Ramblings ....

So I keep thinking "I'm going to blog about that ..." and then it doesn't turn into much to talk about.  So excuse me if this blog is rambling a bit - just a bunch of things going on in my head.

So I'm now 13 months out from surgery.  I have been stuck playing with the same few pounds since September.  I had to stop running when I had the vertigo problems and the ear surgery.  It took me a while to get back into a good running routine with how cold it has been here.  I have a hard time running in the cold - my old asthma rears it's ugly head then.  I am now back into a good running and exercise routine in order to meet my running goals for 2010.  But I am still stuck at the same weight. Frustrating.

I had my 1 year follow up appointment with my doctor.  He was happy with my progress but would like to see me loose another 20 pounds.  I, personally, would like to loose another 30 pounds.  I have come so far - I find it hard to believe I can't loose this last 30 pounds.  So I have recommitted myself to tracking my calories and my exercise on http://www.livestrong.com/ (they took over The Daily Plate).  I am trying to stick to 1100-1200 net calories a day.  I am easily able to eat about 1500 or so calories a day.  That is really wreaking havoc with my brain.  This part won't make sense to some of you.  I know that is a normal amount of calories to be taking in - possibly even still pretty low.  But it scares me.  I'm afraid to take in too much more than that in a day.  The fact that I haven't lost weight in 3 or so months scares me.  I am not ready to be done and I am afraid of going in the other direction.  I have actually started dreaming about it - waking up and I'm up over 200 pounds and I'm so mad and afraid and disappointed.

And there are some days I think Kanga has become made of steel - I can eat a lot of things I couldn't before - I can take in more than I could before.  I don't like that.  I don't want to go back to "normal".  And then there are some days that she reminds me that she is still in charge and I can't get more than a couple of bites of anything or I dump on something that hasn't caused me to dump in the past.

I did get my hand slapped at my 1 year follow up with Dr. Enochs.  I am not good at the vitamin regimine.  And for no good reason - just not good at it.  So I really need to get on top of that pretty quickly here.  I am going to have some bloodwork run soon and that should give us an idea of what the impact of that truly is.

Some other things that have been rearing their ugly heads now that I am a year out:  I have been having some off and on pain my abdomen.  Sometimes it's breath-taking pain - sometimes it's just an ache.  I talked to Dr. Enochs about it and he has a couple of different concerns that can be common after gastric bypass.  One is scar tissue.  I have had quite a few abdominal surgeries - 2 c-sections, an open hysterectomy, an open gallbladder removal, and some laparascopic surgeries.  So I most likely have quite a bit of scar tissue - that could be catching or kind of strangulating my intestines.  Something else that is common is that you can get an internal hernia once all the fat that used to hold things in place is gone.  So what do we do about it?  The only way to tell if the pain I'm having is one of these two things is to have surgery - there's no test that will tell them definitively if one of these things is what is happening.  It's a fine line to when we decide to do something about it - right now it doesn't normally interfere with daily life, but it could happen over night and become something that needs to be taken care of immediately.  So the approach we are taking right now is "watchful waiting".  We shall see.

I have also started having some reactive hypoglycemia symptoms.  I haven't had that officially checked out, but it looks like that is what I am dealing with - drops in blood sugar that make me weak and shaky, etc...  From what I can track it appears to be reactive which means I should be able to control it with what I am eating and how often I eat.  I plan on talking to my doctor about it when I see him next week.

I see my doctor next week to get fitted for orthotics for my running shoes.  I seem to have developed bursitis in my left foot and I don't want anything to distract me from my goals for running this year.

Speaking of running goals - I have already raised $500 for my Polar Plunge after the 2010 Torch Run.  I can't believe I have raised that much money!  I am looking forward to that run and will be sure to post pictures of of the craziness that ensues.

So thanks for listening to me ramble on and on.  I just had a bunch of things on my mind and no clear way to get them all out, but getting them out on this blog really is cathartic.

I'm Leavin' On A Jet Plane ...

I think I mentioned on here before that my sister has seen that I am in desperate need of a break from reality - a getaway - and has graciously arranged for me to come visit her. I am leaving tomorrow evening to go down to Clearwater Beach for the rest of the week. There will be no children and no husbands - just us sisters sitting on the beach and doing blissfully nothing. Expect to see pictures posted here so I can torture you all. :)

In getting ready to leave I have had an interesting problem - finding clothes that fit. I have found a ton that fit, but now the problem is deciding which to take with me! It's so exciting to have cute clothes that fit. I drove my husband crazy last night trying on a gagillion things and going "Does this look OK?" Of course, he's not that crazy about me going without him - so he could care less if I look OK or not. :)

I am looking forward to sleeping in, napping, sitting in the sun, walking, reading a book without being interrupted every 5 minutes, and just basically not living by anyone else's timeline.

When I come back I have an appointment with my Primary Care Physician (Dr. Bloom) to discuss some hip pain I have been having. I went to the chiropractor about the hip pain earlier this week. He said my hip was mis-aligned, but he also feels that because of the rapid weight loss I have my hips are having some bio-mechanical issues. He feels physical therapy is in order because my gait has probably changed. Right now my hip locks up randomly and really hurts when it does. So we'll see how physical therapy helps.

Still ...

So I am still having problems with Kanga. She just seems to never be happy. The steroids don't seem to have worked. If I don't refund the Roo and manage to keep everything down - I have awful foamies and I am in pain for several hours afterwards - even liquids can do this to me now. It's kind of hit or miss. But I am miserable. Yesterday I was actually at -147 calories for the day because I went hiking. I am so tired because I am hardly getting any calories in. And because I am hardly taking anything in my body is holding on to every ounce of it so I haven't lost any weight this week.

So I called my surgeon today to let them know that the steroids didn't seem to work, etc... The nurse called me back and had me call the GI Doc and get in with them. I called the GI doc and they can't see me until next Friday. WWWWWAAAAAAAAHHHHHHH!!!!!!! I was assured I wouldn't die staying on liquids until then. Yes, thank you, I realize I have enough fat to sustain me for quite some time. But that is just the consult. That isn't actually correcting the problem!

SSSSSSSOOOOOOOOOOOOOO - here I sit playing Russian Roulette with my food for another 8 days.

On another note - I kinda had a WOW moment today. I had to take my daughter to the doctor for a rash she has. My whole family sees one family doctor. I love him - Dr. Bloom. He is da bomb! Anyway - he hasn't seen me since I was trying to get my paperwork together for surgery. So he walked in and he got this huge smile and said "Did you have the surgery?" Yes, 6 weeks ago. He told me he could tell and that he thought I looked great and he was very excited for me. But the best was he couldn't believe my blood pressure was already under control. He checked it and it was phenomenal as usual. Yeah Me!

Jumping Through Hoops

So many people don't really understand what's involved with gastric bypass surgery. I think that as much as I will be using this blog as a place for my own catharsis I will also be spending a good amount of energy educating friends and family about gastric bypass surgery - what it actually is, how it works, and how it will affect me.

So we'll start with Weight Loss Surgery, or more commonly referred to online as WLS. There are several different types of WLS. You can have gastric bypass, lap-band, duodenal switch, vertical gastric sleeve, and the list goes on and on. I chose gastric bypass surgery, or Roux-en-Y gastric bypass. Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss. I am having the surgery laparascopically. I will be in the hospital for 2 days and I plan to only take a week off of work.

I choose gastric bypass over the lap-band (which has grown in popularity a lot over the past few years) for several reasons. Lap-band can be easily cheated and I knew that if I could cheat it I would. The gastric bypass has immediate measures built into it to kind of give you a "hand-slap" when you eat wrong. If you eat too much sugar or carbs or fat you will get what is lovingly referred to as "Dumping Syndrome". I won't go into too much detail here (I may at a later time), but I think you get the idea. I also don't have a good history with having foreign object in my body. My body usually rejects foreign objects - pushing them out of my body. Don't ask me how or why I know this about my body - I just do. Also, the lap-band would require a lot of follow up visits with the surgeon to adjust the band and to do "fills". From past experience I know that I may not always have the incredibly great insurance I have now - so I can't be guaranteed that I would have the financial means to continue in that manner.

And so my official journey towards WLS began in July. I had reached the height of feeling sick of myself. I had been feeling for quite some time that I was almost ready to make some changes in my life. But now I was finally ready and I did my first ever search on weight loss surgery. I researched surgeons in my area and accepted by my insurance. I was very impressed by Dr. Paul Enochs reviews and his internet presence. So I called his office to schedule an initial consultation. I was instructed to attend one of his weekly seminars on Weight Loss Surgery and I signed up for the first available seminar. I had broached the subject with my husband (who I shall refer to on this blog as D) and asked him if he would attend the seminar with me. We went and it was very informative. Dr. Enochs' insurance specialist spoke and gave a lot of information on what the various insurance companies would require before approving the surgery. I found out that my insurance, Cigna, would require a 6 month doctor supervised weight loss program in addition to all of the other tests and sign offs from various doctors. Then Dr. Enochs did a 2 hour presentation on weight loss surgery, the various types, as well as some information on him and his experience. He was incredibly easy to listen to. His voice was soft and gentle and comforting. He was very patient and gracious. He listened and responded to every question that was posed and never made anyone feel as though their question was stupid (and believe me - some of those questions were stupid!). By the time D and I left the seminar I felt that I had a good idea of which surgery I was going to have. I remember asking D what his thoughts were on which surgery I should have and his exact words were "You're Pam! Go big or stay home!" Allrighty then!

So I quickly moved into attack mode. The insurance specialist had said that the more involved I was in the process the faster it would get done. So I scheduled an appointment with my Primary Care Physician (the astounding Dr. Bloom) and got to working on everything. To make a long story shorter here is a list of all the things I have had to ensure happen in the last 6 months so that Dr. Enochs office could submit a package to my insurance company requesting approval for my gastric bypass surgery:

• 6 month Dr. supervised weight loss program
• 5 year weight history
• Chest X-Ray
• EKG
• Upper GI
• Endoscopy
• Sign off from GI doc on my fitness for surgery
• Nutritionist appointments and approval
• Psychiatrist appointments and approval
• Labwork requiring 6 vials of blood

So after all of those doctors appointments (not all of them covered by insurance), an enrollment fee of $400 with Dr. Enochs office (to ensure that I am serious about committing to this life change and to cover a lot of the work of those in the office that can't bill insurance companies like the doctor does), and all of the poking and proding we had a package to submit to insurance requesting approval. I was approved pretty quickly and on the first try (did I mention I have great insurance right now?) and then was able to schedule my surgery. It is scheduled for Monday, December 29 at 5pm.

I will go into all of the changes that I have ahead of me immediately following surgery and beyond in another post.