Goals

Today we took the kids to Remlinger Farms. It's a large local farm with some fun rides and activities thrown in. It's our first time going and while it's been a lot of fun, it also helped make me look forward to next summer. There were a few rides that our son wanted to go on, and while he was tall enough the problem was we were too heavy to accompany him.

I can't wait for next year when that, hopefully won't even be a worry.

My goal by next summer is to be light enough that I can ride the Flying Pumpkin, the roller coaster and Barrel rides with Oliver.

So the current goal?  200lbs ... which would mean a loss of 127 from where I am right at this moment. I know it's a lot, but I'm going to bust my butt to get there.

Waiting Game

It's official - all of my Pre-Op requirements (except the weight-loss and 1 test) are complete. I've also satisfied all of the initial insurance requirements for approval - so all of my docs have been submitted for pre-approval. Fingers crossed! The PC at my surgeon's office says they usually hear back within a couple of weeks. I may start calling next week just to 'check' on things.

All my tests came back good with the exception of an umbilical hernia, slight Hiatal hernia and some of my blood work was off (iron, live enzymes, etc - nothing unexpected). I think my least favorite test was the Upper GI (swallow study). I've never had one, so had no idea what to expect which was probably a good thing. That stuff they make you drink is DISGUSTING! I barely made it through the test without throwing up. I really hope I don't have to do another one right after surgery, because I can't imagine how I'd be able to keep it down.

The only things I have left to do are get my infusions of iron and turn in my 24hr urine test. I figure I'll do that next Sunday and drop it off on Monday when I have to bring the hubby to the hospital to do his testing.

This is probably going to be my least favorite stage - where I get to sit and wait until we hear back.

I'm still on the mostly-liquid diet and plan to stay on it until 10 days before surgery. Then I'll go on my clear-liquid diet in prep. As of last Friday I had 17lbs left to lose. It's been a bit slow-going this week, but I didn't really start until Monday. Either way, as of today I'm down around 5lbs ... so 12 left to go! If I can get my butt in gear, that (hopefully) shouldn't be a problem at all.

As we get closer and closer to approval, I find myself getting more nervous and scared. I think it's normal. I keep wondering if this is really the path I need to go. I mean, I'm losing weight on this pre-op diet, so why not just stick with it for a while until  lose weight? The problem is I fell into that trap before and I know how it ends. I lose a good amount of weight (usually in the 60-80lb range), then I start slacking off and before you know it I've gained it all back. There's nothing that's FORCING me to stick to it and keep from cheating. There's no consequences other than slowly tightening pants that I can ignore for a while. I know I need more than that.

I need help to keep me on track for longer than a few months. Restriction, malabsorption and physical side-effects if I don't follow plan. Yes, I know I can't count on those side effects but at least I can count on the rest. I'll have a smaller stomach that will feel full sooner. I'll have lost a good portion of the stomach that releases the hormone that makes me think I'm hungry.

I think my biggest fear is having this surgery and then becoming one of those people that doesn't lose or winds up gaining back most of their weight. I hope I have the mental and physical strength to keep that from happening.

The Good, the Bad and what I'm doing about it

So first the good news - as of t his morning I'm 14lbs down in 16 days. I had a slight regain at the end of the first week due to poor choices. I also think we were both treating it as a 'last supper' type of thing because the liquid diet was looming.

Still, if I can maintain this rate of loss I'll be at my goal weight by mid-August.

The bad news - the liquid phase is torture and I didn't do very well.

Between trying to choke down a protein shake that tastes like rotten monkey butt (though the cocoa powder helped a little) and feeling like absolute crap all last week, it was miserable. I know ther's usually a certain level of 'detox' to be expected, but I'm doing this to get healthy - not to feel even worse than I normally do.

The challenges:
1 - the level of salt in most broths was triggering headaches. Due to my BP, I'm sensitive to salt and I guess not eating anything to balance it out increased that sensitivity. The ones that are low-sodium have absolutely no flavor and despite being hungry I had trouble forcing myself to drink them.

2 - I HATE SUCRALOSE. Seriously - I cannot stand the flavor. I don't understand how people can live on it and don't notice the flavor difference. I can take a taste of something and immediately tell you that it has sucralose by that nasty after-taste it leaves in my mouth. This means that these protein shakes, sugar-free jello, sugar-free pospicles are about as appetizing as eating dirt. I deal with it while drinking the protein shakes, but it pretty much eliminates the other 'free foods' I'm allowed.

The above challenges, combined with the nurse's failure to explain a few details about this portion of the diet, meant I was subsisting on 2-3 12oz protein shakes a day and maybe 1 cup of broth. Oh and my multivitamins and calcium of course.

So the hubby and I had a talk about it and have decided to make adjustments. Yes, I fully understand I won't have the freedom to do this after surgery, however I do now and am taking advantage of it. Plus, when the hubby had his consult with the (same) surgeon he was just told to lose the weight and the surgeon ultimately didn't care how.

So for week 2 of our 'liquid' phase, we've mad the following changes.

- Picked up 2 cases of the Premier protein shakes. The surgeon isn't a fan of these because of the protein degrading or something along those lines, but I can stomach these. I don't feel like I'm marching along death-row every time I have to drink one.

- We're picking up 1 container of Body Fortress protein powder from WalMart. I've heard that it tastes decent and I'm willing to try. I'm making sure it's a flavor other than chocolate.

- We're eating a sensible, protein-centric dinner. This has helped tremendously. The first night, after about 5-6oz of steak and a 1/2 cup of veggies sauteed in coconut oil I felt 100% better. My headache started going away, I didn't have the shakes, I didn't feel sick.

So far so good. I'm still losing. I feel human again. I can think clearly again. I can work and take care of my kids the way I have to every day and not want to just sleep.

If I notice that it's seriously stalling my weight-loss, I'll re-evaluate. Right now though, I've got to do what I've got to do to survive.

In other news, just 6 days until I go have my EGD and the majority of the other testing I have to get done. I'm looking forward to it, but I'm also nervous. It's been 16 years since I was under anestisia or in the hospital for anything other than child birth. I know I'll be fine - hubby was fine after his 3 years ago. I think it's normal to be a little apprehensive though.

I just keep reminding myself that it means I'm that much closer to being able to get a surgery date. I'll have 75% of my testing done that same day. Then I'll get the remaining 25% done the following Friday along with my cardiologist visit and the nutrition consult. I think it's then just a matter of waiting for insurance approval once the office gets all of the paperwork submitted. I think I'll feel a lot better about all of this (including the torturous liquid diet) once I have a date. Once I have a surgery date, then at least I know there's a light at the end of the tunnel. I can't say an 'end date', since I know I'll be back on the liquid diet after surgery, but at least I'll have a goal. I do much better when I have a goal or a countdown to use as reference. Then it doesn't feel like I could be doing this for weeks and for no reason (well, other than whatever weight I manage to lose) if I can't get approved for surgery.

Moving right along

So since my last update I've survived my 1 week of high protein, low carb eating. It wasn't too bad, especially since I followed a lot of my Whole30 strategies. I also managed to drop around 8lbs which isn't to bad. I'd hoped for more, but considering I had a hard time getting in regular exercise, I'm not going to complain.

This week I've started my 2 weeks of clear liquids and it's definitely tough. I'm home with the kids all day and between prepping their food and having to feed the youngest, it's kind of torture. I'm starting to realize how often I take a bite or taste of her food during mealtime. If it didn't require massive amounts of clean-up, she'd be full-on finger foods. I know it'll get easier - but during these first few days it's definitely harder than I expected. I'll admit, I was looking forward to the 'ease' of this phase, for the sheer fact that I wouldn't have to put much thought or prep into what I'm going to eat. I think I'd enjoy it more if it was just and my husband (who's being a champ and doing this with me!) that I had to worry about. Ah well - the life of a parent. :)

On the upside, I did discover that adding a scoop of unsweetened cocoa powder to the shake helps the taste tremendously. I also think I'll be picking up some sugar-free syrups to help with the flavor, as well. I definitely need to find at least one other shake option, because chocolate is going to get really old really fast. I wish there was an option that didn't use sucralose, because I have a hard time with that flavor.

I am hoping for some big losses with this stage. I have to lose 35lbs before I have surgery and I think I'll have all of my pre-op testing and requirements fulfilled by August 1st. Once that happens it's just a matter of getting insurance approval and I think we can set a surgery date. I really want to get this done the first week of September to ensure I'll have double-coverage for my insurance and so that I'll be a couple of weeks out from surgery when it's time for my daughter's first birthday. I want to be able to celebrate and enjoy the milestone. 

Anyway, that means I've got to lose around 27lbs more in just a few weeks. Even when I was hardcore dieting and working out 1-2hrs/day, it would still take me a few months to lose that amount. It's intimidating and discouraging but I'm trying to stay positive. If my intake is around 800-900 calories a day for 2 weeks, it's got to result in some decent loss. If not, I'm in trouble even after surgery LOL

In less stressful news, I did my psych consult yesterday. As long as I don't come back as a raving lunatic, that should be all they need to submit my paperwork for approval.

So fingers crossed and lots of losing weight vibes going on over here! 

Big Day #1 - Consult with the Surgeon

I had my consult with Dr. Srikanth today and overall it went as I expected. No, actually, it went exactly as I expected. He definitely recommends the DS as the best surgery for my situation. I don't have to jump through a bunch of hoops with my insurance company, meaning no 6 month supervised diet (as of yet). I just have to get my Psych evaluation done and provide proof of past, failed weight-loss attempts. I've got logs from SparkPeople, Weight Watchers and doctor's records that should suffice. I do have to lose 10% prior to surgery, which at this point is going to be somewhere in the range of 35lbs. To do that, Dr. Srikanth has me following his 'sandwich diet' - which looks o-so-fun!

Starting next week I get to eat high protein, low carb for a week. Breakfast is protein and more protein, lunch is protein plus some veggies if I'm still hungry and dinner is a salad with added protein. That doesn't worry me too much - it's a lot like the Whole30 I did last year prior to getting pregnant and I loved how I felt on it. 

The week after, however - not such a fan! For the next 2 weeks (yes, 2 weeks) I get to do a clear liquid diet that consists of 80oz of water/liquids, clear broths and 3 protein shakes per day. I can have all of the sugar-free jello and popsicles I want - well I could if I could stomach the taste. I can't stand fake sugar, so unless I get really desperate I'm going to be skipping those. I know that'll be challenging when it comes to the protein shake, but I'm going to do my best to find one that doesn't taste like total crap thanks to the nasty sucralose. Yes - I can taste the difference.

After that, I get to go back to Week 1 and rinse and repeat until I've lost enough weight for him to schedule me for surgery. My goal is to have my surgery by the beginning of September, so I've got my work cut out for me but I also have a lot of motivation to stick to the rules. 

I also have to find a way to fit in 90min of exercise every day and, I have to be honest, I'm stuck on that one. I work from home and take care of my kids, so it's not like I can just go for a quick jaunt on my lunch break and then again before I get home at night. It's going to take some creative scheduling - okay, a lot of creative scheduling considering my schedule. Don't get me wrong, I know I need to make exercise a part of my daily life, even after surgery, it's just hard to figure out where it'll fit in and still allow me time to eat, sleep and spend time with my husband.

There's also a long list of tests and appointments I have to schedule. I already have my EGD and Nutritionist appointments scheduled for the end of this month. I still have to get a bunch of blood work, an electrocardiogram, a psych evaluation, a consultation with a cardiologist, a pulmonary function test, an EKG and I think 1 or two other tests. My head is spinning just thinking about it all.

I decided to use the weekend to take a breath, get my food in order and then start scheduling everything on Monday.

Here we go again!  Here's hoping I can make it to the end this time. :)

Reminders of why I'm doing this - Part 1: Medical

I'm a planner. I'm a researcher. I'm a worrier. Those three things aren't bad on their own, but when put together it becomes fun. What it means for me is that I'm constantly in a state of flux between being incredibly excited and incredibly terrified about the journey ahead of me. I know this will continue from now until they start the anesthesia and I'm okay with that, as long as it doesn't make me change my mind (unlikely) or make me drag my feet (much more likely).

So I've started making mental lists of things like NSV's I can't wait to have, weight milestones I'm excited to meet, things I want to make sure I do with my kids, ways I want to celebrate and so many other things to keep my outlook as positive as possible. This entry isn't dedicated to the fun stuff, though. This entry is dedicated to the nitty, gritty, sometimes embarrassing medical and physical reasons I NEED to have this done.

So here we go.

Let's start with the list of medications I have to take daily.

6 Aleve

300mg of Labetalol

25mg of Hydrochlorothiazide

300mg of Wellbutrin

2000mg of Metformin XR

All in total that equals out to 15 pills per day. Don't get me wrong - I understand that I will be taking a large number of vitamins and supplements after surgery, but I'm okay with that. I'm not okay with needing this many prescription medications at age 33.

Now the underlying conditions:

- Hypertension: I've had high blood pressure since I was a pre-teen. That's an extremely long time. I didn't become good about taking my medication until I was late teens or early 20's, but even so that puts me at over 10 years of being on blood pressure medications of varying strengths. High blood pressure, even when it's treated, does nasty things to the body. It's part of the reason that, when I'm pregnant, I always test positive for protein in my urine. Usually that's a sign of impending pre-eclampsia, but for me it's 'normal' ... which isn't good. I want to be 50 with a set of working kidneys, thank you very much.

- Enlarged Heart: When you're classified as "Super Morbidly Obese" and have never been just Obese or overweight in over 20 years, your body has to work harder to do things. That includes things like walking, standing and moving blood from one place to another. I was first diagnosed with an enlarged heart about 4-5 years ago I think. It wasn't anything they were horribly worried about, but it's certainly not ideal. Again, I'd like to reach 50 (or 60 or 70) with a working heart.

- Sleep Apnea: So, don't get me wrong - I absolutely adore my machine and the fact that for the first time in quite a few years I can get a good night's sleep. I don't wake up with headaches all the time (well, unless I'm congested), I usually have energy if I've been able to get a decent night's sleep and I just feel better. That said, I'd love to not have to go to sleep looking like someone preparing to walk through a gas cloud or to worry about where my hose is. I'd love to not have to worry about packing it and never being able to spontaneously stay at a hotel or sleep somewhere other than at home because I don't need my machine. Right now that's just not possible. No matter what, I need that mask to sleep otherwise I feel it the next morning. Granted, getting rid of sleep apnea isn't a guarantee, but at least if I do lose weight I'll know I did what I could.

- PCOS: So first, being overweight doesn't cause PCOS but PCOS can contribute to you being overweight. It's all about hormonal imbalances and hormonal imbalances don't just affect things like mood or fertility. They also affect weight and how your body metabolizes food. Insulin is a hormone and at the root of PCOS is usually some sort of issue with how your body deals with insulin. I know this and I've proven it to myself in the past. I've fixed it in the past as well - it's how I wound up with two beautiful children. That said, I don't want it to be fixed for a little while only to come back with a vengeance anymore. For me, PCOS is a downward spiral of symptoms that all conglomerate into me being one big mess. I know that losing weight will help, but I know that being able to actually keep that weight off will get me to a point where it's 'fixed'. I don't necessarily want more kids, but I'd like my body to work right, y'know?

- Depression / Social Anxiety: So yes, this is a surgery that's meant to fix my stomach, but I'm also hoping that it will also help fix my head just a little. I'm hoping that as I approach a more normal size it might be easier for me to interact with other people without feeling like I'm about to walk across fire. I'm hoping that by losing weight and being able to exercise and be more active it will help with my depression. Because exercise releases endorphins and endorphins make you happy and happy people don't murder their husbands. ;) Beyond that I just want to feel normal and not freak out so much about having to interact with other Mom's at my son's school because I'm the biggest one there.

- Chronic Pain / Arthritis: Extra weight on the joints is bound to cause more pain than normal, but I'm at a point where I am in constant pain. From the time I wake up in the morning until I go to bed I have achy, stabbing and throbbing pain in most parts of my body. Right now as I'm writing thisI have sharp pains in my neck, my shoulders and middle back are burning, my lower back is achy, my feet are stiff and sore and I know that when I get up there will be additional aches in my hips and a sharp, shooting pain in my lower back when I try to pick up my 8 month old daughter. Again, I know that losing weight may not (and probably won't) "fix" all of these problems. I've done what I'm guessing is irreversible damage to my lower back and neck. I've broken both of my ankles 3 times. I've had whiplash 3 or 4 times. Those problems are with me forever. What I do know I'll get from weight loss is less pain. Maybe I won't have to take 6 Aleve a day just to be able to function. Perhaps I'll be able to wake up in the morning and not need to immediately jump into a hot shower so I can move. Hopefully I'll be able to get up and down from playing with my kids and not have to groan in pain because something is hurting.

Overall, if you're looking just at my physical state, I've got a pretty darned low quality of life right now. I realize that it could be so much worse and i'm thankful every day that it's not, but the point is that at my age it shouldn't be where it is. Not only that, but if I keep going the way I am, it's only a matter of time until things do start getting worse.

I've got way too much to live for to let that happen. I've got a husband, a 4 year old boy and an 8 month old little girl that I want to be able to enjoy and right now I just can't.

So that's my list of medical reasons. I'm sure I'll be coming back to this in the coming weeks while I'm trudging my way through my Surgeon's pre-op diet (1 week low carb/high protein, 1 week clear liquids, rinse and repeat), going through all of my tests and ultimately preparing for surgery. I'm going to need these reminders and it's a lot harder to brush them off when they're right there in front of you in black and white.

16 days until my appointment.

The Beginning ... Again

This journey really began about 3 years ago when my husband and I first looked into WLS. We were both super morbidly obese and despite our best efforts we were having a hard time doing it in our own. We picked our surgeon, went to the seminar, got all the info and started scheduling our tests. Then, about a month into the process my husband lost his job and with it our WLS coverage. My insurance excluded it.

It sucked. I cried and got angry. Then I moved on with a renewed determination to do it on my own. It would take almost three years, but I did manage to lose around 60lbs on my own. It required a special diet, intense exercise and no cheating. Then I got pregnant, got morning sickness and the only foods that I could keep down were the ones that I had to avoid. The good news is that despite that I only gained back 15lbs. The bad news is after my daughter was born I gained another 15 on top of that.

Despite my best efforts I need help doing this. I need to be able to not have to exercise 2 hours a day to get the weight to come off. I need a longer term solution that will help with me stuck to those healthy food choices because I won't have room for the other ones. Sweets aren't my problem, volume is. I need something that will help me get faster results so I can exercise and not be in constant pain.

So when I started my new job and saw that my benefits included WLS coverage I started mentioning it to my husband. Then he got his job which also offered coverage. It felt like it was time.

I contacted the surgeon we had originally picked because of his expertise and the fact that he performs the Duodenal Switch surgery, which is the one I'm leaning toward. Waiting for them to verify my insurance coverage was the longest week ever but I finally got the email.

On July 3rd, 2014, I'm hopefully taking the first step on a journey that's going to help change and extend my life. Fingers crossed that it all works out this time.