them boosted. I will be taking 50,000 IUI once a week, indefinitely, just like a certain awesome runner friend of mine. My GP, who is opposed to high dosages of Vitamin D, is just going to have to stuff it on this one. I'd like to get my iron, VitD and B-12 levels to normal-people levels and see how that affects my day to day life for a change.

Cost of Care

As I'm starting the process for my weight loss surgery, it's obvious how quickly the cost of everything is going to add up! I'm looking at my insurance website to date. Thank goodness for a wonderful insurance plan! Even the copays I have now will be the death of me around the holidays - I can't begin to imagine what I'd do without great coverage.

9/30 - first appointment with surgeon (my share) $15 / (insurance payment) $236

10/6 - X-rays and labs (me) $23 / (insurance) $204

10/6 - X-rays and labs (me) $19 / (insurance) $175

10/6 - X-rays and labs (me) $2 / (insurance) $18

10/7 - Hospital incidentals ?? (me) $20 / (insurance) $184

10/8 - Physical therapist (me) $32 / (insurance) $285 (SERIOUSLY????)

10/14 - Sleep doctor, first appt (me) $15 / (insurance) $355

10/15 - Overnight sleep study (me) $142 / (insurance) $1279

10/20 - Lab (me) $2 / (insurance) $17

10/25 - Sleep doctor, second appt (me) $15 / (insurance) $123

10/27 - Overnight sleep study (me) $155 / (insurance) $1398

10/28 - General practictioner (me) $15 / (insurance) $75

10/28 - Surgeon, second appointment (me) $15 / (insurance) $71

11/3 - CPAP set-up appt at home (me) $15 / (insurance) $62

You can see this is going to get very expensive, very quickly. Thus far, my actual out of pocket costs are $500, and my insurance has paid $4482. Gulp. You know what's missing here? The appointments for my iron infusions. They have not been submitted to my insurance yet, so I don't know what the cost will be.

For next year, I set aside $5,000 in my flexible spending account. This is money that I have immediate access to at the beginning of the year. It is tax-free and can be used to pay medical expenses. If I don't use it by the end of the year, I lose it. With three kids, and this surgery planned - well, I'll use it. But if I don't have the surgery?? I may be in a bit of trouble. Next year, you can no longer use your flexible spending account for over the counter medications! This has been the saving grace of "leftover" money at the end of the year: just go buy a bunch of Tylenol. No more! Although, truth be told, I haven't had leftover money at the end of the year in any year since I've been using the FSA.

The biggest appeal to me with the FSA is that I have full access to the $5K at the beginning of the year. It is then taken in equal installments from my paychecks throughout the whole year. For people like me who suck at money management, it's a good way to be able to cover expenses up front.

Prick Me, Baby

I love accupuncture. I've been doing it for many years, off and on. I can't remember how I got started, but my first accupuncturist, Gloria, was really wonderful. She was a nurse, and she wanted to start a program with the hospital for end of life care. It was her passion and it quickly became difficult to get an appointment with her for accupuncture, because she was moving on to different things. She was wonderful, though, and if I had a headache, she could stick that pin in and slowly twist and my headache was gone like magic.

It does matter what sort of practitioner you get. I started accupuncture again this fall because I wanted to treat my super-tight ligament on one of my calves that tightens horribly while I sleep and sometimes wakes me with incredibly painful cramps. There was a provider across the street from my office, so I saw him...once. What a hack. I should have known: I had seen the chiropractor in the same office off and on for years, and he is all. about. the. money. I have never been driven so crazy by a health care provider as by this chiropractor's office. Calling me to remind me of appointments, to remind me to schedule appointments, blah blah blah. I finally told them NO MORE PHONE CALLS...EVER. But foolishly, I went to the accupuncturist in the same office. He jabbed a few pins in and billed my insurance about $300. Then came after me for the difference when the insurance company only paid about $65. HELLO -- here's my Explanation of Benefits stating that I only have to pay my $15 copay and you've agreed to waive the rest. Really slimy business practices.

Oh, also: I asked that accupuncturist to put in pins for quitting smoking (as if it's a button that must be pushed, haha). Well, he couldn't do that, but he has a special 10-session program that is not covered by insurance that involves treatments and aromatherapy and blah, blah, blah.

Forgettaboutit.

I decided my next accupuncturist must be an authentic practitioner of eastern medicine. I specifically searched my insurance company website for names I could not pronounce, I'll admit. But then I happened to ask my chiropractor if he knew an accupuncturist...and he referred me to someone wonderful. She is an authentic-ish practitioner of eastern medicine with a strictly Biff-and-Muffy sounding name. But I adore her, positively adore her. I saw her for the first time on 10/16, the day I stopped smoking. She sticks me full of needles and pins and gets them zinging the way I like, while we laugh and chat. Then I get to zone out under the heat lamp and warm blankies for half an hour or so. I've probably seen her or her coworker eight or ten times in the last month. I'm tapering off, now, my next appointment is the 27th.

So...accupuncture for the newbie. Don't be afraid, it doesn't hurt. The needles are super skinny. Some of them sting a bit going in: the most painful I've had are for the cravings/detox for smoking. Those are the five pins that go in each ear. They're the worst, but they aren't bad at all.

Accupuncture is all about energy flow through your body. I can't speak to the meaning of it all, but I do know I like it and it works for me. I've mentioned that accupuncture can make a headache disappear for me. And if the needle goes into the wrong spot, or not deep enough, you notice it. It just feels like nothing. But a needle to a good spot gives you a little "zing," a little something that tells you it's working. And while I can't say that accupuncture made me quit smoking, I can certainly say that it helped. My first visit was on the day I quit, and I've had several follow up appointments and I am nearly a month smoke-free. The relationship between correlation and causation? I dunno. It worked. I don't question it. :)

If you're at all interested, give it a try. I am a proponent of any self-care treatments involving heated massage tables, warm blankies and quiet time spent by oneself.

Bah-ha-ha-ha! To Dream, the Impossible Dream

I've been playing with this BMI calculator. Would you believe my "normal weight range" is 103 - 138 pounds? This, if I give myself the extra 1/2" of height that I seem to have grown at all these doctor appointments. Who knew? A growth spurt at 40!

Well, the last time I was 103 pounds was 5th grade. And I probably passed by that particular milestone pretty quickly, too! I've been trying to think of how much I've weighed at various times as an adult. I was 275 when I was 40 weeks pregnant with my second child in 2001. I was 167 when I had taken off 69 pounds at Weight Watchers, but before I quit smoking - so probably 1996. Up and down, up and down, for many, many years.

A couple things on the iron infusions. I had my second this week, and will have my third on Tuesday. This morning, I woke up early and had nothing pressing to do before work (e.g. the kids are at their dad's). I gave myself permission to fall back asleep. But I didn't want to! Wasn't tired at all. Instead, I got up and got some stuff done around the house. A sign of improvement on the horizon? I hope!

That little anecdote needs a disclaimer, though, as I think I also pretty much went to bed at 3:30 yesterday afternoon. The kids were with their dad, I had gotten a one-hour foot massage, 15-minute chair massage and a 30 minute sauna treatment...oh, how hard it is to be a lady of luxury! Bahaha. No, I'm not a lady of luxury, but I did treat myself yesterday. My accupuncturist (more later!) recommended the foot massage place. It was $25 for an hour long massage, plus $10 for the 15 minute chair massage. And it was worth every penny, 100 times over. Wow! $25 for an hour massage! The accupuncturist's recommendation stemmed from the coupon placed in her office for a $5 sauna treatment at a nearby spa. I said I was going to go check it out - she said if I did, I must visit the foot massage place. The sauna was okay, the foot massage was to die for!

Anyway, after my spa day, it was pouring down rain, and the traffic was miserable on the way home. I opted to curl up under a blankie and watch t.v., which of course led to napping. I dozed off and on, visited with 2/3 of my kids when they stopped by to get something (Part III was asleep in daddy's car), and watched the NBC Thursday night tv. It was not a grueling afternoon and evening, haha.

I did feel pretty vexed by my laziness this morning when I realized I completely spaced off the bariatric surgery support group meeting last night. I am very disappointed about missing it, especially since the next one takes place on the Saturday after Thanksgiving and I have my kids all that weekend and may have to miss it. D'oh! What price, laziness?

I have been using the CPAP machine at night. I can't say I love it. Maybe I'm getting better quality sleep, maybe it's worse. I do know it is affecting my dreams and stirring up my sleepwalking tendencies. A couple times I have woken up and thought it was morning, took the thing off and went to bathroom, then realized hours later that it is still the middle of the night. It is making my nose break out in pimples. Many mornings, I have mask-imprint-face. Sometimes, I feel like the thing is actually trying to suffocate me: I'll find that breathing deeply into the mask through my nose is not giving me enough air, and I'll end up breathing through my mouth - which creates this bizarre vacuum sensation. No, I do not love it.

But, I'll continue to wear it. Why? Am I glutton for punishment? No! But, for my insurance to pay for it, I have to wear it 21 days out of a 30-day period. And you won't believe how Big Brothery it is, either. The machine has a removable disk I will take to my follow-up appointment with the sleep doctor on 12/21. There, he will be able to see when I've worn it, and for how long, and all sorts of information about my sleep patterns. FREAKY SHIT, MAN!!*

(*Oh, I am so torn about my language on this blog. I am truly a trash mouth. Thankfully, my bosses and coworkers are also trashmouths, so this doesn't get me in trouble at work. No, we are not longshoremen. Anyway, I try to keep my language clean here, because I don't want to offend anyone who may one day be helped in some small way by my experience. But...I gotta be me, too. And I'm not a FIDDLYSTICKS! kind of girl.)

Okay, so on 12/21, the sleep doctor will examine my sleep patterns and have altogether too much information about my nocturnal habits. And I believe the supplier of the CPAP machine will actually come calling at some point to take data off this disk, specifically related to how much I use it so the insurance company will pay him. Funny how I post my whole life on the blog, but am UP IN ARMS about this little disk. Sheesh.

The sleep doctor and surgeon will want me to take the CPAP with me to the hospital to wear after surgery. I've already been given pep talks about this: I will be recovering on my back, the CPAP is most helpful for sleeping on your back, etc. I am a good girl. I don't want to disappoint and tell them to take their obnoxious machine and shove it.

Oh, I guess I have stronger feelings about the CPAP than I was willing to admit. Yes, I hate the damn thing. If it is making me sleep better, I haven't noticed it. It's not like when my ex used to wear one: pre-CPAP, I could lay in bed next to him and listen to him stop breathing for five, ten seconds even, before GASPING back to life. Had I known then we were going to get divorced...mwahahaha. (Without a doubt, I get better sleep than when I was in the bed with him, just because of the snoring and gasping disruptions that probably killed the quality of my sleep, as well as his.)

Tuesday, November 9, 2010

Self-Doubt, Dismay...Determination and Optimism

It's an interesting state of limbo, this pre-surgical waiting period. Besides all the health-related stuff: blood tests and sleep studies, corrective measures to adjust various levels of nutrients and such...it's a deeply reflective time, too.

Oh heck, who am I kidding? Everything with me is a deeply reflective time. :) But the topic of WLS (remember, that's "weight loss surgery" - I'm really going to use that acronym here!) is front and center at the forefront of my mind.

Feelings range from dismay - "oh, look at the mess I made for myself," to complete optimism, "Imagine! Me, taking care of *ME*!" I struggle with WLS as a cop-out. I'm a pretty determined and strong person, and it is painful for me to continue "losing" (in every sense of the word except for the way I want it!) in regard to my weight. There isn't a lot that I haven't "won" at in my life. In many ways, that's what put me in the condition I'm in. With career, education, family, etc. I've been able to go all out: setting goals and meeting them. But with eating...it's always been my self-care. Tired? Stressed? Burned out? Worried? Sad? Food can soothe all these feelings. Years and years of self-medicating with carbs and other yummy goodness has taken its toll on my body.

When I think of WLS as a cop-out, I realize it's all part of the way I torture myself for not being *enough.* Not good enough, not disciplined enough, not strong enough. Enough. I don't let myself have anything easily. I don't celebrate my victories, I don't give myself credit where credit is due. I've gotten better about that over the last couple years, I think. Personal drama, e.g. divorce and all its ugly fall-out, has led me to examine and ruminate over every facet of my being. I've come to know myself a lot better in this time: the good, the bad, and the ugly.

So I know when I stress out about WLS as a copout, I also know that any path I take from here, I'll be pretty judge-y about my success, or lack of it. Nobody beats up me as well as I beat up me:

Lose the weight "on my own"?(<--I am beginning to hate this term more and more) Good for you - you should have never allowed yourself to get so fat in the first place! How much of your life did you waste? Yes, you lost it, but it sure took you a long time to do it!

Have the surgery?
Good for you! Now, how much of your life did you waste before you had the surgery? But, if you would have only had the (fill in the blank) surgery instead of the type you chose, you wouldn't be stuck with this (fill in the blank) symptom!

I'm looking for peace. Self-acceptance. Forgiveness. Yes, this is rather a bad spot I'm in, but I can find a way out of it and feel better. Feel good, even. I'm not a terrible person: I've made mistakes, I've damaged and been damaged. But I deserve to turn things around, and all the benefits (and challenges) that come from it.

I could take the phrase "on my own" and print it out, wad it up, stomp it on the ground and grind it into shreds. I read the phrase everywhere, I say it to myself all the time. "If I could lose the weight on my own instead..." WLS is not a magic fairy who will make it all better with the wave of a wand. Not at all. It will be a difficult recovery and it will present its own new challenges. And even with all that? It won't take away all my extra weight! Depending on which option I choose (I am planning gastric sleeve), my surgeon says it will take away about 75 pounds of my 125 pounds or so I want to lose. There will be a lot of work for me to do "on my own." Additionally, it's on me to solve the issues that led to the obesity in the first place. Where am I going to channel this extra energy that currently goes toward eating? How do I make sure I don't give up compulsive eating in favor of another addiction?

Either way, surgery or not, it's all on my own. I'm not sure exactly how I see or feel about the surgery, but I always at least see it as a tool to get me on the right road. And as far as the permanency of the smaller stomach - well, it's the guardrails along that road.

Much more on this later, at various times, because it's pretty much all I think about right now. ;)

The Waiting Game and Protein Drinks

I have been doing some reading about others' experience with weight loss surgery (WLS) and musing about the many pros and cons of such an approach for myself. I'm still planning to go through with it, but it is a tough decision. Right now, I'm just focusing on taking care of myself: getting my blood work in order, taking vitamins, trying to get my body as it is now in its best condition. I am looking forward to another iron infusion tomorrow: will this one bring about noticeable changes in how I feel? I hope so! I can be reasonably patient, however, if I don't feel an improvement from this one, perhaps the next. I'm just glad to be on the road to feeling better!

I'm happy - I've started finding some blogs out there related to bariatric surgery. I *knew* they must be out there! It's why I started this blog: it's the sort of anecdotal information that I find helpful, and I figured others must be looking for it, as well. I've stumbled on a few that I really like and will link to here sometime, when I get my blog logistics worked out. I also found a couple non-surgery weight loss blogs that I am enjoying, as well.

Yesterday, I did a trial run of the protein shake diet I'll have to do for two weeks before surgery. Protein shakes all day (I had three) and a reasonable dinner. I was *hungry* during the day! Funny, because I will quite often skip lunch and not be so terribly put out about it as I was yesterday. It's mostly a mental game, I'm sure.

Today, I had a breakfast quesadilla from the cafe in my building. I am full. Too full, really. Actually, it feels better to be a little hungry than a little too full. What a revolutionary life lesson, haha.

This morning, I also had a Slim Fast protein drink. Hey - I just realized I doubled up!! No wonder I'm extra full! I bought this last night - Bartell's seems to have stopped selling Muscle Milk powder, so I picked up a can of this. They all taste the same to me, frankly.

The sundries shop in my building sells Atkins Advantage Milk Chocolate Delight Shakes. I was surprised to see it has 10 grams of fat in an 11-oz serving. No wonder it is my favorite pre-made shake to date! Only 15 grams of protein, as well.

A comparable shake that I've bought is the pre-made Muscle Milk Light, which has 4.5 grams of fat in a 14 oz serving, as well as 20 grams of protein. I like it in the larger bottles, but I have had the Muscle Milk Light in the aseptic boxes and did not like it at all.

Now, the Muscle Milk Light powder prepared with non-fat milk is yummy. I can really drink this without problem or complaint. Except, of course, that I can't seem to find it locally right now, haha. Bartell's sold it and had the best price, but they've stopped selling it. My local Super Supplements sells regular Muscle Milk in powder, but not light. I'll have to order some online.

The Slim Fast Protein Shake is okay - really, the powders taste the same to me and the pre-mades taste the same (although Atkins is noticeably yummiest). Four grams of fat, 15 grams of protein in an 8 oz serving made with non-fat milk.

The Muscle Milk Light powder is really the best way to go, it seems. It would be interesting to plug all these variables into a calculator: serving size, grams of fat, grams of protein. It says to mix the Muscle Milk Light powder with water, which I would never do. Ew!! With water, a 12-oz serving has six grams of fat and 25 grams of protein. Add in the non-fat milk and your protein intake is boosted considerably. What a difference over the Slim Fast with milk!

Wednesday, November 3, 2010

Iron and CPAP Machine...Restful Bliss? I Think Not!

So, yesterday I had my first IV iron infusion. It was uneventful, except that I had to get poked twice for the IV needle. No side effects, no rash, no constricted breathing. Just me and a recliner and a heated blankie, kicking back reading a book for an hour. Niiiiiiiiicccceee.

Originally, I was scheduled to go back next week for another blood test, but this morning they called and changed the appointment to another transfusion. Apparently, my levels are so low, they've decided I can have three infusions before they even begin to wonder what level I'm at, haha.

Now, foolishly or not, I was hoping - praying - that I would wake up this morning feeling like a BRAND NEW WOMAN!! Sadly, I do not. I actually feel pretty awful. Not sure if it is from the infusion, or from the first night sleeping with a CPAP machine for my mild sleep apnea.

See, last night, the medical supply company brought over my CPAP and taught me how to use it. I had a pretty rough night's sleep with it, waking up a few times, not getting comfortable, etc.

But I feel worse than just *tired,* so we will say that it is from a combination of the infusion and the CPAP. Regardless, I am pouty and whiny this morning, and I am eating a turkey pot pie for lunch along with a side of mashed potatoes and gravy, and this proves a couple things:

- There is a reason I am obese. Duh.
- Comfort food = gold.

Hopefully tonight will go better. I was pretty tyrannical to my kids this morning, and, uh, last night. Mommy needs some good, high quality sleep.

Tuesday, November 2, 2010

Insurance Approval?

Hmm, I was looking at my insurance company's requirements for obesity surgery this afternoon. I know that they will cover the standard "gastric bypass surgery" and that they also cover the vertical banded gastroplasty (VBG), the type of surgery I want to have. However, it looks like, from the criteria, that I may have a hard time getting approval for the VBG. In addition to their standard criteria (e.g. BMI, co-morbidity or other conditions that affect your health such as high blood pressure or diabetes), for VBG you must have:

- complications from extensive adhesions
- liver disease
- Chrohn's disease or ulcerative colitis
- some poorly controlled disease (such as renal/kidney failure)
- Readiation enteritis (??)

Now, I see online that my insurance does actually approve VBG for people, and my surgeon does this type of surgery for people with aetna insurance. He hasn't raised a red flag about it, but I definitely need to follow up. I am less interested in the more invasive gastric bypass surgery, although I am not prepared to rule it out at this time.

Iron Infusion

Yesterday, I saw the hematologist for the first time. He reviewed my lab results and said I should have an IV iron infusion to boost my iron levels. With the infusion, I can expect my energy levels to increase and the quality of my sleep to improve dramatically! I AM SO EXCITED!

The doctor thinks that several things drove down my iron levels over the course of time: two pregnancies, six months of heavy periods after I had one five-year Mirena IUD removed and then six weeks of heavy flow after I had another Mirena IUD inserted. The biggest culprit, however? Years of regular blood donations, but over the last two years, I've donated pretty consistently every 56 days or so. Whenever the blood drive showed up at work, I made an appointment and donated.

Since I don't eat a lot of meat, and don't take iron supplements, the doctor thinks I ran down my iron supplies and never replenished them. Our new plan is an IV infusion this afternoon, followed by new blood tests in 10 days. We'll keep doing the IVs until my iron levels are holding at a respectable number, then he'll give me prescription iron supplements.

I. am. so. excited!! I have been feeling like C-R-A-P for months and months now, and it has been a driving force in my decision to have the gastric sleeve operation. I figured I had reached maximum density: the point where I was so obese that there was no saving myself from myself. Blech. Too tired to work out, too tired to improve my life. I'm still committed to the gastric sleeve, but *NOW* I can get my blood levels fixed and go into the procedure with some momentuum! Energy - exercise - strength. Much, much better place to be!

The doctor said he wants to get my ferritin level to 50. I am currently at zero. He says I have a long way to go, probably will take several IVs, but I should start feeling a noticeable improvement very soon. YAY!

More on this following my first IV this afternoon.

Monday, November 1, 2010

Muscle Milk Light

I've been experimenting with protein drinks, because for two weeks prior to my surgery and two weeks after, I have to drink primarily protein drinks.

I already know I really like chocolate Muscle Milk Light. But mostly in the powdered form, added to skim milk. Refrigerated bottles are ok - aseptic boxes are my least favorite. Yesterday, I stopped at Bartell's for more powdered mix, and was told they are no longer selling it, at least at that location!

A quick online search tells me that Muscle Milk Light comes in these flavors. I've only tried Chocolate Milk, thus far.

Dark Chocolate
Cake Batter
Chocolate Mint
Chocolate Peanut Butter
Cookies n Crème
Banana Crème
Strawberries n' Crème
Chocolate Milk
Vanilla Crème