Was it worth it?

So I have been asked twice today if I think that my gastric bypass was worth it in light of the rare complications I have suffered in the past year that seem to be connected to my altered anatomy.

My answer ... YES!  115 pounds does not come off this quickly without some ramifications.  But they are gone and I am so much better in every way because of it.

The saga continues

Since I have been home from the hospital last week I have continued to deal with twinges of pain and a headache that won't quit.  I have not felt "right".  I followed up with my PCP (the most wonderful Dr. Josh Bloom) as well as with my GI Doc (the equally wonderful Dr. Hutzenbuhler).  Dr. Bloom was stumped and felt I needed to give my body a break from all the "noise" and just rest.  He felt that the physiological and psychological stresses that I have been under were causing my body to just cry UNCLE.  I couldn't agree more.

Then I went to see Dr. Hutz.  She said I was presenting with classic symptoms of having a stone stuck somewhere - like in my common bile duct or pancreatic duct (remember that I haven't had a gallbladder since 06).  We decided to follow up with an MRCP - which is basically an MRI of that area.  She said there were some problems - one is they wouldn't find a stone - which could also mean that I'm getting them and passing them but the act of passing them is painful.  Two is they would find a stone.  Normally you would then need an ERCP.  An ERCP is like an upper endoscopy - they just go down further past the stomach - and use the instruments in the endoscope to perform manometry on the Sphincter of Oddi (doesn't that sound like a bad word?).  It's actually a pretty simple procedure - in and out.  Problem is - not for someone who has had gastric bypass surgery - visualizing the SOD, etc... is very difficult.

I saw Dr. Hutz Monday morning and on Monday afternoon I started in with the pain again.  At work again.  This time it was accompanied by pretty bad vomitting.  I called Dr. Hutz and she sent me to the ER.  Have I mentioned I hate the ER?  I was there in extreme pain for over 6 hours before I was seen by a doctor.  I hate the ER!  By then I was so dehydrated they had a heck of a time getting an IV started - 6 times they tried!  They finally had to use doppler to find a good vein - even then they had a hard time threading the catheter.

I was admitted again.  My blood work was fine, but I was still having pain despite the good pain meds and obviously something is going on here.  So I was made comfortable for the evening and this morning an MRCP was performed.  The MRCP did not show any stones, but did show that the ducts and sphincter were dilated and inflamed.  So this fed the idea that I could be getting stones (or small stones) and passing them - causing these "attacks" - or I had some sludge build up at the SOD and it was acting kind of like a dam.  Dr. Hutz consulted with some other GI surgeons about how an ERCP could be done on a gastric bypass patient.  A former partner of hers does have some experience with this and consults with my bairatric surgeon (the incomparable Dr. Enochs) on a regular basis for them.  Dr. Enochs actually goes to the OR with them and helps them to visualize what they need to do the sphincterectomy.

So that is the plan - to have a sphincterectomy done here in fairly short order.  I don't have too many other details than that, but I am encouraged that I'm not just being told "We don't know what's wrong with you."  Pissy Pam takes up residence here at Rex when you tell her you don't know why she's in pain or when it will stop or get better.  :)

So the sag continues and I will update everyone on what is found and done next.  Thank you to everyone who has been praying for me - it means a lot to me and is very helpful.

Weighty Secrets

Have you heard of the website http://www.postsecrets.com/?  People can anonymously post their secrets on this website.  It's rather cathartic for those posting, and it's some great therapy for those of us reading it as well.

So a new website has been put out there by the most wonderful Melting Mama herself (who has also brought us the fabulous Bariatric Bad Girls Club), called Weighty Secrets (http://www.weightysecrets.com/). This is a place where people can post secret submissinos about life after weight loss surgery.  To quote Melting Mama ...

A lot of people who undergo weight loss surgery are told that having the surgery would be a cure for a their fat "disease" and life. After the honeymoon period of weight loss wears off - and the reality sets in - what then? This blog will give you a peek into the real life of WLS patients and those around them.


Life after weight loss surgery is filled with doubts, concerns and often? Secrets. Send yours.

As y'all know - I love my RNY.  I have a much different life than I did just 18 months ago.  But I am leaving that magic window and settling down into "normal".  Normal is never what you thought it was going to be.  I have tried my best to use the magic window to make the necessary changes in my life to make sure that this time "it sticks", but it's still a struggle.  I often feel like I'm still living in the fat me - still dealing with all the same feelings and responses I had before.  Reading this site has been immensely helpful for me on several levels.  One to realize that I'm not alone - others have gone before me - and have done it successfully.  If I'm willing to be taught - I can learn from them.  Two to remind myself that I can not be complacent about this - not now - not ever.  There is too much at stake.  I can't ... no I won't ... go back.

Bariatric Bad Girls Club

I am now officially 18 months post op.  That magic window that I have spoken of before is closing and closing fast.  I have always advocated that Weight Loss Surgery is not a quick bandaid approach to losing weight.  If you treat it as such - you will still lose the weight - but then you are at risk of putting it all right back on.  Because of the surgery - you will lose weight - and a lot of it.  But your body (I still marvel at our bodies and how they adjust to things - smaller stomach - missing organs, etc...) will adjust to a smaller stomach and re-routed intestines. You may stop dumping when you eat too much sugar or carbs - your little pouch may stretch a bit to accomodate more food - or you and your brain may figure out how to bypass the signals that your body is telling you you have eaten too much or the wrong things.  I mean - let's face it - I didn't get fat by accident people.  I ate - and ate - and ate.  And to be honest - there are days even now that I can get around the rules and eat quite a few things that I couldn't before - and eat all day if I time it right.  I still dump, but it takes more sugar for me to dump than it did before and I'm still unpredictable at it.  I can't eat a lot at one time, but if I time it right I could snack all day long and get in a ton of calories.

So the question becomes - what am I going to do about it?  I've lost about 115 pounds.  I would love to lose about 10 more.  I am down to a size 10 (I have even managed to squeeze into a few size 8's - but the extra skin makes it quite difficult).  I don't want to go back to the land of size 26 !  I don't even want to go back to size 12 or 14! I want this to stick - I want to take what I have learned over the past 18 months and make it work for me.

So that is where the Bariatric Bad Girls come in.  They are a group of wonderful women I have come to know (and quite honestly stalk!) who have are several years out from surgery.  They have lost the weight - and some of them have gained a little back - but they have lived to tell the story.  They do have the occassional slip in behavior - but they are committed to keeping the weight off.  These are the women I identify with - they don't sugar coat life.  In fact, they sometimes have sugar!!!  OH NO!  But then they get back on the band wagon - and they get back to the business of living the post bariatric surgery life.  I love it.  I am so with them.

The Obesity Action Coalition has been formed as a way to educate people about obesity and it's effects on our lives.  The Obesity Action Coalition is an IRS registered 501(c)3 National non profit organization dedicated to giving a voice to those affected by obesity. The OAC was formed to build a nationwide coalition of those affected to become active advocates and spread the important message of the need for obesity education. To increase obesity education, the OAC offers a wide variety of free educational resources on obesity, morbid obesity and childhood obesity, in addition to consequences and treatments of these conditions. The OAC also conducts a variety of advocacy efforts throughout the U.S. on both the National and state levels, and encourages individuals to become proactive advocates.

The Bariatric Bad Girls Club has come up with a way to donate some money for the OAC.  They have created a bracelet that you can purchase for just $5 and proudly display your membership in the BBGC!  Part of the procedes go to the OAC to help promote Obesity action and awareness.  I have a link for purchasing the bracelets on the right of my page.  Click on and join the cause to bring more awareness!  I know it can be a touchy subject - it was for me for many a year, but my sister reminded me of something recently when I had to have my kidney removed.  She said "Can you imagine having to do this 115 pounds ago?"  Yeah - kinda brings a lot into perspective for me.  :)

My scale is in shock!

I think my scale is in shock!  It registered the lowest weight EVER when I got on it this morning!  I had gained 10 pounds after surgery from the IV fluids and such - it was quite disheartening.  So I have lost that 10 pounds and an additional 7 pounds since that - just over a week past surgery.  I'm hoping that it's not a fluke - I guess the coming days will tell.  I have just 8 pounds to go until I hit the weight that my bariatric surgeon had set for me.  If I can hit that and stay there for a while I will be draggin' my butt straight to the plastic surgeons!  This extra skin has proven to be a major issue.  The small incision that Dr. Jalkut made was where my c-sections and hysterectomy were - all the extra skin has made healing a bit hard.  I won't get into the graphic details - but I'm hoping this actually helps my case for getting the abdominoplasty (read ... tummy tuck!) covered by insurance.  And it's great encouragement to continue my walking while I can't run!

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.

Biggest Loser

I am a big fan of The Biggest Loser. I haven't always been a fan. When it first came on I saw a few episodes, but I just couldn't get into it. And I know why - there was just something wrong about sitting in front of the TV eating Doritos and watching others work their butts off and losing tons of weight. I just didn't want to be reminded of what I wasn't doing for myself.

But once my head was in the right place and I myself was losing weight I became a huge fan of the show. That was just this past season. And I quickly became a HUGE fan of Daniel. For several reasons. The first being that I felt he had the desire - had come to that mental place of making the big changes in his life that were so desperately needed - and I felt bad that his partner (David) had not come to that same place and was proving to be a hinderance in his journey. The second reason I was a huge fan is because I kina felt like I knew him! Daniel went to my kids school (my kids attend a small Christian school) - we had seen him on campus - everyone knew who Daniel was. So he was the hometown kid and even though he didn't know me - I felt like I knew him (though I realize I really didn't). My kids also recognized him and we quickly began to cheer him on.

We were super excited to find out that he had been given a second chance on this latest season of the show. His humble attitude and gracious spirit led him to choose Shay as his partner - he identified with being the heaviest contestant on the show. (On a side note - how does losing 17 pounds in one week earn you the privelege of getting voted off?!?!?! Seriously? So wrong!)

So we were so disappointed when he got voted off the show last night - just 2 pounds shy of losing 200 pounds! He has accomplished so much and even though we really don't know him - feel a sense of pride in his awesome accomplishments.

At the end of the episode they did the "reveal" of the ousted players. They showed Daniel going home and re-uniting with his family. They also showed him re-uniting with his friend, David, from the previous season. David is obviously still struggling with his weight. When Daniel asked him where his head was with his weight his response was ""I've got other things going on that are more important to me right now," he told Daniel. "I'm overweight, yeah I'm a big guy... I don't feel unhealthy. So when that changes, then I'll start losing it."

I just started to cry when he said that. That is exactly where I was at one time. I had other priorities. I had small children that took up all my time. I had a career that I was trying to move up in. I didn't "feel" unhealthy. I also recently saw an interview that Ellen did with Mo'nique where she addressed her recent weight loss. She said she started out at 262 pounds and that at that weight when she looked at herself naked in the mirror she didn't see anything wrong with herself - she saw a sex kitten - full of life and vitality.

I did all the same things ... for years. I wouldn't do Weight Watchers. I wouldn't entertain surgery. I knew that I was not mentally ready. And to cover I convinced myself that I was OK with who I was and how fat I was. I was a good person. I was a nice person. I was outgoing and I had lots of friends. I chose to ignore a lot of things. I chose to ignore my high blood pressure that had me taking 3 different pills. I chose to ignore the SEVERE sleep apnea I had that impaired my sleep as well as my body's ability to regenerate, etc.... I chose to ignore my high levels of triglycerides, my high cholesterol, my insulin resistance, my not-so-gradual path to type 2 diabetes, my inability to breathe going up stairs, the fact that all of my doctors were concerned about my health, the fact that my children couldn't sit on my lap - or rather my lack of lap.

I knew that I needed to loose the weight - but I also knew that I wasn't ready. I knew that any effort to do it would be totally unfruitful until my mind caught up with what my body was screaming at me. So seeing David say that totally brought me back - seeing him in such denial about his need to change broke my heart. But to be honest - until he's ready - he won't be able to do it. And it's obvious he's not ready. This battle is as much a mental battle as it is a physical battle. Dealing with my issues and going through this divorce from food was one of the most difficult mental battles I have ever been through.

So I am praying for the renewing of David's mind and healing of his heart. I know that his friend Daniel will be there to help him along the way when he is ready.

And thank you for being such an inspiration, Daniel. Not only to me and to my family, but to all of those who's hearts you have touched through your appearance on The Biggest Loser.

Overweight

I know! I know! I know! I have been neglecting Pamelot again! I have many worthy excuses, I promise. Though, I'm sure you're not really interested in any of them. It's been a crazy few weeks getting things ready and set up for this year's Upward Cheerleading season. The work as Cheer Commissioner is keeping me a bit busy. I am also in a very busy phase of my project at work.

I am now 10 months out from surgery - hard to believe. I am in the phase where I am able to eat more and more foods - my body is adjusting nicely to my new insides - and I am feeling like I have adjusted to "my new normal". It's no longer this new novel thing to have had gastric bypass. I feel like I have finally adjusted and settled in to life with a smaller stomach and less intestines (romantic isn't it?). I don't have to think so hard about what I'm going to eat, or plan ahead so much. This is just my life and I have settled into it. And I like it.

The weight loss has slowed dramatically - as I knew it would. I would like to lose 20-30 more pounds. I feel that when I up my exercise (I have been slowly getting back to exercise since my ear surgery) I will be able to get a better handle on that and make some progress there. The scale still does move, which is encouraging.

I was having an interesting conversation with some co-workers about BMI yesterday. We were talking about what a "normal" BMI is - how most people are not "normal", and how even though I have lost over 100 pounds I would still be considered in the "obese" range. We were playing around with a BMI calculator and seeing what different weight and heights gave us. So I plugged in my latest weight and discovered .... I am finally overweight! I am no longer obese!

18.5 or less	Underweight
18.5 to 24.99	Normal Weight
25 to 29.99	Overweight
30 to 34.99	Obesity (Class 1)
35 to 39.99	Obesity (Class 2)
40 or greater	Morbid Obesity

Some calculators also put a category of BMI's above 45 as "Super Morbidly Obese". At my heaviest just before surgery my BMI was 47.6, and so I fell into that awful category. As if "obese" isn't bad enough - you add morbidly to it - then super morbidly. UGH! I always hated that! But it was telling me what I didn't want to hear.

Dictionary.com defines the word morbid as:

1.	suggesting an unhealthy mental state or attitude; unwholesomely gloomy, sensitive, extreme, etc.: a morbid interest in death.

2.	affected by, caused by, causing, or characteristic of disease.

3.	pertaining to diseased parts: morbid anatomy.

4.	gruesome; grisly.

Unhealthy mental state or attitude - check. I had a bad attitude (some would argue I still do!)
Characteristic of disease - check. High Blood Pressure, Sleep Apnea, sneaking up on Type II Diabetes, hard to breathe, hard to exercise, hard to do just about anything.
Pertaining to diseased parts - check. Not much to explain there - felt like my whole body was diseased.
Gruesome; grisly - check. That is definitely how I felt about myself.

But I spent many years denying and simply avoiding this about myself. If I can actually loose these last pounds I will find myself in a "normal" BMI range. That actually blows my mind a bit.

Myths about Weight Loss Surgery

I frequent a site called Obesity Help. They often have some great articles on there. I really liked the one they recently posted on myths surrounding weight loss surgery. So I am posting it here.


1. Weight loss surgery requires an inpatient hospital stay.
Not true! In fact, most weight loss surgeries can now be performed as an outpatient. The laparoscopic adjustable gastric band is the most popular outpatient weight loss procedure. The laparoscopic sleeve gastrectomy can often be performed as an outpatient. Laparoscopic Roux-en-Y gastric bypass can also be performed with an overnight stay or a short one to two-night hospital stay.

I was released from the hospital the day after my surgery.

2. Weight loss surgery has high risks.
While weight loss surgery used to be considered a high-risk operation in the 1970s and 80s, this was due to many factors including the large open incision required, the severe medical problems of the patient candidate, and the relative inexperience of the surgeons and staff. All of these factors have changed markedly. Today, weight loss surgery is performed very safely with low risks in the hands of experienced surgeons and centers. And while any treatment or surgery or intervention has risks, for most people considering weight loss surgery, the risks of not undergoing surgery usually far exceed the risks of undergoing the procedure.

3. Surgery is the “easy way out.”
Successfully losing weight and keeping it off with weight loss surgery requires lots of hard work. It requires undergoing a rigorous evaluation and then attending educational classes and support groups and working on lifelong healthy habits and behaviors. It requires a great commitment and desire to achieve a valuable lifelong goal of reaching and maintaining a healthy weight.

Don't get me started on this one. Major pet peeve of mine.

4. You have to weigh over 300 pounds to qualify for weight loss surgery.
Many studies and many societies including the American Heart Association, the National Institutes of Health and the Medicare Reimbursement Process consider people candidates based on health conditions plus a calculation of the height and weight called the Body Mass Index or BMI (go to www.sasseguide.com to calculate your BMI). Numerous studies in recent years have shown marked health advantages to even moderately obese individuals who undergo weight loss surgery. Many people qualify who are as little as 50 pounds overweight.

My insurance requirements were a BMI of 40 or above OR BMI of 35
with 2 co-morbidities. I started out at a BMI of almost 48 and I
had 2 serious co-morbidities - high blood pressure and severe sleep
apnea.

5. People who undergo weight loss surgery need to have advanced, serious health conditions such as advanced diabetes and heart disease to qualify.
Each individual is assessed based on his or her specific health conditions and the Body Mass Index calculation. It is widely agreed that anyone with a Body Mass Index over 40 qualifies for weight loss surgery, even in the absence of health problems. It is also widely agreed that people with a Body Mass Index over 35 qualify for weight loss surgery when one or more obesity-related health conditions is present (including high blood pressure, diabetes, high cholesterol and obstructive sleep apnea).

6. You have to be in perfect health to qualify for weight loss surgery.
In fact, many people undergoing weight loss surgery do have health problems related to obesity. Some of these individuals have mild forms of the conditions and other people have more severe forms of the conditions. Each person should be assessed by an experienced bariatric surgeon to determine candidacy.

If you were in perfect health - why would you need surgery? Let's
own up to it - if you're heavy enough to qualify for surgery you are not in
perfect health.

7. There is a long recovery time after weight loss surgery.
Most people recover from weight loss surgery within one to two weeks. Some people go back to work and activities within a few days, especially after adjustable gastric banding surgery.

I timed my surgery between Christmas and New Year's. I took 4
days off of work - I was back to work a week after surgery. It was one of
the easiest surgeries to recover from - and I've had my share of
surgery.

8. After weight loss surgery, you won’t be able to eat anything that’s good.
Most people can eat a wide variety of all kinds of foods after weight loss surgery. Some people who have had Roux-en-Y gastric bypass surgery experience an unpleasant sensation when eating concentrated sweets such as desserts. However, most people can eat just about anything after weight loss surgery in small quantities.

Let's face it - I have redefined what "good" means to me. It does
take a while to get back to being able to eat "normally", but with the exception
of foods high in sugar - you should be able to eat other foods in
moderation.

9. You have to be a certain age to have weight loss surgery.
While it’s true that most centers describe age criteria, the range is usually very wide such as from 18 to 65. In addition, there are many studies citing the benefits of weight-loss surgery in patients over 65 and under 18.

10. You can’t have surgery if you have diabetes.
In fact, weight loss surgery is fast becoming a primary treatment for diabetes, particularly type II diabetes because of the high rate of cure of the disease after weight-loss surgery.

11. You’ll have a large incision and a big scar from weight-loss surgery.
Many centers perform over 95% of the weight loss surgical cases with minimally-invasive surgery or laparoscopy. This normally requires five or six small incisions on the abdomen.

I can't even see the small incisions from my surgery any more. I
have much larger scars from other surgeries.

12. Weight loss surgery is irreversible.
While most weight-loss surgeons and centers believe that it is best to think of the surgery as permanent, the truth is that surgery can be reversible. Laparoscopic adjustable gastric banding, in particular, is reversible fairly easily. Laparoscopic Roux-en-Y gastric bypass is reversible but requires a more significant operation in order to undo the bypass procedure.

It is helpful to think of it as irreversible, though.

13. Weight loss surgery has no real benefits except for looking better.
The truth is that weight loss surgery is primarily an intervention for improved health. While there are side benefits of improved self-esteem and cosmetic appearance, many of the health complications caused by being overweight can be dramatically improved or, in some cases, completely resolved by surgical weight loss procedures.

Two immediate benefits that I had from surgery was resolution of my
blood pressure and my sleep apnea. I was quickly headed to being a
diabetic and that resolved as well. And while I won't lie in that I feel I
do look better - there are parts of me that are SCARY from the extra
skin.

Kent Sasse, MD, MPH, FACS, is founder and medical director of both the
iMetabolic International Metabolic Institute and Western Bariatric Institute. He
is the author of Outpatient Weight-Loss Surgery: Safe and Successful Weight Loss
with Modern Bariatric Surgery. www.sasseguide.com.

How cool is this?

There is a website that I frequent quite often and that I have had a link to on my site for quite some time. If you go down this blog, on the right hand side you will see a small TV where you can watch the latest episode on the WLS (Weight Loss Surgery) Channel. It's got tons of great information, the latest news on the various surgeries, etc...

There is a segment in these episodes by Yvonne McCarthy (a well known advocate in the WLS environment) called WLS Journeys. She always likes to feature a website for people to check out and visit. In this week's episode - she is featuring mine!!!!!! How cool is that?

You can either watch the episode through the little TV lower on my page, or by following this link:

http://www.weightlosssurgerychannel.com/breaking-wls-news/weight-loss-surgery-news-august-21-2009.html/#more-5457

The segment is about half way through the episode!

Let me know what you think!

Percentages

So as I posted a couple of days ago - I am at a stall. It's very frustrating and messes with my mind in new and irritating ways. Right now no matter what I do I just play with the same 2 pounds. I run, I drink, I count, I eat less, I eat more, you get the picture.

But today on one of the support boards that I live on these days (shout out to all my OH Peeps! Holla!) someone asked a question that intrigued me. She asked us what percentage of your excess body weight have you lost? Well, at first I started having flashbacks to Jr. High Math class with Mr. Verkaik and my head started to pound. But once I took a deep breath and though through exactly what I was trying to calculate I decided to go ahead and figure it out.

So I want to loose about 130 pounds total. Of that 130 pounds I have lost 75 pounds so far. That means have lost 58% of my excess body weight! In just over 4 months! That's craziness!

Looking at the numbers that way gives me a whole new outlook on the situation that I'm in at the moment.

Another friend gave me encouragement this week on focusing on the long term changes that I am making for myself and that those are the most important things I can do for myself. Changing my eating habits, my exercise habits, my relationship with food in general. Those things aren't easy and I knew in my head they wouldn't be easy. But now as the rubber meets the road and I actually have to do it - it's just not always fun. But it is always good.

So here's a picture of me today in some of my new clothes that are regular sized. Yeah me!

A Belt!

Today I am wearing a belt! I know - that doesn't sound like much to you guys - but I don't think I have even OWNED a belt since jr. high - maybe high school? The clothes that I was able to scratch together from my mom no longer fit me. They are all too big already. But I don't have the money to be buying clothes that won't fit me very long. So I'm trying to make do with what I have.


Here are some pics I took. They aren't the best - but they show the belt and just how big these pants are!

Such an interesting problem for me to have. I've always dealt with clothes that don't fit - but always because they were too small! I can remember my freshman year in high school. I had tried out for the cheerleading squad. I didn't make it as a regular, but as a substitute. I would take it. That meant that if anyone was sick or couldn't cheer for some reason - I would cheer in their place. That meant that I had to know what to do in everyone's position so that I could fill in at a moments notice. That also meant that I had to fit into anyone's uniform at any moment. There weren't enough uniforms for me to have my own - and no money to buy my own. So if someone was out - I had to fit into their uniform. Can I just tell you - it scared the bejeezus out of me? There were some teeny tiny girls on that squad! Uniforms in a size 0! Uniforms in a size 2! I mean - I would be lucky if I was in a size 10! You have to be kidding me! So my first opportunity to cheer came up. And don't you know it was one of those skinny beyotch's! :) (If any of you are reading this - you know I am joking!) There was no way I was squeezing into a 2. We ended up switching things around and someone smaller than me squeezed into the 2 and I squeezed into a 7 I think. Still needed a safety pin, etc..., but I was simply horrified by the whole experience. Eventually that year someone had to drop off the squad and I was made a permanent cheerleader. I loved cheerleading - but I was acutely aware that I was always the heaviest on the team. I was always the base on the bottom of the pyramid or the stand. "Go ahead - climb on up! No big deal." And it wasn't. The rest of them were so petite and tiny. You will never hear anyone use those words to describe me! And I have come to accept that. I don't say that as in "Whoa is me - I am such a pig." It's part of who I am and I am OK with that. I have always been the big girl with the big hair and the big personality. Go big or stay home is my motto. Even in weight loss. I either have to go whole hog and have this surgery and loose it all - or why bother? If I can only do something half-assed I don't want to do it. It's how I live, it's how I love, it's how I am.

Food and Feelings

I see a wonderful therapist and she has been helping me with this after-WLS world I am in. She has me going through a book called "The Food and Feelings Workbook". It is by Karen Koenig. I highly recommend this book for anyone who struggles with their relationship with food - whether it's turning to it for comfort, or trying to control it by denying yourself of it - this book is great. The basic tenant of this book is that "accepting your emotions, however painful they are, is the key not only to ending dysfunctional eating but also to achieving the health, happiness, success, and deep satisfaction about life you want and deserve." Going through this book has been a big wake up call for me about how I use food to avoid certain feelings. It's not just a comfort to me - the food and eating it is comforting - but I seek the comfort so that I don't have to feel things I don't want to feel. Do you find yourself doing this, too? Here are some guidelines that Karen Koenig has in her book:

1. First, acknowledge that, as a person who intentionally and regularly rejects or consumes food to distract from feeling, you most likely have a negative view of uncomfortable emotions.


2. Second, identify exactly what you believe about emotions.


3. Third, make a conscious, ongoing effort to change your beliefs.

Acceptance does not mean letting them run you ragged or having a field day with other people. Nor does it imply that you must like having unsettling and sometimes acutely wounding emotions. it merely requires that you acknowledge the hurt and give unpleasant feelings the right to come and go, just as you do the pleasant ones.

If you want to end disordered eating, you have to break the link between feelings and food.

If you're a dysfunctional eater who turns toward food when you're feeling bad, it tastes good in part because you're desperately looking for ways to ward off the blues, the blahs, the jitters. ... Another reason that food tastes good for people who view it as a panacea is that it's meant to be eaten so that our species will survive and flourish. Food is supposed to be appetizing and appealing, delectable and divine. So when you bite into a juicy apple or a buttery croissant, it's no surprise that your taste buds cheer wildly. They're happy even if you're not. But just because something tastes good doesn't mean you should be eating it, especially if the real business at hand is
attending to emotions.

Science has come a long way in understanding the complexities of appetite and affect. Research tells us that under stress our bodies crave carbohydrates, which have chemical properties to soothe and relax us, just as milk did in infancy. not only does food taste heavenly, it's also a source of what we're physiologically lacking in moments of distress. Take carbohydrates whose chemical compounds break down in our bodies in such a way as to calm and comfort us. Food does this job extremely well - too well!

She talks about the physical manifestation of emotions - takes you through exercises to help you recognize those physical manifestations - things such as:

• dry throat


• fatigue


• shortness of breath


• queasiness


• racing pulse


• flushing


• inability to focus or concentrate


• butterflies in your stomach


• pounding heart


• a lump in your throat


• tightness or hollowness in your chest


• constriction around your eyes

She says "To become a whole, healthy person, you have to stop trying to avoid feeling badly and welcome all your emotions without judgment, no matter what they are."

I have been known as the Queen of Denial. I like to camp out there often. It's really quite comfortable there, and I tend to find an unending supply of cookie dough when I need it. I also like to point out to other people when they are visiting that great land. I know because I am the Queen and I can recognize it easily in others.

Karen Koenig identifies the 7 most difficult feelings for disordered eaters. They are:

1. Guilt - Practically every dysfunctional eater is other-oriented, a caretaker, a do-gooder, has an overly-developed sense of responsibility, and rarely (if ever) believes she is doing enough. Because they are people pleasers and feel naughty or selfish when they do things for themselves, their self care is only fair to poor. The major way they take care of themselves is - you guessed it - through food.


2. Shame - Disordered eating may be a way to maintain the shame they unconsciously think they ought to feel or are used to feeling.


3. Helplessness - Occurs when there is nothing we can do. It underlies many feelings - frustration, impatience, anger, and anxiety. Something terrible is going to happen and I can't do a damned thing about it! Many disordered eaters combat their helplessness by taking action, usually in the form of micromanaging their food intake or consuming every morsel in sight.


4. Anxiety - People who eat to sooth their nerves. These individuals are anxious about what they did yesterday and about what they're going to do tomorrow.


5. Disappointment - Chronic disappointment can lead people to believe that they don't deserve to have positive expectations and outcomes in life. Wanting causes them to feel needy and so they deny their genuine desires. Because it's too scary to have expectations of themselves or of other people, they turn to something that's predictable and always in good supply - food. When an emotional eater suffers the letdown of disappointment, food picks them up, at least for a while.


6. Confusion - It runs rampant in a population of eaters who are out of touch with their physical needs and wants. They're not sure whether they're really hungry or deserve to eat, what they should eat, when they're full, what they ought to look like, and what they should weigh. Most of their confusion is about the concept of enough in numerous areas of their lives. What drives their confusion is the desperate urge to find out what's right so they won't fail or make mistakes. Because it's difficult to tolerate the tension created by vague, mixed or conflicting feelings, they often give up and instead take a stroll down a supermarket aisle or focus on numbers, which are sharp and clear - on a scale or food package.


7. Loneliness - A soul killer - no wonder lonely people seek solace in food! When disordered eaters feel this depth of loneliness, they're desperate to bond with something, anything - to merely feel alive.

You will begin to realize your dreams when you allow your emotions to speak to you, when you listen carefully to what they have to say, and when you make conscious choices based on authentic feelings couples with sound judgment. To do this, however, you must become conversant with the language that emotions speak - and that's often the language of pain.

People who allow themselves to experience their heartache and learn from it lead happy, successful lives, whereas people who run from emotional pain end up unhappy and unfulfilled.

So I think the feelings that stand out for me are Helplessness, Anxiety, Disappointment, and sometimes Loneliness.

There are so many things in this life that I have learned I have absolutely no control over. It makes me feel helpless - I don't like not having control (as I have talked about in earlier blogs). Eating gives me a sense of control - and it also feels very good. Problem is - when I have binged to give myself the feeling of control - I only end up feeling more out of control. Why did I do that?

I totally eat to soothe my nerves. This is still a problem for me. I had a disturbing appointment last week and as I was driving back to work I found myself screaming in the car "I just want a freakin' cheeseburger, damn it!" I passed an Arby's (which I love) and I just wanted to pull in for a roast beef sandwich and some curly fries! Make it go away!

Ah yes, Disappointment. Somehow in my twisted mind I have convinced myself that my favorite foods never disappoint me. They are always there for me when I need them - always providing the comfort I seek. When someone doesn't treat me the way I feel I deserve to be treated - food does - it makes me feel so good. But how twisted is that? It disappoints me every time - every pound I put on because of it.

I have had those moments of strolling down the supermarket aisles - searching for my comfort. I have found myself going faster and faster - not even knowing what I'm looking for - just knowing that I will know it when I find it. It could be some cookie dough - maybe brownie mix or frosting - or how about that Ben & Jerry's Phish Food ice cream - or it could be something salty like Doritos or a sausage egg and cheese biscuit. I have even found myself standing in front of my pantry or refrigerator in the middle of the night after a stressful confrontation or a fight with my husband. I'm tired of the conflict and I am tired of feeling this way - give me some food to make it go away.

And having de-carbed since surgery - I can so see how carbs do affect my feelings. The few times that I have had some small carb with what I am eating since surgery have nearly sent me on an eating binge again. I can't even describe it! It just feels so good! I know that this surgery is the only way for me to divorce food. I can't binge anymore - I get sick - very ill - it downright hurts. In fact, there are days that eating is a downright chore.

Karen Koenig gives some great techniques for slowing down - recognizing the physical manifestations of our emotions and feelings - deep breathing that helps you become more in tune with what your body is trying to tell you.

So how is your relationship with food? Are you obsessed with it? Or are you using it the way it should be used? Have you learned to live with your feelings? Do you turn to food or to something else to not have to deal with those feelings? Do you have feelings which you have deemed "bad"? Why do we think emotions in and of themselves are bad? They were given to us by our creator for a reason. We should not ignore them or push them aside - we need to get to the root of the emotions and discern what they are telling us so that we can move on.

GGGGGGGRRRRRRRRRRRRRRRRR!!!!!!!!!!!

I usually take stupid comments by stupid people in stride. (I know some of you are reading this and totally laughing at me and thinking "Pam? Seriously?") But I realize that most people have no idea how WLS works. Many people consider it the "easy way out". And part of why I started this blog was to help educate friends and family (and cyber stalkers) about this process and journey. So I do understand that there are a lot of misconceptions out there about this whole thing.

But today - someone's comment to me has really stuck in my craw! UGH! We were in the kitchen at work and she was asking me how I was doing (everyone at work knows I have had this surgery). Her son-in-law is considering this surgery and she keeps checking in with me to see how it's going. A frequent question I get is "Are you able to eat real food yet?" That one always gets me. Well most food I put in my mouth is real - what kind of food do you eat? Never mind - that is just the dry humor of my Father coming out in me. So I was telling her some of the things I can eat now that I am in the pureed/soft food stage. So she mentions that her son-in-law "needs to get his act together soon or he's gonna have to do this the hard way by watching what he eats and exercising."

Yeah - so I made a real conscious effort not to beat her down.

As politely as I could I told her that if he chose to have surgery he would have to watch what he eats EVEN MORE than if he hadn't had surgery. I have never been so conscious about what I am putting in my mouth in all my life! I count calories, I count fat grams, I count carbs, and protein and ounces of water. I have cut out virtually all sugar from my diet. And exercise - I exercise a lot! This is a lifestyle change people - that's not cliche. Doing what I have always done will NOT get me anywhere different. I have to change everything about how I was living if I want this to be a permanenet and life altering change. People who don't abide by these new rules do not succeed. They are the ones that your friends will whisper to you about ... "My aunt had her stomach stapled, but now she put all the weight back on" ... I did not go through all of this to keep living the same way. I knew there had to be changes - major changes - this surgery has helped me to make those changes and helps me to stick by them. With a regular "diet" you can cheat - you can have that one candy bar - those 2 cookies - that bite of ice cream. I can't. This surgery ensures that I don't cheat. I don't eat too much, I don't eat too fast, and I don't eat what my body cannot absorb and process well.

So let me assure all of you out there that may be reading this thinking that I took the easy way out - this was anything but easy. You still have to watch what you eat - even more so now than ever. You don't want to put something in your mouth that will make you dump. You can't eat too much or you will puke. You have to go through a lot of stages while your new pouch heals with clear liquids, full liquids, pureed foods, soft foods. You have to be sure to get a certain amount of protein, and fluid in each day. And you still need to exercise - that needs to become part of your daily routine. It helps the weight come off - it helps it stay off - it helps your body heal - it helps your energy levels - it helps with extra skin. WLS is a tool for those looking to loose a lot of weight. A tool. Not a magical wand. More like a sledge hammer or a chisel. Be careful with both.

WLS Oddities

So there are a few odd things that have happened with my WLS. No one tells you about the odd things that happen to your body after WLS. Like re-routing my intestines isn't odd enough.

The first is that I am breaking out like I have hit puberty all over again. Apparently hormones like to hide out in your fat cells, and as the fat cells shrink the hormones are released back into your body. UGH! It wreaks havoc with you!

The second is that I am COLD ... all the time!! I am not used to this at all. Being fat I was hot all the time. Now I can't get warm. I feel like I will never get warm again! I have been told by my surgeon that because I am taking in so little calories right now, my internal thermostat is low on the priority list for keeping me going.

I have to be really careful drinking cold drinks. That first sip had better be just that - a sip. If I take in a bit too much it hurts - like Kanga cramps up from the shock or something. I still can't gulp anything - have to be careful about how much I take in at one time. And in that vain - burping has never been so painful! I work and work and work at getting a bubble up (and I suddenly have to burp all the freakin' time!) only for it to be just a little something. I would think for all that work and effort it should be one monster belch. And I am good at the monster belch, but now I seem to have broken my burping bone or something.

Feeling Fantastic!

I can't believe how good I am feeling after this surgery. I'm sure the fact that it was laparoscopic made a huge difference. The surgeries that I have had in the past have all been open. When I had my gallbladder out 2 years ago they tried to do it laparoscopically, but the surgeon found that he could not, so he converted the surgery to open. So It's weird for me to be feeling this good this soon after surgery. I just have one area that is still a bit painful. I talked to the surgeon earlier today and he assures me that I'm doing well and that my "insides are angry" right now. He's not joking! :)

I have been trying to walk a little bit - yesterday I think I did about a half a mile. It was a lot - took a lot out of me, but it's a start. I would love to join a gym this year - as a family - but I'm not sure our finances can take that hit just yet.

This is a definite adjustment for me in the food department. I think this is probably the only way I could divorce myself from the foods I should no longer be eating. I am not physically hungry - that is not the problem. But I literally have to stay out of the kitchen right now. For some reason we have a ton of food in our house right now and it is all calling to me. The delicious food that friends are bringing over for D and the kids, the left over pizza, the cookies, heck - even the toaster taunts me! And I simply can not have them right now even if I wanted to. My new pouch of a stomach is still healing from surgery - if I were to try to eat those things it would be a bad bad thing.

Last night D went to bed early and after the kids went to bed it was like I didn't know what to do with myself. That is usually the time that I eat. No one is looking at me to tell me I don't really need that - no one is giving me "the look". I can eat whatever I want and however much I want. I found myself pacing in the kitchen last night! I just wanted a taste! What is wrong with me? This is ridiculous! I can't eat these things - I just plain can't. This "tool" of WLS has allowed me to by-pass my will power. I have to play by the rules - I can't cheat. There are very specific boundaries for me now. And hopefully by living within those imposed boundaries I can retrain myself to eat better, to exercise, to live life better. Not just for me, but for my family, too.

More than just the physical

So God has been working on my heart today - the day before my surgery - that this change MUST be about more than just the physical - it must be spiritual - a total transformation of my life.

The first was a radio piece that I was listening to on the way to church this morning. It was about Mike Huckabee, former governor and presidential candidate. They talked about how he had lost over 100 pounds a few years ago and how he had to confront a few of his own demons regarding his faith and how he had mistreated his body which is considered a temple. Specifically looking at the sin of gluttony - you know - that one no one wants to talk about? :)

Then I had church this morning. I do video projection for our church and whenever I am on for video projection I have to do all 3 services. So I had a chance to ruminate over the message 3 times! :) It was about Pressing on in 2009. As the new year approaches lots of people are prone to making resolutions. I've never really been one to make resolutions - I can't take the guilt when I fail! But seeing as how I am having WLS and I have been feeling like 2009 would be my year - the year to make the changes I have been struggling with for so long. But I am struck with the knowledge that these changes have to be complete and total. I can't just have WLS and eat less and exercise - building those new physical habits without addressing the other vital part of my being - my spiritual being - would just be a recipe for failure.

The sermon was based on Philippians 3:10-14.

I want to know Christ and the power of his resurrection and the fellowship of sharing in his sufferings, becoming like him in his death, 11and so, somehow, to attain to the resurrection from the dead.
Pressing on Toward the Goal 12Not that I have already obtained all this, or have already been made perfect, but I press on to take hold of that for which Christ Jesus took hold of me. 13Brothers, I do not consider myself yet to have taken hold of it. But one thing I do: Forgetting what is behind and straining toward what is ahead, 14I press on toward the goal to win the prize for which God has called me heavenward in Christ Jesus.

So taking the outline of the sermon - this is some of what God was laying on my heart. First are the four goals outlined in the above text.

1. To know Jesus more - For me to turn my focus more to Jesus and less on myself - especially as I face the next few months and re-evaluate my relationship with food. Instead of turning to food I need to be turning to my Lord for my satisfaction.
2. To experience His power - God still works in miraculous ways. I want to be an open vessel to Him - not only to experience His power - but to help others see it.
3. To share in His sufferings - Pastor Ben said today that Any time there is suffering - there is a call to intimacy. I'm fairly certain that the next week or so will bring me some suffering as I sever my relationship with food. In replacement I need to drawing nearer to God. Pastor Ben also said that if you are not willing to go through the pain - your vision or dream is not very big. I have a big dream and I am finally willing to do the hard things required to achieve it.
4. To strive in eternal life - Keep your eye on the ultimate prize - what's truly important - when Jesus is at the center all other things fall in to place. You must have long term goals to keep from being frustrated by short term failures. I must remember I'm in this for the long haul.

But besides goals, Paul gave us ways to accomplish those goals in his letter to the Philippians as well.

1. Have a humble attitude - all I could think was "Pamelot"! Yeah - me and humility - I got some work to do there.
2. Maintain a singular focus - In Christ alone I place my trust.
3. Remember God's claim on your life - my calling is to worship God with my life. If I am worthy of His calling - why have I been treating my body this way?
4. Do not be imprisoned by your past - whether it's bad and you are stuck in guilt, or whether they were better times and you wish you could bring them back. Don't look back - don't rest on it - rest in the Lord.
5. Run the race today as if it were your last - no more excuses - no more postponing what I know needs to be done.

So as I sit here eyeing the cookies my kids are having with their lunch while I am surviving on clear liquids, I am encouraged by all that I have heard this morning. God is working on me - changing me from the inside out - literally and figuratively! I need to learn to subsist on Him!

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.