Interesting

I have noticed some interesting things since my surgical ERCP.  I was always kinda disappointed after my  gastric bypass that I was an inconsistent dumper at best.  I did this surgery this way because I wanted those very specific rules to help me eat right.  The inconsistency allowed me to test the waters which was always a little scary.

But since the surgical ERCP - I dump like a truck.  The littlest bit of sugar and I am miserable ... for hours!  I talked to my bariatric surgeon about it when I had my follow up appointment with him earlier this week.  He said it kind of made sense because now that they opened up the sphincter of oddi the bile, etc... is making it to the intestines much better - that would be assisting in the dumping syndrome.

Also, since the surgical ERCP my weight loss has kicked back in.  I have been quite steady for at least 8 months.  Now I am losing weight again.  I am down to a weight my scale has never seen and only 6 pounds from my goal weight!  I am more motivated than ever!  Especially since I am very limited in whatever exercise I can do because of my foot.  If I can't exercise I need to pay closer attention to what I'm eating.

That Never Gets Old

I love WOW moments since surgery.  But I've been pretty steady with my weight for a while now, so they don't come as often as they used to.  I used to have them several times a week when the weight was just melting away.  And I'm OK with not having as many of them - this is the new life I am settling into.  And to be honest - many times I didn't know how to handle them and they made me uncomfortable. 

But today I had a WOW moment in a very unexpected place and I have to tell you - that never gets old.  :)  I went to a dear friends house for her sons birthday party.  I knew everyone there, but one lady I hadn't seen in a while.  Apparently, when I walked in - she didn't recognize me.  When my friend told her who I was she exclaimed "NO WAY!"  She didn't recognize me at all.  And a little while later she came over to me and was like "I don't know what it is - whether it's the blonde hair or what - but you just look fantastic!"  HEHEHEHEHE.  THANKS!  I kinda needed that shot in the arm.  Later she was asking me when I went blonde and she said "I bet your husband loves that!  It must be like being with a different woman!"  My husband's reaction ...  Yeah ... it kinda is!  Truly - that never gets old.  :)

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.

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.

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.

Hunger Hormones - who knew!

I have found some very interesting and educational articles recently. Here is one by National Geographic:

http://science.nationalgeographic.com/science/health-and-human-body/human-body/fat-costs.html

The National Geographic Channel is also running a show called The Science of Obesity on this Sunday at 3pm. I haven't seen the show myself, but I have heard it is very interesting and educational. Here is a link with more about that show:

http://channel.nationalgeographic.com/episode/science-of-obesity-3082/Overview

Another show that I really like to watch is Big Medicine on TLC. Here's a link to that as well:

http://tlc.discovery.com/tv/big-medicine/big-medicine.html

But the most interesting information I have found on gastric bypass and the difference between it and say the Lap-Band is regarding the Hunger Hormones in our body. I had no idea that our body had hormones that control our appetite, our hunger, our physiological reaction to dieting or conversely - over-eating. I can't explain it as well as the experts - so here are some links to some very well written articles on the subject that you may find interesting:

http://www.webmd.com/diet/news/20040712/gastric-bypass-curb-hunger-hormone

http://news.bbc.co.uk/1/hi/health/3889185.stm

http://news.bio-medicine.org/medicine-news-2/Hunger-hormone-may-be-key-in-weight-loss-8006-1/

Happy reading!

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.